NSG 5140 ADVANCED PATHOPHYSIOLOGY
FINAL
1. A patient with chronic hypertension develops left
ventricular hypertrophy primarily because of:
A. Decreased myocardial workload
B. Increased afterload
C. Reduced cardiac output
D. Increased venous return
Answer: B. Increased afterload
Rationale: Chronic hypertension forces the left ventricle to
pump against elevated systemic vascular resistance, increasing
afterload. In response, myocardial fibers enlarge to compensate
for the increased workload, leading to left ventricular
hypertrophy. Over time, this adaptation may result in decreased
cardiac compliance and heart failure.
2. Which electrolyte imbalance is most commonly associated
with peaked T waves on an electrocardiogram?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: Hyperkalemia alters cardiac electrical conduction by
increasing resting membrane potential excitability.
Characteristic ECG findings include peaked T waves, widened
QRS complexes, and potentially life-threatening arrhythmias.
,Early recognition is critical because severe hyperkalemia can
lead to cardiac arrest.
3. The primary pathophysiologic mechanism of type 1
diabetes mellitus is:
A. Peripheral insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon secretion
D. Increased hepatic glucose uptake
Answer: B. Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes mellitus results from autoimmune-
mediated destruction of insulin-producing beta cells in the
pancreas. This leads to absolute insulin deficiency,
hyperglycemia, and dependence on exogenous insulin therapy
for survival.
4. A patient experiencing respiratory acidosis would most
likely exhibit:
A. Decreased PaCO2
B. Increased bicarbonate loss
C. Hypoventilation
D. Hyperventilation
Answer: C. Hypoventilation
Rationale: Respiratory acidosis occurs when alveolar
hypoventilation causes carbon dioxide retention. Elevated
PaCO2 increases carbonic acid concentration in the blood,
lowering pH. Causes include COPD, sedative overdose, and
neuromuscular disorders affecting respiration.
, 5. Which condition is characterized by demyelination within
the central nervous system?
A. Myasthenia gravis
B. Guillain-Barré syndrome
C. Multiple sclerosis
D. Parkinson disease
Answer: C. Multiple sclerosis
Rationale: Multiple sclerosis is an autoimmune disorder
involving destruction of myelin within the central nervous
system. Demyelination disrupts nerve impulse conduction,
producing neurologic deficits such as weakness, visual
disturbances, and sensory abnormalities.
6. The hallmark manifestation of nephrotic syndrome is:
A. Hematuria
B. Massive proteinuria
C. Oliguria
D. Renal calculi
Answer: B. Massive proteinuria
Rationale: Nephrotic syndrome is characterized by increased
glomerular membrane permeability, leading to massive protein
loss in urine. This results in hypoalbuminemia, edema,
hyperlipidemia, and increased risk for thrombosis and infection.
7. Which hormone is primarily responsible for increasing
serum calcium levels?
A. Calcitonin
B. Insulin
, C. Parathyroid hormone
D. Aldosterone
Answer: C. Parathyroid hormone
Rationale: Parathyroid hormone raises serum calcium by
stimulating bone resorption, increasing intestinal calcium
absorption through vitamin D activation, and promoting renal
calcium reabsorption. It is the primary regulator of calcium
homeostasis.
8. A patient with liver cirrhosis is at risk for ascites primarily
because of:
A. Increased plasma oncotic pressure
B. Portal hypertension and hypoalbuminemia
C. Increased renal filtration
D. Hypercalcemia
Answer: B. Portal hypertension and hypoalbuminemia
Rationale: Cirrhosis causes portal hypertension, which increases
hydrostatic pressure in the portal circulation, and decreases
albumin synthesis, lowering plasma oncotic pressure. Together
these changes promote fluid accumulation in the abdominal
cavity.
9. Which finding is most characteristic of iron deficiency
anemia?
