NURS 370 | PATH370 Exam 4: Pathophysiology -
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. Which of the following is a classic clinical manifestation of Cushing’s Triad, indicating
increased intracranial pressure (ICP)?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Tachycardia, hypertension, and Cheyne-Stokes respirations
D. Bradycardia, hypotension, and apnea
Correct Answer: A
Rationale: Cushing’s Triad is a late sign of increased intracranial pressure and impending
brain herniation. It is characterized by a rise in systolic blood pressure with a widening
pulse pressure to maintain cerebral perfusion. Reflexive bradycardia occurs in response to
the high blood pressure detected by baroreceptors. Irregular respirations, such as Cheyne-
Stokes, indicate pressure on the brainstem. Identifying these signs is critical for emergency
neurological intervention.
2. A patient with Rheumatoid Arthritis (RA) asks why their joints are swollen and painful.
Which pathophysiological process should the nurse explain?
A. Wear and tear leading to the loss of articular cartilage
B. Excessive production of synovial fluid due to a viral infection
C. Accumulation of uric acid crystals in the joint space
D. Systemic autoimmune inflammation of the synovial membrane
Correct Answer: D
Rationale: Rheumatoid Arthritis is a systemic autoimmune disease where the immune
system attacks the synovium of the joints. This process leads to the formation of pannus,
which is highly vascularized granulation tissue. Unlike osteoarthritis, RA involves chronic
inflammation that can lead to joint destruction and deformity. The inflammatory cytokines
released during this process cause the characteristic swelling and pain. Early intervention
aims to suppress this immune response to preserve joint function.
3. Which type of anemia is characterized by a lack of intrinsic factor, leading to Vitamin B12
malabsorption?
A. Iron Deficiency Anemia
B. Pernicious Anemia
,C. Aplastic Anemia
D. Sickle Cell Anemia
Correct Answer: B
Rationale: Pernicious anemia is a megaloblastic anemia caused by the loss of gastric
parietal cells. These cells are responsible for secreting intrinsic factor, which is essential for
B12 absorption in the ileum. Without B12, DNA synthesis in red blood cells is impaired,
resulting in large, immature erythrocytes. Clinical manifestations often include
neurological symptoms like paresthesia due to demyelination. Treatment typically requires
lifelong Vitamin B12 injections to bypass the digestive tract.
4. A patient presents with ‘the worst headache of my life’ and neck stiffness. Which condition
is most likely?
A. Ischemic Stroke
B. Epidural Hematoma
C. Transient Ischemic Attack
D. Subarachnoid Hemorrhage
Correct Answer: D
Rationale: A subarachnoid hemorrhage is often described by patients as a sudden,
thunderclap headache. This condition usually results from a ruptured cerebral aneurysm,
spilling blood into the subarachnoid space. The presence of blood causes meningeal
irritation, leading to nuchal rigidity or neck stiffness. Rapid diagnosis via CT scan is
essential to prevent re-bleeding or vasospasm. This represents a medical emergency with
high mortality if not treated promptly.
5. What is the primary pathophysiology behind Parkinson’s Disease?
A. Degeneration of the myelin sheath in the CNS
B. Loss of acetylcholine receptors at the neuromuscular junction
C. Excessive accumulation of amyloid-beta plaques in the hippocampus
D. Degeneration of dopamine-producing neurons in the substantia nigra
Correct Answer: D
Rationale: Parkinson’s Disease involves the progressive loss of dopaminergic neurons in
the basal ganglia. Dopamine is a neurotransmitter that inhibits excessive muscle movement
and coordinates motor control. When dopamine levels drop, the balance between
dopamine and acetylcholine is disrupted, leading to tremors. Symptoms include
bradykinesia, resting tremors, and muscle rigidity. Pharmacological treatments usually
focus on replenishing dopamine levels or mimicking its action.
, 6. Which laboratory finding is most indicative of Disseminated Intravascular Coagulation
(DIC)?
