NSG3280/NSG 3280 Exam 2 | Pathophysiology for Nurses I | Galen College | Q & A | 2026/2027 Edition (PDF)

NSG3280/NSG 3280 Exam 2 | Pathophysiology xz xz xz x




for Nurses I | Galen College | Q & A | 2026/2027
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Edition (PDF) xz




1. A patient with heart failure is prescribed furosemide. The nurse understands that the pr
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imary therapeutic effect of this medication is to:
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a) Increase cardiac contractility
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b) Decrease preload by reducing fluid volume
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c) Decrease afterload by vasodilation
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d) Increase heart rate
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Rationale: Furosemide is a loop diuretic that reduces preload by decreasing circulating blood vol
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ume. While some diuretics cause mild vasodilation, the primary effect for heart failure is volume r
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eduction.



2. In a patient with left-
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sided heart failure, which pathophysiological mechanism is the primary cause of pulmonar
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y edema?
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a) Increased systemic vascular resistance
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b) Increased hydrostatic pressure in the pulmonary capillaries
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c) Decreased plasma oncotic pressure in the pulmonary capillaries
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d) Obstruction of the pulmonary lymphatics
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Rationale: Left- xz




sided heart failure causes blood to back up into the pulmonary circulation. This increases the hyd
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rostatic pressure in the pulmonary capillaries, forcing fluid out into the interstitial space and alve
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oli, resulting in pulmonary edema.
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3. A patient is diagnosed with stable angina. The nurse explains that this condition is most
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likely caused by:
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a) Complete occlusion of a coronary artery by a thrombus
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b) Reversible myocardial ischemia due to a fixed atherosclerotic plaque
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c) Spasm of a coronary artery
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d) Increased myocardial oxygen demand with no obstruction
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,Rationale: Stable angina is predictable chest pain that occurs with exertion or stress and is reliev
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ed by rest. It is caused by a fixed, stable atherosclerotic plaque that partially occludes the artery, l
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eading to reversible ischemia when demand increases.
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4. Which finding is most characteristic of a right-sided myocardial infarction (MI)?
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a) Pulmonary crackles
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b) Dyspnea on exertion
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c) S3 heart sound
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d) Jugular venous distention (JVD)
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Rationale: A right- xz xz




sided MI affects the right ventricle's ability to pump blood to the pulmonary artery. This leads to
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systemic venous backup, which manifests as JVD, hepatomegaly, and peripheral edema. Pulmona
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ry congestion (crackles, S3, dyspnea) is a hallmark of left-sided failure.
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5. The nurse is caring for a patient with a complete heart block (third-
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degree AV block). Which electrocardiogram (ECG) characteristic is expected?
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a) Prolonged PR interval
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b) Dropped QRS complexes
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c) P waves and QRS complexes that are completely independent of each other
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d) Wide QRS complexes with a regular rhythm
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Rationale: In a complete heart block, the atria and ventricles beat independently of each other (A
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V dissociation). P waves have no relationship to the QRS complexes. Prolonged PR interval is 1st-
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degree. Dropped QRS is 2nd-degree Type I (Wenckebach).
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6. A patient with a history of deep vein thrombosis (DVT) is at the highest risk for which c
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omplication?
a) Pulmonary embolism
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b) Cerebral vascular accident
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c) Myocardial infarction
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d) Arterial thrombosis
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Rationale: The most serious complication of a DVT is a pulmonary embolism, where the thrombu
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s breaks off and travels to the pulmonary circulation, lodging in a pulmonary artery.
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7. The pathophysiology of primary hypertension is most often associated with:
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a) A single genetic mutation
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,b) A specific tumor on the adrenal gland
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c) An interplay of genetic, environmental, and hemodynamic factors
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d) A sudden increase in blood volume
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Rationale: Primary (essential) hypertension is a multifactorial disease with no single identifiable c
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ause. It involves a complex interaction of genetics, environmental factors (e.g., diet, stress), and h
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emodynamic alterations (e.g., increased systemic vascular resistance). xz xz xz xz xz xz




8. A patient's blood pressure is 160/100 mmHg. The nurse understands that the "160" rep
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resents the: xz




a) Pressure in the aorta during ventricular filling
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b) Pressure against arterial walls during ventricular relaxation
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c) Maximum pressure exerted against arterial walls during ventricular contraction
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d) Pulse pressure
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Rationale: Systolic blood pressure is the peak pressure in the arteries during ventricular systole (
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contraction). Diastolic pressure (the "100") is the pressure during ventricular relaxation.
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9. In a patient with asthma, which pathophysiological event is primarily responsible for th
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e early-phase response (immediate reaction)?
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a) Mast cell degranulation releasing histamine and leukotrienes
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b) Infiltration of eosinophils and T-lymphocytes
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c) Airway remodeling due to chronic inflammation
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d) Thickening of the basement membrane of the bronchial epithelium
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Rationale: The early asthmatic response is triggered by an allergen binding to IgE on mast cells,
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causing degranulation and the release of inflammatory mediators (like histamine, leukotrienes, a
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nd prostaglandins) leading to bronchospasm. The other options describe the late-
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phase response or chronic changes. xz xz xz xz




10. A patient with chronic bronchitis is at risk for developing cor pulmonale. The nurse un
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derstands that cor pulmonale is: xz xz xz xz




a) An acute inflammation of the heart muscle
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b) A congenital heart defect
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c) Right-sided heart failure secondary to pulmonary disease
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d) Left-sided heart failure secondary to pulmonary disease
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Rationale: Cor pulmonale is defined as right ventricular hypertrophy and failure that results from
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pulmonary hypertension caused by diseases of the lung, pulmonary vasculature, or chest wall.
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, 11. The primary acid-
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base disturbance seen in a patient with an acute asthma exacerbation is:
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a) Respiratory alkalosis
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b) Respiratory acidosis
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c) Metabolic acidosis
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d) Metabolic alkalosis
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Rationale: In the early stages of an asthma attack, the patient hyperventilates due to hypoxia an
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d anxiety. This 'blows off' CO2, leading to a deficit of carbonic acid, resulting in respiratory alkalos
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is. Respiratory acidosis occurs later as airway obstruction worsens and the patient tires.
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12. A patient with emphysema will demonstrate which of the following lung function resu
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lts?
a) Decreased total lung capacity (TLC)
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b) Increased FEV1/FVC ratio
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c) Increased residual volume
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d) Normal compliance
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Rationale: In emphysema, there is a loss of elastic recoil. This makes it difficult for the patient to
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exhale, leading to air trapping. This significantly increases the residual volume and functional resi
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dual capacity. TLC is often increased.
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13. Which of the following is a classic clinical manifestation of a tension pneumothorax?
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a) Absent breath sounds on the affected side
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b) Hypotension and tracheal deviation to the ipsilateral side
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c) Hypotension and tracheal deviation to the contralateral side
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d) Hyperresonance to percussion and sudden chest pain
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Rationale: All of the options describe a pneumothorax, but the life-
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threatening finding of a tension pneumothorax is tracheal deviation away from the affected side
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(contralateral) due to increasing pressure in the pleural space. This increased pressure causes me
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diastinal shift and obstructs venous return, leading to hypotension.
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14. A patient is diagnosed with community-
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acquired pneumonia. The most common causative organism is:
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a) Streptococcus pneumoniae
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b) Haemophilus influenzae
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