NURS6501 / NURS 6501: ADVANCED
PATHOPHYSIOLOGY FINAL MIDTERM
1. A 68-year-old patient with long-standing hypertension
develops left ventricular hypertrophy. Which cellular
adaptation is primarily responsible for this condition?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Rationale: Hypertrophy refers to an increase in cell size in
response to increased workload or stress. In chronic
hypertension, cardiac muscle cells enlarge to compensate for
the increased resistance against which the heart must pump.
Cardiac muscle cells cannot significantly divide, so hypertrophy
rather than hyperplasia occurs.
2. Which laboratory finding is most commonly associated
with iron deficiency anemia?
A. Increased ferritin
B. Elevated mean corpuscular volume (MCV)
C. Low hemoglobin and low ferritin levels
D. Increased reticulocyte count
Rationale: Iron deficiency anemia typically presents with
decreased hemoglobin and ferritin levels due to depleted iron
stores. Ferritin reflects iron storage, and low levels strongly
support iron deficiency. The anemia is usually microcytic and
hypochromic.
, 3. A patient with chronic obstructive pulmonary disease
(COPD) is likely to develop which acid-base imbalance?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
Rationale: COPD impairs ventilation, causing carbon dioxide
retention. Elevated carbon dioxide levels increase carbonic acid
in the blood, leading to respiratory acidosis. The kidneys may
partially compensate over time by retaining bicarbonate.
4. Which hormone is primarily responsible for increasing
blood glucose levels during fasting?
A. Insulin
B. Somatostatin
C. Glucagon
D. Calcitonin
Rationale: Glucagon, secreted by pancreatic alpha cells, raises
blood glucose by stimulating glycogenolysis and
gluconeogenesis in the liver during fasting states. Insulin has
the opposite effect.
5. A patient develops edema due to decreased plasma
oncotic pressure. Which condition is the most likely cause?
A. Heart failure
B. Lymphatic obstruction
C. Liver failure with hypoalbuminemia
D. Sodium retention
,Rationale: Plasma oncotic pressure is mainly maintained by
albumin. Liver failure decreases albumin synthesis, resulting in
reduced oncotic pressure and fluid movement into interstitial
spaces, causing edema.
6. Which electrolyte imbalance is most likely to cause cardiac
dysrhythmias?
A. Hypercalcemia
B. Hypernatremia
C. Hyperkalemia
D. Hypermagnesemia
Rationale: Potassium is critical for normal cardiac electrical
activity. Elevated potassium levels disrupt membrane potentials
and conduction, increasing the risk of dangerous dysrhythmias
and cardiac arrest.
7. What is the hallmark pathological feature of type 1
diabetes mellitus?
A. Peripheral insulin resistance
B. Excess glucagon secretion
C. Autoimmune destruction of pancreatic beta cells
D. Increased hepatic glycogen storage
Rationale: Type 1 diabetes results from autoimmune
destruction of insulin-producing beta cells in the pancreas,
leading to absolute insulin deficiency and hyperglycemia.
8. A patient experiences sudden chest pain and elevated
troponin levels. Which process is occurring in the
myocardium?
, A. Atrophy
B. Hyperplasia
C. Apoptosis
D. Necrosis
Rationale: Elevated troponin indicates myocardial cell death
due to ischemia. Necrosis is uncontrolled cell death caused by
injury such as myocardial infarction.
9. Which component of the immune system is primarily
involved in allergic reactions?
A. T lymphocytes
B. Neutrophils
C. IgE antibodies
D. Macrophages
Rationale: IgE antibodies mediate type I hypersensitivity
reactions. They bind mast cells and trigger histamine release
upon exposure to allergens.
10. A deficiency of intrinsic factor leads to which
condition?
A. Iron deficiency anemia
B. Aplastic anemia
C. Hemolytic anemia
D. Pernicious anemia
Rationale: Intrinsic factor is required for vitamin B12 absorption
in the ileum. Deficiency results in pernicious anemia, a
megaloblastic anemia caused by impaired DNA synthesis.
