WALDEN UNIVERSITY MIDTERM EXAM 2024/2025
NURS 6501 ADVANCED PATHOPHYSIOLOGY
A 65-year-old female presents to your office complaining of fatigue. She has a long of
rheumatoid arthritis. A CBC reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87 fL/red
cell, platelet count of 268,000/microliter, and WBC count of 6800/microliter. The serum
haptoglobin level is normal, and the serum iron concentration is 20 micrograms/dL. The total
iron binding capacity is 195 micrograms/dL, and the percent saturation is 10.2. The serum
ferritin concentration is 317 ng/mL. No fibrin split products are detected. The reticulocyte
concentration is 1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia
Anemia of chronic disease
A 14-year-old male presents with high fever for ten days. Physical examination reveals scattered
petechial hemorrhages but is negative for enlargement of the liver or spleen or lymph nodes.
Bone marrow examination does not show any abnormal cells. The complete blood count (CBC)
demonstrates a hemoglobin concentration (HgB) of 13.2 g/dL, hematocrit (Hct) of 38.9%, mean
cell volume (MCV) of 93 fL, platelet count of 175,000/microliter, and white blood cell (WBC)
count of 1850/microliter, with the differential count showing 1 segmented neutrophil, 98
lymphocytes, and 1 monocyte per 100 WBCs. What is the most likely cause of these findings?
A. Overwhelming bacterial infection
B. Acute lymphocytic (or lymphoblastic) leukemia
C. Acute myeloid leukemia
D. Aplastic anemia
Overwhelming bacterial infection
A 31-year-old male has a history of chronic anemia and painful crises with joint and abdominal
pain. A head computed tomography (CT) scan reveals several small remote infarctions. During
one of these acute crises, he is admitted with severe dyspnea. A CBC is performed. Which of the
following morphologic findings for RBCs is most likely to be seen on the peripheral blood
smear?
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,A. Tear drop cells
B. Schistocytes
C. Sickle cells
D. Spherocytes
Sickle cells
A 50-year-old male has a blood pressure of 160/95 mm Hg. If this condition remains untreated
for years, which of the following cardiovascular alterations will be seen on a transthoracic
echocardiogram and ECG?
A. Left Ventricular Hypertrophy
B. Left Ventricular Atrophy
C. Left Atrial Atrophy
D. Right Ventricular Hypertrophy
Left ventricular hypertrophy
A 65-year-old male with longstanding uncontrolled HTN presents to the office for evaluation of
syncope. His vital signs are temperature=98.3, Pulse=85, RR=17, BP=165/85. Physical
examination reveals a fourth heart sound and a 4/6 crescendo-decrescendo murmur heard at the
right upper sternal border with radiation to the carotid arteries. His ECG reveals enlarged QRS
waves, consistent with left ventricular hypertrophy. What is the most likely cause of his syncopal
episodes?
A. Mitral regurgitation
B. Mitral Stenosis
C. Aortic regurgitation
D. Aortic stenosis
Aortic stenosis
A 63-year-old female presents to the emergency room with sudden onset of severe chest and
back pain. She describes the pain as sharp and different from her anginal pain. Her past medical
history is positive for HTN X 20 years. VS: HR 105, BP 160/105, RR 17. On physical
examination, the NP notices that her pedal and radial pulses are not equal. What is the most
likely cause of her chest pain?
A. Unstable angina
B. Aortic dissection
C. Prinzmetal angina
D. Acute myocardial infarction
Aortic dissection
A 45-year-old male collapsed suddenly while playing basketball. Bystander CPR and
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
,defibrillation was performed using an automatic external defibrillator or AED. When EMS
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QUESTIONS WITH DETAILED ANSWERS
, arrived, the gentleman was awake and alert. The recorded rhythm strip on the AED shows
tachycardia with AV dissociation (rate, approximately 220 bpm). Which arrhythmia induced his
arrest?
A. Nonsustained supraventricular tachycardia
B. Sustained wide complex atrial tachycardia
C. Wide complex ventricular tachycardia
D. Narrow complex ventricular tachycardia
Wide complex tachycardia
A 44-year-old previously healthy male presents to the office complaining of increasing dyspnea
on exertion and exercise intolerance over the last six months. The NP order a chest XRAY and
transthoracic echocardiogram. The chest XRAY shows an enlarged heart and mild pulmonary
edema. The echocardiogram reveals four-chamber cardiac dilation with an ejection fraction of
30% and mitral and tricuspid valve regurgitation. The patient is referred to the cardiologist who
orders a CAT scan of the coronary arteries which is negative for obstructive coronary artery
disease. What is the most likely underlying cause of the dyspnea?
A. Idiopathic dilated cardiomyopathy
B. Rheumatic heart disease
C. Hemochromatosis
D. Chagas disease
Idiopathic dilated cardiomyopathy
A 72-year-old female with a known cardiac history of coronary artery disease presents to the
emergency room following a syncopal episode. She received a stent to the right coronary artery
in 2017 and was noted to have an ejection fraction of 40% at that time. A 12 lead ECG reveals a
regular rhythm with a rate of 35. What is the most likely cause of her bradycardia?
A. Blocked pathway at or below the AV node
B. Blocked pathway at or below the SA node
C. Reentry pathway at or near the SA node
D. Reentry pathway at or near the AV node
Blocked pathway at or below the AV node
A 43-year-old female is ten years post prosthetic aortic valve replacement secondary to infective
endocarditis. Which of the following valvular conditions would be an expected finding?
