NUR 546/NUR546 Exam 2 V1 | Advanced
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with chronic obstructive pulmonary disease (COPD) presents with increased
anteroposterior chest diameter. Which pathophysiological mechanism primarily causes this
‘barrel chest’?
A. Excessive mucus production in the bronchioles
B. Increased compliance of the chest wall
C. Air trapping and hyperinflation of the lungs
D. Pulmonary hypertension leading to right-sided heart failure
Correct Answer: C
Expert Explanation: In COPD, the loss of elastic recoil in the alveoli leads to air being
trapped during expiration. This persistent air trapping results in chronic hyperinflation of
the lungs. Over time, the thoracic cage compensates for this increased volume by adopting
a more rounded shape, known as a barrel chest.
2. Which electrolyte imbalance is a common complication of excessive antidiuretic hormone
(ADH) secretion, such as in SIADH?
A. Hypernatremia
B. Hypokalemia
,C. Hyponatremia
D. Hypercalcemia
Correct Answer: C
Expert Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes the
kidneys to reabsorb excessive amounts of water. This leads to an increase in total body
water, which dilutes the concentration of sodium in the blood. This condition is known as
dilutional hyponatremia and can lead to severe neurological symptoms if left untreated.
3. A patient is diagnosed with right-sided heart failure. Which of the following clinical findings
is most likely present?
A. Pulmonary edema
B. Dyspnea on exertion
C. Jugular venous distention (JVD)
D. Cough with frothy sputum
Correct Answer: C
Expert Explanation: Right-sided heart failure occurs when the right ventricle fails to
pump blood effectively into the pulmonary artery. This causes blood to back up into the
systemic venous system, leading to increased pressure. Common signs include JVD,
peripheral edema, and hepatomegaly, whereas pulmonary symptoms are associated with
left-sided failure.
, 4. What is the primary pathophysiology underlying the development of Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion from alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Downregulation of insulin receptors
Correct Answer: C
Expert Explanation: Type 1 Diabetes Mellitus is characterized by an absolute insulin
deficiency. This occurs because the body’s immune system mistakenly attacks and destroys
the insulin-producing beta cells in the Islets of Langerhans. Consequently, the individual
becomes dependent on exogenous insulin for survival and glucose management.
5. Which physiological process is responsible for the activation of the Renin-Angiotensin-
Aldosterone System (RAAS)?
A. Increased renal perfusion
B. Decreased blood pressure or renal ischemia
C. Excessive intake of sodium
D. High levels of circulating atrial natriuretic peptide
Correct Answer: B
Pathophysiology Q&A with Rationale |
William Paterson University
1. A patient with chronic obstructive pulmonary disease (COPD) presents with increased
anteroposterior chest diameter. Which pathophysiological mechanism primarily causes this
‘barrel chest’?
A. Excessive mucus production in the bronchioles
B. Increased compliance of the chest wall
C. Air trapping and hyperinflation of the lungs
D. Pulmonary hypertension leading to right-sided heart failure
Correct Answer: C
Expert Explanation: In COPD, the loss of elastic recoil in the alveoli leads to air being
trapped during expiration. This persistent air trapping results in chronic hyperinflation of
the lungs. Over time, the thoracic cage compensates for this increased volume by adopting
a more rounded shape, known as a barrel chest.
2. Which electrolyte imbalance is a common complication of excessive antidiuretic hormone
(ADH) secretion, such as in SIADH?
A. Hypernatremia
B. Hypokalemia
,C. Hyponatremia
D. Hypercalcemia
Correct Answer: C
Expert Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes the
kidneys to reabsorb excessive amounts of water. This leads to an increase in total body
water, which dilutes the concentration of sodium in the blood. This condition is known as
dilutional hyponatremia and can lead to severe neurological symptoms if left untreated.
3. A patient is diagnosed with right-sided heart failure. Which of the following clinical findings
is most likely present?
A. Pulmonary edema
B. Dyspnea on exertion
C. Jugular venous distention (JVD)
D. Cough with frothy sputum
Correct Answer: C
Expert Explanation: Right-sided heart failure occurs when the right ventricle fails to
pump blood effectively into the pulmonary artery. This causes blood to back up into the
systemic venous system, leading to increased pressure. Common signs include JVD,
peripheral edema, and hepatomegaly, whereas pulmonary symptoms are associated with
left-sided failure.
, 4. What is the primary pathophysiology underlying the development of Type 1 Diabetes
Mellitus?
A. Insulin resistance in peripheral tissues
B. Excessive glucagon secretion from alpha cells
C. Autoimmune destruction of pancreatic beta cells
D. Downregulation of insulin receptors
Correct Answer: C
Expert Explanation: Type 1 Diabetes Mellitus is characterized by an absolute insulin
deficiency. This occurs because the body’s immune system mistakenly attacks and destroys
the insulin-producing beta cells in the Islets of Langerhans. Consequently, the individual
becomes dependent on exogenous insulin for survival and glucose management.
5. Which physiological process is responsible for the activation of the Renin-Angiotensin-
Aldosterone System (RAAS)?
A. Increased renal perfusion
B. Decreased blood pressure or renal ischemia
C. Excessive intake of sodium
D. High levels of circulating atrial natriuretic peptide
Correct Answer: B
