NSG 3850 Exam 1 Pathophysiology II Prep 2026 | 200
Practice Questions with Answers & Rationales | Nursing
Study Guide
Section 1: Cardiovascular Pathophysiology (Questions 1–30)
1. A patient with chronic hypertension develops left ventricular hypertrophy. This is an example of:
A) Metaplasia
B) Dysplasia
C) Hyperplasia
D) Hypertrophy
Answer: D
Explanation: Hypertrophy is an increase in cell size, leading to enlargement of the heart muscle in
response to increased afterload. Hyperplasia is an increase in cell number.
2. True or False: Aortic stenosis causes pressure overload of the left ventricle.
Answer: True
Explanation: Aortic stenosis increases resistance to ejection, causing left ventricular pressure overload
and concentric hypertrophy.
3. Which of the following is a hallmark of heart failure with reduced ejection fraction (HFrEF)?
A) Left ventricular ejection fraction (LVEF) <40%
B) Preserved LVEF (>50%)
C) Normal brain natriuretic peptide (BNP)
D) Isolated diastolic dysfunction
Answer: A
,Explanation: HFrEF is defined by LVEF ≤40%. HFpEF (preserved ejection fraction) has LVEF ≥50% with
diastolic dysfunction.
4. True or False: BNP is released from ventricular myocytes in response to increased wall tension.
Answer: True
Explanation: BNP (B‑type natriuretic peptide) is a biomarker for heart failure; elevated levels indicate
ventricular stretch.
5. The most common cause of right‑sided heart failure is:
A) Left‑sided heart failure
B) Pulmonary hypertension
C) Cor pulmonale
D) Myocardial infarction
Answer: A
Explanation: Left‑sided heart failure leads to pulmonary congestion and increased afterload on the right
ventricle, eventually causing right‑sided failure.
6. True or False: Jugular venous distention (JVD) is a sign of right‑sided heart failure.
Answer: True
Explanation: Right‑sided failure causes systemic venous congestion, leading to JVD, hepatomegaly,
ascites, and peripheral edema.
7. A patient with acute myocardial infarction develops a new systolic murmur. Which complication is
most likely?
A) Cardiac tamponade
B) Ventricular septal rupture
C) Papillary muscle rupture
D) Free wall rupture
,Answer: C
Explanation: Papillary muscle rupture causes acute mitral regurgitation, producing a holosystolic
murmur. Ventricular septal rupture causes a harsh holosystolic murmur and thrill.
8. True or False: Unstable angina is characterized by elevated cardiac troponin levels.
Answer: False
Explanation: Unstable angina is defined by ischemic symptoms without elevated biomarkers of
myocardial necrosis. Non‑ST‑elevation MI (NSTEMI) has elevated troponin.
9. Which of the following ECG findings is diagnostic of ST‑elevation myocardial infarction (STEMI)?
A) ST‑segment depression
B) T‑wave inversion
C) ST‑segment elevation in two contiguous leads
D) Pathologic Q waves only
Answer: C
Explanation: STEMI is defined by new ST‑segment elevation at the J point in two contiguous leads. Q
waves may develop later.
10. True or False: Atherosclerosis begins with endothelial injury and accumulation of low‑density
lipoproteins (LDL).
Answer: True
Explanation: The response‑to‑injury hypothesis describes endothelial damage, LDL deposition,
oxidation, and recruitment of monocytes/macrophages.
11. Which of the following is a risk factor for venous thromboembolism (VTE)?
A) Immobilization
B) Active cancer
C) Recent surgery
D) All of the above
, Answer: D
Explanation: Virchow’s triad (venous stasis, hypercoagulability, endothelial injury) includes all these risk
factors.
12. True or False: Deep vein thrombosis (DVT) of the lower extremity most commonly originates in the
calf veins.
Answer: True
Explanation: DVTs often start in the calf veins; proximal DVTs (popliteal, femoral, iliac) have higher risk
of pulmonary embolism.
13. The hallmark of cardiac tamponade is:
A) Narrowed pulse pressure and pulsus paradoxus
B) Widened pulse pressure
C) Bounding pulses
D) Hypertension
Answer: A
Explanation: Cardiac tamponade presents with hypotension, distended neck veins, muffled heart sounds
(Beck’s triad), and pulsus paradoxus (exaggerated drop in systolic BP during inspiration).
14. True or False: Pericarditis often causes a friction rub that is best heard with the patient leaning
forward.
Answer: True
Explanation: Pericardial friction rub is a scratchy, high‑pitched sound; leaning forward and holding
expiration may enhance it.