A. Macrocytic red blood cells
B. Elevated ferritin level
C. Microcytic hypochromic red blood cells
D. Increased vitamin B12 levels
Answer: C. Microcytic hypochromic red blood cells
FINAL
1. A patient with chronic hypertension develops left
ventricular hypertrophy primarily because of:
A. Decreased myocardial workload
B. Increased afterload
C. Reduced cardiac output
D. Increased venous return
Answer: B. Increased afterload
Rationale: Chronic hypertension forces the left ventricle to
pump against elevated systemic vascular resistance, increasing
afterload. In response, myocardial fibers enlarge to compensate
for the increased workload, leading to left ventricular
hypertrophy. Over time, this adaptation may result in decreased
cardiac compliance and heart failure.
2. Which electrolyte imbalance is most commonly associated
with peaked T waves on an electrocardiogram?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hyponatremia
Answer: C. Hyperkalemia
Rationale: Hyperkalemia alters cardiac electrical conduction by
increasing resting membrane potential excitability.
Characteristic ECG findings include peaked T waves, widened
QRS complexes, and potentially life-threatening arrhythmias.
,Early recognition is critical because severe hyperkalemia can
lead to cardiac arrest.
3. The primary pathophysiologic mechanism of type 1
diabetes mellitus is:
A. Peripheral insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess glucagon secretion
D. Increased hepatic glucose uptake
Answer: B. Autoimmune destruction of pancreatic beta cells
Rationale: Type 1 diabetes mellitus results from autoimmune-
mediated destruction of insulin-producing beta cells in the
pancreas. This leads to absolute insulin deficiency,
hyperglycemia, and dependence on exogenous insulin therapy
for survival.
4. A patient experiencing respiratory acidosis would most
likely exhibit:
A. Decreased PaCO2
B. Increased bicarbonate loss
C. Hypoventilation
D. Hyperventilation
Answer: C. Hypoventilation
Rationale: Respiratory acidosis occurs when alveolar
hypoventilation causes carbon dioxide retention. Elevated
PaCO2 increases carbonic acid concentration in the blood,
lowering pH. Causes include COPD, sedative overdose, and
neuromuscular disorders affecting respiration.
, 5. Which condition is characterized by demyelination within
the central nervous system?
A. Myasthenia gravis
B. Guillain-Barré syndrome
C. Multiple sclerosis
D. Parkinson disease
Answer: C. Multiple sclerosis
Rationale: Multiple sclerosis is an autoimmune disorder
involving destruction of myelin within the central nervous
system. Demyelination disrupts nerve impulse conduction,
producing neurologic deficits such as weakness, visual
disturbances, and sensory abnormalities.
6. The hallmark manifestation of nephrotic syndrome is:
A. Hematuria
B. Massive proteinuria
C. Oliguria
D. Renal calculi
Answer: B. Massive proteinuria
Rationale: Nephrotic syndrome is characterized by increased
glomerular membrane permeability, leading to massive protein
loss in urine. This results in hypoalbuminemia, edema,
hyperlipidemia, and increased risk for thrombosis and infection.
7. Which hormone is primarily responsible for increasing
serum calcium levels?
A. Calcitonin
B. Insulin
, C. Parathyroid hormone
D. Aldosterone
Answer: C. Parathyroid hormone
Rationale: Parathyroid hormone raises serum calcium by
stimulating bone resorption, increasing intestinal calcium
absorption through vitamin D activation, and promoting renal
calcium reabsorption. It is the primary regulator of calcium
homeostasis.
8. A patient with liver cirrhosis is at risk for ascites primarily
because of:
A. Increased plasma oncotic pressure
B. Portal hypertension and hypoalbuminemia
C. Increased renal filtration
D. Hypercalcemia
Answer: B. Portal hypertension and hypoalbuminemia
Rationale: Cirrhosis causes portal hypertension, which increases
hydrostatic pressure in the portal circulation, and decreases
albumin synthesis, lowering plasma oncotic pressure. Together
these changes promote fluid accumulation in the abdominal
cavity.
9. Which finding is most characteristic of iron deficiency
anemia?
A. Macrocytic red blood cells
B. Elevated ferritin level
C. Microcytic hypochromic red blood cells
D. Increased vitamin B12 levels
Answer: C. Microcytic hypochromic red blood cells
