, NR 507 Advanced Pathophysiology: Cardiovascular
Disorders Questions, Answers, & Rationales
2026/2027 Update
Question 1
Which of the following best describes primary (essential)
hypertension?
A. High blood pressure caused by an underlying renal
disease.
B. Hypertension resulting from a tumor in the adrenal
medulla.
C. Temporary elevation in blood pressure due to acute
stress.
D. High blood pressure with no identifiable cause, likely
due to genetics and environment.
Answer: D
Rationale: Primary hypertension accounts for approximately
95% of all hypertension cases. It has no single identifiable
organic cause, but rather stems from a complex multifactorial
interaction between genetic predispositions and environmental
risk factors (e.g., sodium intake, stress, sympathetic nervous
system overactivity).
Question 2
What is the primary pathophysiological mechanism behind the
development of foam cells in atherosclerosis?
A. Rupture of the fibrous cap.
, B. Proliferation of smooth muscle cells in the tunica media.
C. Macrophages engulfing oxidized LDL cholesterol.
D. Platelet aggregation at the site of endothelial injury.
Answer: C
Rationale: Foam cells are lipid-laden macrophages that form
when macrophages migrate into the arterial intima and engulf
large amounts of oxidized low-density lipoprotein (LDL)
cholesterol via scavenger receptors. This marks the foundational
stage of fatty streak formation in atherosclerotic vascular
disease.
Question 3
Which electrolyte imbalance is frequently associated with the
therapeutic use of ACE inhibitors for heart failure?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Rationale: Angiotensin-Converting Enzyme (ACE) inhibitors
block the conversion of angiotensin I to angiotensin II, leading
to a decrease in aldosterone secretion. Because aldosterone is
responsible for excreting potassium and retaining sodium, its
suppression causes potassium to be retained by the distal renal
tubules, placing patients at risk for hyperkalemia.
Question 4
, In right-sided heart failure, which clinical manifestation is most
likely to be observed?
A. Pulmonary edema.
B. Orthopnea.
C. Paroxysmal nocturnal dyspnea.
D. Peripheral edema and jugular venous distention.
Answer: D
Rationale: Right-sided heart failure impairs the ability of the
right ventricle to effectively pump blood into the pulmonary
circulation. This results in a systemic venous backup, translating
clinically to dependent peripheral edema, hepatosplenomegaly,
and jugular venous distention (JVD). Pulmonary manifestations
(like orthopnea and paroxysmal nocturnal dyspnea) are
characteristic of left-sided failure.
Question 5
What is the hallmark physiological mechanism of Prinzmetal
(variant) angina?
A. Chest pain that occurs exclusively with predictable
physical exertion.
B. Chest pain that is consistently relieved by deep breathing
or positional changes.
C. Pain that occurs unpredictably at rest due to transient
coronary artery vasospasm.
D. Irreversible myocardial necrosis caused by a fixed
atherosclerotic plaque rupture.
Answer: C
Disorders Questions, Answers, & Rationales
2026/2027 Update
Question 1
Which of the following best describes primary (essential)
hypertension?
A. High blood pressure caused by an underlying renal
disease.
B. Hypertension resulting from a tumor in the adrenal
medulla.
C. Temporary elevation in blood pressure due to acute
stress.
D. High blood pressure with no identifiable cause, likely
due to genetics and environment.
Answer: D
Rationale: Primary hypertension accounts for approximately
95% of all hypertension cases. It has no single identifiable
organic cause, but rather stems from a complex multifactorial
interaction between genetic predispositions and environmental
risk factors (e.g., sodium intake, stress, sympathetic nervous
system overactivity).
Question 2
What is the primary pathophysiological mechanism behind the
development of foam cells in atherosclerosis?
A. Rupture of the fibrous cap.
, B. Proliferation of smooth muscle cells in the tunica media.
C. Macrophages engulfing oxidized LDL cholesterol.
D. Platelet aggregation at the site of endothelial injury.
Answer: C
Rationale: Foam cells are lipid-laden macrophages that form
when macrophages migrate into the arterial intima and engulf
large amounts of oxidized low-density lipoprotein (LDL)
cholesterol via scavenger receptors. This marks the foundational
stage of fatty streak formation in atherosclerotic vascular
disease.
Question 3
Which electrolyte imbalance is frequently associated with the
therapeutic use of ACE inhibitors for heart failure?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Rationale: Angiotensin-Converting Enzyme (ACE) inhibitors
block the conversion of angiotensin I to angiotensin II, leading
to a decrease in aldosterone secretion. Because aldosterone is
responsible for excreting potassium and retaining sodium, its
suppression causes potassium to be retained by the distal renal
tubules, placing patients at risk for hyperkalemia.
Question 4
, In right-sided heart failure, which clinical manifestation is most
likely to be observed?
A. Pulmonary edema.
B. Orthopnea.
C. Paroxysmal nocturnal dyspnea.
D. Peripheral edema and jugular venous distention.
Answer: D
Rationale: Right-sided heart failure impairs the ability of the
right ventricle to effectively pump blood into the pulmonary
circulation. This results in a systemic venous backup, translating
clinically to dependent peripheral edema, hepatosplenomegaly,
and jugular venous distention (JVD). Pulmonary manifestations
(like orthopnea and paroxysmal nocturnal dyspnea) are
characteristic of left-sided failure.
Question 5
What is the hallmark physiological mechanism of Prinzmetal
(variant) angina?
A. Chest pain that occurs exclusively with predictable
physical exertion.
B. Chest pain that is consistently relieved by deep breathing
or positional changes.
C. Pain that occurs unpredictably at rest due to transient
coronary artery vasospasm.
D. Irreversible myocardial necrosis caused by a fixed
atherosclerotic plaque rupture.
Answer: C
