NSG 5140 ADVANCED PATHOPHYSIOLOGY
FINAL EXAM EXAM QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. Which pathophysiologic mechanism underlies acute respiratory distress
syndrome (ARDS)?
A. Bronchoconstriction
B. Diffuse alveolar damage → increased permeability → pulmonary edema
C. Pulmonary embolism
D. Pneumothorax
Answer: B
Rationale: ARDS is caused by inflammatory injury to alveoli → non-cardiogenic
pulmonary edema → hypoxemia.
2. Which type of shock is characterized by low SVR and warm extremities?
A. Hypovolemic
B. Cardiogenic
C. Obstructive
D. Distributive (septic/anaphylactic)
Answer: D
Rationale: Vasodilation → hypotension, warm peripheries.
3. Which electrolyte abnormality occurs in tumor lysis syndrome?
A. Hyponatremia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia
C. Hypercalcemia only
D. Hypokalemia
,Answer: B
Rationale: Massive cell lysis → release of intracellular K⁺, phosphate, nucleic
acids → uric acid ↑, Ca²⁺ ↓.
4. Which hormone deficiency causes diabetes insipidus?
A. Aldosterone
B. Cortisol
C. ADH (vasopressin)
D. Insulin
Answer: C
Rationale: ADH deficiency → inability to concentrate urine → polyuria,
hypernatremia.
5. Which lab marker is most specific for liver injury?
A. ALP
B. Bilirubin
C. ALT
D. Albumin
Answer: C
Rationale: ALT is liver-specific, released during hepatocyte injury.
6. Which electrolyte abnormality can cause cardiac arrhythmias and peaked
T-waves on ECG?
A. Hypokalemia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: C
Rationale: ↑ K⁺ alters cardiac action potentials → arrhythmias.
,7. Which acid-base disorder occurs in prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Loss of H⁺ from stomach → ↑ serum HCO₃⁻ → alkalosis.
8. Which type of necrosis is typical in tuberculosis?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: C
Rationale: Granulomatous inflammation → cheesy, caseous necrosis.
9. Which lab value is most sensitive for early kidney injury?
A. BUN
B. Creatinine
C. LDH
D. Urine sodium
Answer: B
Rationale: Creatinine rises early when GFR declines.
10. Which pathophysiologic mechanism causes edema in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Hypoalbuminemia → ↓ oncotic pressure
C. Lymphatic obstruction
D. Hypernatremia
, Answer: B
Rationale: Protein loss → low plasma oncotic pressure → fluid shifts into
interstitium.
11. Which compensatory mechanism occurs in chronic respiratory acidosis?
A. Hypoventilation
B. Renal HCO₃⁻ retention
C. CO₂ retention
D. Decreased renal H⁺ excretion
Answer: B
Rationale: Kidneys retain bicarbonate to partially correct chronic hypercapnia.
12. Which electrolyte imbalance is characteristic of primary
hyperaldosteronism?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: Aldosterone → Na⁺ retention, K⁺ excretion → hypokalemia.
13. Which hormone excess causes Cushing’s syndrome?
A. Aldosterone
B. Cortisol
C. T3/T4
D. Growth hormone
Answer: B
Rationale: Cortisol excess → hyperglycemia, central obesity, muscle wasting.
FINAL EXAM EXAM QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. Which pathophysiologic mechanism underlies acute respiratory distress
syndrome (ARDS)?
A. Bronchoconstriction
B. Diffuse alveolar damage → increased permeability → pulmonary edema
C. Pulmonary embolism
D. Pneumothorax
Answer: B
Rationale: ARDS is caused by inflammatory injury to alveoli → non-cardiogenic
pulmonary edema → hypoxemia.
2. Which type of shock is characterized by low SVR and warm extremities?
A. Hypovolemic
B. Cardiogenic
C. Obstructive
D. Distributive (septic/anaphylactic)
Answer: D
Rationale: Vasodilation → hypotension, warm peripheries.
3. Which electrolyte abnormality occurs in tumor lysis syndrome?
A. Hyponatremia
B. Hyperkalemia, hyperphosphatemia, hyperuricemia, hypocalcemia
C. Hypercalcemia only
D. Hypokalemia
,Answer: B
Rationale: Massive cell lysis → release of intracellular K⁺, phosphate, nucleic
acids → uric acid ↑, Ca²⁺ ↓.
4. Which hormone deficiency causes diabetes insipidus?
A. Aldosterone
B. Cortisol
C. ADH (vasopressin)
D. Insulin
Answer: C
Rationale: ADH deficiency → inability to concentrate urine → polyuria,
hypernatremia.
5. Which lab marker is most specific for liver injury?
A. ALP
B. Bilirubin
C. ALT
D. Albumin
Answer: C
Rationale: ALT is liver-specific, released during hepatocyte injury.
6. Which electrolyte abnormality can cause cardiac arrhythmias and peaked
T-waves on ECG?
A. Hypokalemia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: C
Rationale: ↑ K⁺ alters cardiac action potentials → arrhythmias.
,7. Which acid-base disorder occurs in prolonged vomiting?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Loss of H⁺ from stomach → ↑ serum HCO₃⁻ → alkalosis.
8. Which type of necrosis is typical in tuberculosis?
A. Coagulative
B. Liquefactive
C. Caseous
D. Fat
Answer: C
Rationale: Granulomatous inflammation → cheesy, caseous necrosis.
9. Which lab value is most sensitive for early kidney injury?
A. BUN
B. Creatinine
C. LDH
D. Urine sodium
Answer: B
Rationale: Creatinine rises early when GFR declines.
10. Which pathophysiologic mechanism causes edema in nephrotic syndrome?
A. Increased hydrostatic pressure
B. Hypoalbuminemia → ↓ oncotic pressure
C. Lymphatic obstruction
D. Hypernatremia
, Answer: B
Rationale: Protein loss → low plasma oncotic pressure → fluid shifts into
interstitium.
11. Which compensatory mechanism occurs in chronic respiratory acidosis?
A. Hypoventilation
B. Renal HCO₃⁻ retention
C. CO₂ retention
D. Decreased renal H⁺ excretion
Answer: B
Rationale: Kidneys retain bicarbonate to partially correct chronic hypercapnia.
12. Which electrolyte imbalance is characteristic of primary
hyperaldosteronism?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: Aldosterone → Na⁺ retention, K⁺ excretion → hypokalemia.
13. Which hormone excess causes Cushing’s syndrome?
A. Aldosterone
B. Cortisol
C. T3/T4
D. Growth hormone
Answer: B
Rationale: Cortisol excess → hyperglycemia, central obesity, muscle wasting.
