NURS 6501 Advanced Pathophysiology Practice Test
Sample Questions and Answers
Which of the following best describes the primary characteristic of inflammation?
A) Decreased blood flow to the affected area
B) Tissue necrosis
C) Vasodilation and increased permeability of blood vessels
D) Decreased white blood cell count
Answer: C) Vasodilation and increased permeability of blood vessels
Explanation: Inflammation is a protective response of the body involving vasodilation and increased permeability of blood vessels, allowing immune cells, nutrients, and oxygen to reach the site of injury or infection.
Which organ system is primarily responsible for regulating acid-base balance in the body?
A) Respiratory system
B) Cardiovascular system
C) Renal system
D) Endocrine system
Answer: C) Renal system
Explanation: The renal system regulates acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate from the urine.
Which pathophysiological process is most likely associated with an increase in blood viscosity?
A) Anemia
B) Dehydration
C) Shock
D) Hemorrhage
Answer: B) Dehydration
Explanation: Dehydration leads to a decrease in plasma volume, which increases the viscosity (thickness) of the blood.
A patient with asthma is most likely to experience which of the following pathophysiological changes in the lungs?
A) Increased airway resistance
B) Bronchoconstriction and mucus production
C) Increased lung compliance
D) Decreased lung volume
Answer: B) Bronchoconstriction and mucus production
Explanation: Asthma causes bronchoconstriction and increased mucus production, leading to obstructed airflow in the lungs.
Which of the following is a common cause of hypoxemia in patients with chronic obstructive pulmonary disease (COPD)?
A) Ventilation-perfusion mismatch
B) Decreased pulmonary blood flow
C) Increased alveolar ventilation
D) Bronchodilation
Answer: A) Ventilation-perfusion mismatch
Explanation: In COPD, the mismatch between ventilation (airflow) and perfusion (blood flow) leads to hypoxemia (low oxygen levels in the blood).
Which of the following is most characteristic of acute myocardial infarction (MI)?
A) Increased blood oxygen levels
B) Reduced blood flow to the myocardium
C) Decreased potassium levels in the blood
D) Normal electrocardiogram (ECG) findings
Answer: B) Reduced blood flow to the myocardium
Explanation: Acute MI occurs due to a blockage of blood flow to the heart muscle, leading to ischemia and damage to the myocardial tissue.
Which of the following is a common consequence of prolonged hypoperfusion in the kidneys?
A) Acute renal failure
B) Hypertension
C) Hyperkalemia
D) Hypoglycemia
Answer: A) Acute renal failure
Explanation: Prolonged hypoperfusion (reduced blood flow) to the kidneys can lead to ischemic damage, resulting in acute renal failure.
In which condition does the body experience a shift from aerobic to anaerobic metabolism, leading to lactic acidosis?
A) Hyperthyroidism
B) Sepsis
C) Chronic obstructive pulmonary disease
D) Hyperkalemia
Answer: B) Sepsis
Explanation: In sepsis, tissue hypoxia causes a shift to anaerobic metabolism, producing lactic acid and resulting in lactic acidosis.
Which of the following is a hallmark feature of diabetes mellitus at the cellular level?
A) Impaired insulin secretion
B) Increased glucose utilization
C) Enhanced glucose uptake by cells
D) Increased glycogen synthesis in the liver
Answer: A) Impaired insulin secretion
Explanation: In diabetes mellitus, either insulin secretion is impaired (Type 1) or cells become resistant to insulin (Type 2), leading to elevated blood glucose levels.
Which pathophysiological process is most commonly associated with cirrhosis of the liver?
A) Increased bilirubin production
B) Decreased liver enzyme levels
C) Fibrosis and scarring of liver tissue
D) Decreased blood clotting factors
Answer: C) Fibrosis and scarring of liver tissue
Explanation: Cirrhosis is characterized by the progressive scarring of liver tissue, leading to liver dysfunction.
Which of the following is a primary cause of hypercapnia (elevated carbon dioxide levels) in patients with emphysema?
A) Inadequate oxygenation of the blood
B) Decreased alveolar ventilation
C) Increased pulmonary circulation
D) Decreased ventilation-perfusion ratio
Answer: B) Decreased alveolar ventilation
Explanation: Emphysema leads to damage of the alveoli, decreasing the efficiency of gas exchange and causing a buildup of carbon dioxide in the blood (hypercapnia).
Which of the following best describes the pathophysiology of rheumatoid arthritis?