A. Elevated platelet count
B. Increased hemoglobin and hematocrit
C. Decreased Prothrombin Time (PT)
D. Elevated D-dimer and decreased fibrinogen
Correct Answer: D
Rationale: DIC is a complex disorder where systemic activation of coagulation results in
widespread clot formation. This consumes clotting factors and platelets, eventually leading
to severe bleeding. An elevated D-dimer indicates that significant fibrinolysis (clot
breakdown) is occurring. Decreased fibrinogen levels occur because the body’s supply is
exhausted during the initial clotting phase. DIC is always secondary to another condition,
such as sepsis or trauma.
7. Which of the following best describes the pathogenesis of Osteoarthritis (OA)?
A. Autoimmune destruction of the bone marrow
B. Infection of the bone by Staphylococcus aureus
C. Metabolic bone disease causing decreased bone density
D. Progressive loss of articular cartilage and formation of osteophytes
Correct Answer: D
Rationale: Osteoarthritis is a degenerative joint disease characterized by the mechanical
breakdown of cartilage. As the protective cartilage wears away, bone-on-bone friction
occurs, causing pain and inflammation. The body attempts to repair the damage, resulting
in the formation of bone spurs called osteophytes. OA typically affects weight-bearing
joints like the knees and hips or frequently used joints in the hands. Unlike RA, it is
generally considered a non-inflammatory, ‘wear-and-tear’ condition.
8. In Sickle Cell Anemia, what is the primary cause of a ‘Vaso-occlusive Crisis’?
A. Sickled RBCs obstructing blood flow in small capillaries
B. Lack of iron leading to microcytic cells
C. Autoimmune destruction of red blood cells in the spleen
D. Excessive production of white blood cells crowding the circulation
Correct Answer: A
Rationale: Sickle cell anemia involves a genetic mutation that causes hemoglobin to
polymerize under low oxygen conditions. This causes red blood cells to take on a rigid,
sickle shape. These misshapen cells become trapped in small vessels, blocking distal blood
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. Which of the following is a classic clinical manifestation of Cushing’s Triad, indicating
increased intracranial pressure (ICP)?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Tachycardia, hypertension, and Cheyne-Stokes respirations
D. Bradycardia, hypotension, and apnea
Correct Answer: A
Rationale: Cushing’s Triad is a late sign of increased intracranial pressure and impending
brain herniation. It is characterized by a rise in systolic blood pressure with a widening
pulse pressure to maintain cerebral perfusion. Reflexive bradycardia occurs in response to
the high blood pressure detected by baroreceptors. Irregular respirations, such as Cheyne-
Stokes, indicate pressure on the brainstem. Identifying these signs is critical for emergency
neurological intervention.
2. A patient with Rheumatoid Arthritis (RA) asks why their joints are swollen and painful.
Which pathophysiological process should the nurse explain?
A. Wear and tear leading to the loss of articular cartilage
B. Excessive production of synovial fluid due to a viral infection
C. Accumulation of uric acid crystals in the joint space
D. Systemic autoimmune inflammation of the synovial membrane
Correct Answer: D
Rationale: Rheumatoid Arthritis is a systemic autoimmune disease where the immune
system attacks the synovium of the joints. This process leads to the formation of pannus,
which is highly vascularized granulation tissue. Unlike osteoarthritis, RA involves chronic
inflammation that can lead to joint destruction and deformity. The inflammatory cytokines
released during this process cause the characteristic swelling and pain. Early intervention
aims to suppress this immune response to preserve joint function.
3. Which type of anemia is characterized by a lack of intrinsic factor, leading to Vitamin B12
malabsorption?
