NR 545 PHARMACOLOGY, PHYSICAL ASSESSMENT &
PATHOPHYSIOLOGY EXAM 2 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Cardiovascular Disorders – Angina and Chest Pain
1. What is the pathophysiology of chest pain (angina)?
A) Inflammation of the pericardial sac
B) Chest pain associated with decreased blood flow or ischemia to the myocardial
tissue
C) Infection of the cardiac valves
D) Rupture of the aortic wall
Correct Answer: B) Chest pain associated with decreased blood flow or ischemia
to the myocardial tissue
Rationale: Angina is caused by myocardial ischemia from reduced coronary blood
flow, typically due to atherosclerotic heart disease. Option A describes pericarditis,
C is endocarditis, and D is aortic dissection .
2. What are the physical assessment findings in angina?
A) Chest heaviness, pressure, squeezing, fullness, pain radiating to left
shoulder/arm/jaw, elevated BP during attack
B) Sharp pleuritic pain worsened by inspiration
C) Pain relieved by leaning forward
D) Burning epigastric pain
Correct Answer: A) Chest heaviness, pressure, squeezing, fullness, pain radiating
to left shoulder/arm/jaw, elevated BP during attack
Rationale: Angina presents with retrosternal pressure and radiation to the left arm
or jaw. Option B is pleurisy/pericarditis, C is pericarditis, and D is GERD .
3. What is the pharmacological treatment for acute angina?
A) Aspirin 81 mg daily
B) Nitroglycerin 0.3-0.6 mg every 5 minutes for a maximum of 3 doses
C) Metoprolol 25 mg twice daily
D) Lisinopril 10 mg daily
,Correct Answer: B) Nitroglycerin 0.3-0.6 mg every 5 minutes for a maximum of
3 doses
Rationale: Nitroglycerin relaxes and widens blood vessels for acute angina relief.
Aspirin, metoprolol, and lisinopril are used for long-term management, not acute
symptom relief .
4. What are the risks and complications of angina?
A) Gastroesophageal reflux disease
B) Acute Coronary Syndrome
C) Peptic ulcer disease
D) Pulmonary embolism
Correct Answer: B) Acute Coronary Syndrome
Rationale: Angina is a manifestation of coronary artery disease and can progress
to Acute Coronary Syndrome, which includes unstable angina and myocardial
infarction .
Section 2: Cardiovascular Disorders – Myocardial Infarction
5. What is a myocardial infarction (MI)?
A) Inflammation of the heart muscle
B) Complete cessation of cardiac activity
C) Blood flow to the heart is minimized with buildup of cholesterol
D) Infection of the cardiac valves
Correct Answer: C) Blood flow to the heart is minimized with buildup of
cholesterol
Rationale: MI occurs when coronary blood flow is significantly reduced or
blocked, leading to myocardial ischemia and tissue death. Option A is myocarditis,
B is cardiac arrest, and D is endocarditis .
6. What is the pathophysiology of a myocardial infarction?
A) Sudden rupture of a cerebral vessel
B) Imbalance between myocardial oxygen supply and demand; prolonged for
greater than 30 minutes can lead to cardiac tissue death
,C) Valve stenosis causing backflow
D) Inflammation of the pericardium
Correct Answer: B) Imbalance between myocardial oxygen supply and demand;
prolonged for greater than 30 minutes can lead to cardiac tissue death
Rationale: MI results from an imbalance between oxygen supply and demand.
Ischemia lasting more than 30 minutes causes irreversible myocardial necrosis.
Option A describes stroke, C is valvular disease, and D is pericarditis .
7. What are the physical assessment findings in myocardial infarction?
A) Pain relieved by rest
B) Pain at rest, not relieved with nitro, lightheadedness, impending doom, nausea,
diaphoresis, wheezing
C) Pain worsened by deep inspiration
D) Pain improved with nitroglycerin
Correct Answer: B) Pain at rest, not relieved with nitro, lightheadedness,
impending doom, nausea, diaphoresis, wheezing
Rationale: MI pain occurs at rest, is unrelieved by nitroglycerin, and is
accompanied by autonomic symptoms such as nausea and diaphoresis. Option A is
stable angina, C is pericarditis, and D is angina .