A) Destruction of joint cartilage due to hyperuricemia
B) Autoimmune attack on synovial joints
C) Joint inflammation caused by bacterial infection
D) Joint degeneration due to mechanical wear and tear
Answer: B) Autoimmune attack on synovial joints
Explanation: Rheumatoid arthritis is an autoimmune disorder where the body’s immune system attacks the synovial membranes of joints, leading to inflammation and damage.
In patients with congestive heart failure (CHF), what pathophysiological change causes fluid retention?
A) Increased blood volume due to renal compensation
B) Decreased secretion of antidiuretic hormone (ADH)
C) Decreased aldosterone levels
D) Decreased cardiac output leading to renal hypoperfusion
Answer: D) Decreased cardiac output leading to renal hypoperfusion
Explanation: In CHF, decreased cardiac output leads to reduced perfusion of the kidneys, triggering the renin-angiotensin-aldosterone system and causing fluid retention.
Which of the following is a primary pathophysiological mechanism in the development of peptic ulcers?
A) Decreased hydrochloric acid secretion
B) Infection with Helicobacter pylori
C) Excessive mucosal barrier protection
D) Decreased pepsinogen production
Answer: B) Infection with Helicobacter pylori
Explanation: H. pylori infection is the leading cause of peptic ulcers, as it damages the gastric mucosa and increases acid secretion.
Which of the following is most likely to result in increased intracranial pressure (ICP)?
A) Increased cerebral blood flow
B) Increased cerebrospinal fluid production
C) Decreased cerebral venous return
D) Decreased cerebral oxygen demand
Answer: C) Decreased cerebral venous return
Explanation: Decreased venous return from the brain can cause a buildup of blood, leading to increased ICP.
Which of the following can cause a shift of potassium from the extracellular fluid to the intracellular space?
A) Insulin administration
B) Metabolic acidosis
C) Hyperglycemia
D) Renal failure
Answer: A) Insulin administration
Explanation: Insulin facilitates the movement of potassium into cells, lowering extracellular potassium levels.
Which of the following is most likely to cause metabolic acidosis?
A) Respiratory depression
B) Excessive vomiting
C) Renal failure
D) Hyperventilation
Answer: C) Renal failure
Explanation: Renal failure impairs the kidneys’ ability to excrete acid, leading to the accumulation of hydrogen ions and resulting in metabolic acidosis.
In the pathophysiology of systemic lupus erythematosus (SLE), which immune system abnormality occurs?
A) Overproduction of cytokines by T-cells
B) Autoantibodies against DNA and other cellular components
C) Deficiency in complement protein function
D) Excessive neutrophil activity
Answer: B) Autoantibodies against DNA and other cellular components
Explanation: SLE is characterized by the production of autoantibodies that target the body’s own tissues, leading to inflammation and tissue damage.
Which of the following is associated with an increase in systemic vascular resistance (SVR)?
A) Arteriolar vasodilation
B) Venodilation
C) Arteriolar vasoconstriction
D) Decreased blood viscosity
Answer: C) Arteriolar vasoconstriction
Explanation: Arteriolar vasoconstriction increases systemic vascular resistance, which raises blood pressure.
In which of the following conditions is the production of antidiuretic hormone (ADH) most likely to be increased?
A) Dehydration
B) Hypercalcemia
C) Hyperthyroidism
D) Liver failure
Answer: A) Dehydration
Explanation: In dehydration, the body increases ADH secretion to retain water and prevent further fluid loss.
Which of the following best describes the pathophysiology of congestive heart failure (CHF)?
A) Decreased cardiac output leading to compensatory mechanisms
B) Increased cardiac output causing systemic fluid retention
C) Impaired myocardial contractility leading to decreased preload
D) Increased systemic vascular resistance leading to increased preload
Answer: A) Decreased cardiac output leading to compensatory mechanisms
Explanation: In CHF, the heart’s reduced ability to pump blood effectively results in decreased cardiac output. The body compensates with mechanisms like the activation of the renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system activation, and fluid retention.
Which of the following is most commonly associated with aortic aneurysm?
A) Arterial wall degeneration leading to weakening and dilation
B) Excessive vasoconstriction of the aorta
C) Increased collagen production in the vessel wall
D) Endothelial cell hyperplasia in the aorta
Answer: A) Arterial wall degeneration leading to weakening and dilation
Explanation: An aortic aneurysm results from the weakening and dilation of the arterial wall, often due to hypertension or atherosclerosis, increasing the risk of rupture.
In acute respiratory distress syndrome (ARDS), which of the following is a key pathological process?