A. Iron Deficiency Anemia
B. Pernicious Anemia
,C. Aplastic Anemia
D. Sickle Cell Anemia
Correct Answer: B
Rationale: Pernicious anemia is a megaloblastic anemia caused by the loss of gastric
parietal cells. These cells are responsible for secreting intrinsic factor, which is essential for
B12 absorption in the ileum. Without B12, DNA synthesis in red blood cells is impaired,
resulting in large, immature erythrocytes. Clinical manifestations often include
neurological symptoms like paresthesia due to demyelination. Treatment typically requires
lifelong Vitamin B12 injections to bypass the digestive tract.
4. A patient presents with ‘the worst headache of my life’ and neck stiffness. Which condition
is most likely?
A. Ischemic Stroke
B. Epidural Hematoma
C. Transient Ischemic Attack
D. Subarachnoid Hemorrhage
Correct Answer: D
Rationale: A subarachnoid hemorrhage is often described by patients as a sudden,
thunderclap headache. This condition usually results from a ruptured cerebral aneurysm,
spilling blood into the subarachnoid space. The presence of blood causes meningeal
irritation, leading to nuchal rigidity or neck stiffness. Rapid diagnosis via CT scan is
essential to prevent re-bleeding or vasospasm. This represents a medical emergency with
high mortality if not treated promptly.
5. What is the primary pathophysiology behind Parkinson’s Disease?
A. Degeneration of the myelin sheath in the CNS
B. Loss of acetylcholine receptors at the neuromuscular junction
C. Excessive accumulation of amyloid-beta plaques in the hippocampus
D. Degeneration of dopamine-producing neurons in the substantia nigra
Correct Answer: D
Rationale: Parkinson’s Disease involves the progressive loss of dopaminergic neurons in
the basal ganglia. Dopamine is a neurotransmitter that inhibits excessive muscle movement
and coordinates motor control. When dopamine levels drop, the balance between
dopamine and acetylcholine is disrupted, leading to tremors. Symptoms include
bradykinesia, resting tremors, and muscle rigidity. Pharmacological treatments usually
focus on replenishing dopamine levels or mimicking its action.
, 6. Which laboratory finding is most indicative of Disseminated Intravascular Coagulation
(DIC)?
A. Elevated platelet count
B. Increased hemoglobin and hematocrit
C. Decreased Prothrombin Time (PT)
D. Elevated D-dimer and decreased fibrinogen
Correct Answer: D
Rationale: DIC is a complex disorder where systemic activation of coagulation results in
widespread clot formation. This consumes clotting factors and platelets, eventually leading
to severe bleeding. An elevated D-dimer indicates that significant fibrinolysis (clot
breakdown) is occurring. Decreased fibrinogen levels occur because the body’s supply is
exhausted during the initial clotting phase. DIC is always secondary to another condition,
such as sepsis or trauma.
7. Which of the following best describes the pathogenesis of Osteoarthritis (OA)?
A. Autoimmune destruction of the bone marrow
B. Infection of the bone by Staphylococcus aureus
C. Metabolic bone disease causing decreased bone density
D. Progressive loss of articular cartilage and formation of osteophytes
Correct Answer: D
Rationale: Osteoarthritis is a degenerative joint disease characterized by the mechanical
breakdown of cartilage. As the protective cartilage wears away, bone-on-bone friction
occurs, causing pain and inflammation. The body attempts to repair the damage, resulting
in the formation of bone spurs called osteophytes. OA typically affects weight-bearing
joints like the knees and hips or frequently used joints in the hands. Unlike RA, it is
generally considered a non-inflammatory, ‘wear-and-tear’ condition.
8. In Sickle Cell Anemia, what is the primary cause of a ‘Vaso-occlusive Crisis’?
A. Sickled RBCs obstructing blood flow in small capillaries
B. Lack of iron leading to microcytic cells
C. Autoimmune destruction of red blood cells in the spleen
D. Excessive production of white blood cells crowding the circulation
Correct Answer: A
Rationale: Sickle cell anemia involves a genetic mutation that causes hemoglobin to
polymerize under low oxygen conditions. This causes red blood cells to take on a rigid,
sickle shape. These misshapen cells become trapped in small vessels, blocking distal blood