8. What diagnostic findings are seen in myocardial infarction?
A) Normal troponins
B) Troponins elevated, often stay elevated for one week; EKG shows ST elevation
or new left bundle branch block
C) ST depression only
D) Elevated BNP only
Correct Answer: B) Troponins elevated, often stay elevated for one week; EKG
shows ST elevation or new left bundle branch block
Rationale: Elevated troponins are the gold standard for MI diagnosis. EKG
findings include ST elevation (STEMI) or new LBBB. Option A rules out MI, C
indicates ischemia, and D indicates heart failure .
9. Prolonged ischemia greater than what duration can lead to cardiac tissue
death?
, A) 5 minutes
B) 15 minutes
C) 30 minutes
D) 60 minutes
Correct Answer: C) 30 minutes
Rationale: Myocardial ischemia lasting more than 30 minutes causes irreversible
necrosis. Options A and B are too short, while D exceeds the threshold .
Section 3: Cardiovascular Disorders – Atherosclerosis
10. What is atherosclerosis?
A) Vasodilation of blood vessels
B) Hardening of vessels from buildup of fats and cholesterol in artery walls; plaque
can break off and trigger a blood clot
C) Inflammation of the pericardium
D) Bacterial infection of the endocardium
Correct Answer: B) Hardening of vessels from buildup of fats and cholesterol in
artery walls; plaque can break off and trigger a blood clot
Rationale: Atherosclerosis is progressive arterial narrowing from plaque buildup.
Option A is vasodilation, C is pericarditis, and D is endocarditis .
11. What is the pathophysiology of atherosclerosis?
A) Sudden rupture of a cerebral vessel
B) Inflammatory process beginning with endothelial damage from HTN, smoking,
high cholesterol; fatty streak to fibrous plaque and then complicated lesion
C) Valve stenosis
D) Myocardial hypertrophy
Correct Answer: B) Inflammatory process beginning with endothelial damage
from HTN, smoking, high cholesterol; fatty streak to fibrous plaque and then
complicated lesion
Rationale: Atherosclerosis is a chronic inflammatory response to endothelial
injury progressing through stages: fatty streak → fibrous plaque → complicated
lesion. Option A is stroke, C is valvular, and D is cardiac remodeling .
PATHOPHYSIOLOGY EXAM 2 (PDF) | 2026 EXAM
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
Section 1: Cardiovascular Disorders – Angina and Chest Pain
1. What is the pathophysiology of chest pain (angina)?
A) Inflammation of the pericardial sac
B) Chest pain associated with decreased blood flow or ischemia to the myocardial
tissue
C) Infection of the cardiac valves
D) Rupture of the aortic wall
Correct Answer: B) Chest pain associated with decreased blood flow or ischemia
to the myocardial tissue
Rationale: Angina is caused by myocardial ischemia from reduced coronary blood
flow, typically due to atherosclerotic heart disease. Option A describes pericarditis,
C is endocarditis, and D is aortic dissection .
2. What are the physical assessment findings in angina?
A) Chest heaviness, pressure, squeezing, fullness, pain radiating to left
shoulder/arm/jaw, elevated BP during attack
B) Sharp pleuritic pain worsened by inspiration
C) Pain relieved by leaning forward
D) Burning epigastric pain
Correct Answer: A) Chest heaviness, pressure, squeezing, fullness, pain radiating
to left shoulder/arm/jaw, elevated BP during attack
Rationale: Angina presents with retrosternal pressure and radiation to the left arm
or jaw. Option B is pleurisy/pericarditis, C is pericarditis, and D is GERD .
3. What is the pharmacological treatment for acute angina?
A) Aspirin 81 mg daily
B) Nitroglycerin 0.3-0.6 mg every 5 minutes for a maximum of 3 doses
C) Metoprolol 25 mg twice daily
D) Lisinopril 10 mg daily
,Correct Answer: B) Nitroglycerin 0.3-0.6 mg every 5 minutes for a maximum of
3 doses
Rationale: Nitroglycerin relaxes and widens blood vessels for acute angina relief.
Aspirin, metoprolol, and lisinopril are used for long-term management, not acute
symptom relief .
4. What are the risks and complications of angina?
A) Gastroesophageal reflux disease
B) Acute Coronary Syndrome
C) Peptic ulcer disease
D) Pulmonary embolism
Correct Answer: B) Acute Coronary Syndrome
Rationale: Angina is a manifestation of coronary artery disease and can progress
to Acute Coronary Syndrome, which includes unstable angina and myocardial
infarction .