A) Increased pulmonary capillary permeability leading to pulmonary edema
B) Increased production of surfactant
C) Bronchoconstriction leading to decreased airway resistance
D) Increased mucus production in the lower airways
Answer: A) Increased pulmonary capillary permeability leading to pulmonary edema
Explanation: ARDS is characterized by inflammation and increased permeability of the pulmonary capillaries, leading to leakage of fluid into the alveoli, causing pulmonary edema and impaired gas exchange.
Which of the following changes is most likely to occur in a patient with untreated hypothyroidism?
A) Increased basal metabolic rate (BMR)
B) Decreased body temperature
C) Increased heart rate
D) Increased production of thyroid-stimulating hormone (TSH)
Answer: B) Decreased body temperature
Explanation: In hypothyroidism, there is a decreased production of thyroid hormones, which leads to a lower basal metabolic rate and often results in a decreased body temperature. TSH is typically elevated due to feedback mechanisms.
Which of the following is a hallmark feature of nephrotic syndrome?
A) Proteinuria greater than 3.5 g per day
B) Hematuria with red blood cell casts
C) Elevated blood urea nitrogen (BUN) levels
D) Hyperkalemia due to kidney failure
Answer: A) Proteinuria greater than 3.5 g per day
Explanation: Nephrotic syndrome is characterized by significant proteinuria (more than 3.5 g per day), hypoalbuminemia, and edema. It results from damage to the glomeruli that allows large amounts of protein to pass into the urine.
Which of the following is most commonly associated with Crohn’s disease?
A) Continuous mucosal inflammation of the colon
B) Skip lesions with transmural inflammation
C) Formation of pseudopolyps
D) Absence of granulomas
Answer: B) Skip lesions with transmural inflammation
Explanation: Crohn’s disease is characterized by transmural (full-thickness) inflammation of the gastrointestinal tract, often with skip lesions—areas of inflamed tissue interspersed with normal tissue.
In patients with chronic hyperglycemia, which of the following mechanisms contributes to the development of diabetic retinopathy?
A) Microvascular damage leading to retinal ischemia
B) Decreased retinal blood flow due to hypertension
C) Excessive production of retinal growth factors
D) Increased glucose utilization in retinal cells
Answer: A) Microvascular damage leading to retinal ischemia
Explanation: Diabetic retinopathy is caused by chronic hyperglycemia, which leads to microvascular damage in the retina, resulting in retinal ischemia and subsequent vision loss.
Which of the following pathophysiological mechanisms is involved in the development of peptic ulcers?
A) Decreased production of gastric acid
B) Helicobacter pylori infection and acid hypersecretion
C) Decreased mucosal blood flow and mucus secretion
D) Increased secretion of somatostatin
Answer: B) Helicobacter pylori infection and acid hypersecretion
Explanation: Peptic ulcers often result from an H. pylori infection and increased acid production in the stomach, which damages the mucosal lining and leads to ulceration.
Which of the following conditions is most commonly associated with the development of metabolic syndrome?
A) Low blood pressure and low cholesterol
B) Insulin resistance and obesity
C) Decreased circulating levels of triglycerides
D) Excessive production of adrenal hormones
Answer: B) Insulin resistance and obesity
Explanation: Metabolic syndrome is primarily characterized by insulin resistance, central obesity, dyslipidemia, and hypertension, which increase the risk for cardiovascular disease and type 2 diabetes.
Which of the following best describes the mechanism behind the development of acromegaly?
A) Overproduction of antidiuretic hormone (ADH)
B) Excessive secretion of growth hormone due to a pituitary adenoma
C) Increased production of insulin-like growth factor (IGF-1) from the liver
D) Hypersecretion of thyroid hormone from the thyroid gland
Answer: B) Excessive secretion of growth hormone due to a pituitary adenoma
Explanation: Acromegaly is caused by the overproduction of growth hormone (GH) due to a pituitary adenoma, which results in excessive growth of bones and soft tissues, especially in the hands, feet, and face.
Which of the following is the most common cause of acute liver failure?
A) Hepatitis B infection
B) Alcoholic liver disease
C) Acetaminophen overdose
D) Cirrhosis
Answer: C) Acetaminophen overdose
Explanation: Acetaminophen overdose is the most common cause of acute liver failure, as it leads to hepatocyte necrosis and loss of liver function.
In the pathophysiology of asthma, which of the following is most responsible for airway obstruction?
