NSG 5003 Week 3 Exam Questions and
Answers
Course: NSG 5003 - Advanced Pathophysiology & Health Assessment
Coverage: Week 3 Exam Preparation (Cardiovascular, Hemodynamics, Lymphatic, and
Hematologic Systems)
Section 1: Cardiovascular Pathophysiology &
Hemodynamics (Questions 1–20)
1. What factor is the primary determinant of cardiac preload?
Correct Answer: End-diastolic volume (EDV)
Rationale: Preload refers to the degree of stretch on the myocardial fibers at the end of diastole, which
is directly determined by venous return and end-diastolic volume.
2. Which mechanism describes the Frank-Starling law of the heart?
Correct Answer: An increase in end-diastolic volume increases myocardial fiber
stretch, leading to stronger contraction force.
Rationale: Within physiological limits, greater filling volume stretches cardiac myocytes, optimizing
actin-myosin overlap and increasing stroke volume.
3. Systemic vascular resistance (SVR) is the major component of which cardiac
parameter?
Correct Answer: Afterload
Rationale: Afterload represents the resistance or pressure against which the left ventricle must pump
to eject blood into the systemic circulation.
4. Which clinical finding is most specific to left-sided heart failure?
Correct Answer: Pulmonary rales and orthopnea
Rationale: Inability of the left ventricle to empty properly increases pressures in the left atrium and
pulmonary veins, causing transudation of fluid into alveoli.
5. Right ventricular failure secondary to chronic pulmonary hypertension is known as:
Correct Answer: Cor pulmonale
, Rationale: Chronic pulmonary arterial hypertension elevates right ventricular afterload, resulting in
hypertrophy and eventually right heart failure.
6. What cardiac cardiac enzyme marker is considered most specific for diagnosing
myocardial infarction?
Correct Answer: Cardiac Troponin I (cTnI)
Rationale: Cardiac troponins are regulatory proteins specific to heart muscle cells released during
myocardial necrosis.
7. A cardiac murmur that is loudest in the 2nd right intercostal space with radiation to
the carotids indicates:
Correct Answer: Aortic stenosis
Rationale: Aortic stenosis creates a systolic ejection murmur heard best at the right upper sternal
border with classic carotid radiation.
8. Which compensatory mechanism in heart failure initially maintains cardiac output
but eventually accelerates heart failure progression?
Correct Answer: Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Rationale: RAAS activation retains fluid and causes vasoconstriction, increasing preload and
afterload, which worsens myocardial workload over time.
9. Brain Natriuretic Peptide (BNP) is synthesized and secreted by ventricular
myocardium primarily in response to:
Correct Answer: Increased ventricular wall stretch and volume overload
Rationale: BNP acts as a physiological antagonist to RAAS, promoting natriuresis, diuresis, and
vasodilation to alleviate wall tension.
10. What ECG change is classic for transmural myocardial ischemia (STEMI)?
Correct Answer: ST-segment elevation
Rationale: Complete transmural injury disrupts normal ventricular repolarization, causing ST-segment
elevation in anatomical leads.
11. Stable angina is primarily caused by:
Correct Answer: Fixed atherosclerotic stenosis in coronary arteries during elevated
myocardial demand
Rationale: When exertional demand exceeds blood flow restricted by fixed plaque, transient
Answers
Course: NSG 5003 - Advanced Pathophysiology & Health Assessment
Coverage: Week 3 Exam Preparation (Cardiovascular, Hemodynamics, Lymphatic, and
Hematologic Systems)
Section 1: Cardiovascular Pathophysiology &
Hemodynamics (Questions 1–20)
1. What factor is the primary determinant of cardiac preload?
Correct Answer: End-diastolic volume (EDV)
Rationale: Preload refers to the degree of stretch on the myocardial fibers at the end of diastole, which
is directly determined by venous return and end-diastolic volume.
2. Which mechanism describes the Frank-Starling law of the heart?
Correct Answer: An increase in end-diastolic volume increases myocardial fiber
stretch, leading to stronger contraction force.
Rationale: Within physiological limits, greater filling volume stretches cardiac myocytes, optimizing
actin-myosin overlap and increasing stroke volume.
3. Systemic vascular resistance (SVR) is the major component of which cardiac
parameter?
Correct Answer: Afterload
Rationale: Afterload represents the resistance or pressure against which the left ventricle must pump
to eject blood into the systemic circulation.
4. Which clinical finding is most specific to left-sided heart failure?
Correct Answer: Pulmonary rales and orthopnea
Rationale: Inability of the left ventricle to empty properly increases pressures in the left atrium and
pulmonary veins, causing transudation of fluid into alveoli.
5. Right ventricular failure secondary to chronic pulmonary hypertension is known as:
Correct Answer: Cor pulmonale
, Rationale: Chronic pulmonary arterial hypertension elevates right ventricular afterload, resulting in
hypertrophy and eventually right heart failure.
6. What cardiac cardiac enzyme marker is considered most specific for diagnosing
myocardial infarction?
Correct Answer: Cardiac Troponin I (cTnI)
Rationale: Cardiac troponins are regulatory proteins specific to heart muscle cells released during
myocardial necrosis.
7. A cardiac murmur that is loudest in the 2nd right intercostal space with radiation to
the carotids indicates:
Correct Answer: Aortic stenosis
Rationale: Aortic stenosis creates a systolic ejection murmur heard best at the right upper sternal
border with classic carotid radiation.
8. Which compensatory mechanism in heart failure initially maintains cardiac output
but eventually accelerates heart failure progression?
Correct Answer: Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Rationale: RAAS activation retains fluid and causes vasoconstriction, increasing preload and
afterload, which worsens myocardial workload over time.
9. Brain Natriuretic Peptide (BNP) is synthesized and secreted by ventricular
myocardium primarily in response to:
Correct Answer: Increased ventricular wall stretch and volume overload
Rationale: BNP acts as a physiological antagonist to RAAS, promoting natriuresis, diuresis, and
vasodilation to alleviate wall tension.
10. What ECG change is classic for transmural myocardial ischemia (STEMI)?
Correct Answer: ST-segment elevation
Rationale: Complete transmural injury disrupts normal ventricular repolarization, causing ST-segment
elevation in anatomical leads.
11. Stable angina is primarily caused by:
Correct Answer: Fixed atherosclerotic stenosis in coronary arteries during elevated
myocardial demand
Rationale: When exertional demand exceeds blood flow restricted by fixed plaque, transient
