NUR 5461/NUR5461 Final Exam V1 |
Comprehensive Final Exam Covering All
Modules Q&A with Rationale | William
Paterson University
1. A patient is diagnosed with metaplasia. Which of the following statements best describes
this cellular adaptation?
A. An increase in the number of cells in an organ or tissue.
B. An increase in the size of cells resulting in an increase in organ size.
C. The replacement of one mature cell type by another less mature cell type.
D. Disordered cellular growth and maturation with variation in size and shape.
Correct Answer: C
Expert Explanation: Metaplasia is a reversible replacement of one mature cell type by
another, often as a response to chronic irritation. For example, in the lungs of smokers,
ciliated columnar epithelium is replaced by stratified squamous epithelium. This process
allows the tissue to survive better under harsh conditions but often results in the loss of
specialized functions.
2. Which physiological process is primarily responsible for the development of edema in a
patient with liver failure and low albumin levels?
A. Increased capillary hydrostatic pressure
,B. Lymphatic obstruction
C. Increased capillary permeability
D. Decreased capillary oncotic pressure
Correct Answer: D
Expert Explanation: Albumin is the primary protein responsible for maintaining plasma
oncotic pressure, which keeps fluid within the vasculature. In liver failure, decreased
albumin production leads to a drop in oncotic pressure, allowing fluid to leak into the
interstitial space. This imbalance between hydrostatic and oncotic pressures is a hallmark
of systemic edema in chronic liver disease.
3. A patient presents with a pH of 7.30, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. How
would the nurse practitioner interpret these arterial blood gas (ABG) results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range, this represents an
, uncompensated respiratory acidosis. This condition is typically caused by alveolar
hypoventilation, leading to the retention of carbon dioxide.
4. Which type of hypersensitivity reaction is mediated by IgE antibodies and involves the
release of histamine from mast cells?
A. Type II
B. Type I
C. Type III
D. Type IV
Correct Answer: B
Expert Explanation: Type I hypersensitivity is an immediate allergic reaction triggered
when an allergen binds to IgE on the surface of mast cells. This binding causes
degranulation and the release of inflammatory mediators like histamine and leukotrienes.
Common examples include anaphylaxis, allergic rhinitis, and asthma.
5. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon secretion by alpha cells
D. Increased hepatic glucose production
Correct Answer: A
Comprehensive Final Exam Covering All
Modules Q&A with Rationale | William
Paterson University
1. A patient is diagnosed with metaplasia. Which of the following statements best describes
this cellular adaptation?
A. An increase in the number of cells in an organ or tissue.
B. An increase in the size of cells resulting in an increase in organ size.
C. The replacement of one mature cell type by another less mature cell type.
D. Disordered cellular growth and maturation with variation in size and shape.
Correct Answer: C
Expert Explanation: Metaplasia is a reversible replacement of one mature cell type by
another, often as a response to chronic irritation. For example, in the lungs of smokers,
ciliated columnar epithelium is replaced by stratified squamous epithelium. This process
allows the tissue to survive better under harsh conditions but often results in the loss of
specialized functions.
2. Which physiological process is primarily responsible for the development of edema in a
patient with liver failure and low albumin levels?
A. Increased capillary hydrostatic pressure
,B. Lymphatic obstruction
C. Increased capillary permeability
D. Decreased capillary oncotic pressure
Correct Answer: D
Expert Explanation: Albumin is the primary protein responsible for maintaining plasma
oncotic pressure, which keeps fluid within the vasculature. In liver failure, decreased
albumin production leads to a drop in oncotic pressure, allowing fluid to leak into the
interstitial space. This imbalance between hydrostatic and oncotic pressures is a hallmark
of systemic edema in chronic liver disease.
3. A patient presents with a pH of 7.30, PaCO2 of 55 mmHg, and HCO3 of 26 mEq/L. How
would the nurse practitioner interpret these arterial blood gas (ABG) results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: A
Expert Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range, this represents an
, uncompensated respiratory acidosis. This condition is typically caused by alveolar
hypoventilation, leading to the retention of carbon dioxide.
4. Which type of hypersensitivity reaction is mediated by IgE antibodies and involves the
release of histamine from mast cells?
A. Type II
B. Type I
C. Type III
D. Type IV
Correct Answer: B
Expert Explanation: Type I hypersensitivity is an immediate allergic reaction triggered
when an allergen binds to IgE on the surface of mast cells. This binding causes
degranulation and the release of inflammatory mediators like histamine and leukotrienes.
Common examples include anaphylaxis, allergic rhinitis, and asthma.
5. What is the primary pathophysiology behind Type 1 Diabetes Mellitus?
A. Autoimmune destruction of pancreatic beta cells
B. Insulin resistance in peripheral tissues
C. Excessive glucagon secretion by alpha cells
D. Increased hepatic glucose production
Correct Answer: A