15. Infective endocarditis most commonly affects:
A) The tricuspid valve
B) The aortic valve
C) The mitral valve
Practice Questions with Answers & Rationales | Nursing
Study Guide
Section 1: Cardiovascular Pathophysiology (Questions 1–30)
1. A patient with chronic hypertension develops left ventricular hypertrophy. This is an example of:
A) Metaplasia
B) Dysplasia
C) Hyperplasia
D) Hypertrophy
Answer: D
Explanation: Hypertrophy is an increase in cell size, leading to enlargement of the heart muscle in
response to increased afterload. Hyperplasia is an increase in cell number.
2. True or False: Aortic stenosis causes pressure overload of the left ventricle.
Answer: True
Explanation: Aortic stenosis increases resistance to ejection, causing left ventricular pressure overload
and concentric hypertrophy.
3. Which of the following is a hallmark of heart failure with reduced ejection fraction (HFrEF)?
A) Left ventricular ejection fraction (LVEF) <40%
B) Preserved LVEF (>50%)
C) Normal brain natriuretic peptide (BNP)
D) Isolated diastolic dysfunction
Answer: A
,Explanation: HFrEF is defined by LVEF ≤40%. HFpEF (preserved ejection fraction) has LVEF ≥50% with
diastolic dysfunction.
4. True or False: BNP is released from ventricular myocytes in response to increased wall tension.
Answer: True
Explanation: BNP (B‑type natriuretic peptide) is a biomarker for heart failure; elevated levels indicate
ventricular stretch.
5. The most common cause of right‑sided heart failure is:
A) Left‑sided heart failure
B) Pulmonary hypertension
C) Cor pulmonale
D) Myocardial infarction
Answer: A
Explanation: Left‑sided heart failure leads to pulmonary congestion and increased afterload on the right
ventricle, eventually causing right‑sided failure.
6. True or False: Jugular venous distention (JVD) is a sign of right‑sided heart failure.
Answer: True
Explanation: Right‑sided failure causes systemic venous congestion, leading to JVD, hepatomegaly,
ascites, and peripheral edema.
7. A patient with acute myocardial infarction develops a new systolic murmur. Which complication is
most likely?
A) Cardiac tamponade
B) Ventricular septal rupture
C) Papillary muscle rupture
D) Free wall rupture
,Answer: C
Explanation: Papillary muscle rupture causes acute mitral regurgitation, producing a holosystolic
murmur. Ventricular septal rupture causes a harsh holosystolic murmur and thrill.
8. True or False: Unstable angina is characterized by elevated cardiac troponin levels.
Answer: False
Explanation: Unstable angina is defined by ischemic symptoms without elevated biomarkers of
myocardial necrosis. Non‑ST‑elevation MI (NSTEMI) has elevated troponin.
9. Which of the following ECG findings is diagnostic of ST‑elevation myocardial infarction (STEMI)?
A) ST‑segment depression
B) T‑wave inversion
C) ST‑segment elevation in two contiguous leads
D) Pathologic Q waves only
Answer: C
Explanation: STEMI is defined by new ST‑segment elevation at the J point in two contiguous leads. Q
waves may develop later.
10. True or False: Atherosclerosis begins with endothelial injury and accumulation of low‑density
lipoproteins (LDL).
Answer: True
Explanation: The response‑to‑injury hypothesis describes endothelial damage, LDL deposition,
oxidation, and recruitment of monocytes/macrophages.
11. Which of the following is a risk factor for venous thromboembolism (VTE)?
A) Immobilization
B) Active cancer
C) Recent surgery
D) All of the above
, Answer: D
Explanation: Virchow’s triad (venous stasis, hypercoagulability, endothelial injury) includes all these risk
factors.
12. True or False: Deep vein thrombosis (DVT) of the lower extremity most commonly originates in the
calf veins.
Answer: True
Explanation: DVTs often start in the calf veins; proximal DVTs (popliteal, femoral, iliac) have higher risk
of pulmonary embolism.
13. The hallmark of cardiac tamponade is:
A) Narrowed pulse pressure and pulsus paradoxus
B) Widened pulse pressure
C) Bounding pulses
D) Hypertension
Answer: A
Explanation: Cardiac tamponade presents with hypotension, distended neck veins, muffled heart sounds
(Beck’s triad), and pulsus paradoxus (exaggerated drop in systolic BP during inspiration).
14. True or False: Pericarditis often causes a friction rub that is best heard with the patient leaning
forward.
Answer: True
Explanation: Pericardial friction rub is a scratchy, high‑pitched sound; leaning forward and holding
expiration may enhance it.
15. Infective endocarditis most commonly affects:
A) The tricuspid valve
B) The aortic valve
C) The mitral valve
