NUR 631/NUR631 Exam 2 V2 | Advanced
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Orthopnea
D. Hepatomegaly
Correct Answer: C
Expert Explanation: Orthopnea is the difficulty breathing while lying flat and is a hallmark
of pulmonary congestion in left-sided heart failure. When a patient lies down, fluid is
redistributed from the lower extremities to the lungs, increasing preload on an already
failing left ventricle. Other symptoms like peripheral edema and jugular venous distention
are more commonly associated with right-sided heart failure.
2. In the pathophysiology of atherosclerosis, what is the first step in the formation of a fatty
streak?
A. Endothelial injury and inflammation
B. Platelet aggregation
C. Smooth muscle cell proliferation
,D. Rupture of fibrous plaque
Correct Answer: A
Expert Explanation: The development of atherosclerosis begins with injury to the
endothelial cells lining the arterial wall. This injury triggers an inflammatory response that
leads to the migration of leukocytes and the accumulation of lipids. Without this initial
endothelial dysfunction, the cascade of plaque formation would not occur.
3. A patient is diagnosed with nephrotic syndrome. Which laboratory finding would the nurse
expect to see?
A. Proteinuria greater than 3.5 g/day
B. Gross hematuria
C. Hypolipidemia
D. Elevated serum albumin
Correct Answer: A
Expert Explanation: Nephrotic syndrome is defined by massive proteinuria exceeding 3.5
grams per day due to increased glomerular permeability. This loss of protein leads to
hypoalbuminemia and generalized edema as plasma oncotic pressure drops. In contrast,
hematuria is a defining characteristic of nephritic syndrome rather than nephrotic
syndrome.
4. What is the primary mechanism by which Angiotensin II increases blood pressure?
A. Systemic vasoconstriction
, B. Inhibiting aldosterone secretion
C. Promoting vasodilation
D. Increasing urinary sodium excretion
Correct Answer: A
Expert Explanation: Angiotensin II is a potent vasoconstrictor that directly increases
systemic vascular resistance and blood pressure. It also stimulates the adrenal cortex to
release aldosterone, which leads to sodium and water retention by the kidneys. These
combined actions significantly elevate circulating blood volume and arterial pressure.
5. A patient with emphysema presents with a ‘barrel chest.’ This physical finding is primarily
due to:
A. Chronic inflammation of the bronchi
B. Pulmonary fibrosis and scarring
C. Fluid accumulation in the pleural space
D. Air trapping and hyperinflation
Correct Answer: D
Expert Explanation: Emphysema involves the destruction of alveolar walls and loss of
elastic recoil, which leads to permanent air trapping. Over time, the lungs remain partially
inflated during expiration, forcing the rib cage to expand and remain in an inspiratory
Physiology and Pathophysiology Q&A with
Rationale | Grand Canyon University
1. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Jugular venous distention
C. Orthopnea
D. Hepatomegaly
Correct Answer: C
Expert Explanation: Orthopnea is the difficulty breathing while lying flat and is a hallmark
of pulmonary congestion in left-sided heart failure. When a patient lies down, fluid is
redistributed from the lower extremities to the lungs, increasing preload on an already
failing left ventricle. Other symptoms like peripheral edema and jugular venous distention
are more commonly associated with right-sided heart failure.
2. In the pathophysiology of atherosclerosis, what is the first step in the formation of a fatty
streak?
A. Endothelial injury and inflammation
B. Platelet aggregation
C. Smooth muscle cell proliferation
,D. Rupture of fibrous plaque
Correct Answer: A
Expert Explanation: The development of atherosclerosis begins with injury to the
endothelial cells lining the arterial wall. This injury triggers an inflammatory response that
leads to the migration of leukocytes and the accumulation of lipids. Without this initial
endothelial dysfunction, the cascade of plaque formation would not occur.
3. A patient is diagnosed with nephrotic syndrome. Which laboratory finding would the nurse
expect to see?
A. Proteinuria greater than 3.5 g/day
B. Gross hematuria
C. Hypolipidemia
D. Elevated serum albumin
Correct Answer: A
Expert Explanation: Nephrotic syndrome is defined by massive proteinuria exceeding 3.5
grams per day due to increased glomerular permeability. This loss of protein leads to
hypoalbuminemia and generalized edema as plasma oncotic pressure drops. In contrast,
hematuria is a defining characteristic of nephritic syndrome rather than nephrotic
syndrome.
4. What is the primary mechanism by which Angiotensin II increases blood pressure?
A. Systemic vasoconstriction
, B. Inhibiting aldosterone secretion
C. Promoting vasodilation
D. Increasing urinary sodium excretion
Correct Answer: A
Expert Explanation: Angiotensin II is a potent vasoconstrictor that directly increases
systemic vascular resistance and blood pressure. It also stimulates the adrenal cortex to
release aldosterone, which leads to sodium and water retention by the kidneys. These
combined actions significantly elevate circulating blood volume and arterial pressure.
5. A patient with emphysema presents with a ‘barrel chest.’ This physical finding is primarily
due to:
A. Chronic inflammation of the bronchi
B. Pulmonary fibrosis and scarring
C. Fluid accumulation in the pleural space
D. Air trapping and hyperinflation
Correct Answer: D
Expert Explanation: Emphysema involves the destruction of alveolar walls and loss of
elastic recoil, which leads to permanent air trapping. Over time, the lungs remain partially
inflated during expiration, forcing the rib cage to expand and remain in an inspiratory
