NUR 2063 Exam 4: Essentials of Pathophysiology -
Rasmussen University Updated and Latest Questions and
Correct Answers with Rationale
1. A patient with Parkinson’s disease presents with tremors and bradykinesia. What is the primary
underlying pathophysiology?
A. Autoimmune destruction of the myelin sheath in the CNS
B. Degeneration of dopamine-producing neurons in the substantia nigra
C. Excessive production of acetylcholine at the neuromuscular junction
D. Loss of motor neurons in the anterior horn of the spinal cord
Correct Answer: B
Rationale: Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the
substantia nigra. The lack of dopamine leads to an imbalance between excitatory and inhibitory
neurotransmitters in the basal ganglia. Common clinical manifestations include resting tremors,
bradykinesia, and postural instability. Patients often exhibit a characteristic shuffling gait and a mask-like
facial expression. Current therapies aim to restore dopamine levels or block the effects of acetylcholine.
2. Which clinical manifestation should a nurse expect in a patient experiencing a sickle cell crisis?
A. Severe pain due to tissue ischemia
B. Increased blood viscosity and hypertension
C. Excessive bleeding from mucosal membranes
D. Bradycardia and decreased respiratory rate
Correct Answer: A
,Rationale: Sickle cell anemia involves the formation of abnormal hemoglobin S which distorts red blood
cells under stress. Dehydration and hypoxia are major triggers for a sickling crisis in these patients. The
sickled cells obstruct small blood vessels, leading to severe pain and potential organ damage. This
condition is inherited in an autosomal recessive pattern. Management includes oxygenation, hydration,
and aggressive pain control to mitigate the crisis.
3. A patient is diagnosed with osteoarthritis. What is the hallmark pathophysiological change in this
condition?
A. Systemic inflammation of the synovial membranes
B. Deposition of uric acid crystals in the joint space
C. Progressive loss of articular cartilage
D. Infection of the bone by Staphylococcus aureus
Correct Answer: C
Rationale: Osteoarthritis is primarily a degenerative joint disease characterized by the breakdown of
articular cartilage. It is often referred to as wear-and-tear arthritis because it usually affects weight-
bearing joints over time. Unlike rheumatoid arthritis, it is not a systemic autoimmune inflammatory
condition. Patients typically report pain that worsens with activity and improves with rest. Heberden and
Bouchard nodes are common physical findings in the hands of affected individuals.
4. Which of the following signs constitutes Cushing’s triad, indicating increased intracranial pressure?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and kussmaul respirations
, Correct Answer: C
Rationale: Cushing’s triad is a significant clinical indicator of increased intracranial pressure that
requires immediate intervention. It consists of three primary signs: bradycardia, irregular respirations,
and a widening pulse pressure. This physiological response occurs as the brain attempts to maintain
cerebral perfusion in the face of rising pressure. Recognizing these signs early is crucial for preventing
permanent neurological damage or brain herniation. Treatment focuses on reducing intracranial
pressure and addressing the underlying cause.
5. A patient’s lab results show a high Mean Corpuscular Volume (MCV) and a low hemoglobin. Which type
of anemia is most likely?
A. Iron deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B
Rationale: A high MCV indicates macrocytic anemia, which is commonly seen in Vitamin B12 or folate
deficiencies. Pernicious anemia is a specific type of macrocytic anemia caused by a lack of intrinsic factor.
Intrinsic factor is necessary for the absorption of Vitamin B12 in the terminal ileum. Patients may present
with neurological symptoms such as paresthesia and ataxia due to myelin damage. Treatment involves
lifelong administration of Vitamin B12, usually via intramuscular injection.
6. Which of the following is the primary cause of gouty arthritis?
A. Chronic vitamin D deficiency
B. Repetitive trauma to the joint
Rasmussen University Updated and Latest Questions and
Correct Answers with Rationale
1. A patient with Parkinson’s disease presents with tremors and bradykinesia. What is the primary
underlying pathophysiology?
A. Autoimmune destruction of the myelin sheath in the CNS
B. Degeneration of dopamine-producing neurons in the substantia nigra
C. Excessive production of acetylcholine at the neuromuscular junction
D. Loss of motor neurons in the anterior horn of the spinal cord
Correct Answer: B
Rationale: Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the
substantia nigra. The lack of dopamine leads to an imbalance between excitatory and inhibitory
neurotransmitters in the basal ganglia. Common clinical manifestations include resting tremors,
bradykinesia, and postural instability. Patients often exhibit a characteristic shuffling gait and a mask-like
facial expression. Current therapies aim to restore dopamine levels or block the effects of acetylcholine.
2. Which clinical manifestation should a nurse expect in a patient experiencing a sickle cell crisis?
A. Severe pain due to tissue ischemia
B. Increased blood viscosity and hypertension
C. Excessive bleeding from mucosal membranes
D. Bradycardia and decreased respiratory rate
Correct Answer: A
,Rationale: Sickle cell anemia involves the formation of abnormal hemoglobin S which distorts red blood
cells under stress. Dehydration and hypoxia are major triggers for a sickling crisis in these patients. The
sickled cells obstruct small blood vessels, leading to severe pain and potential organ damage. This
condition is inherited in an autosomal recessive pattern. Management includes oxygenation, hydration,
and aggressive pain control to mitigate the crisis.
3. A patient is diagnosed with osteoarthritis. What is the hallmark pathophysiological change in this
condition?
A. Systemic inflammation of the synovial membranes
B. Deposition of uric acid crystals in the joint space
C. Progressive loss of articular cartilage
D. Infection of the bone by Staphylococcus aureus
Correct Answer: C
Rationale: Osteoarthritis is primarily a degenerative joint disease characterized by the breakdown of
articular cartilage. It is often referred to as wear-and-tear arthritis because it usually affects weight-
bearing joints over time. Unlike rheumatoid arthritis, it is not a systemic autoimmune inflammatory
condition. Patients typically report pain that worsens with activity and improves with rest. Heberden and
Bouchard nodes are common physical findings in the hands of affected individuals.
4. Which of the following signs constitutes Cushing’s triad, indicating increased intracranial pressure?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and kussmaul respirations
, Correct Answer: C
Rationale: Cushing’s triad is a significant clinical indicator of increased intracranial pressure that
requires immediate intervention. It consists of three primary signs: bradycardia, irregular respirations,
and a widening pulse pressure. This physiological response occurs as the brain attempts to maintain
cerebral perfusion in the face of rising pressure. Recognizing these signs early is crucial for preventing
permanent neurological damage or brain herniation. Treatment focuses on reducing intracranial
pressure and addressing the underlying cause.
5. A patient’s lab results show a high Mean Corpuscular Volume (MCV) and a low hemoglobin. Which type
of anemia is most likely?
A. Iron deficiency anemia
B. Pernicious anemia
C. Aplastic anemia
D. Hemolytic anemia
Correct Answer: B
Rationale: A high MCV indicates macrocytic anemia, which is commonly seen in Vitamin B12 or folate
deficiencies. Pernicious anemia is a specific type of macrocytic anemia caused by a lack of intrinsic factor.
Intrinsic factor is necessary for the absorption of Vitamin B12 in the terminal ileum. Patients may present
with neurological symptoms such as paresthesia and ataxia due to myelin damage. Treatment involves
lifelong administration of Vitamin B12, usually via intramuscular injection.
6. Which of the following is the primary cause of gouty arthritis?
A. Chronic vitamin D deficiency
B. Repetitive trauma to the joint
