NR 507 Week 8 Final
Exams NR-507 Adv
Pathophysiology Actual
Week 8 Final Exam
1. Question
Which of the following best explains the role of the renin-angiotensin-aldosterone
system (RAAS) in blood pressure regulation?
A. It decreases sodium reabsorption in the kidneys.
B. It promotes vasodilation and fluid loss.
C. It increases blood volume and vasoconstriction.
D. It reduces cardiac output and systemic vascular resistance.
Answer: ✅ C. It increases blood volume and vasoconstriction.
Rationale:
Renin converts angiotensinogen to angiotensin I, then ACE converts it to angiotensin
II, which causes vasoconstriction and stimulates aldosterone release, increasing
sodium and water retention — thereby raising BP.
2. Question
A 60-year-old male presents with dyspnea and fatigue. Echocardiogram shows a
decreased ejection fraction and left ventricular hypertrophy. Which of the following
pathophysiologic changes occurs in heart failure?
,A. Increased cardiac contractility
B. Decreased preload
C. Activation of the sympathetic nervous system and RAAS
D. Decreased afterload
Answer: ✅ C. Activation of the sympathetic nervous system and RAAS.
Rationale:
Compensatory mechanisms in heart failure involve SNS activation (↑ HR,
contractility) and RAAS activation to maintain perfusion — both initially helpful but
ultimately increase workload and worsen heart failure.
3. Question
A patient with type 2 diabetes mellitus develops nephropathy. Which mechanism
contributes to kidney damage in this condition?
A. Decreased glomerular filtration pressure
B. Glomerular basement membrane thickening due to hyperglycemia
C. Decreased renal perfusion secondary to vasodilation
D. Increased secretion of erythropoietin
Answer: ✅ B. Glomerular basement membrane thickening due to hyperglycemia.
Rationale:
Chronic hyperglycemia causes glycosylation of proteins and thickening of the
glomerular basement membrane, leading to increased permeability and eventual
nephropathy.
4. Question
Which immune response is primarily responsible for type I hypersensitivity reactions
such as anaphylaxis?
A. T-cell–mediated cytotoxicity
B. IgG immune complex deposition
,C. IgE-mediated mast cell degranulation
D. Complement activation
Answer: ✅ C. IgE-mediated mast cell degranulation.
Rationale:
Type I hypersensitivity involves allergen-induced IgE binding to mast cells, triggering
histamine release and systemic vasodilation or bronchoconstriction (as in
anaphylaxis).
5. Question
A 35-year-old woman presents with butterfly rash, joint pain, and fatigue. Which
laboratory finding supports a diagnosis of systemic lupus erythematosus (SLE)?
A. Elevated TSH
B. Presence of anti-DNA and ANA antibodies
C. Decreased ESR
D. Low CRP levels
Answer: ✅ B. Presence of anti-DNA and ANA antibodies.
Rationale:
SLE is an autoimmune disease characterized by autoantibody production against
nuclear components (ANA, anti-dsDNA) leading to immune complex deposition and
inflammation.
6. Question
Which cellular adaptation is most likely seen in the cardiac muscle of a hypertensive
patient?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
, Answer: ✅ B. Hypertrophy.
Rationale:
In response to increased afterload from chronic hypertension, myocardial cells
enlarge (hypertrophy) to increase contractile strength.
7. Question
Which of the following best describes the mechanism of insulin resistance in type 2
diabetes?
A. Beta-cell destruction by autoantibodies
B. Decreased number and sensitivity of insulin receptors
C. Excessive insulin release from the pancreas
D. Glucagon receptor mutation
Answer: ✅ B. Decreased number and sensitivity of insulin receptors.
Rationale:
Type 2 diabetes involves peripheral insulin resistance due to down-regulation or
dysfunction of insulin receptors, resulting in impaired glucose uptake.
8. Question
A 55-year-old man has chronic obstructive pulmonary disease (COPD). Which acid-
base imbalance is most consistent with this condition?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: ✅ B. Respiratory acidosis.
