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NSG 1700 PATHOPHYSIOLOGY MIDTERM EXAM 1 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025 GALEN COLLEGE OF NURSING
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1. Which type of cellular adaptation occurs when a cell decreases in size due to decreased workload? a. Hyperplasia b. Metaplasia c. Atrophy d. Hypertrophy Atrophy is the decrease in cell size due to reduced functional demand or nutrient supply. 2. Which term best describes the process of programmed cell death? a. Necrosis b. Inflammation
c. Apoptosis d. Phagocytosis Apoptosis is a regulated process of cell death that occurs without inflammation.
3. Which electrolyte imbalance is most likely in a patient with chronic renal failure? a. Hypokalemia b. Hyperkalemia c. Hypocalcemia d. Hypernatremia Kidneys can't excrete potassium efficiently in chronic renal failure, leading to hyperkalemia. 4. What causes the redness and heat in inflammation? a. Phagocyte migration b. Vasodilation c. Capillary occlusion d. Increased tissue pressure Vasodilation increases blood flow to the affected area, causing redness and warmth. 5. Which condition is associated with Type I hypersensitivity reactions? a. Rheumatoid arthritis b. Type 1 diabetes c. Asthma
9. Which condition is a common complication of prolonged immobility? a. Metaplasia b. Pressure ulcer c. Rheumatoid arthritis d. Diabetic neuropathy Pressure ulcers develop due to prolonged pressure and decreased blood flow to tissues. 10. What is the key characteristic of benign tumors? a. Rapid metastasis b. Poorly differentiated cells c. Infiltrative growth d. Encapsulated and localized Benign tumors are usually well-circumscribed and do not invade other tissues. 11. Which of the following is a common sign of left-sided heart failure? a. Pulmonary edema b. Peripheral edema c. Jugular vein distension d. Hepatomegaly Left-sided heart failure leads to fluid backup in the lungs, causing pulmonary congestion.
12. What is the main pathophysiologic mechanism of emphysema? a. Bronchial constriction b. Increased mucus production c. Destruction of alveolar walls d. Alveolar fluid accumulation Emphysema involves permanent enlargement and destruction of alveoli, impairing gas exchange. 13. Which lab finding indicates respiratory acidosis? a. pH 7.50, CO2 35 b. pH 7.40, CO2 40 c. pH 7.30, CO2 55 d. pH 7.48, CO2 30 Respiratory acidosis is caused by CO2 retention and is indicated by low pH and high CO2. 14. A patient with anemia may present with which compensatory mechanism? a. Bradycardia b. Hypotension c. Tachycardia d. Hypoventilation Tachycardia increases oxygen delivery to tissues when hemoglobin levels are low.
c. Confusion d. Dry mucous membranes Low blood glucose affects brain function, leading to confusion and mental changes.
19. What is the primary pathophysiologic issue in Type 2 Diabetes Mellitus? a. Absolute insulin deficiency b. Autoimmune beta-cell destruction c. Insulin resistance d. Hypersecretion of glucagon Type 2 diabetes involves cellular resistance to insulin’s effects. 20. Which sign is characteristic of nephrotic syndrome? a. Hematuria b. Hypotension c. Proteinuria d. Hyperkalemia Nephrotic syndrome is marked by massive protein loss in the urine. 21. Which respiratory condition involves reversible airway obstruction? a. COPD b. Asthma c. Bronchiectasis
d. Emphysema Asthma is characterized by reversible bronchoconstriction.
22. What is the cause of cyanosis in a patient with chronic hypoxia? a. Dehydration b. Excess oxygen c. Increased deoxygenated hemoglobin d. Elevated white blood cells Cyanosis occurs when hemoglobin is not saturated with oxygen. 23. Atherosclerosis begins with which key process? a. Lipid oxidation b. Endothelial injury c. Platelet rupture d. Myocardial ischemia Damage to the endothelium triggers the cascade leading to plaque formation. 2 4. Which electrolyte abnormality causes muscle weakness and cardiac dysrhythmias? a. Hypernatremia b. Hypocalcemia c. Hyperkalemia d. Hypophosphatemia High potassium levels disrupt normal electrical activity of muscles and heart.
28. Which type of immunity is gained through vaccination? a. Natural active b. Natural passive c. Artificial active d. Artificial passive Vaccination introduces antigens to stimulate the production of antibodies (artificial active immunity). 29. What is the initial step in the development of cancer? a. Metastasis b. Promotion c. Initiation d. Progression Initiation involves genetic mutation that begins the transformation of normal cells into cancer cells. 30. Which hormone is released in response to low blood calcium levels? a. Parathyroid hormone (PTH) b. Calcitonin c. Insulin d. Cortisol PTH increases blood calcium by stimulating bone resorption, calcium reabsorption, and vitamin D activation. 31. What is a hallmark sign of inflammation in laboratory testing? a. Decreased hematocrit
b. High red blood cell count c. Elevated C-reactive protein (CRP) d. Low sodium levels CRP is a non-specific marker of systemic inflammation.
