NURS 231/NURS231 Final Exam V2 |
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient is diagnosed with atrophy of the gastrocnemius muscle following a prolonged
period of immobilization in a cast. Which statement best describes the cellular mechanism of
this adaptation?
A. The cells increase in number to compensate for lack of movement.
B. The cells undergo apoptosis immediately after the limb is immobilized.
C. The cells decrease in size due to a decrease in protein synthesis and increased protein
degradation.
D. The cells are replaced by a different cell type better suited for lack of use.
Correct Answer: C
Rationale: Atrophy is a cellular adaptation where cells decrease in size in response to a
decrease in work demand or adverse environmental conditions. This reduction in size is
typically due to decreased protein synthesis and increased catabolism through the
ubiquitin-proteasome pathway. In the case of disuse atrophy from a cast, the workload is
removed, leading to a functional shrinkage of the muscle cells.
,2. Which type of cellular adaptation is most commonly observed in the respiratory tract of a
chronic smoker where ciliated columnar epithelium is replaced by stratified squamous
epithelium?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Hypertrophy
Correct Answer: A
Rationale: Metaplasia represents a reversible change in which one adult cell type is
replaced by another adult cell type. In smokers, the fragile ciliated columnar cells are
replaced by tougher stratified squamous cells to withstand the chronic irritation of tobacco
smoke. While this provides protection, the loss of cilia impairs the respiratory system’s
ability to clear mucus and debris.
3. A patient presents with peripheral edema, weight gain, and jugular venous distention.
These clinical manifestations are most indicative of which condition?
A. Right-sided Heart Failure
B. Left-sided Heart Failure
C. Pulmonary Hypertension alone
D. Hypovolemic Shock
,Correct Answer: A
Rationale: Right-sided heart failure leads to a backup of blood into the systemic venous
circulation because the right ventricle cannot pump effectively. This increase in venous
pressure causes fluid to leak into the interstitial spaces, manifesting as peripheral edema
and jugular venous distention. Weight gain occurs as a result of the significant systemic
fluid retention associated with this condition.
4. During the process of acute inflammation, which chemical mediator is primarily
responsible for the initial vasodilation and increased capillary permeability?
A. Histamine
B. Leukotrienes
C. Interleukin-1
D. C-reactive protein
Correct Answer: A
Rationale: Histamine is one of the first mediators released during an inflammatory
response, primarily by mast cells. It acts rapidly to cause vasodilation of arterioles and
increases the permeability of venules. This allows for the exudation of plasma proteins and
leukocytes into the site of injury, which is a hallmark of the vascular phase of inflammation.
, 5. A 55-year-old male with a history of hypertension presents with crushing chest pain that
radiates to his left jaw. The ECG shows ST-segment elevation. Which underlying
pathophysiology is most likely occurring?
A. Stable angina due to gradual vessel narrowing
B. Pericarditis resulting from viral infection
C. STEMI caused by complete occlusion of a coronary artery
D. NSTEMI caused by transient vasospasm
Correct Answer: C
Rationale: An ST-elevation myocardial infarction (STEMI) occurs when a coronary artery
is completely occluded, usually by a thrombus following plaque rupture. This leads to
transmural ischemia and necrosis of the myocardial tissue, which is reflected as ST-
segment elevation on an ECG. Immediate reperfusion therapy is critical to prevent
permanent damage to the heart muscle.
6. Which of the following describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Decreased glucose absorption in the small intestine
C. Excessive secretion of glucagon from alpha cells
D. Absolute insulin deficiency due to autoimmune destruction of beta cells
Correct Answer: D
Pathophysiology Q&A with Rationale |
Portage Learning
1. A patient is diagnosed with atrophy of the gastrocnemius muscle following a prolonged
period of immobilization in a cast. Which statement best describes the cellular mechanism of
this adaptation?
A. The cells increase in number to compensate for lack of movement.
B. The cells undergo apoptosis immediately after the limb is immobilized.
C. The cells decrease in size due to a decrease in protein synthesis and increased protein
degradation.
D. The cells are replaced by a different cell type better suited for lack of use.
Correct Answer: C
Rationale: Atrophy is a cellular adaptation where cells decrease in size in response to a
decrease in work demand or adverse environmental conditions. This reduction in size is
typically due to decreased protein synthesis and increased catabolism through the
ubiquitin-proteasome pathway. In the case of disuse atrophy from a cast, the workload is
removed, leading to a functional shrinkage of the muscle cells.
,2. Which type of cellular adaptation is most commonly observed in the respiratory tract of a
chronic smoker where ciliated columnar epithelium is replaced by stratified squamous
epithelium?
A. Metaplasia
B. Dysplasia
C. Hyperplasia
D. Hypertrophy
Correct Answer: A
Rationale: Metaplasia represents a reversible change in which one adult cell type is
replaced by another adult cell type. In smokers, the fragile ciliated columnar cells are
replaced by tougher stratified squamous cells to withstand the chronic irritation of tobacco
smoke. While this provides protection, the loss of cilia impairs the respiratory system’s
ability to clear mucus and debris.
3. A patient presents with peripheral edema, weight gain, and jugular venous distention.
These clinical manifestations are most indicative of which condition?
A. Right-sided Heart Failure
B. Left-sided Heart Failure
C. Pulmonary Hypertension alone
D. Hypovolemic Shock
,Correct Answer: A
Rationale: Right-sided heart failure leads to a backup of blood into the systemic venous
circulation because the right ventricle cannot pump effectively. This increase in venous
pressure causes fluid to leak into the interstitial spaces, manifesting as peripheral edema
and jugular venous distention. Weight gain occurs as a result of the significant systemic
fluid retention associated with this condition.
4. During the process of acute inflammation, which chemical mediator is primarily
responsible for the initial vasodilation and increased capillary permeability?
A. Histamine
B. Leukotrienes
C. Interleukin-1
D. C-reactive protein
Correct Answer: A
Rationale: Histamine is one of the first mediators released during an inflammatory
response, primarily by mast cells. It acts rapidly to cause vasodilation of arterioles and
increases the permeability of venules. This allows for the exudation of plasma proteins and
leukocytes into the site of injury, which is a hallmark of the vascular phase of inflammation.
, 5. A 55-year-old male with a history of hypertension presents with crushing chest pain that
radiates to his left jaw. The ECG shows ST-segment elevation. Which underlying
pathophysiology is most likely occurring?
A. Stable angina due to gradual vessel narrowing
B. Pericarditis resulting from viral infection
C. STEMI caused by complete occlusion of a coronary artery
D. NSTEMI caused by transient vasospasm
Correct Answer: C
Rationale: An ST-elevation myocardial infarction (STEMI) occurs when a coronary artery
is completely occluded, usually by a thrombus following plaque rupture. This leads to
transmural ischemia and necrosis of the myocardial tissue, which is reflected as ST-
segment elevation on an ECG. Immediate reperfusion therapy is critical to prevent
permanent damage to the heart muscle.
6. Which of the following describes the pathophysiology of Type 1 Diabetes Mellitus?
A. Insulin resistance in peripheral tissues
B. Decreased glucose absorption in the small intestine
C. Excessive secretion of glucagon from alpha cells
D. Absolute insulin deficiency due to autoimmune destruction of beta cells
Correct Answer: D