Rationale:
Exams NR-507 Adv
Pathophysiology Actual
Week 8 Final Exam
1. Question
Which of the following best explains the role of the renin-angiotensin-aldosterone
system (RAAS) in blood pressure regulation?
A. It decreases sodium reabsorption in the kidneys.
B. It promotes vasodilation and fluid loss.
C. It increases blood volume and vasoconstriction.
D. It reduces cardiac output and systemic vascular resistance.
Answer: ✅ C. It increases blood volume and vasoconstriction.
Rationale:
Renin converts angiotensinogen to angiotensin I, then ACE converts it to angiotensin
II, which causes vasoconstriction and stimulates aldosterone release, increasing
sodium and water retention — thereby raising BP.
2. Question
A 60-year-old male presents with dyspnea and fatigue. Echocardiogram shows a
decreased ejection fraction and left ventricular hypertrophy. Which of the following
pathophysiologic changes occurs in heart failure?
,A. Increased cardiac contractility
B. Decreased preload
C. Activation of the sympathetic nervous system and RAAS
D. Decreased afterload
Answer: ✅ C. Activation of the sympathetic nervous system and RAAS.
Rationale:
Compensatory mechanisms in heart failure involve SNS activation (↑ HR,
contractility) and RAAS activation to maintain perfusion — both initially helpful but
ultimately increase workload and worsen heart failure.
3. Question
A patient with type 2 diabetes mellitus develops nephropathy. Which mechanism
contributes to kidney damage in this condition?
A. Decreased glomerular filtration pressure
B. Glomerular basement membrane thickening due to hyperglycemia
C. Decreased renal perfusion secondary to vasodilation
D. Increased secretion of erythropoietin
Answer: ✅ B. Glomerular basement membrane thickening due to hyperglycemia.
Rationale:
Chronic hyperglycemia causes glycosylation of proteins and thickening of the
glomerular basement membrane, leading to increased permeability and eventual
nephropathy.
4. Question
Which immune response is primarily responsible for type I hypersensitivity reactions
such as anaphylaxis?
A. T-cell–mediated cytotoxicity
B. IgG immune complex deposition
,C. IgE-mediated mast cell degranulation
D. Complement activation
Answer: ✅ C. IgE-mediated mast cell degranulation.
Rationale:
Type I hypersensitivity involves allergen-induced IgE binding to mast cells, triggering
histamine release and systemic vasodilation or bronchoconstriction (as in
anaphylaxis).
5. Question
A 35-year-old woman presents with butterfly rash, joint pain, and fatigue. Which
laboratory finding supports a diagnosis of systemic lupus erythematosus (SLE)?
A. Elevated TSH
B. Presence of anti-DNA and ANA antibodies
C. Decreased ESR
D. Low CRP levels
Answer: ✅ B. Presence of anti-DNA and ANA antibodies.
Rationale:
SLE is an autoimmune disease characterized by autoantibody production against
nuclear components (ANA, anti-dsDNA) leading to immune complex deposition and
inflammation.
6. Question
Which cellular adaptation is most likely seen in the cardiac muscle of a hypertensive
patient?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
, Answer: ✅ B. Hypertrophy.
Rationale:
In response to increased afterload from chronic hypertension, myocardial cells
enlarge (hypertrophy) to increase contractile strength.
7. Question
Which of the following best describes the mechanism of insulin resistance in type 2
diabetes?
A. Beta-cell destruction by autoantibodies
B. Decreased number and sensitivity of insulin receptors
C. Excessive insulin release from the pancreas
D. Glucagon receptor mutation
Answer: ✅ B. Decreased number and sensitivity of insulin receptors.
Rationale:
Type 2 diabetes involves peripheral insulin resistance due to down-regulation or
dysfunction of insulin receptors, resulting in impaired glucose uptake.
8. Question
A 55-year-old man has chronic obstructive pulmonary disease (COPD). Which acid-
base imbalance is most consistent with this condition?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: ✅ B. Respiratory acidosis.
Rationale:
