NURS 5315 PATHOPHYSIOLOGY THE BIOLOGIC
BASIS FOR DISEASE IN ADULTS AND CHILDREN
2026 LEARNING MODULE ASSESSMENT
QUESTIONS AND ANSWERS 100%
◉ Heart Failure with PRESERVED Ejection Fraction (HFpEF),
LEFT-SIDED heart failure. Answer: -Diastolic heart failure (heart
can't relax)
-Characterized by pulmonary congestion in the presence of normal
left systolic ejection fraction, stoke volume, and cardiac output.
-More common in WOMEN
-Most commonly caused by hypertension-induced hypertrophy or
myocardial ischemia resulting in remodeling
-Patho: Myocytes are unable to actively pump out CALCIUM, which
IMPAIRS VENTRICULAR RELAXATION.
-Pressure backs up into left atrium and pulmonary circulation,
resulting in PULMONARY EDEMA.
-Over time, pulmonary hypertension and right-sided failure may
develop.
◉ Heart failure with Reduced Ejection Fraction combined with Heart
Failure with Heart Failure with Preserved Ejection Fraction (HFrEF
,combined with HFpEF). Answer: Combination of SYSTOLIC &
DIASTOLIC heart failure
◉ Left-sided heart failure. Answer: Same as HFrEF. Systolic heart
failure.
Heart Failure with Reduced Ejection Fraction
*Systolic heart failure - avoid calcium channel blockers (Diltiazem &
Verapamil)*
◉ RIGHT-sided Heart Failure. Answer: -Characterized by failing right
ventricle which results in its inability to pump blood forward to the
pulmonary circulation
-Most common CAUSE is LEFT-sided heart failure, but it can occur
without left-sided heart failure
-When it happens without left-sided failure, it's usually the result of
LUNG DISORDERS, such as COPD, cystic fibrosis, ARDS, pulmonary
fibrosis, pulmonary hypertension.
-When pressures are too high in left ventricle, the back flow of blood
into the pulmonary circulation against causes higher pressures in
the pulmonary circulation against which the right ventricle must
pump.
-The right ventricle is unable to effectively pump against the
increased pressure and it ultimatately dilates and fails.
,-As a result, the pressure and volume backs up causing right atrial
hypertrophy, JUGULAR VEIN DISTENTION, hepatosplenomegaly, and
peripheral edema.
◉ Systolic heart failure patients should avoid what meds?. Answer:
Calcium channel blockers (Diltiazem & Verapamil)*
In systolic heart failure, the contraction is weak. Calcium helps to
strengthen the contraction (systole), so you don't want the calcium
blocked!
◉ What increases contraction?. Answer: *Systolic heart failure needs
help contracting!*
-Catecholamines - epinephrine & norepinephrine make heart pump
harder
-Increases in intracellular calcium
-Decreased sodium in blood (decreases activity of the
sodium/calcium exchanger)
-DIGITALIS: increases intracellular calcium
◉ What decreases contraction and promotes r? (improves diastolic
heart failure). Answer: *Diastolic heart failure needs help relaxing!*
-Beta Blockers: Block effects of catecholamines. Metoprolol, Bystolic
, -Acidosis
-Hypoxia/hypercapnia
-Calcium channel blockers
◉ Systole. Answer: Contraction of heart as it shoots blood
◉ Diastole. Answer: Relaxing of heart so it can fill with blood
◉ Systolic heart failure. Answer: Heart can't contract
◉ Diastolic heart failure. Answer: Heart can't relax
◉ Coronary artery dominance. Answer: 85% of people are right
dominant
Right dominant - posterior descending artery arises from right
coronary artery
Left dominant - posterior descending artery arises from left
circumflex artery (about 8% of population)
Codominant - posterior descending artery arises from both the left &
right coronary arteries
BASIS FOR DISEASE IN ADULTS AND CHILDREN
2026 LEARNING MODULE ASSESSMENT
QUESTIONS AND ANSWERS 100%
◉ Heart Failure with PRESERVED Ejection Fraction (HFpEF),
LEFT-SIDED heart failure. Answer: -Diastolic heart failure (heart
can't relax)
-Characterized by pulmonary congestion in the presence of normal
left systolic ejection fraction, stoke volume, and cardiac output.
-More common in WOMEN
-Most commonly caused by hypertension-induced hypertrophy or
myocardial ischemia resulting in remodeling
-Patho: Myocytes are unable to actively pump out CALCIUM, which
IMPAIRS VENTRICULAR RELAXATION.
-Pressure backs up into left atrium and pulmonary circulation,
resulting in PULMONARY EDEMA.
-Over time, pulmonary hypertension and right-sided failure may
develop.
◉ Heart failure with Reduced Ejection Fraction combined with Heart
Failure with Heart Failure with Preserved Ejection Fraction (HFrEF
,combined with HFpEF). Answer: Combination of SYSTOLIC &
DIASTOLIC heart failure
◉ Left-sided heart failure. Answer: Same as HFrEF. Systolic heart
failure.
Heart Failure with Reduced Ejection Fraction
*Systolic heart failure - avoid calcium channel blockers (Diltiazem &
Verapamil)*
◉ RIGHT-sided Heart Failure. Answer: -Characterized by failing right
ventricle which results in its inability to pump blood forward to the
pulmonary circulation
-Most common CAUSE is LEFT-sided heart failure, but it can occur
without left-sided heart failure
-When it happens without left-sided failure, it's usually the result of
LUNG DISORDERS, such as COPD, cystic fibrosis, ARDS, pulmonary
fibrosis, pulmonary hypertension.
-When pressures are too high in left ventricle, the back flow of blood
into the pulmonary circulation against causes higher pressures in
the pulmonary circulation against which the right ventricle must
pump.
-The right ventricle is unable to effectively pump against the
increased pressure and it ultimatately dilates and fails.
,-As a result, the pressure and volume backs up causing right atrial
hypertrophy, JUGULAR VEIN DISTENTION, hepatosplenomegaly, and
peripheral edema.
◉ Systolic heart failure patients should avoid what meds?. Answer:
Calcium channel blockers (Diltiazem & Verapamil)*
In systolic heart failure, the contraction is weak. Calcium helps to
strengthen the contraction (systole), so you don't want the calcium
blocked!
◉ What increases contraction?. Answer: *Systolic heart failure needs
help contracting!*
-Catecholamines - epinephrine & norepinephrine make heart pump
harder
-Increases in intracellular calcium
-Decreased sodium in blood (decreases activity of the
sodium/calcium exchanger)
-DIGITALIS: increases intracellular calcium
◉ What decreases contraction and promotes r? (improves diastolic
heart failure). Answer: *Diastolic heart failure needs help relaxing!*
-Beta Blockers: Block effects of catecholamines. Metoprolol, Bystolic
, -Acidosis
-Hypoxia/hypercapnia
-Calcium channel blockers
◉ Systole. Answer: Contraction of heart as it shoots blood
◉ Diastole. Answer: Relaxing of heart so it can fill with blood
◉ Systolic heart failure. Answer: Heart can't contract
◉ Diastolic heart failure. Answer: Heart can't relax
◉ Coronary artery dominance. Answer: 85% of people are right
dominant
Right dominant - posterior descending artery arises from right
coronary artery
Left dominant - posterior descending artery arises from left
circumflex artery (about 8% of population)
Codominant - posterior descending artery arises from both the left &
right coronary arteries
