Page 1 of 165
NUR 631 ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY EXAM 300 QUESTIONS WITH
ANSWERS AND RATIONALES JUST RELEASED THIS
YEAR
NUR 631 Advanced Physiology and Pathophysiology, aligned with typical graduate-level NP
content. Questions are scenario-based, exam-relevant, and cover cellular biology, inflammation,
genetics, fluid/electrolytes, acid-base, and major organ system pathophysiology. Each question
includes the correct answer and a summarized italicized rationale—no subtopics or domain
labels.
1. A patient with chronic heart failure has jugular venous distension, peripheral edema, and an
S3 gallop. These findings are most consistent with:
A) Right-sided heart failure only
B) Left-sided heart failure only
C) Biventricular failure
D) Pericardial tamponade
Answer: C
An S3 gallop suggests left ventricular dysfunction, while JVD and peripheral edema indicate
right-sided failure; together they point to biventricular failure.
2. A 62-year-old with diabetes and hypertension has a urine albumin-to-creatinine ratio of 300
mg/g. This finding indicates:
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A) Normal renal function
B) Microalbuminuria
C) Macroalbuminuria (overt nephropathy)
D) Glomerulonephritis
Answer: C
*UACR >300 mg/g defines macroalbuminuria, indicating established diabetic kidney disease.
Microalbuminuria is 30–300 mg/g.*
3. A patient with asthma develops increased work of breathing, wheezing, and a prolonged
expiratory phase. Which pathophysiologic change is most directly responsible for the prolonged
expiration?
A) Decreased lung compliance
B) Increased airway resistance with air trapping
C) Impaired surfactant production
D) Pulmonary fibrosis
Answer: B
Airway narrowing increases resistance; during expiration, airway collapse occurs earlier,
trapping air and prolonging expiration.
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4. A patient with chronic obstructive pulmonary disease (COPD) has a forced expiratory volume
in 1 second (FEV1) of 40% predicted and an FEV1/FVC ratio of 0.55. This pattern is characteristic
of:
A) Restrictive lung disease
B) Obstructive lung disease
C) Mixed obstructive-restrictive disease
D) Normal pulmonary function
Answer: B
*FEV1/FVC <0.70 indicates obstruction. Low FEV1% predicted reflects severity. Restrictive
diseases typically have normal or increased FEV1/FVC.*
5. A 55-year-old with alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Thiamine is administered immediately. These symptoms are characteristic of:
A) Korsakoff syndrome
B) Wernicke encephalopathy
C) Hepatic encephalopathy
D) Alcohol withdrawal delirium
Answer: B
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Wernicke encephalopathy (confusion, ataxia, ophthalmoplegia) is caused by thiamine deficiency
and is a medical emergency. Korsakoff syndrome is a chronic sequelae.
6. A patient with septic shock has a serum lactate of 6 mmol/L (normal <2). The elevated lactate
is most directly due to:
A) Increased aerobic metabolism
B) Anaerobic glycolysis from tissue hypoxia
C) Hepatic failure reducing lactate clearance
D) Rhabdomyolysis
Answer: B
Sepsis causes tissue hypoperfusion and hypoxia, shifting metabolism to anaerobic glycolysis,
which produces lactic acid.
7. A 68-year-old with heart failure is taking furosemide. Laboratory results: Na 135 mEq/L, K 3.2
mEq/L, Cl 90 mEq/L, CO2 32 mEq/L. The acid-base disturbance is:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
4
SUCCESS!
NUR 631 ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY EXAM 300 QUESTIONS WITH
ANSWERS AND RATIONALES JUST RELEASED THIS
YEAR
NUR 631 Advanced Physiology and Pathophysiology, aligned with typical graduate-level NP
content. Questions are scenario-based, exam-relevant, and cover cellular biology, inflammation,
genetics, fluid/electrolytes, acid-base, and major organ system pathophysiology. Each question
includes the correct answer and a summarized italicized rationale—no subtopics or domain
labels.
1. A patient with chronic heart failure has jugular venous distension, peripheral edema, and an
S3 gallop. These findings are most consistent with:
A) Right-sided heart failure only
B) Left-sided heart failure only
C) Biventricular failure
D) Pericardial tamponade
Answer: C
An S3 gallop suggests left ventricular dysfunction, while JVD and peripheral edema indicate
right-sided failure; together they point to biventricular failure.
2. A 62-year-old with diabetes and hypertension has a urine albumin-to-creatinine ratio of 300
mg/g. This finding indicates:
1
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,Page 2 of 165
A) Normal renal function
B) Microalbuminuria
C) Macroalbuminuria (overt nephropathy)
D) Glomerulonephritis
Answer: C
*UACR >300 mg/g defines macroalbuminuria, indicating established diabetic kidney disease.
Microalbuminuria is 30–300 mg/g.*
3. A patient with asthma develops increased work of breathing, wheezing, and a prolonged
expiratory phase. Which pathophysiologic change is most directly responsible for the prolonged
expiration?
A) Decreased lung compliance
B) Increased airway resistance with air trapping
C) Impaired surfactant production
D) Pulmonary fibrosis
Answer: B
Airway narrowing increases resistance; during expiration, airway collapse occurs earlier,
trapping air and prolonging expiration.
2
SUCCESS!
,Page 3 of 165
4. A patient with chronic obstructive pulmonary disease (COPD) has a forced expiratory volume
in 1 second (FEV1) of 40% predicted and an FEV1/FVC ratio of 0.55. This pattern is characteristic
of:
A) Restrictive lung disease
B) Obstructive lung disease
C) Mixed obstructive-restrictive disease
D) Normal pulmonary function
Answer: B
*FEV1/FVC <0.70 indicates obstruction. Low FEV1% predicted reflects severity. Restrictive
diseases typically have normal or increased FEV1/FVC.*
5. A 55-year-old with alcohol use disorder presents with confusion, ataxia, and
ophthalmoplegia. Thiamine is administered immediately. These symptoms are characteristic of:
A) Korsakoff syndrome
B) Wernicke encephalopathy
C) Hepatic encephalopathy
D) Alcohol withdrawal delirium
Answer: B
3
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, Page 4 of 165
Wernicke encephalopathy (confusion, ataxia, ophthalmoplegia) is caused by thiamine deficiency
and is a medical emergency. Korsakoff syndrome is a chronic sequelae.
6. A patient with septic shock has a serum lactate of 6 mmol/L (normal <2). The elevated lactate
is most directly due to:
A) Increased aerobic metabolism
B) Anaerobic glycolysis from tissue hypoxia
C) Hepatic failure reducing lactate clearance
D) Rhabdomyolysis
Answer: B
Sepsis causes tissue hypoperfusion and hypoxia, shifting metabolism to anaerobic glycolysis,
which produces lactic acid.
7. A 68-year-old with heart failure is taking furosemide. Laboratory results: Na 135 mEq/L, K 3.2
mEq/L, Cl 90 mEq/L, CO2 32 mEq/L. The acid-base disturbance is:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
4
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