32. What term describes the accumulation of fluid in the peritoneal cavity? a. Edema b. Ascites c. Effusion d. Hydrocele Ascites is fluid collection in the abdominal cavity, often due to liver disease. 33. Which system is responsible for the body's immediate response to stress? a. Immune system b. Sympathetic nervous system c. Parasympathetic nervous system d. Musculoskeletal system The sympathetic nervous system mediates the "fight or flight" stress response. 34. A patient presents with extreme thirst, dry mucous membranes, and elevated sodium levels. What condition is suspected? a. SIADH b. Diabetes insipidus c. Diabetes mellitus
d. Hiatal hernia GERD occurs when stomach acid flows back into the esophagus due to a weak lower sphincter.
38. What acid-base disorder is caused by vomiting? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis Vomiting leads to loss of gastric acid, causing alkalosis. 39. Which complication is associated with prolonged hyperglycemia? a. Hypernatremia b. Neuropathy c. Hypercalcemia d. Muscle wasting Chronic hyperglycemia damages nerves, leading to peripheral neuropathy. 40. What finding is expected in a patient with SIADH (Syndrome of Inappropriate Antidiuretic Hormone)? a. Polyuria b. Hyponatremia c. Hyperkalemia d. Elevated serum osmolality SIADH causes water retention, diluting sodium in the blood.
41. Which condition involves destruction of the myelin sheath in the central nervous system? a. Guillain-Barré syndrome b. Multiple sclerosis c. Parkinson’s disease d. Myasthenia gravis Multiple sclerosis is an autoimmune disease targeting CNS myelin. 42. A patient with chronic obstructive pulmonary disease (COPD) retains CO₂. What is the expected acid-base disturbance? a. Metabolic alkalosis b. Respiratory acidosis c. Respiratory alkalosis d. Metabolic acidosis CO₂ retention from hypoventilation causes respiratory acidosis. 43. Which lab result supports a diagnosis of iron-deficiency anemia? a. Elevated hematocrit b. Low hemoglobin c. High ferritin d. Elevated WBCs Low hemoglobin and ferritin indicate iron-deficiency anemia. 44. What finding is consistent with fluid volume overload? a. Decreased blood pressure b. Crackles in lungs
d. Immune system The respiratory system increases ventilation to blow off CO₂ and raise pH.
48. What electrolyte imbalance is most associated with muscle cramps and tetany? a. Hyperkalemia b. Hypermagnesemia c. Hypocalcemia d. Hypernatremia Low calcium increases neuromuscular excitability, leading to cramps and tetany. 49. Which finding is a hallmark of acute pancreatitis? a. Bradycardia b. Left lower quadrant pain c. Elevated serum amylase and lipase d. Elevated creatinine Amylase and lipase are pancreatic enzymes that rise during acute inflammation. 50. What is the pathophysiologic cause of edema in liver cirrhosis? a. Decreased potassium b. Increased aldosterone c. Decreased albumin d. Increased blood glucose
Albumin production drops in cirrhosis, reducing oncotic pressure and causing edema.
51. A patient with hyperthyroidism is likely to experience which symptom? a. Weight loss b. Constipation c. Cold intolerance d. Bradycardia Hyperthyroidism increases metabolism, leading to weight loss and heat intolerance. 52. Which cell type produces antibodies? a. T cells b. B cells c. Macrophages d. Natural killer cells B cells differentiate into plasma cells that produce antibodies. 53. What is the effect of aldosterone on the kidneys? a. Increased water excretion b. Sodium and water retention c. Increased potassium reabsorption d. Decreased blood pressure Aldosterone promotes sodium retention and potassium excretion, increasing blood volume.
b. Homeostasis regulation c. Blood cell production d. Voluntary movement The hypothalamus regulates body temperature, hunger, thirst, and hormones.
58. Which type of hypersensitivity reaction is anaphylaxis? a. Type II b. Type III c. Type I d. Type IV Type I hypersensitivity involves IgE-mediated mast cell degranulation leading to anaphylaxis. 59. Which of the following is an early sign of hypoxia? a. Restlessness b. Cyanosis c. Bradycardia d. Apnea Restlessness is an early neurobehavioral sign of low oxygen levels. 60. Which lab finding is expected in metabolic alkalosis? a. Low pH, low HCO₃ b. High pH, high HCO₃ c. Normal pH, low PaCO₂
d. Low pH, high PaCO₂ Metabolic alkalosis presents with increased pH and bicarbonate levels.
61. Which of the following can trigger sickling of red blood cells in sickle cell anemia? a. Hypoxia b. Hypernatremia c. Polycythemia d. Hyperglycemia Low oxygen tension promotes abnormal hemoglobin S polymerization, causing sickling. 62. What complication is associated with long-term uncontrolled hypertension? a. Iron-deficiency anemia b. Type 1 diabetes c. Left ventricular hypertrophy d. Hypokalemia Chronic hypertension increases afterload, causing the heart muscle to enlarge. 63. Which blood component is essential for clot formation? a. Albumin b. Hemoglobin c. Platelets
