NURS 5315 Advanced Pathophysiology Exams 1–5 | Latest Update
2026/2027 | Questions and Verified Answers with Rationales | 100%
Correct | UTA
1. A patient presents with muscle weakness, smooth muscle atony, paresthesia, and cardiac
dysrhythmias. Laboratory studies reveal a serum potassium level of 2.8 mEq/L. Which of the following
best explains the effect of this electrolyte imbalance on action potentials?
A. Hypopolarization with increased excitability
B. Hyperpolarization with decreased excitability
C. No change in resting membrane potential
D. Persistent depolarization without repolarization
Correct Answer: B. Hypokalemia results in hyperpolarization of the cell membrane (more negative, e.g.,
–100 mV), making the neuron less excitable. This decreased neuromuscular excitability leads to
weakness, smooth muscle atony, paresthesia, and cardiac dysrhythmias.
2. A 45‑year‑old patient with chronic kidney disease has a serum potassium level of 6.5 mEq/L. Which of
the following ECG findings would you most expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged PR interval
Correct Answer: C. Hyperkalemia causes hypopolarization (more positive resting membrane potential,
closer to 0), leading to increased excitability and peaked T waves on ECG. When the resting membrane
potential equals the threshold potential, cardiac standstill can occur.
,3. A 60‑year‑old woman with breast cancer is receiving chemotherapy. Which of the following best
describes the process of programmed cell death that is critical for eliminating cancer cells?
A. Necrosis
B. Apoptosis
C. Autolysis
D. Pyroptosis
Correct Answer: B. Apoptosis is programmed cell death that is needed to prevent cellular proliferation
that would result in an abnormally large body. It plays a crucial role in eliminating virus‑infected cells
and cancer cells, and defects in apoptosis are implicated in neurodegenerative diseases and ischemic
injury.
4. A patient with heavy alcohol use presents with confusion and hypoglycemia. The increased
NADH/NAD⁺ ratio in the liver from ethanol metabolism leads to which of the following metabolic
consequences?
A. Increased gluconeogenesis and hyperglycemia
B. Pyruvate conversion to lactate, causing lactic acidosis
C. Increased citric acid cycle activity
D. Decreased fatty acid synthesis
Correct Answer: B. The increased NADH/NAD⁺ ratio in the liver from ethanol metabolism causes
pyruvate to be converted to lactic acid, resulting in lactic acidosis. It also shifts oxaloacetate to malate,
preventing gluconeogenesis and leading to hypoglycemia.
5. A 35‑year‑old woman presents with fatigue, joint pain, and a facial rash. Laboratory findings show
positive antinuclear antibodies (ANA). The pathogenesis of her condition is primarily related to:
A. Direct viral infection of tissues
B. Deposition of antibody‑antigen complexes in tissues and organs
,C. Autoantibodies against acetylcholine receptors
D. Immune‑complex deposition in the glomerulus only
Correct Answer: B. The pathogenesis of systemic lupus erythematosus (SLE) is related to
antibody/antigen complexes that are deposited in tissues and organs, triggering the immune response.
This leads to the multisystem manifestations characteristic of SLE.
6. An elderly patient presents with a beefy red tongue, neurologic symptoms including paresthesia of
the hands and feet, and loss of position and vibration sense. These symptoms are characteristic of:
A. Iron deficiency anemia
B. Folate deficiency anemia
C. Pernicious anemia
D. Anemia of chronic disease
Correct Answer: C. Pernicious anemia results from lack of intrinsic factor, leading to vitamin B₁₂
deficiency. The classic triad includes a beefy red tongue (glossitis), neurologic symptoms (paresthesia,
loss of position/vibration sense), and possibly myocardial damage and poor heart contractility if
untreated.
7. A patient develops severe cheilosis, burning mouth syndrome, dysphagia, flatulence, and watery
diarrhea. A complete blood count shows macrocytic anemia. Which of the following deficiencies is the
most likely cause?
A. Iron
B. Vitamin B₁₂
C. Folate
D. Vitamin C
, Correct Answer: C. These symptoms—severe cheilosis, burning mouth syndrome, dysphagia, flatulence,
and watery diarrhea—are classic for folate deficiency anemia. Alcohol interferes with folate metabolism
in the liver, depleting folate stores.
8. A patient’s laboratory report shows normocytic anemia, and further testing reveals low serum iron
and low total iron‑binding capacity (TIBC). This pattern is most consistent with:
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Hemolytic anemia
D. Sideroblastic anemia
Correct Answer: B. Anemia of chronic disease typically presents with low serum iron and low TIBC due to
sequestration of iron in the reticuloendothelial system. In contrast, iron deficiency anemia typically
shows low serum iron but high TIBC.
9. A patient with long‑standing rheumatoid arthritis develops fatigue and pallor. Laboratory evaluation
reveals hemoglobin 9.5 g/dL, serum iron low, TIBC low, and ferritin high. These findings are most
consistent with:
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Hemolytic anemia
D. Aplastic anemia
Correct Answer: B. Anemia of chronic disease is characterized by low serum iron, low TIBC, and normal
to high ferritin due to inflammatory cytokines (especially IL‑6) that increase hepcidin, trapping iron in
stores. This is commonly seen in chronic inflammatory conditions such as rheumatoid arthritis.
