NURS 5315 Exam 3 UTA 2026 Actual
Exam Test Bank | Advanced
Pathophysiology | Complete0 Q&A with
Verified Answers | Graded A+
1. A patient with chronic hypertension develops left ventricular hypertrophy.
This adaptive change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
,,,,answer,,,: B) Hypertrophy
Rationale: Hypertension increases afterload, forcing the left ventricle to pump
against higher pressure. Over time, myocardial cells increase in size (hypertrophy)
as an adaptive response, not in number (hyperplasia, which occurs in dividing
cells). This initially compensates but eventually leads to diastolic dysfunction.
2. In aortic stenosis, the pressure overload on the left ventricle leads to which
type of hypertrophy?
A) Eccentric hypertrophy (increase in chamber radius)
B) Concentric hypertrophy (thickening of the wall without chamber enlargement)
C) Dilated cardiomyopathy with thinning of the wall
D) No significant change in wall thickness
,,,,answer,,,: B) Concentric hypertrophy (thickening of the wall without
chamber enlargement)
,Rationale: Pressure overload (e.g., aortic stenosis, hypertension) causes concentric
hypertrophy, where sarcomeres are added in parallel, thickening the wall and
reducing wall stress. Volume overload (e.g., aortic or mitral regurgitation) causes
eccentric hypertrophy, where sarcomeres are added in series, increasing chamber
radius.
3. A patient presents with chest pain that occurs predictably with exertion and
is relieved by rest. This is characteristic of:
A) Unstable angina
B) Stable angina
C) NSTEMI
D) STEMI
,,,,answer,,,: B) Stable angina
Rationale: Stable angina is caused by fixed coronary artery stenosis. Symptoms
are predictable (with exertion or stress) and relieved by rest or nitroglycerin.
Unstable angina occurs at rest or with minimal exertion and is unpredictable.
4. Which of the following is the most common cause of an acute myocardial
infarction (MI)?
A) Coronary artery vasospasm
B) Embolism from a cardiac thrombus
C) Plaque rupture with superimposed thrombus formation
D) Spontaneous coronary artery dissection
,,,,answer,,,: C) Plaque rupture with superimposed thrombus formation
Rationale: The vast majority of acute MIs result from the rupture or erosion of an
unstable atherosclerotic plaque, leading to platelet aggregation and thrombus
formation that occludes the coronary artery. Vasospasm is a cause of variant
(Prinzmetal) angina but not typical MI.
,5. A 62-year-old man presents with acute substernal chest pain radiating to
the jaw and left arm, diaphoresis, and shortness of breath. His ECG shows
ST-segment elevation in leads V1-V4. Which artery is most likely occluded?
A) Right coronary artery (RCA)
B) Left circumflex artery (LCx)
C) Left anterior descending artery (LAD)
D) Posterior descending artery (PDA)
,,,,answer,,,: C) Left anterior descending artery (LAD)
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall MI.
The LAD supplies blood to the anterior wall of the left ventricle, the anterior two-
thirds of the interventricular septum, and the anterior papillary muscle. Occlusion
of the RCA typically causes inferior wall MI (leads II, III, aVF).
6. Which process is responsible for slowing the heart rate?
A) Sympathetic excitation
B) Parasympathetic excitation
C) Bainbridge reflex
D) Baroreceptor reflex
,,,,answer,,,: B) Parasympathetic excitation
Rationale: The parasympathetic excitation (via the vagus nerve) slows the heart
rate and is often referred to as the cardioinhibitory center. The sympathetic
stimulation is often called the cardioaccelerator center.
7. A patient with mitral valve regurgitation would most likely present with:
A) Dyspnea, rales, pansystolic murmur, and S3/S4 heart sounds
B) Syncope, angina, and systolic ejection murmur
, C) Wide pulse pressure and bounding pulses
D) Pericardial friction rub and fever
,,,,answer,,,: A) Dyspnea, rales, pansystolic murmur, and S3/S4 heart sounds
Rationale: Mitral valve regurgitation is characterized by incomplete mitral valve
closure, allowing blood to back up from the left ventricle to the left atrium during
systole. This leads to atrial dilation/hypertrophy, increased pulmonary vascular
pressure, and pulmonary edema. Signs and symptoms include dyspnea, rales,
pansystolic murmur, and S3/S4 heart sounds.
8. Aortic valve stenosis most commonly results from:
A) Infective endocarditis
B) Aortic root dilation
C) Aortic valve calcification in patients over 60
D) Rheumatic fever in young adults
,,,,answer,,,: C) Aortic valve calcification in patients over 60
Rationale: Aortic valve stenosis is most commonly caused by aortic valve
calcification (stiffening) in people over 60. Congenital bicuspid valve is another
cause in younger patients (under 30). Normal valve area is 3 cm²; symptoms seen
when less than 1 cm².
