Portage Learning | Pathophysiology |
NURS 231/BIOD 331 Exam Prep with
Complete Solutions
1. Which mechanism is primarily responsible for edema formation in
congestive heart failure?
A. Increased oncotic pressure
B. Decreased hydrostatic pressure
C. Increased capillary hydrostatic pressure
D. Increased lymphatic drainage
Correct Answer: C
Explanation: In congestive heart failure, poor cardiac output leads to
venous congestion. This increases capillary hydrostatic pressure,
forcing fluid out of the vessels and into the interstitial space. The
lymphatic system becomes overwhelmed, resulting in edema. Oncotic
pressure is often unchanged or reduced.
2. What is the primary pathophysiologic cause of atherosclerosis?
A. Acute infection
B. Lipid accumulation and chronic inflammation
C. Sudden arterial spasm
D. Venous obstruction
Correct Answer: B
Explanation: Atherosclerosis develops from lipid deposition within the
arterial wall combined with chronic inflammatory processes. LDL
cholesterol triggers endothelial injury, leading to plaque formation.
Over time, plaques narrow arteries and impair blood flow. This process
increases the risk of cardiovascular events.
3. Which condition results from prolonged hypertension?
A. Left ventricular hypertrophy
B. Mitral valve prolapse
C. Pulmonary embolism
D. Cardiac tamponade
Correct Answer: A
Explanation: Chronic hypertension forces the left ventricle to pump
against increased resistance. To compensate, the ventricular wall
thickens, resulting in left ventricular hypertrophy. While initially
adaptive, this change can eventually impair cardiac function. It also
increases the risk of heart failure.
4. What is the primary cause of myocardial infarction?
A. Coronary artery vasodilation
B. Sudden drop in blood pressure
C. Prolonged ischemia due to coronary artery blockage
, D. Increased oxygen delivery
Correct Answer: C
Explanation: Myocardial infarction occurs when coronary blood flow is
blocked, usually by a thrombus overlying an atherosclerotic plaque.
This leads to prolonged ischemia and irreversible myocardial cell
death. Early restoration of blood flow is critical to limit damage.
Symptoms often include chest pain and dyspnea.
5. Which electrolyte imbalance is most commonly associated with cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B
Explanation: Potassium plays a critical role in cardiac electrical
conduction. Hypokalemia alters membrane potential, increasing the
risk of dysrhythmias. It may result from diuretic use, vomiting, or
diarrhea. Monitoring potassium levels is essential in cardiac patients.
6. What is the hallmark pathophysiologic feature of heart failure?
A. Increased cardiac output
B. Decreased preload
C. Inability of the heart to meet metabolic demands
D. Excessive oxygen delivery
Correct Answer: C
Explanation: Heart failure occurs when the heart cannot pump
sufficient blood to meet the body’s metabolic needs. This can result
from impaired contractility or filling. Compensatory mechanisms
initially help but eventually worsen symptoms. Common manifestations
include fatigue and fluid retention.
7. Which hormone is primarily responsible for fluid retention in heart
failure?
A. Insulin
B. Aldosterone
C. Thyroxine
D. Parathyroid hormone
Correct Answer: B
Explanation: Aldosterone promotes sodium and water reabsorption in
the kidneys. In heart failure, decreased perfusion activates the renin-
angiotensin-aldosterone system. This leads to fluid retention and
worsens edema. Although compensatory, it ultimately increases
cardiac workload.
8. What occurs during stable angina?
A. Complete coronary artery occlusion
B. Chest pain at rest only
C. Transient myocardial ischemia during exertion
D. Myocardial necrosis
, Correct Answer: C
Explanation: Stable angina is caused by transient ischemia due to
partial coronary artery obstruction. Symptoms typically occur during
physical exertion or stress and resolve with rest. There is no
permanent myocardial damage. Nitroglycerin often relieves symptoms.
9. Which factor increases the risk of thrombus formation?
A. Increased blood flow
B. Decreased platelet aggregation
C. Endothelial injury
D. Reduced coagulation factors
Correct Answer: C
Explanation: Endothelial injury exposes underlying tissue, promoting
platelet adhesion and clot formation. This is one component of
Virchow’s triad. Injury may result from hypertension, smoking, or
atherosclerosis. Thrombi can obstruct blood flow or embolize.
10. What is the primary effect of chronic hypoxia on pulmonary
circulation?
A. Pulmonary vasodilation
B. Pulmonary hypertension
C. Decreased red blood cell production
D. Reduced cardiac output
Correct Answer: B
Explanation: Chronic hypoxia causes vasoconstriction in pulmonary
vessels. Over time, this leads to pulmonary hypertension. Increased
pulmonary resistance strains the right side of the heart. This may
progress to right-sided heart failure.
11. Which condition is characterized by inflammation of the
endocardium?
A. Myocarditis
B. Pericarditis
C. Endocarditis
D. Cardiomyopathy
Correct Answer: C
Explanation: Endocarditis involves inflammation of the inner lining of
the heart chambers and valves. It is often caused by bacterial
infection. Vegetations may form, impairing valve function. Untreated
endocarditis can be life-threatening.
12. What is the primary cause of cardiogenic shock?
A. Severe dehydration
B. Loss of myocardial contractility
C. Systemic infection
D. Anaphylaxis
Correct Answer: B
Explanation: Cardiogenic shock results from the heart’s inability to
pump effectively. It often follows a massive myocardial infarction.
, Decreased cardiac output leads to poor tissue perfusion. This condition
requires immediate intervention.
13. Which lab marker is most specific for myocardial injury?
A. Creatinine
B. Troponin
C. C-reactive protein
D. Potassium
Correct Answer: B
Explanation: Troponin is released into the bloodstream when
myocardial cells are damaged. It is highly specific and sensitive for
myocardial infarction. Elevated levels indicate cardiac injury. Troponin
remains elevated for several days.
14. What happens to preload in left-sided heart failure?
A. It decreases
B. It remains normal
C. It increases
D. It is eliminated
Correct Answer: C
Explanation: In left-sided heart failure, blood backs up into the
pulmonary circulation. This increases venous return to the heart,
raising preload. Increased preload initially helps maintain output but
eventually worsens congestion. Pulmonary edema may develop.
15. Which condition results from chronic right-sided heart failure?
A. Pulmonary edema
B. Hepatomegaly
C. Cerebral hypoxia
D. Left ventricular hypertrophy
Correct Answer: B
Explanation: Right-sided heart failure causes blood to back up into
systemic circulation. This leads to liver congestion and hepatomegaly.
Peripheral edema and ascites are also common. These symptoms
reflect systemic venous congestion.
16. What is the primary cause of essential hypertension?
A. Identifiable secondary disease
B. Genetic and environmental factors
C. Renal artery obstruction
D. Endocrine tumors
Correct Answer: B
Explanation: Essential hypertension has no single identifiable cause. It
results from a combination of genetic predisposition and lifestyle
factors. These include diet, obesity, and stress. It accounts for most
hypertension cases.
17. Which mechanism compensates for decreased cardiac output?
A. Decreased heart rate
B. Vasodilation
C. Sympathetic nervous system activation
NURS 231/BIOD 331 Exam Prep with
Complete Solutions
1. Which mechanism is primarily responsible for edema formation in
congestive heart failure?
A. Increased oncotic pressure
B. Decreased hydrostatic pressure
C. Increased capillary hydrostatic pressure
D. Increased lymphatic drainage
Correct Answer: C
Explanation: In congestive heart failure, poor cardiac output leads to
venous congestion. This increases capillary hydrostatic pressure,
forcing fluid out of the vessels and into the interstitial space. The
lymphatic system becomes overwhelmed, resulting in edema. Oncotic
pressure is often unchanged or reduced.
2. What is the primary pathophysiologic cause of atherosclerosis?
A. Acute infection
B. Lipid accumulation and chronic inflammation
C. Sudden arterial spasm
D. Venous obstruction
Correct Answer: B
Explanation: Atherosclerosis develops from lipid deposition within the
arterial wall combined with chronic inflammatory processes. LDL
cholesterol triggers endothelial injury, leading to plaque formation.
Over time, plaques narrow arteries and impair blood flow. This process
increases the risk of cardiovascular events.
3. Which condition results from prolonged hypertension?
A. Left ventricular hypertrophy
B. Mitral valve prolapse
C. Pulmonary embolism
D. Cardiac tamponade
Correct Answer: A
Explanation: Chronic hypertension forces the left ventricle to pump
against increased resistance. To compensate, the ventricular wall
thickens, resulting in left ventricular hypertrophy. While initially
adaptive, this change can eventually impair cardiac function. It also
increases the risk of heart failure.
4. What is the primary cause of myocardial infarction?
A. Coronary artery vasodilation
B. Sudden drop in blood pressure
C. Prolonged ischemia due to coronary artery blockage
, D. Increased oxygen delivery
Correct Answer: C
Explanation: Myocardial infarction occurs when coronary blood flow is
blocked, usually by a thrombus overlying an atherosclerotic plaque.
This leads to prolonged ischemia and irreversible myocardial cell
death. Early restoration of blood flow is critical to limit damage.
Symptoms often include chest pain and dyspnea.
5. Which electrolyte imbalance is most commonly associated with cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B
Explanation: Potassium plays a critical role in cardiac electrical
conduction. Hypokalemia alters membrane potential, increasing the
risk of dysrhythmias. It may result from diuretic use, vomiting, or
diarrhea. Monitoring potassium levels is essential in cardiac patients.
6. What is the hallmark pathophysiologic feature of heart failure?
A. Increased cardiac output
B. Decreased preload
C. Inability of the heart to meet metabolic demands
D. Excessive oxygen delivery
Correct Answer: C
Explanation: Heart failure occurs when the heart cannot pump
sufficient blood to meet the body’s metabolic needs. This can result
from impaired contractility or filling. Compensatory mechanisms
initially help but eventually worsen symptoms. Common manifestations
include fatigue and fluid retention.
7. Which hormone is primarily responsible for fluid retention in heart
failure?
A. Insulin
B. Aldosterone
C. Thyroxine
D. Parathyroid hormone
Correct Answer: B
Explanation: Aldosterone promotes sodium and water reabsorption in
the kidneys. In heart failure, decreased perfusion activates the renin-
angiotensin-aldosterone system. This leads to fluid retention and
worsens edema. Although compensatory, it ultimately increases
cardiac workload.
8. What occurs during stable angina?
A. Complete coronary artery occlusion
B. Chest pain at rest only
C. Transient myocardial ischemia during exertion
D. Myocardial necrosis
, Correct Answer: C
Explanation: Stable angina is caused by transient ischemia due to
partial coronary artery obstruction. Symptoms typically occur during
physical exertion or stress and resolve with rest. There is no
permanent myocardial damage. Nitroglycerin often relieves symptoms.
9. Which factor increases the risk of thrombus formation?
A. Increased blood flow
B. Decreased platelet aggregation
C. Endothelial injury
D. Reduced coagulation factors
Correct Answer: C
Explanation: Endothelial injury exposes underlying tissue, promoting
platelet adhesion and clot formation. This is one component of
Virchow’s triad. Injury may result from hypertension, smoking, or
atherosclerosis. Thrombi can obstruct blood flow or embolize.
10. What is the primary effect of chronic hypoxia on pulmonary
circulation?
A. Pulmonary vasodilation
B. Pulmonary hypertension
C. Decreased red blood cell production
D. Reduced cardiac output
Correct Answer: B
Explanation: Chronic hypoxia causes vasoconstriction in pulmonary
vessels. Over time, this leads to pulmonary hypertension. Increased
pulmonary resistance strains the right side of the heart. This may
progress to right-sided heart failure.
11. Which condition is characterized by inflammation of the
endocardium?
A. Myocarditis
B. Pericarditis
C. Endocarditis
D. Cardiomyopathy
Correct Answer: C
Explanation: Endocarditis involves inflammation of the inner lining of
the heart chambers and valves. It is often caused by bacterial
infection. Vegetations may form, impairing valve function. Untreated
endocarditis can be life-threatening.
12. What is the primary cause of cardiogenic shock?
A. Severe dehydration
B. Loss of myocardial contractility
C. Systemic infection
D. Anaphylaxis
Correct Answer: B
Explanation: Cardiogenic shock results from the heart’s inability to
pump effectively. It often follows a massive myocardial infarction.
, Decreased cardiac output leads to poor tissue perfusion. This condition
requires immediate intervention.
13. Which lab marker is most specific for myocardial injury?
A. Creatinine
B. Troponin
C. C-reactive protein
D. Potassium
Correct Answer: B
Explanation: Troponin is released into the bloodstream when
myocardial cells are damaged. It is highly specific and sensitive for
myocardial infarction. Elevated levels indicate cardiac injury. Troponin
remains elevated for several days.
14. What happens to preload in left-sided heart failure?
A. It decreases
B. It remains normal
C. It increases
D. It is eliminated
Correct Answer: C
Explanation: In left-sided heart failure, blood backs up into the
pulmonary circulation. This increases venous return to the heart,
raising preload. Increased preload initially helps maintain output but
eventually worsens congestion. Pulmonary edema may develop.
15. Which condition results from chronic right-sided heart failure?
A. Pulmonary edema
B. Hepatomegaly
C. Cerebral hypoxia
D. Left ventricular hypertrophy
Correct Answer: B
Explanation: Right-sided heart failure causes blood to back up into
systemic circulation. This leads to liver congestion and hepatomegaly.
Peripheral edema and ascites are also common. These symptoms
reflect systemic venous congestion.
16. What is the primary cause of essential hypertension?
A. Identifiable secondary disease
B. Genetic and environmental factors
C. Renal artery obstruction
D. Endocrine tumors
Correct Answer: B
Explanation: Essential hypertension has no single identifiable cause. It
results from a combination of genetic predisposition and lifestyle
factors. These include diet, obesity, and stress. It accounts for most
hypertension cases.
17. Which mechanism compensates for decreased cardiac output?
A. Decreased heart rate
B. Vasodilation
C. Sympathetic nervous system activation
