NSG 5140 ADVANCED
PATHOPHYSIOLOGY MIDTERM
1. A patient with chronic hypertension develops left
ventricular hypertrophy. Which mechanism is primarily
responsible for this adaptation?
A. Increased myocardial apoptosis
B. Decreased afterload
C. Increased cardiac muscle fiber size due to pressure overload
D. Reduced sympathetic stimulation
Rationale: Left ventricular hypertrophy occurs because chronic
pressure overload from hypertension forces cardiac muscle cells
to enlarge in order to generate greater contractile force. This
represents cellular hypertrophy, not hyperplasia, because
cardiac muscle cells have limited ability to divide.
2. Which electrolyte imbalance is most commonly associated
with peaked T waves on an ECG?
A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hyperkalemia
Rationale: Hyperkalemia alters cardiac membrane excitability
and conduction, producing characteristic ECG changes such as
peaked T waves, widened QRS complexes, and potentially fatal
arrhythmias.
3. A patient with metabolic acidosis would most likely exhibit
which compensatory response?
,A. Hypoventilation
B. Bradycardia
C. Hyperventilation
D. Increased bicarbonate excretion
Rationale: In metabolic acidosis, the respiratory system
compensates by increasing ventilation to eliminate carbon
dioxide, thereby reducing carbonic acid concentration and
helping normalize pH.
4. Which hormone is primarily responsible for increasing
water reabsorption in the renal collecting ducts?
A. Aldosterone
B. Renin
C. Atrial natriuretic peptide
D. Antidiuretic hormone (ADH)
Rationale: ADH acts on the collecting ducts of the kidneys to
increase water permeability, allowing greater water
reabsorption and concentration of urine.
5. A deficiency in intrinsic factor would most likely lead to
which condition?
A. Iron-deficiency anemia
B. Aplastic anemia
C. Pernicious anemia
D. Hemolytic anemia
Rationale: Intrinsic factor is required for vitamin B12 absorption
in the ileum. Deficiency results in pernicious anemia,
characterized by megaloblastic red blood cells and neurologic
manifestations.
, 6. Which process describes movement of fluid from the
intravascular space into the interstitial space due to
increased hydrostatic pressure?
A. Osmosis
B. Active transport
C. Diffusion
D. Filtration
Rationale: Filtration occurs when hydrostatic pressure pushes
fluid across a semipermeable membrane from the vascular
compartment into surrounding tissues.
7. A patient with COPD develops chronic hypoxemia. Which
compensatory response may occur?
A. Leukopenia
B. Polycythemia
C. Thrombocytopenia
D. Hypoglycemia
Rationale: Chronic hypoxemia stimulates erythropoietin release,
increasing red blood cell production and resulting in secondary
polycythemia to improve oxygen-carrying capacity.
8. Which statement best describes apoptosis?
A. It always causes inflammation
B. It occurs only in pathologic conditions
C. It is programmed cell death without significant
inflammation
D. It results from traumatic cellular injury only
, Rationale: Apoptosis is a controlled, energy-dependent process
of programmed cell death that removes damaged or
unnecessary cells while minimizing inflammation.
9. Which acid-base imbalance is characterized by elevated
bicarbonate levels?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Rationale: Metabolic alkalosis occurs when bicarbonate
concentration increases, often due to excessive vomiting,
diuretic use, or antacid ingestion.
10. A patient with heart failure presents with bilateral
lower extremity edema. Which mechanism contributes
most directly to edema formation?
A. Decreased capillary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Increased capillary hydrostatic pressure
D. Reduced sodium retention
Rationale: Heart failure increases venous pressure, which
elevates capillary hydrostatic pressure and pushes fluid into the
interstitial tissues, causing edema.
11. Which type of shock is associated with widespread
vasodilation and increased vascular permeability?
A. Hypovolemic shock
B. Cardiogenic shock
PATHOPHYSIOLOGY MIDTERM
1. A patient with chronic hypertension develops left
ventricular hypertrophy. Which mechanism is primarily
responsible for this adaptation?
A. Increased myocardial apoptosis
B. Decreased afterload
C. Increased cardiac muscle fiber size due to pressure overload
D. Reduced sympathetic stimulation
Rationale: Left ventricular hypertrophy occurs because chronic
pressure overload from hypertension forces cardiac muscle cells
to enlarge in order to generate greater contractile force. This
represents cellular hypertrophy, not hyperplasia, because
cardiac muscle cells have limited ability to divide.
2. Which electrolyte imbalance is most commonly associated
with peaked T waves on an ECG?
A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hyperkalemia
Rationale: Hyperkalemia alters cardiac membrane excitability
and conduction, producing characteristic ECG changes such as
peaked T waves, widened QRS complexes, and potentially fatal
arrhythmias.
3. A patient with metabolic acidosis would most likely exhibit
which compensatory response?
,A. Hypoventilation
B. Bradycardia
C. Hyperventilation
D. Increased bicarbonate excretion
Rationale: In metabolic acidosis, the respiratory system
compensates by increasing ventilation to eliminate carbon
dioxide, thereby reducing carbonic acid concentration and
helping normalize pH.
4. Which hormone is primarily responsible for increasing
water reabsorption in the renal collecting ducts?
A. Aldosterone
B. Renin
C. Atrial natriuretic peptide
D. Antidiuretic hormone (ADH)
Rationale: ADH acts on the collecting ducts of the kidneys to
increase water permeability, allowing greater water
reabsorption and concentration of urine.
5. A deficiency in intrinsic factor would most likely lead to
which condition?
A. Iron-deficiency anemia
B. Aplastic anemia
C. Pernicious anemia
D. Hemolytic anemia
Rationale: Intrinsic factor is required for vitamin B12 absorption
in the ileum. Deficiency results in pernicious anemia,
characterized by megaloblastic red blood cells and neurologic
manifestations.
, 6. Which process describes movement of fluid from the
intravascular space into the interstitial space due to
increased hydrostatic pressure?
A. Osmosis
B. Active transport
C. Diffusion
D. Filtration
Rationale: Filtration occurs when hydrostatic pressure pushes
fluid across a semipermeable membrane from the vascular
compartment into surrounding tissues.
7. A patient with COPD develops chronic hypoxemia. Which
compensatory response may occur?
A. Leukopenia
B. Polycythemia
C. Thrombocytopenia
D. Hypoglycemia
Rationale: Chronic hypoxemia stimulates erythropoietin release,
increasing red blood cell production and resulting in secondary
polycythemia to improve oxygen-carrying capacity.
8. Which statement best describes apoptosis?
A. It always causes inflammation
B. It occurs only in pathologic conditions
C. It is programmed cell death without significant
inflammation
D. It results from traumatic cellular injury only
, Rationale: Apoptosis is a controlled, energy-dependent process
of programmed cell death that removes damaged or
unnecessary cells while minimizing inflammation.
9. Which acid-base imbalance is characterized by elevated
bicarbonate levels?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Rationale: Metabolic alkalosis occurs when bicarbonate
concentration increases, often due to excessive vomiting,
diuretic use, or antacid ingestion.
10. A patient with heart failure presents with bilateral
lower extremity edema. Which mechanism contributes
most directly to edema formation?
A. Decreased capillary hydrostatic pressure
B. Increased plasma oncotic pressure
C. Increased capillary hydrostatic pressure
D. Reduced sodium retention
Rationale: Heart failure increases venous pressure, which
elevates capillary hydrostatic pressure and pushes fluid into the
interstitial tissues, causing edema.
11. Which type of shock is associated with widespread
vasodilation and increased vascular permeability?
A. Hypovolemic shock
B. Cardiogenic shock
