25 Mar Midterm Exam for NURS 5051/6051: Transforming Nursing and Healthcare Through Technology

Cellular & Genetic Topics
A patient presents with fatigue and pallor. Lab results reveal abnormal hemoglobin synthesis due to a genetic mutation. Which disorder is most consistent with these findings?

A. Sickle cell anemia

B. Iron-deficiency anemia

C. Thalassemia

D. Pernicious anemia
Answer: A

A nurse explains to a patient that mutations in tumor suppressor genes can lead to cancer. Which example best illustrates this concept?

A. BRCA1 mutation increasing breast cancer risk

B. CFTR mutation causing cystic fibrosis

C. HFE mutation causing hemochromatosis

D. APOE mutation linked to Alzheimer’s disease
Answer: A

Neurological Topics
A patient with Parkinson’s disease is experiencing tremors and rigidity. Which neurotransmitter imbalance is primarily responsible?

A. Increased serotonin

B. Decreased dopamine

C. Increased acetylcholine

D. Decreased norepinephrine
Answer: B

A patient presents with sudden unilateral weakness and slurred speech. CT scan confirms an ischemic stroke. Which immediate nursing priority is most appropriate?

A. Administer oxygen and monitor airway

B. Begin physical therapy exercises

C. Provide patient education on lifestyle changes

D. Schedule MRI for further evaluation
Answer: A

Cardiovascular Topics
A patient with hypertension is prescribed an ACE inhibitor. What is the primary mechanism of action?

A. Blocks beta-adrenergic receptors

B. Inhibits conversion of angiotensin I to angiotensin II

C. Promotes sodium reabsorption in kidneys

D. Increases cardiac contractility
Answer: B

A patient with left-sided heart failure presents with dyspnea and orthopnea. Which pathophysiological mechanism explains these symptoms?

A. Pulmonary congestion due to impaired left ventricular function

B. Peripheral edema due to venous pooling

C. Increased systemic vascular resistance

D. Decreased preload from dehydration
Answer: A

Respiratory Topics
A patient with COPD has chronic hypoxemia. Which compensatory mechanism is most likely to occur?

A. Increased erythropoietin production leading to polycythemia

B. Decreased cardiac output

C. Reduced alveolar ventilation

D. Increased renal excretion of bicarbonate
Answer: A

A patient with asthma experiences wheezing and shortness of breath after exposure to pollen. Which pathophysiological process is occurring?

A. Destruction of alveolar walls

B. Airway inflammation and bronchoconstriction

C. Loss of surfactant production

D. Collapse of bronchioles due to fibrosis
Answer: B

Integrated Application
A patient with cystic fibrosis develops recurrent respiratory infections. Which underlying mechanism explains this complication?

A. Excess mucus production impairs ciliary clearance

B. Autoimmune destruction of alveoli

C. Genetic mutation causes decreased surfactant

D. Increased alveolar macrophage activity
Answer: A

A patient with cirrhosis develops hepatic encephalopathy. Which nursing intervention is most critical?

A. Monitor ammonia levels and assess mental status

B. Encourage high-protein diet

C. Administer diuretics to reduce ascites

D. Provide patient education on alcohol cessation only
Answer: A

Cellular & Genetic
A nurse is caring for a patient with Down syndrome. Which chromosomal abnormality is responsible?

A. Trisomy 21

B. Monosomy X

C. Trisomy 18

D. Deletion of chromosome 5
Answer: A

A patient with cystic fibrosis has thickened secretions. Which cellular transport defect explains this?

A. Sodium-potassium pump malfunction

B. Chloride channel dysfunction

C. Calcium channel overactivity

D. Excessive glucose transport
Answer: B

Apoptosis differs from necrosis because:

A. Apoptosis is uncontrolled cell death

B. Necrosis is programmed cell death

C. Apoptosis maintains tissue homeostasis

D. Necrosis preserves cell membrane integrity
Answer: C

Neurological
A patient with multiple sclerosis experiences numbness and weakness. Which pathophysiological process is occurring?