PATHOPHYSIOLOGY FINAL MIDTERM
1. A 68-year-old patient with long-standing hypertension
develops left ventricular hypertrophy. Which cellular
adaptation is primarily responsible for this condition?
A. Hyperplasia
B. Metaplasia
C. Hypertrophy
D. Dysplasia
Rationale: Hypertrophy refers to an increase in cell size in
response to increased workload or stress. In chronic
hypertension, cardiac muscle cells enlarge to compensate for
the increased resistance against which the heart must pump.
Cardiac muscle cells cannot significantly divide, so hypertrophy
rather than hyperplasia occurs.
2. Which laboratory finding is most commonly associated
with iron deficiency anemia?
A. Increased ferritin
B. Elevated mean corpuscular volume (MCV)
C. Low hemoglobin and low ferritin levels
D. Increased reticulocyte count
Rationale: Iron deficiency anemia typically presents with
decreased hemoglobin and ferritin levels due to depleted iron
stores. Ferritin reflects iron storage, and low levels strongly
support iron deficiency. The anemia is usually microcytic and
hypochromic.
, 3. A patient with chronic obstructive pulmonary disease
(COPD) is likely to develop which acid-base imbalance?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
Rationale: COPD impairs ventilation, causing carbon dioxide
retention. Elevated carbon dioxide levels increase carbonic acid
in the blood, leading to respiratory acidosis. The kidneys may
partially compensate over time by retaining bicarbonate.
4. Which hormone is primarily responsible for increasing
blood glucose levels during fasting?
A. Insulin
B. Somatostatin
C. Glucagon
D. Calcitonin
Rationale: Glucagon, secreted by pancreatic alpha cells, raises
blood glucose by stimulating glycogenolysis and
gluconeogenesis in the liver during fasting states. Insulin has
the opposite effect.
5. A patient develops edema due to decreased plasma
oncotic pressure. Which condition is the most likely cause?
A. Heart failure
B. Lymphatic obstruction
C. Liver failure with hypoalbuminemia
D. Sodium retention
,Rationale: Plasma oncotic pressure is mainly maintained by
albumin. Liver failure decreases albumin synthesis, resulting in
reduced oncotic pressure and fluid movement into interstitial
spaces, causing edema.
6. Which electrolyte imbalance is most likely to cause cardiac
dysrhythmias?
A. Hypercalcemia
B. Hypernatremia
C. Hyperkalemia
D. Hypermagnesemia
Rationale: Potassium is critical for normal cardiac electrical
activity. Elevated potassium levels disrupt membrane potentials
and conduction, increasing the risk of dangerous dysrhythmias
and cardiac arrest.
7. What is the hallmark pathological feature of type 1
diabetes mellitus?
A. Peripheral insulin resistance
B. Excess glucagon secretion
C. Autoimmune destruction of pancreatic beta cells
D. Increased hepatic glycogen storage
Rationale: Type 1 diabetes results from autoimmune
destruction of insulin-producing beta cells in the pancreas,
leading to absolute insulin deficiency and hyperglycemia.
8. A patient experiences sudden chest pain and elevated
troponin levels. Which process is occurring in the
myocardium?
, A. Atrophy
B. Hyperplasia
C. Apoptosis
D. Necrosis
Rationale: Elevated troponin indicates myocardial cell death
due to ischemia. Necrosis is uncontrolled cell death caused by
injury such as myocardial infarction.
9. Which component of the immune system is primarily
involved in allergic reactions?
A. T lymphocytes
B. Neutrophils
C. IgE antibodies
D. Macrophages
Rationale: IgE antibodies mediate type I hypersensitivity
reactions. They bind mast cells and trigger histamine release
upon exposure to allergens.
10. A deficiency of intrinsic factor leads to which
condition?
A. Iron deficiency anemia
B. Aplastic anemia
C. Hemolytic anemia
D. Pernicious anemia
Rationale: Intrinsic factor is required for vitamin B12 absorption
in the ileum. Deficiency results in pernicious anemia, a
megaloblastic anemia caused by impaired DNA synthesis.
