,NUR 5461 EXAM 3 – Advanced Pathophysiology
(2026)
William Paterson University (WPU) – Practice
Examination
Questions 1–200
SECTION 1: Cardiovascular Pathophysiology
(Questions 1–50)
1. A patient with heart failure with reduced
ejection fraction (HFrEF) has an ejection fraction of
35%. Which pathophysiological mechanism best
explains the development of HFrEF?
A. Impaired ventricular relaxation with normal
contractility
B. Reduced left ventricular contractility with
decreased ejection fraction
,C. Obstructive outflow tract hypertrophy
D. Dilated ventricular chambers with wall thinning
Answer: B
Rationale: HFrEF (systolic heart failure) is
characterized by reduced left ventricular
contractility, leading to decreased ejection fraction
(<40%). The heart cannot pump blood effectively,
causing forward failure and backward congestion.
2. A patient with heart failure with preserved
ejection fraction (HFpEF) has an ejection fraction
of 60%. Which pathophysiological mechanism best
explains HFpEF?
A. Reduced left ventricular contractility
B. Impaired ventricular relaxation and increased
filling pressure (diastolic dysfunction)
C. Obstructive outflow tract hypertrophy
D. Dilated ventricular chambers
Answer: B
, Rationale: HFpEF (diastolic heart failure) is
characterized by normal ejection fraction (>50%)
but impaired ventricular relaxation (diastolic
dysfunction), leading to increased filling pressures
and pulmonary congestion.
3. A patient with acute decompensated heart
failure presents with dyspnea, crackles, and
jugular venous distention. Which medication is
most appropriate for immediate symptom relief?
A. Digoxin
B. Furosemide (IV)
C. Metoprolol
D. Spironolactone
Answer: B
Rationale: IV furosemide is the first-line treatment
for acute decompensated heart failure to reduce
volume overload and relieve pulmonary congestion.
Digoxin is used for chronic HF. Beta-blockers are
used in chronic HF.
(2026)
William Paterson University (WPU) – Practice
Examination
Questions 1–200
SECTION 1: Cardiovascular Pathophysiology
(Questions 1–50)
1. A patient with heart failure with reduced
ejection fraction (HFrEF) has an ejection fraction of
35%. Which pathophysiological mechanism best
explains the development of HFrEF?
A. Impaired ventricular relaxation with normal
contractility
B. Reduced left ventricular contractility with
decreased ejection fraction
,C. Obstructive outflow tract hypertrophy
D. Dilated ventricular chambers with wall thinning
Answer: B
Rationale: HFrEF (systolic heart failure) is
characterized by reduced left ventricular
contractility, leading to decreased ejection fraction
(<40%). The heart cannot pump blood effectively,
causing forward failure and backward congestion.
2. A patient with heart failure with preserved
ejection fraction (HFpEF) has an ejection fraction
of 60%. Which pathophysiological mechanism best
explains HFpEF?
A. Reduced left ventricular contractility
B. Impaired ventricular relaxation and increased
filling pressure (diastolic dysfunction)
C. Obstructive outflow tract hypertrophy
D. Dilated ventricular chambers
Answer: B
, Rationale: HFpEF (diastolic heart failure) is
characterized by normal ejection fraction (>50%)
but impaired ventricular relaxation (diastolic
dysfunction), leading to increased filling pressures
and pulmonary congestion.
3. A patient with acute decompensated heart
failure presents with dyspnea, crackles, and
jugular venous distention. Which medication is
most appropriate for immediate symptom relief?
A. Digoxin
B. Furosemide (IV)
C. Metoprolol
D. Spironolactone
Answer: B
Rationale: IV furosemide is the first-line treatment
for acute decompensated heart failure to reduce
volume overload and relieve pulmonary congestion.
Digoxin is used for chronic HF. Beta-blockers are
used in chronic HF.
