ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
1. A 4-year-old child appears listless for the last week. He complains of pain when he is picked up by his mother,
and he is irritable when touching his arms or legs. Several large ecchymotic lesions have appeared on his right
thigh and left shoulder. A complete blood count reveals a HgB=10.2, Hct=30.5%, MCV=96fL, platelet count of
45,000/ML, and WBC count of 13,990/ML. Exami- nation of the peripheral blood smear reveals numerous blasts.
The blasts lack peroxidase-positive granules but do contain periodic acid-Schiff (PAS)-posi- tive aggregates and
stain positively for TdT. Flow cytometry shows the pheno- type of blasts to be CD19+, CD3-, and sIg-. What is the
most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML): Acute lymphblastic leukemia
2. A 3-year-old child of Italian ancestry presents with failure to thrive. Physical examination indicates
hepatosplenomegaly. His hemoglobin concentration is 6 g/dL, and the peripheral blood smear reveals severely
hypochromic micro- cytic red cells. Total serum iron level is normal. The reticulocyte count is 10%.
Hemoglobin electrophoresis shows very little hemoglobin A. A radiograph of the skull shows maxillofacial
deformities. What is the principle cause of anemia and other abnormalities in this patient?
A. Reduced synthesis of hemoglobin F
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
B. Reduced red blood cell survival from imbalance in the production of alpha and beta globin chains
C. Relative deficiency of vitamin B12
D. Increased fragility of the erythrocyte membrane: Reduced synthesis of hemo- globin F
3. A 68-year-old previously healthy female has been feeling increasingly tired and weak for several months. She
states that she has had black, tarry stools for several weeks. She is found to be anemic with a hemoglobin
concentration of 9.3g/dL. The peripheral blood smear reveals microcytic and hypochromic blood cells. Which of
the following conditions should be suspected as the most likely of her condition as indicated by the peripheral
blood smear?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia: Gastrointestinal blood loss
4. A 76-year-old female notices that small, pinpoint to blotchy areas of super- ficial hemorrhage have appeared
on her gums and on the skin of her arms and legs over several weeks. She is found to have a normal prothrombin
time(PT) and partial thromboplastin time (PTT). Her CBC shows hemoglobin concentration of 12.7 g/dL,
hematocrit of 37.2%. MCV of 80 fL/red cell, platelet count of 276,000/microliter, and WBC of 5600/microliter. Her
template bleeding time is 3 minutes. Her fibrinogen level is normal, and there are no fibrin split products
detectable. Which of the following conditions best explain these findings?
A. Chronic renal failure
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency: Vitamin C deficiency
5. A young adult patient has just been diagnosed with Von Willebrand disease. Which of the following statements
should you make to advise the patient of potential consequences of this disease?
A. You may need an allogeneic bone marrow transplant
B. You may have excessive bleeding following tooth extraction
C. A splenectomy may be necessary to control the disease
D. Expect increasing difficulties with joint mobility: You may have excessive bleeding following tooth
extraction
6. Low dose aspirin is commonly used to reduce the risk of arterial thrombo- sis in patients who have suffered a
myocardial infarction. Which one of the following steps in homeostasis is inhibited by aspirin?
A. Synthesis of von Willebrand factor
B. Aggregation of platelets
C. Activation of factor Xa
D. Synthesis of antithrombin III: Aggregation of platelets
7. A 24-year-old presents to the office with fatigue. On physical exam, the NP notices that she ispale with the
following vital signs: HR 112, BP 98/64,
resp 20, O2 sats 99%. Her CBC shows: WBC6,000, Hemoglobin 9.6, Hematocrit 30.2, MCV is decreased at 76. What
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
is the mostly likely causeof this patient's
anemia?
A. Iron deficiency anemia caused by menstruation
B. Beta Thalassemia of genetic origin
C. Pernicious anemia caused by dietary deficiency
D. Folate deficiency caused by alcoholism: Iron deficiency anemia caused by menstruation
8. A 65-year-old female presents to your office complaining of fatigue. She has a long of rheumatoid arthritis. A
CBC reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87 fL/red cell, platelet count of 268,000/microliter,
and WBC count of 6800/microliter. The serum haptoglobin level is normal, and the serum iron concentration is
20 micrograms/dL. The total iron binding capacity is 195 micrograms/dL, and the percent saturation is 10.2. The
serum ferritin concentration is 317 ng/mL. No fibrin split products are detected. The reticulocyte concentration is
1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia: Anemia of chronic disease
9. A 14-year-old male presents with high fever for ten days. Physical examina- tion reveals scattered petechial
hemorrhages but is negative for enlargement of the liver or spleen or lymph nodes. Bone marrow examination
does not show any abnormal cells. The complete blood count (CBC) demonstrates a hemoglobin concentration
ANSWERS / 2025/2026
1. A 4-year-old child appears listless for the last week. He complains of pain when he is picked up by his mother,
and he is irritable when touching his arms or legs. Several large ecchymotic lesions have appeared on his right
thigh and left shoulder. A complete blood count reveals a HgB=10.2, Hct=30.5%, MCV=96fL, platelet count of
45,000/ML, and WBC count of 13,990/ML. Exami- nation of the peripheral blood smear reveals numerous blasts.
