NURS 611 Exam 1 V3 | NURS 611
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 1
2026)
1. A clinician is examining a patient with chronic ischemia of the lower extremities. Which
cellular adaptation is most likely to be observed in the affected muscle tissue?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Atrophy is a decrease in cellular size caused by aging, disuse, or reduced blood
supply (ischemia). This adaptive response allows the cell to survive in an environment with
diminished nutrients and oxygen. It contrast with hypertrophy, which is an increase in cell
size often due to increased workload.
2. During a genetic consultation, a patient is diagnosed with an aneuploidy where there are
three copies of chromosome 21. Which condition does this characterize?
A. Turner syndrome
,B. Klinefelter syndrome
C. Edwards syndrome
D. Down syndrome
Correct Answer: D
Rationale: Down syndrome, or Trisomy 21, is the most common form of aneuploidy
resulting from a non-disjunction event during meiosis. It is characterized by intellectual
disability, distinct facial features, and increased risk for congenital heart defects. Turner
syndrome involves a missing X chromosome (45,X), whereas Klinefelter syndrome involves
an extra X chromosome in males (47,XXY).
3. A patient presents with severe dehydration and a serum sodium level of 155 mEq/L. Which
physiological process is primarily responsible for the resulting cellular shrinkage?
A. Osmotic movement of water out of the cells
B. Active transport of sodium into the cells
C. Hydrostatic pressure pushing water into the cells
D. Decreased oncotic pressure in the intravascular space
Correct Answer: A
Rationale: Hypernatremia creates a hypertonic extracellular environment, which draws
water out of the intracellular compartment via osmosis. This results in cellular dehydration
and shrinkage as the system attempts to reach osmotic equilibrium. Active transport moves
, solutes against gradients and is not the primary mechanism of water movement in this
context.
4. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse practitioner interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the pH drop. The bicarbonate level is within the normal range,
suggesting that compensation has not yet occurred or is early in the process. This profile is
consistent with hypoventilation or obstructive lung disease.
5. Which organelle is primarily responsible for the synthesis of adenosine triphosphate (ATP)
through oxidative phosphorylation?
A. Lysosomes
B. Ribosomes
C. Mitochondria
D. Endoplasmic reticulum
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 1
2026)
1. A clinician is examining a patient with chronic ischemia of the lower extremities. Which
cellular adaptation is most likely to be observed in the affected muscle tissue?
A. Hypertrophy
B. Atrophy
C. Hyperplasia
D. Metaplasia
Correct Answer: B
Rationale: Atrophy is a decrease in cellular size caused by aging, disuse, or reduced blood
supply (ischemia). This adaptive response allows the cell to survive in an environment with
diminished nutrients and oxygen. It contrast with hypertrophy, which is an increase in cell
size often due to increased workload.
2. During a genetic consultation, a patient is diagnosed with an aneuploidy where there are
three copies of chromosome 21. Which condition does this characterize?
A. Turner syndrome
,B. Klinefelter syndrome
C. Edwards syndrome
D. Down syndrome
Correct Answer: D
Rationale: Down syndrome, or Trisomy 21, is the most common form of aneuploidy
resulting from a non-disjunction event during meiosis. It is characterized by intellectual
disability, distinct facial features, and increased risk for congenital heart defects. Turner
syndrome involves a missing X chromosome (45,X), whereas Klinefelter syndrome involves
an extra X chromosome in males (47,XXY).
3. A patient presents with severe dehydration and a serum sodium level of 155 mEq/L. Which
physiological process is primarily responsible for the resulting cellular shrinkage?
A. Osmotic movement of water out of the cells
B. Active transport of sodium into the cells
C. Hydrostatic pressure pushing water into the cells
D. Decreased oncotic pressure in the intravascular space
Correct Answer: A
Rationale: Hypernatremia creates a hypertonic extracellular environment, which draws
water out of the intracellular compartment via osmosis. This results in cellular dehydration
and shrinkage as the system attempts to reach osmotic equilibrium. Active transport moves
, solutes against gradients and is not the primary mechanism of water movement in this
context.
4. An arterial blood gas (ABG) report shows pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse practitioner interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the pH drop. The bicarbonate level is within the normal range,
suggesting that compensation has not yet occurred or is early in the process. This profile is
consistent with hypoventilation or obstructive lung disease.
5. Which organelle is primarily responsible for the synthesis of adenosine triphosphate (ATP)
through oxidative phosphorylation?
A. Lysosomes
B. Ribosomes
C. Mitochondria
D. Endoplasmic reticulum