A) Mucosal inflammation and bronchoconstriction
B) Decreased mucosal secretions
C) Increased airway compliance
D) Inhibition of surfactant production
Answer: A) Mucosal inflammation and bronchoconstriction
Explanation: In asthma, airway obstruction occurs primarily due to inflammation of the bronchial mucosa and smooth muscle contraction (bronchoconstriction), resulting in airflow limitation and difficulty breathing.
Which of the following is a key pathological feature of multiple sclerosis?
A) Demyelination of neurons in the peripheral nervous system
B) Progressive degeneration of motor neurons in the spinal cord
C) Autoimmune-mediated destruction of the myelin sheath in the central nervous system
D) Atrophy of the basal ganglia neurons
Answer: C) Autoimmune-mediated destruction of the myelin sheath in the central nervous system
Explanation: Multiple sclerosis (MS) is characterized by the autoimmune-mediated destruction of the myelin sheath in the central nervous system, leading to impaired nerve transmission and a range of neurological symptoms.
Which of the following is the most common complication of chronic obstructive pulmonary disease (COPD)?
A) Pulmonary embolism
B) Pneumothorax
C) Respiratory infections
D) Pulmonary hypertension
Answer: C) Respiratory infections
Explanation: Chronic obstructive pulmonary disease (COPD) is associated with frequent respiratory infections due to impaired clearance of mucus and decreased immune response in the lungs.
In rheumatoid arthritis, which of the following is primarily responsible for joint damage?
A) Formation of autoantibodies that attack joint synovium
B) Infiltration of neutrophils into the joint space
C) Infection of the synovium by bacteria
D) Abnormal production of collagen in the joint capsule
Answer: A) Formation of autoantibodies that attack joint synovium
Explanation: In rheumatoid arthritis, autoantibodies (e.g., rheumatoid factor) attack the synovium of the joints, leading to inflammation, cartilage destruction, and bone erosion.
Which of the following is a common cause of hypercalcemia?
A) Hyperthyroidism
B) Malignant tumors releasing parathyroid hormone-related protein
C) Chronic kidney disease
D) Excessive phosphate intake
Answer: B) Malignant tumors releasing parathyroid hormone-related protein
Explanation: Certain cancers (e.g., breast cancer, lung cancer) can cause hypercalcemia by secreting parathyroid hormone-related protein (PTHrP), which mimics parathyroid hormone (PTH) and increases calcium release from bones.
Which of the following changes occurs in the body during the pathophysiology of shock?
A) Increased peripheral vasodilation leading to low blood pressure
B) Increased heart rate and vasoconstriction to preserve blood flow to vital organs
C) Decreased respiratory rate leading to hypoxia
D) Decreased metabolic rate to conserve energy
Answer: B) Increased heart rate and vasoconstriction to preserve blood flow to vital organs
Explanation: In shock, the body compensates by increasing heart rate and causing vasoconstriction to direct blood flow to vital organs, such as the brain and heart, to maintain perfusion.
Which of the following is a typical characteristic of cystic fibrosis?
A) Decreased chloride ion transport leading to thick, sticky mucus production
B) Impaired production of insulin by the pancreas
C) Malabsorption of proteins and fats in the gastrointestinal tract
D) Overproduction of surfactant in the lungs
Answer: A) Decreased chloride ion transport leading to thick, sticky mucus production
Explanation: Cystic fibrosis is caused by mutations in the CFTR gene, leading to impaired chloride ion transport and the production of thick, sticky mucus that affects the respiratory, gastrointestinal, and reproductive systems.
In the pathophysiology of chronic gastritis, which of the following is most commonly responsible for mucosal damage?
A) Infection with Helicobacter pylori
B) Excessive alcohol consumption
C) Overproduction of gastric acid
D) Chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs)
Answer: A) Infection with Helicobacter pylori
Explanation: Helicobacter pylori infection is the most common cause of chronic gastritis. It leads to inflammation of the gastric mucosa, which can result in ulcer formation and other complications.
Which of the following pathophysiological changes occurs in the early stages of diabetic ketoacidosis (DKA)?
A) Decreased insulin production leading to hyperglycemia and lipolysis
B) Increased insulin production causing hypoglycemia
C) Increased glucagon secretion leading to glycogenesis
D) Excessive potassium retention by the kidneys
Answer: A) Decreased insulin production leading to hyperglycemia and lipolysis
Explanation: In DKA, decreased insulin production leads to hyperglycemia and increased lipolysis, resulting in the production of ketones and metabolic acidosis. This can lead to a life-threatening condition if not treated promptly.