2026/2027 | Questions and Verified Answers with Rationales | 100%
Correct | UTA
1. A patient presents with muscle weakness, smooth muscle atony, paresthesia, and cardiac
dysrhythmias. Laboratory studies reveal a serum potassium level of 2.8 mEq/L. Which of the following
best explains the effect of this electrolyte imbalance on action potentials?
A. Hypopolarization with increased excitability
B. Hyperpolarization with decreased excitability
C. No change in resting membrane potential
D. Persistent depolarization without repolarization
Correct Answer: B. Hypokalemia results in hyperpolarization of the cell membrane (more negative, e.g.,
–100 mV), making the neuron less excitable. This decreased neuromuscular excitability leads to
weakness, smooth muscle atony, paresthesia, and cardiac dysrhythmias.
2. A 45‑year‑old patient with chronic kidney disease has a serum potassium level of 6.5 mEq/L. Which of
the following ECG findings would you most expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged PR interval
Correct Answer: C. Hyperkalemia causes hypopolarization (more positive resting membrane potential,
closer to 0), leading to increased excitability and peaked T waves on ECG. When the resting membrane
potential equals the threshold potential, cardiac standstill can occur.
,3. A 60‑year‑old woman with breast cancer is receiving chemotherapy. Which of the following best
describes the process of programmed cell death that is critical for eliminating cancer cells?
A. Necrosis
B. Apoptosis
C. Autolysis
D. Pyroptosis
Correct Answer: B. Apoptosis is programmed cell death that is needed to prevent cellular proliferation
that would result in an abnormally large body. It plays a crucial role in eliminating virus‑infected cells
and cancer cells, and defects in apoptosis are implicated in neurodegenerative diseases and ischemic
injury.
4. A patient with heavy alcohol use presents with confusion and hypoglycemia. The increased
NADH/NAD⁺ ratio in the liver from ethanol metabolism leads to which of the following metabolic
consequences?
A. Increased gluconeogenesis and hyperglycemia
B. Pyruvate conversion to lactate, causing lactic acidosis
C. Increased citric acid cycle activity
D. Decreased fatty acid synthesis
Correct Answer: B. The increased NADH/NAD⁺ ratio in the liver from ethanol metabolism causes
pyruvate to be converted to lactic acid, resulting in lactic acidosis. It also shifts oxaloacetate to malate,
preventing gluconeogenesis and leading to hypoglycemia.
5. A 35‑year‑old woman presents with fatigue, joint pain, and a facial rash. Laboratory findings show
positive antinuclear antibodies (ANA). The pathogenesis of her condition is primarily related to:
A. Direct viral infection of tissues
B. Deposition of antibody‑antigen complexes in tissues and organs
,C. Autoantibodies against acetylcholine receptors
D. Immune‑complex deposition in the glomerulus only
Correct Answer: B. The pathogenesis of systemic lupus erythematosus (SLE) is related to
antibody/antigen complexes that are deposited in tissues and organs, triggering the immune response.
This leads to the multisystem manifestations characteristic of SLE.
6. An elderly patient presents with a beefy red tongue, neurologic symptoms including paresthesia of
the hands and feet, and loss of position and vibration sense. These symptoms are characteristic of:
A. Iron deficiency anemia
B. Folate deficiency anemia
C. Pernicious anemia
D. Anemia of chronic disease
Correct Answer: C. Pernicious anemia results from lack of intrinsic factor, leading to vitamin B₁₂
deficiency. The classic triad includes a beefy red tongue (glossitis), neurologic symptoms (paresthesia,
loss of position/vibration sense), and possibly myocardial damage and poor heart contractility if
untreated.
7. A patient develops severe cheilosis, burning mouth syndrome, dysphagia, flatulence, and watery
diarrhea. A complete blood count shows macrocytic anemia. Which of the following deficiencies is the
most likely cause?
A. Iron
B. Vitamin B₁₂
C. Folate
D. Vitamin C
, Correct Answer: C. These symptoms—severe cheilosis, burning mouth syndrome, dysphagia, flatulence,
and watery diarrhea—are classic for folate deficiency anemia. Alcohol interferes with folate metabolism
in the liver, depleting folate stores.
8. A patient’s laboratory report shows normocytic anemia, and further testing reveals low serum iron
and low total iron‑binding capacity (TIBC). This pattern is most consistent with:
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Hemolytic anemia
D. Sideroblastic anemia
Correct Answer: B. Anemia of chronic disease typically presents with low serum iron and low TIBC due to
sequestration of iron in the reticuloendothelial system. In contrast, iron deficiency anemia typically
shows low serum iron but high TIBC.
9. A patient with long‑standing rheumatoid arthritis develops fatigue and pallor. Laboratory evaluation
reveals hemoglobin 9.5 g/dL, serum iron low, TIBC low, and ferritin high. These findings are most
consistent with:
A. Iron deficiency anemia
B. Anemia of chronic disease
C. Hemolytic anemia
D. Aplastic anemia
Correct Answer: B. Anemia of chronic disease is characterized by low serum iron, low TIBC, and normal
to high ferritin due to inflammatory cytokines (especially IL‑6) that increase hepcidin, trapping iron in
stores. This is commonly seen in chronic inflammatory conditions such as rheumatoid arthritis.