9. In aortic valve regurgitation, the characteristic murmur is:
A) Systolic ejection murmur
B) Early diastolic murmur
C) Continuous machinery murmur
D) Late systolic murmur with click
,,,,answer,,,: B) Early diastolic murmur
Exam Test Bank | Advanced
Pathophysiology | Complete0 Q&A with
Verified Answers | Graded A+
1. A patient with chronic hypertension develops left ventricular hypertrophy.
This adaptive change is best described as:
A) Hyperplasia
B) Hypertrophy
C) Metaplasia
D) Dysplasia
,,,,answer,,,: B) Hypertrophy
Rationale: Hypertension increases afterload, forcing the left ventricle to pump
against higher pressure. Over time, myocardial cells increase in size (hypertrophy)
as an adaptive response, not in number (hyperplasia, which occurs in dividing
cells). This initially compensates but eventually leads to diastolic dysfunction.
2. In aortic stenosis, the pressure overload on the left ventricle leads to which
type of hypertrophy?
A) Eccentric hypertrophy (increase in chamber radius)
B) Concentric hypertrophy (thickening of the wall without chamber enlargement)
C) Dilated cardiomyopathy with thinning of the wall
D) No significant change in wall thickness
,,,,answer,,,: B) Concentric hypertrophy (thickening of the wall without
chamber enlargement)
,Rationale: Pressure overload (e.g., aortic stenosis, hypertension) causes concentric
hypertrophy, where sarcomeres are added in parallel, thickening the wall and
reducing wall stress. Volume overload (e.g., aortic or mitral regurgitation) causes
eccentric hypertrophy, where sarcomeres are added in series, increasing chamber
radius.
3. A patient presents with chest pain that occurs predictably with exertion and
is relieved by rest. This is characteristic of:
A) Unstable angina
B) Stable angina
C) NSTEMI
D) STEMI
,,,,answer,,,: B) Stable angina
Rationale: Stable angina is caused by fixed coronary artery stenosis. Symptoms
are predictable (with exertion or stress) and relieved by rest or nitroglycerin.
Unstable angina occurs at rest or with minimal exertion and is unpredictable.
4. Which of the following is the most common cause of an acute myocardial
infarction (MI)?
A) Coronary artery vasospasm
B) Embolism from a cardiac thrombus
C) Plaque rupture with superimposed thrombus formation
D) Spontaneous coronary artery dissection
,,,,answer,,,: C) Plaque rupture with superimposed thrombus formation
Rationale: The vast majority of acute MIs result from the rupture or erosion of an
unstable atherosclerotic plaque, leading to platelet aggregation and thrombus
formation that occludes the coronary artery. Vasospasm is a cause of variant
(Prinzmetal) angina but not typical MI.
,5. A 62-year-old man presents with acute substernal chest pain radiating to
the jaw and left arm, diaphoresis, and shortness of breath. His ECG shows
ST-segment elevation in leads V1-V4. Which artery is most likely occluded?
A) Right coronary artery (RCA)
B) Left circumflex artery (LCx)
C) Left anterior descending artery (LAD)
D) Posterior descending artery (PDA)
,,,,answer,,,: C) Left anterior descending artery (LAD)
Rationale: ST-segment elevation in leads V1-V4 indicates an anterior wall MI.
The LAD supplies blood to the anterior wall of the left ventricle, the anterior two-
thirds of the interventricular septum, and the anterior papillary muscle. Occlusion
of the RCA typically causes inferior wall MI (leads II, III, aVF).
6. Which process is responsible for slowing the heart rate?
A) Sympathetic excitation
B) Parasympathetic excitation
C) Bainbridge reflex
D) Baroreceptor reflex
,,,,answer,,,: B) Parasympathetic excitation
Rationale: The parasympathetic excitation (via the vagus nerve) slows the heart
rate and is often referred to as the cardioinhibitory center. The sympathetic
stimulation is often called the cardioaccelerator center.
7. A patient with mitral valve regurgitation would most likely present with:
A) Dyspnea, rales, pansystolic murmur, and S3/S4 heart sounds
B) Syncope, angina, and systolic ejection murmur
, C) Wide pulse pressure and bounding pulses
D) Pericardial friction rub and fever
,,,,answer,,,: A) Dyspnea, rales, pansystolic murmur, and S3/S4 heart sounds
Rationale: Mitral valve regurgitation is characterized by incomplete mitral valve
closure, allowing blood to back up from the left ventricle to the left atrium during
systole. This leads to atrial dilation/hypertrophy, increased pulmonary vascular
pressure, and pulmonary edema. Signs and symptoms include dyspnea, rales,
pansystolic murmur, and S3/S4 heart sounds.
8. Aortic valve stenosis most commonly results from:
A) Infective endocarditis
B) Aortic root dilation
C) Aortic valve calcification in patients over 60
D) Rheumatic fever in young adults
,,,,answer,,,: C) Aortic valve calcification in patients over 60
Rationale: Aortic valve stenosis is most commonly caused by aortic valve
calcification (stiffening) in people over 60. Congenital bicuspid valve is another
cause in younger patients (under 30). Normal valve area is 3 cm²; symptoms seen
when less than 1 cm².
9. In aortic valve regurgitation, the characteristic murmur is:
A) Systolic ejection murmur
B) Early diastolic murmur
C) Continuous machinery murmur
D) Late systolic murmur with click
,,,,answer,,,: B) Early diastolic murmur