A. Paravalvular leak
B. Aortic stenosis
C. Aortic valve embolization
D. Aortic regurgitation
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
NURS 6501 ADVANCED PATHOPHYSIOLOGY
A 65-year-old female presents to your office complaining of fatigue. She has a long of
rheumatoid arthritis. A CBC reveals the following: Hgb=11.6 g/dL, Hct=34.8%, MCV=87 fL/red
cell, platelet count of 268,000/microliter, and WBC count of 6800/microliter. The serum
haptoglobin level is normal, and the serum iron concentration is 20 micrograms/dL. The total
iron binding capacity is 195 micrograms/dL, and the percent saturation is 10.2. The serum
ferritin concentration is 317 ng/mL. No fibrin split products are detected. The reticulocyte
concentration is 1.1%. What is the most likely diagnosis?
A. Beta- thalassemia major
B. Anemia of chronic disease
C. Acute blood loss anemia
D. Iron deficiency anemia
Anemia of chronic disease
A 14-year-old male presents with high fever for ten days. Physical examination reveals scattered
petechial hemorrhages but is negative for enlargement of the liver or spleen or lymph nodes.
Bone marrow examination does not show any abnormal cells. The complete blood count (CBC)
demonstrates a hemoglobin concentration (HgB) of 13.2 g/dL, hematocrit (Hct) of 38.9%, mean
cell volume (MCV) of 93 fL, platelet count of 175,000/microliter, and white blood cell (WBC)
count of 1850/microliter, with the differential count showing 1 segmented neutrophil, 98
lymphocytes, and 1 monocyte per 100 WBCs. What is the most likely cause of these findings?
A. Overwhelming bacterial infection
B. Acute lymphocytic (or lymphoblastic) leukemia
C. Acute myeloid leukemia
D. Aplastic anemia
Overwhelming bacterial infection
A 31-year-old male has a history of chronic anemia and painful crises with joint and abdominal
pain. A head computed tomography (CT) scan reveals several small remote infarctions. During
one of these acute crises, he is admitted with severe dyspnea. A CBC is performed. Which of the
following morphologic findings for RBCs is most likely to be seen on the peripheral blood
smear?
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
,A. Tear drop cells
B. Schistocytes
C. Sickle cells
D. Spherocytes
Sickle cells
A 50-year-old male has a blood pressure of 160/95 mm Hg. If this condition remains untreated
for years, which of the following cardiovascular alterations will be seen on a transthoracic
echocardiogram and ECG?
A. Left Ventricular Hypertrophy
B. Left Ventricular Atrophy
C. Left Atrial Atrophy
D. Right Ventricular Hypertrophy
Left ventricular hypertrophy
A 65-year-old male with longstanding uncontrolled HTN presents to the office for evaluation of
syncope. His vital signs are temperature=98.3, Pulse=85, RR=17, BP=165/85. Physical
examination reveals a fourth heart sound and a 4/6 crescendo-decrescendo murmur heard at the
right upper sternal border with radiation to the carotid arteries. His ECG reveals enlarged QRS
waves, consistent with left ventricular hypertrophy. What is the most likely cause of his syncopal
episodes?
A. Mitral regurgitation
B. Mitral Stenosis
C. Aortic regurgitation
D. Aortic stenosis
Aortic stenosis
A 63-year-old female presents to the emergency room with sudden onset of severe chest and
back pain. She describes the pain as sharp and different from her anginal pain. Her past medical
history is positive for HTN X 20 years. VS: HR 105, BP 160/105, RR 17. On physical
examination, the NP notices that her pedal and radial pulses are not equal. What is the most
likely cause of her chest pain?
A. Unstable angina
B. Aortic dissection
C. Prinzmetal angina
D. Acute myocardial infarction
Aortic dissection
A 45-year-old male collapsed suddenly while playing basketball. Bystander CPR and
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
,defibrillation was performed using an automatic external defibrillator or AED. When EMS
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
, arrived, the gentleman was awake and alert. The recorded rhythm strip on the AED shows
tachycardia with AV dissociation (rate, approximately 220 bpm). Which arrhythmia induced his
arrest?
A. Nonsustained supraventricular tachycardia
B. Sustained wide complex atrial tachycardia
C. Wide complex ventricular tachycardia
D. Narrow complex ventricular tachycardia
Wide complex tachycardia
A 44-year-old previously healthy male presents to the office complaining of increasing dyspnea
on exertion and exercise intolerance over the last six months. The NP order a chest XRAY and
transthoracic echocardiogram. The chest XRAY shows an enlarged heart and mild pulmonary
edema. The echocardiogram reveals four-chamber cardiac dilation with an ejection fraction of
30% and mitral and tricuspid valve regurgitation. The patient is referred to the cardiologist who
orders a CAT scan of the coronary arteries which is negative for obstructive coronary artery
disease. What is the most likely underlying cause of the dyspnea?
A. Idiopathic dilated cardiomyopathy
B. Rheumatic heart disease
C. Hemochromatosis
D. Chagas disease
Idiopathic dilated cardiomyopathy
A 72-year-old female with a known cardiac history of coronary artery disease presents to the
emergency room following a syncopal episode. She received a stent to the right coronary artery
in 2017 and was noted to have an ejection fraction of 40% at that time. A 12 lead ECG reveals a
regular rhythm with a rate of 35. What is the most likely cause of her bradycardia?
A. Blocked pathway at or below the AV node
B. Blocked pathway at or below the SA node
C. Reentry pathway at or near the SA node
D. Reentry pathway at or near the AV node
Blocked pathway at or below the AV node
A 43-year-old female is ten years post prosthetic aortic valve replacement secondary to infective
endocarditis. Which of the following valvular conditions would be an expected finding?
A. Paravalvular leak
B. Aortic stenosis
C. Aortic valve embolization
D. Aortic regurgitation
ACTUAL EXAM AND PRACTICE EXAM TEST BANK | ACCURATE AND VERIFIED
QUESTIONS WITH DETAILED ANSWERS
