Succeed in your NUR 6501 Advanced Pathophysiology Midterm Exam for 2025/2026 with this complete resource tailored for Walden University students. This comprehensive guide includes over 150 real exam questions, each with verified, detailed correct answers, covering essential pathophysiology topics such as cellular function, disease processes, and organ system disorders. Designed for MSN and DNP students, it provides in-depth explanations to enhance your understanding of complex concepts like inflammation, immune responses, and genetic disorders. Perfect for midterm preparation, this guide ensures you’re fully equipped to achieve guaranteed success in your Advanced Pathophysiology course and excel in your nursing education.
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1. Pediatric Leukemia Diagnosis
Question:
A 4-year-old child presents with listlessness, irritability, pain in limbs, and ecchymoses.
CBC reveals anemia, thrombocytopenia, and leukocytosis with blasts on smear. Blasts are
TdT+, PAS+, CD19+, CD3-, and sIg-. What is the most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML)
✅ Correct Answer: A. Acute lymphoblastic leukemia (ALL)
Rationale:
The presence of TdT (marker of immature lymphoid cells), PAS+ aggregates, and CD19+ (B
cell marker) confirms B-cell ALL. This is the most common leukemia in children and
typically presents with bone pain, ecchymoses, and pancytopenia due to marrow
infiltration.
2. Beta Thalassemia Major
Question:
A 3-year-old child of Italian ancestry presents with failure to thrive, hepatosplenomegaly,
and severe microcytic anemia. Skull radiograph shows maxillofacial deformities, and
hemoglobin electrophoresis reveals very little hemoglobin A. What is the principal cause?
A. Reduced synthesis of hemoglobin F
B. Imbalance in alpha and beta globin chain production
C. Vitamin B12 deficiency
D. Fragile erythrocyte membranes
✅ Correct Answer: B. Imbalance in alpha and beta globin chain production
Rationale:
Beta-thalassemia major results from deficient beta-globin synthesis, causing excess alpha
chains, ineffective erythropoiesis, and marrow expansion. The electrophoresis typically
shows high HbF and HbA2 with absent HbA.
3. GI Blood Loss Anemia
Question:
A 68-year-old woman reports fatigue and black stools. CBC reveals microcytic,
hypochromic anemia. What is the most likely cause?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia
✅ Correct Answer: C. Gastrointestinal blood loss
Rationale:
Chronic GI bleeding, often due to ulcers or malignancy, leads to iron deficiency anemia,
presenting as microcytic, hypochromic anemia. Black stools (melena) indicate upper GI
bleeding.
4. Vitamin C Deficiency (Scurvy)
Question:
A 76-year-old woman develops gum bleeding and petechiae. Labs show normal PT, PTT,
platelets, and bleeding time. What is the most likely cause?
A. Chronic renal failure
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency
✅ Correct Answer: D. Vitamin C deficiency
Rationale:
Scurvy impairs collagen synthesis, weakening capillaries and connective tissue. This leads
to bleeding and petechiae with otherwise normal coagulation profiles.
5. Von Willebrand Disease Advice
Question:
A young adult is newly diagnosed with von Willebrand disease. Which advice is most
appropriate?
A. You may need a bone marrow transplant
B. You may bleed excessively after dental work
C. A splenectomy might be needed
D. Expect joint mobility issues
✅ Correct Answer: B. You may bleed excessively after dental work
Rationale:
Von Willebrand factor aids platelet adhesion. Deficiency leads to mucocutaneous bleeding
and prolonged bleeding post-injury or surgery, such as tooth extraction.
Question:
A 4-year-old child presents with listlessness, irritability, pain in limbs, and ecchymoses.
CBC reveals anemia, thrombocytopenia, and leukocytosis with blasts on smear. Blasts are
TdT+, PAS+, CD19+, CD3-, and sIg-. What is the most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML)
✅ Correct Answer: A. Acute lymphoblastic leukemia (ALL)
Rationale:
The presence of TdT (marker of immature lymphoid cells), PAS+ aggregates, and CD19+ (B
cell marker) confirms B-cell ALL. This is the most common leukemia in children and
typically presents with bone pain, ecchymoses, and pancytopenia due to marrow
infiltration.
2. Beta Thalassemia Major
Question:
A 3-year-old child of Italian ancestry presents with failure to thrive, hepatosplenomegaly,
and severe microcytic anemia. Skull radiograph shows maxillofacial deformities, and
hemoglobin electrophoresis reveals very little hemoglobin A. What is the principal cause?
A. Reduced synthesis of hemoglobin F
B. Imbalance in alpha and beta globin chain production
C. Vitamin B12 deficiency
D. Fragile erythrocyte membranes
✅ Correct Answer: B. Imbalance in alpha and beta globin chain production
Rationale:
Beta-thalassemia major results from deficient beta-globin synthesis, causing excess alpha
chains, ineffective erythropoiesis, and marrow expansion. The electrophoresis typically
shows high HbF and HbA2 with absent HbA.
3. GI Blood Loss Anemia
Question:
A 68-year-old woman reports fatigue and black stools. CBC reveals microcytic,
hypochromic anemia. What is the most likely cause?
A. Aplastic anemia
B. Beta thalassemia
C. Gastrointestinal blood loss
D. Pernicious anemia
✅ Correct Answer: C. Gastrointestinal blood loss
Rationale:
Chronic GI bleeding, often due to ulcers or malignancy, leads to iron deficiency anemia,
presenting as microcytic, hypochromic anemia. Black stools (melena) indicate upper GI
bleeding.
4. Vitamin C Deficiency (Scurvy)
Question:
A 76-year-old woman develops gum bleeding and petechiae. Labs show normal PT, PTT,
platelets, and bleeding time. What is the most likely cause?
A. Chronic renal failure
B. Macronodular cirrhosis
C. Vitamin B12 deficiency
D. Vitamin C deficiency
✅ Correct Answer: D. Vitamin C deficiency
Rationale:
Scurvy impairs collagen synthesis, weakening capillaries and connective tissue. This leads
to bleeding and petechiae with otherwise normal coagulation profiles.
5. Von Willebrand Disease Advice
Question:
A young adult is newly diagnosed with von Willebrand disease. Which advice is most
appropriate?
A. You may need a bone marrow transplant
B. You may bleed excessively after dental work
C. A splenectomy might be needed
D. Expect joint mobility issues
✅ Correct Answer: B. You may bleed excessively after dental work
Rationale:
Von Willebrand factor aids platelet adhesion. Deficiency leads to mucocutaneous bleeding
and prolonged bleeding post-injury or surgery, such as tooth extraction.
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