NUR 376 Week 3 Module 3A Study Guide
(2026/2027) (PDF) | Applied Pathophysiology
,NUR 376 – Applied Pathophysiology Module 3A (Week 3)
Most Tested & Most Difficult Questions (1–50)
1. Which heart valve prevents backflow of blood from the left ventricle to the left atrium?
A. Tricuspid
B. Mitral
C. Pulmonary
D. Aortic
Answer: B. Mitral
Rationale: The mitral valve (bicuspid) separates the left atrium and ventricle and prevents regurgitation
during ventricular contraction.
2. Which layer of the heart is responsible for the contractile function?
A. Endocardium
B. Epicardium
C. Myocardium
D. Pericardium
Answer: C. Myocardium
Rationale: The myocardium is the muscular middle layer that contracts to pump blood.
3. A patient with atherosclerosis has narrowed coronary arteries. Which physiologic effect is most
likely?
A. Increased cardiac output
B. Decreased myocardial oxygen delivery
C. Increased stroke volume
D. Decreased heart rate
Answer: B. Decreased myocardial oxygen delivery
Rationale: Narrowed coronary arteries reduce blood flow to the myocardium, causing ischemia.
4. Which of the following is the strongest risk factor for primary hypertension?
A. Obesity
B. Smoking
C. Age under 30
D. Hypothyroidism
,Answer: A. Obesity
Rationale: Obesity contributes to increased cardiac workload, vascular resistance, and insulin resistance,
all of which elevate blood pressure.
5. What is the primary pathophysiologic change in left-sided heart failure?
A. Right ventricular dilation
B. Pulmonary congestion
C. Systemic venous congestion
D. Pericardial effusion
Answer: B. Pulmonary congestion
Rationale: Left-sided failure causes blood to back up into the lungs, leading to pulmonary edema and
dyspnea.
6. Which type of shock is caused by severe blood loss?
A. Cardiogenic
B. Hypovolemic
C. Septic
D. Neurogenic
Answer: B. Hypovolemic
Rationale: Hypovolemic shock results from inadequate circulating volume, commonly due to
hemorrhage.
7. Which lab finding is most specific for myocardial infarction?
A. Elevated CK-MB
B. Elevated troponin I
C. Elevated myoglobin
D. Elevated LDH
Answer: B. Elevated troponin I
Rationale: Troponin I is highly specific and sensitive for myocardial injury.
8. A patient with angina reports chest pain after climbing stairs. This is an example of:
A. Unstable angina
B. Variant angina
C. Stable angina
D. Silent ischemia
, Answer: C. Stable angina
Rationale: Stable angina occurs predictably with exertion and resolves with rest or nitroglycerin.
9. Which physiologic change occurs in a patient with chronic hypertension?
A. Left ventricular hypertrophy
B. Right atrial dilation
C. Decreased systemic vascular resistance
D. Decreased afterload
Answer: A. Left ventricular hypertrophy
Rationale: Chronic elevated afterload causes the left ventricle to thicken to compensate.
10. A patient develops sudden hypotension and muffled heart sounds after a myocardial infarction.
Most likely cause:
A. Pericardial effusion
B. Cardiac tamponade
C. Pulmonary embolism
D. Aortic stenosis
Answer: B. Cardiac tamponade
Rationale: Accumulation of fluid in the pericardium compresses the heart, leading to hypotension and
muffled heart sounds (Beck’s triad).
11. The Frank-Starling law states:
A. Increased preload → increased stroke volume
B. Increased afterload → increased stroke volume
C. Increased contractility → decreased cardiac output
D. Increased heart rate → decreased stroke volume
Answer: A. Increased preload → increased stroke volume
Rationale: The more the ventricle is stretched during filling, the stronger the contraction, up to a
physiological limit.
12. Which electrolyte imbalance increases the risk of cardiac arrhythmias?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hypomagnesemia
(2026/2027) (PDF) | Applied Pathophysiology
,NUR 376 – Applied Pathophysiology Module 3A (Week 3)
Most Tested & Most Difficult Questions (1–50)
1. Which heart valve prevents backflow of blood from the left ventricle to the left atrium?
A. Tricuspid
B. Mitral
C. Pulmonary
D. Aortic
Answer: B. Mitral
Rationale: The mitral valve (bicuspid) separates the left atrium and ventricle and prevents regurgitation
during ventricular contraction.
2. Which layer of the heart is responsible for the contractile function?
A. Endocardium
B. Epicardium
C. Myocardium
D. Pericardium
Answer: C. Myocardium
Rationale: The myocardium is the muscular middle layer that contracts to pump blood.
3. A patient with atherosclerosis has narrowed coronary arteries. Which physiologic effect is most
likely?
A. Increased cardiac output
B. Decreased myocardial oxygen delivery
C. Increased stroke volume
D. Decreased heart rate
Answer: B. Decreased myocardial oxygen delivery
Rationale: Narrowed coronary arteries reduce blood flow to the myocardium, causing ischemia.
4. Which of the following is the strongest risk factor for primary hypertension?
A. Obesity
B. Smoking
C. Age under 30
D. Hypothyroidism
,Answer: A. Obesity
Rationale: Obesity contributes to increased cardiac workload, vascular resistance, and insulin resistance,
all of which elevate blood pressure.
5. What is the primary pathophysiologic change in left-sided heart failure?
A. Right ventricular dilation
B. Pulmonary congestion
C. Systemic venous congestion
D. Pericardial effusion
Answer: B. Pulmonary congestion
Rationale: Left-sided failure causes blood to back up into the lungs, leading to pulmonary edema and
dyspnea.
6. Which type of shock is caused by severe blood loss?
A. Cardiogenic
B. Hypovolemic
C. Septic
D. Neurogenic
Answer: B. Hypovolemic
Rationale: Hypovolemic shock results from inadequate circulating volume, commonly due to
hemorrhage.
7. Which lab finding is most specific for myocardial infarction?
A. Elevated CK-MB
B. Elevated troponin I
C. Elevated myoglobin
D. Elevated LDH
Answer: B. Elevated troponin I
Rationale: Troponin I is highly specific and sensitive for myocardial injury.
8. A patient with angina reports chest pain after climbing stairs. This is an example of:
A. Unstable angina
B. Variant angina
C. Stable angina
D. Silent ischemia
, Answer: C. Stable angina
Rationale: Stable angina occurs predictably with exertion and resolves with rest or nitroglycerin.
9. Which physiologic change occurs in a patient with chronic hypertension?
A. Left ventricular hypertrophy
B. Right atrial dilation
C. Decreased systemic vascular resistance
D. Decreased afterload
Answer: A. Left ventricular hypertrophy
Rationale: Chronic elevated afterload causes the left ventricle to thicken to compensate.
10. A patient develops sudden hypotension and muffled heart sounds after a myocardial infarction.
Most likely cause:
A. Pericardial effusion
B. Cardiac tamponade
C. Pulmonary embolism
D. Aortic stenosis
Answer: B. Cardiac tamponade
Rationale: Accumulation of fluid in the pericardium compresses the heart, leading to hypotension and
muffled heart sounds (Beck’s triad).
11. The Frank-Starling law states:
A. Increased preload → increased stroke volume
B. Increased afterload → increased stroke volume
C. Increased contractility → decreased cardiac output
D. Increased heart rate → decreased stroke volume
Answer: A. Increased preload → increased stroke volume
Rationale: The more the ventricle is stretched during filling, the stronger the contraction, up to a
physiological limit.
12. Which electrolyte imbalance increases the risk of cardiac arrhythmias?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hypomagnesemia