The blasts lack peroxidase-positive granules but do contain periodic acid-Schiff (PAS)-posi- tive aggregates and
stain positively for TdT. Flow cytometry shows the pheno- type of blasts to be CD19+, CD3-, and sIg-. What is the
most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML): Acute lymphblastic leukemia
2. A 3-year-old child of Italian ancestry presents with failure to thrive. Physical examination indicates
hepatosplenomegaly. His hemoglobin concentration is 6 g/dL, and the peripheral blood smear reveals severely
hypochromic micro- cytic red cells. Total serum iron level is normal. The reticulocyte count is 10%.
Hemoglobin electrophoresis shows very little hemoglobin A. A radiograph of the skull shows maxillofacial
deformities. What is the principle cause of anemia and other abnormalities in this patient?
A. Reduced synthesis of hemoglobin F
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
B. Reduced red blood cell survival from imbalance in the production of alpha and beta globin chains
C. Relative deficiency of vitamin B12
D. Increased fragility of the erythrocyte membrane: Reduced synthesis of hemo- globin F
3. A 68-year-old previously healthy female has been feeling increasingly tired and weak for several months. She
states that she has had black, tarry stools for several weeks. She is found to be anemic with a hemoglobin
concentration of 9.3g/dL. The peripheral blood smear reveals microcytic and hypochromic blood cells. Which of
the following conditions should be suspected as the most likely of her condition as indicated by the peripheral
blood smear?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia: Gastrointestinal blood loss
4. A 76-year-old female notices that small, pinpoint to blotchy areas of super- ficial hemorrhage have appeared
on her gums and on the skin of her arms and legs over several weeks. She is found to have a normal prothrombin
time(PT) and partial thromboplastin time (PTT). Her CBC shows hemoglobin concentration of 12.7 g/dL,
hematocrit of 37.2%. MCV of 80 fL/red cell, platelet count of 276,000/microliter, and WBC of 5600/microliter. Her
template bleeding time is 3 minutes. Her fibrinogen level is normal, and there are no fibrin split products
detectable. Which of the following conditions best explain these findings?
A. Chronic renal failure
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency: Vitamin C deficiency
5. A young adult patient has just been diagnosed with Von Willebrand disease. Which of the following statements
should you make to advise the patient of potential consequences of this disease?
A. You may need an allogeneic bone marrow transplant
B. You may have excessive bleeding following tooth extraction
C. A splenectomy may be necessary to control the disease
D. Expect increasing difficulties with joint mobility: You may have excessive bleeding following tooth
extraction
6. Low dose aspirin is commonly used to reduce the risk of arterial thrombo- sis in patients who have suffered a
myocardial infarction. Which one of the following steps in homeostasis is inhibited by aspirin?
A. Synthesis of von Willebrand factor
B. Aggregation of platelets
C. Activation of factor Xa
D. Synthesis of antithrombin III: Aggregation of platelets
7. A 24-year-old presents to the office with fatigue. On physical exam, the NP notices that she ispale with the
following vital signs: HR 112, BP 98/64,
resp 20, O2 sats 99%. Her CBC shows: WBC6,000, Hemoglobin 9.6, Hematocrit 30.2, MCV is decreased at 76. What
,ADVANCED PATHOPHYSIOLOGY MIDTERM NUR 6501 WALDEN UNIVERSIT / COMPLETE ACTUAL EXAM / 150+ QUESTIONS AND CORRECT DETAILED
ANSWERS / 2025/2026
is the mostly likely causeof this patient's
anemia?
A. Iron deficiency anemia caused by menstruation
B. Beta Thalassemia of genetic origin
C. Pernicious anemia caused by dietary deficiency
D. Folate deficiency caused by alcoholism: Iron deficiency anemia caused by menstruation
8. A 65-year-old female presents to your office complaining of fatigue. She has a long of rheumatoid arthritis. A
CBC reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87 fL/red cell, platelet count of 268,000/microliter,
and WBC count of 6800/microliter. The serum haptoglobin level is normal, and the serum iron concentration is
20 micrograms/dL. The total iron binding capacity is 195 micrograms/dL, and the percent saturation is 10.2. The
serum ferritin concentration is 317 ng/mL. No fibrin split products are detected. The reticulocyte concentration is
1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia: Anemia of chronic disease
9. A 14-year-old male presents with high fever for ten days. Physical examina- tion reveals scattered petechial
hemorrhages but is negative for enlargement of the liver or spleen or lymph nodes. Bone marrow examination
does not show any abnormal cells. The complete blood count (CBC) demonstrates a hemoglobin concentration
