NSG 530 Advanced Pathophysiology Exam 4 – 50 Original Practice
Questions Wilkes University) | Practice Questions with Detailed Answers
& Rationales | 2026 Study Guide
INTRO:
*This original practice exam is designed for students preparing for NSG 530 Exam 4 at
Wilkes University or similar advanced pathophysiology courses. Topics include
hematologic disorders, genetic disorders, endocrine disorders, musculoskeletal
disorders, neurological disorders, and cell injury mechanisms. Answers are in bold
italic * with italicized rationales.
1. A 57-year-old male presents with a red face, hands, feet, ears, headache, and
drowsiness. A blood smear reveals an increased number of erythrocytes. What is
the most likely diagnosis?
A) Leukemia
B) Polycythemia vera (PV)
C) Hemolytic anemia
D) Thrombocytopenia
Answer: B
Polycythemia vera is a myeloproliferative disorder characterized by increased erythrocytes,
leukocytes, and platelets. Symptoms occur due to increased blood viscosity, including facial
plethora, headache, and drowsiness.
2. Alpha and beta thalassemias are inherited disorders. What is their inheritance
pattern?
A) X-linked recessive
B) Autosomal dominant
C) Autosomal recessive
D) Mitochondrial
, Answer: C
Both alpha and beta thalassemias are inherited in an autosomal recessive pattern.
Mutations in globin chain genes result in reduced hemoglobin synthesis and microcytic
anemia.
3. What nutrient should a nurse encourage a woman in early pregnancy to
consume to prevent neural tube defects?
A) Vitamin B12
B) Folic acid
C) Iron
D) Calcium
Answer: B
Folic acid (folate) supplementation before and during early pregnancy is essential for
neural tube closure. Deficiency increases risk of spina bifida and anencephaly.
4. A 45-year-old female presents with fatigue, pallor, and paresthesias in her
hands and feet. Lab results show macrocytic anemia (MCV 110) and a positive
Schilling test. What is the most likely diagnosis?
A) Iron deficiency anemia
B) Anemia of chronic disease
C) Pernicious anemia (Vitamin B12 deficiency)
D) Folate deficiency anemia
Answer: C
Pernicious anemia is caused by lack of intrinsic factor leading to B12 malabsorption.
Macrocytic anemia with neurologic symptoms (paresthesias) is classic. Schilling test
confirms B12 malabsorption.
5. A patient with sickle cell disease is experiencing a vaso-occlusive crisis. What is
the underlying pathophysiology?
A) Excessive iron absorption
B) Decreased erythropoietin production
C) Polymerization of deoxygenated hemoglobin S leading to RBC sickling and vascular
occlusion
D) Autoimmune destruction of red blood cells
Answer: C
In sickle cell disease, a single amino acid substitution (valine for glutamic acid) in the
beta-globin chain causes hemoglobin S to polymerize when deoxygenated, leading to RBC
sickling, increased viscosity, and vaso-occlusion.
Questions Wilkes University) | Practice Questions with Detailed Answers
& Rationales | 2026 Study Guide
INTRO:
*This original practice exam is designed for students preparing for NSG 530 Exam 4 at
Wilkes University or similar advanced pathophysiology courses. Topics include
hematologic disorders, genetic disorders, endocrine disorders, musculoskeletal
disorders, neurological disorders, and cell injury mechanisms. Answers are in bold
italic * with italicized rationales.
1. A 57-year-old male presents with a red face, hands, feet, ears, headache, and
drowsiness. A blood smear reveals an increased number of erythrocytes. What is
the most likely diagnosis?
A) Leukemia
B) Polycythemia vera (PV)
C) Hemolytic anemia
D) Thrombocytopenia
Answer: B
Polycythemia vera is a myeloproliferative disorder characterized by increased erythrocytes,
leukocytes, and platelets. Symptoms occur due to increased blood viscosity, including facial
plethora, headache, and drowsiness.
2. Alpha and beta thalassemias are inherited disorders. What is their inheritance
pattern?
A) X-linked recessive
B) Autosomal dominant
C) Autosomal recessive
D) Mitochondrial
, Answer: C
Both alpha and beta thalassemias are inherited in an autosomal recessive pattern.
Mutations in globin chain genes result in reduced hemoglobin synthesis and microcytic
anemia.
3. What nutrient should a nurse encourage a woman in early pregnancy to
consume to prevent neural tube defects?
A) Vitamin B12
B) Folic acid
C) Iron
D) Calcium
Answer: B
Folic acid (folate) supplementation before and during early pregnancy is essential for
neural tube closure. Deficiency increases risk of spina bifida and anencephaly.
4. A 45-year-old female presents with fatigue, pallor, and paresthesias in her
hands and feet. Lab results show macrocytic anemia (MCV 110) and a positive
Schilling test. What is the most likely diagnosis?
A) Iron deficiency anemia
B) Anemia of chronic disease
C) Pernicious anemia (Vitamin B12 deficiency)
D) Folate deficiency anemia
Answer: C
Pernicious anemia is caused by lack of intrinsic factor leading to B12 malabsorption.
Macrocytic anemia with neurologic symptoms (paresthesias) is classic. Schilling test
confirms B12 malabsorption.
5. A patient with sickle cell disease is experiencing a vaso-occlusive crisis. What is
the underlying pathophysiology?
A) Excessive iron absorption
B) Decreased erythropoietin production
C) Polymerization of deoxygenated hemoglobin S leading to RBC sickling and vascular
occlusion
D) Autoimmune destruction of red blood cells
Answer: C
In sickle cell disease, a single amino acid substitution (valine for glutamic acid) in the
beta-globin chain causes hemoglobin S to polymerize when deoxygenated, leading to RBC
sickling, increased viscosity, and vaso-occlusion.