Section 2: Cardiovascular Disorders – Myocardial Infarction
5. What is a myocardial infarction (MI)?
A) Inflammation of the heart muscle
B) Complete cessation of cardiac activity
C) Blood flow to the heart is minimized with buildup of cholesterol
D) Infection of the cardiac valves
Correct Answer: C) Blood flow to the heart is minimized with buildup of
cholesterol
Rationale: MI occurs when coronary blood flow is significantly reduced or
blocked, leading to myocardial ischemia and tissue death. Option A is myocarditis,
B is cardiac arrest, and D is endocarditis .
6. What is the pathophysiology of a myocardial infarction?
A) Sudden rupture of a cerebral vessel
B) Imbalance between myocardial oxygen supply and demand; prolonged for
greater than 30 minutes can lead to cardiac tissue death
,C) Valve stenosis causing backflow
D) Inflammation of the pericardium
Correct Answer: B) Imbalance between myocardial oxygen supply and demand;
prolonged for greater than 30 minutes can lead to cardiac tissue death
Rationale: MI results from an imbalance between oxygen supply and demand.
Ischemia lasting more than 30 minutes causes irreversible myocardial necrosis.
Option A describes stroke, C is valvular disease, and D is pericarditis .
7. What are the physical assessment findings in myocardial infarction?
A) Pain relieved by rest
B) Pain at rest, not relieved with nitro, lightheadedness, impending doom, nausea,
diaphoresis, wheezing
C) Pain worsened by deep inspiration
D) Pain improved with nitroglycerin
Correct Answer: B) Pain at rest, not relieved with nitro, lightheadedness,
impending doom, nausea, diaphoresis, wheezing
Rationale: MI pain occurs at rest, is unrelieved by nitroglycerin, and is
accompanied by autonomic symptoms such as nausea and diaphoresis. Option A is
stable angina, C is pericarditis, and D is angina .
8. What diagnostic findings are seen in myocardial infarction?
A) Normal troponins
B) Troponins elevated, often stay elevated for one week; EKG shows ST elevation
or new left bundle branch block
C) ST depression only
D) Elevated BNP only
Correct Answer: B) Troponins elevated, often stay elevated for one week; EKG
shows ST elevation or new left bundle branch block
Rationale: Elevated troponins are the gold standard for MI diagnosis. EKG
findings include ST elevation (STEMI) or new LBBB. Option A rules out MI, C
indicates ischemia, and D indicates heart failure .
9. Prolonged ischemia greater than what duration can lead to cardiac tissue
death?
, A) 5 minutes
B) 15 minutes
C) 30 minutes
D) 60 minutes
Correct Answer: C) 30 minutes
Rationale: Myocardial ischemia lasting more than 30 minutes causes irreversible
necrosis. Options A and B are too short, while D exceeds the threshold .
Section 3: Cardiovascular Disorders – Atherosclerosis
10. What is atherosclerosis?
A) Vasodilation of blood vessels
B) Hardening of vessels from buildup of fats and cholesterol in artery walls; plaque
can break off and trigger a blood clot
C) Inflammation of the pericardium
D) Bacterial infection of the endocardium
Correct Answer: B) Hardening of vessels from buildup of fats and cholesterol in
artery walls; plaque can break off and trigger a blood clot
Rationale: Atherosclerosis is progressive arterial narrowing from plaque buildup.
Option A is vasodilation, C is pericarditis, and D is endocarditis .
11. What is the pathophysiology of atherosclerosis?
A) Sudden rupture of a cerebral vessel
B) Inflammatory process beginning with endothelial damage from HTN, smoking,
high cholesterol; fatty streak to fibrous plaque and then complicated lesion
C) Valve stenosis
D) Myocardial hypertrophy
Correct Answer: B) Inflammatory process beginning with endothelial damage
from HTN, smoking, high cholesterol; fatty streak to fibrous plaque and then
complicated lesion
Rationale: Atherosclerosis is a chronic inflammatory response to endothelial
injury progressing through stages: fatty streak → fibrous plaque → complicated
lesion. Option A is stroke, C is valvular, and D is cardiac remodeling .