A. Demyelination of CNS neurons

B. Overproduction of dopamine

C. Loss of acetylcholine receptors

D. Cerebral ischemia
Answer: A

A patient with Alzheimer’s disease shows progressive memory loss. Which protein accumulation is most implicated?

A. Tau protein tangles

B. Hemoglobin S

C. Collagen fibrils

D. Elastin deposits
Answer: A

A patient with Guillain-Barré syndrome develops ascending paralysis. Which mechanism explains this?

A. Autoimmune attack on peripheral myelin

B. Viral destruction of CNS neurons

C. Genetic mutation in sodium channels

D. Ischemia of spinal cord
Answer: A

Cardiovascular
A patient with myocardial infarction has elevated troponin levels. What does this indicate?

A. Skeletal muscle damage

B. Cardiac muscle injury

C. Renal dysfunction

D. Pulmonary embolism
Answer: B

A patient with atrial fibrillation is at risk for:

A. Pulmonary edema

B. Stroke due to embolism

C. Myocardial hypertrophy

D. Hypotension from bradycardia
Answer: B

A patient with peripheral artery disease reports leg pain when walking that resolves with rest. This is:

A. Claudication

B. Neuropathy

C. Venous stasis

D. Raynaud’s phenomenon
Answer: A

A patient with right-sided heart failure presents with:

A. Pulmonary congestion

B. Jugular vein distension and peripheral edema

C. Orthopnea and dyspnea

D. Decreased systemic vascular resistance
Answer: B

Respiratory
A patient with pneumonia develops hypoxemia. Which mechanism explains this?

A. Alveolar consolidation impairs gas exchange

B. Increased surfactant production

C. Bronchial dilation improves oxygenation

D. Hyperventilation increases PaO2
Answer: A

A patient with ARDS (acute respiratory distress syndrome) has refractory hypoxemia. Which pathophysiological change is most responsible?

A. Loss of surfactant and alveolar collapse

B. Increased airway resistance

C. Excess mucus secretion

D. Pulmonary embolism
Answer: A

A patient with tuberculosis presents with night sweats and hemoptysis. Which cellular response is typical?

A. Granuloma formation in lungs

B. Neutrophil infiltration only

C. Fibrosis of alveolar walls

D. Increased surfactant secretion
Answer: A

A patient with emphysema has barrel chest. Which mechanism explains this?

A. Air trapping and hyperinflation

B. Fibrosis of bronchioles

C. Collapse of alveoli

D. Increased mucus production
Answer: A

A patient with pulmonary embolism develops sudden dyspnea and chest pain. Which immediate nursing action is most critical?

A. Administer oxygen and monitor vital signs

B. Encourage ambulation

C. Provide patient education on diet

D. Schedule pulmonary function testing
Answer: A

Integrated Application
A patient with sickle cell disease presents with severe pain. Which pathophysiological mechanism explains this?

A. Vaso-occlusion from sickled RBCs

B. Autoimmune destruction of RBCs

C. Excess iron deposition

D. Increased platelet aggregation
Answer: A

A patient with chronic kidney disease develops anemia. Which mechanism explains this?

A. Decreased erythropoietin production

B. Increased hemolysis of RBCs

C. Excessive iron absorption

D. Vitamin B12 deficiency
Answer: A

A patient with sepsis develops hypotension and tachycardia. Which underlying mechanism is most responsible?

A. Widespread vasodilation and capillary leak

B. Increased cardiac contractility

C. Decreased oxygen demand

D. Excess surfactant production
Answer: A

A patient with diabetes mellitus develops peripheral neuropathy. Which mechanism explains this?

A. Chronic hyperglycemia damages nerves

B. Autoimmune destruction of myelin

C. Genetic mutation in sodium channels

D. Ischemia of spinal cord
Answer: A

A patient with COPD develops cor pulmonale. Which mechanism explains this complication?

A. Pulmonary hypertension increases right ventricular workload

B. Left ventricular hypertrophy

C. Increased systemic vascular resistance

D. Decreased preload from dehydration
Answer: A