NURS 6501N Exam 2 V1 | NURS 6501N
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS6501N Exam 2) |
Walden University
1. A 68-year-old male presents with orthopnea, paroxysmal nocturnal dyspnea, and
peripheral edema. Which of the following is the most likely primary pathophysiological
mechanism for his pulmonary symptoms?
A. Decreased capillary oncotic pressure
B. Decreased left ventricular end-diastolic volume
C. Increased pulmonary capillary hydrostatic pressure
D. Increased systemic vascular resistance
Answer: C
Rationale: In left-sided heart failure, the left ventricle fails to pump blood effectively into
the systemic circulation. This results in a backup of blood into the pulmonary veins and
capillaries, significantly increasing hydrostatic pressure. This pressure forces fluid into the
interstitial space and alveoli, leading to the clinical manifestation of pulmonary edema and
associated breathing difficulties.
,2. An advanced practice nurse is caring for a patient with chronic hypertension. The nurse
understands that long-term exposure to high blood pressure causes which cellular adaptation
in the left ventricle?
A. Metaplasia
B. Hyperplasia
C. Pathologic hypertrophy
D. Atrophy
Answer: C
Rationale: Chronic hypertension increases the afterload that the left ventricle must pump
against to maintain cardiac output. In response to this persistent mechanical stress, the
myocytes undergo hypertrophy to increase the force of contraction. This is considered a
pathologic adaptation because it eventually leads to decreased compliance and potential
heart failure.
3. A 10-year-old child is diagnosed with acute post-streptococcal glomerulonephritis. What is
the underlying immunologic mechanism responsible for this condition?
A. Type I hypersensitivity reaction
B. Type III hypersensitivity reaction
C. Type II hypersensitivity reaction
D. Type IV hypersensitivity reaction
,Answer: B
Rationale: Acute post-streptococcal glomerulonephritis is caused by the deposition of
antigen-antibody complexes within the glomerular basement membrane. This represents a
Type III hypersensitivity reaction where these immune complexes trigger the complement
cascade and inflammatory cell infiltration. The resulting inflammation leads to glomerular
damage, hematuria, and proteinuria.
4. Which clinical finding is most characteristic of nephrotic syndrome?
A. Gross hematuria
B. Hypolipidemia
C. Excretion of 3.5 grams or more of protein in the urine per day
D. Elevated serum albumin
Answer: C
Rationale: Nephrotic syndrome is defined by massive proteinuria, typically exceeding 3.5
grams over a 24-hour period. This loss of protein occurs due to increased glomerular
permeability, which also results in hypoalbuminemia and generalized edema. Additionally,
the liver increases lipid synthesis in response to low protein levels, leading to
hyperlipidemia.
, 5. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and hemoptysis. A
pulmonary embolism is suspected. Which of the following is the most common source of the
embolus?
A. Right atrium
B. Axillary veins
C. Carotid arteries
D. Deep veins of the lower extremities
Answer: D
Rationale: Pulmonary embolisms most frequently originate from deep vein thrombosis
(DVT) in the lower extremities, particularly the iliofemoral veins. Risk factors for this
include stasis of blood flow, endothelial injury, and hypercoagulability, known as Virchow’s
triad. Once a thrombus dislodges, it travels through the vena cava and right heart to lodge
in the pulmonary arterial circulation.
6. Which of the following describes the pathophysiology of emphysema?
A. Hypersecretion of mucus in large airways
B. Reversible bronchospasm and airway inflammation
C. Permanent enlargement of gas-exchange airways with destruction of alveolar walls
D. Infection of the lower respiratory tract
Answer: C
Advanced Pathophysiology | Actual Q&A
with Rationale (NURS6501N Exam 2) |
Walden University
1. A 68-year-old male presents with orthopnea, paroxysmal nocturnal dyspnea, and
peripheral edema. Which of the following is the most likely primary pathophysiological
mechanism for his pulmonary symptoms?
A. Decreased capillary oncotic pressure
B. Decreased left ventricular end-diastolic volume
C. Increased pulmonary capillary hydrostatic pressure
D. Increased systemic vascular resistance
Answer: C
Rationale: In left-sided heart failure, the left ventricle fails to pump blood effectively into
the systemic circulation. This results in a backup of blood into the pulmonary veins and
capillaries, significantly increasing hydrostatic pressure. This pressure forces fluid into the
interstitial space and alveoli, leading to the clinical manifestation of pulmonary edema and
associated breathing difficulties.
,2. An advanced practice nurse is caring for a patient with chronic hypertension. The nurse
understands that long-term exposure to high blood pressure causes which cellular adaptation
in the left ventricle?
A. Metaplasia
B. Hyperplasia
C. Pathologic hypertrophy
D. Atrophy
Answer: C
Rationale: Chronic hypertension increases the afterload that the left ventricle must pump
against to maintain cardiac output. In response to this persistent mechanical stress, the
myocytes undergo hypertrophy to increase the force of contraction. This is considered a
pathologic adaptation because it eventually leads to decreased compliance and potential
heart failure.
3. A 10-year-old child is diagnosed with acute post-streptococcal glomerulonephritis. What is
the underlying immunologic mechanism responsible for this condition?
A. Type I hypersensitivity reaction
B. Type III hypersensitivity reaction
C. Type II hypersensitivity reaction
D. Type IV hypersensitivity reaction
,Answer: B
Rationale: Acute post-streptococcal glomerulonephritis is caused by the deposition of
antigen-antibody complexes within the glomerular basement membrane. This represents a
Type III hypersensitivity reaction where these immune complexes trigger the complement
cascade and inflammatory cell infiltration. The resulting inflammation leads to glomerular
damage, hematuria, and proteinuria.
4. Which clinical finding is most characteristic of nephrotic syndrome?
A. Gross hematuria
B. Hypolipidemia
C. Excretion of 3.5 grams or more of protein in the urine per day
D. Elevated serum albumin
Answer: C
Rationale: Nephrotic syndrome is defined by massive proteinuria, typically exceeding 3.5
grams over a 24-hour period. This loss of protein occurs due to increased glomerular
permeability, which also results in hypoalbuminemia and generalized edema. Additionally,
the liver increases lipid synthesis in response to low protein levels, leading to
hyperlipidemia.
, 5. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and hemoptysis. A
pulmonary embolism is suspected. Which of the following is the most common source of the
embolus?
A. Right atrium
B. Axillary veins
C. Carotid arteries
D. Deep veins of the lower extremities
Answer: D
Rationale: Pulmonary embolisms most frequently originate from deep vein thrombosis
(DVT) in the lower extremities, particularly the iliofemoral veins. Risk factors for this
include stasis of blood flow, endothelial injury, and hypercoagulability, known as Virchow’s
triad. Once a thrombus dislodges, it travels through the vena cava and right heart to lodge
in the pulmonary arterial circulation.
6. Which of the following describes the pathophysiology of emphysema?
A. Hypersecretion of mucus in large airways
B. Reversible bronchospasm and airway inflammation
C. Permanent enlargement of gas-exchange airways with destruction of alveolar walls
D. Infection of the lower respiratory tract
Answer: C
