NSG 3850 PATHOPHYSIOLOGY FOR
NURSES II EXAM 2 REVIEW
QUESTIONS AND ANSWERS
1. A patient with chronic heart failure has a reduced ejection fraction. Which compensatory
mechanism initially increases cardiac output but eventually leads to deleterious ventricular
remodeling?
A. Activation of the parasympathetic nervous system
B. Activation of the renin-angiotensin-aldosterone system (RAAS)
C. Decrease in systemic vascular resistance
D. Inhibition of antidiuretic hormone (ADH)
Answer: B
Conceptual Explanation: The activation of RAAS leads to fluid retention and
vasoconstriction, which increases preload and afterload. While this supports cardiac output
initially, chronic activation leads to hypertrophy and fibrosis (remodeling).
,2. In the context of myocardial infarction, which biomarker is considered the most specific
indicator of myocardial injury?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. Lactate dehydrogenase (LDH)
D. Troponin I
Answer: D
Conceptual Explanation: Troponins are highly specific to cardiac muscle and remain
elevated for several days, making them the gold standard for diagnosing MI.
3. Which type of shock is characterized by a high cardiac output despite low systemic vascular
resistance and impaired tissue oxygenation?
A. Septic shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Neurogenic shock
Answer: A
Conceptual Explanation: Septic shock is a form of distributive shock where vasodilation
and capillary leak occur, often resulting in a high-output state initially before progressive
failure.
, 4. A patient presents with jugular venous distention, muffled heart sounds, and hypotension.
This clinical triad (Beck’s triad) is indicative of:
A. Tension pneumothorax
B. Aortic dissection
C. Pulmonary embolism
D. Cardiac tamponade
Answer: D
Conceptual Explanation: Cardiac tamponade involves fluid in the pericardial sac that
compresses the heart, leading to the symptoms described in Beck’s triad.
5. Which underlying pathophysiological process leads to the formation of an atherosclerotic
plaque?
A. Hypertrophy of the tunica media
B. Spasm of the coronary arteries
C. Increase in high-density lipoproteins (HDL)
D. Endothelial injury and inflammatory response
Answer: D
Conceptual Explanation: Atherosclerosis begins with endothelial dysfunction, followed by
lipid accumulation and inflammation within the vessel wall.
NURSES II EXAM 2 REVIEW
QUESTIONS AND ANSWERS
1. A patient with chronic heart failure has a reduced ejection fraction. Which compensatory
mechanism initially increases cardiac output but eventually leads to deleterious ventricular
remodeling?
A. Activation of the parasympathetic nervous system
B. Activation of the renin-angiotensin-aldosterone system (RAAS)
C. Decrease in systemic vascular resistance
D. Inhibition of antidiuretic hormone (ADH)
Answer: B
Conceptual Explanation: The activation of RAAS leads to fluid retention and
vasoconstriction, which increases preload and afterload. While this supports cardiac output
initially, chronic activation leads to hypertrophy and fibrosis (remodeling).
,2. In the context of myocardial infarction, which biomarker is considered the most specific
indicator of myocardial injury?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. Lactate dehydrogenase (LDH)
D. Troponin I
Answer: D
Conceptual Explanation: Troponins are highly specific to cardiac muscle and remain
elevated for several days, making them the gold standard for diagnosing MI.
3. Which type of shock is characterized by a high cardiac output despite low systemic vascular
resistance and impaired tissue oxygenation?
A. Septic shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Neurogenic shock
Answer: A
Conceptual Explanation: Septic shock is a form of distributive shock where vasodilation
and capillary leak occur, often resulting in a high-output state initially before progressive
failure.
, 4. A patient presents with jugular venous distention, muffled heart sounds, and hypotension.
This clinical triad (Beck’s triad) is indicative of:
A. Tension pneumothorax
B. Aortic dissection
C. Pulmonary embolism
D. Cardiac tamponade
Answer: D
Conceptual Explanation: Cardiac tamponade involves fluid in the pericardial sac that
compresses the heart, leading to the symptoms described in Beck’s triad.
5. Which underlying pathophysiological process leads to the formation of an atherosclerotic
plaque?
A. Hypertrophy of the tunica media
B. Spasm of the coronary arteries
C. Increase in high-density lipoproteins (HDL)
D. Endothelial injury and inflammatory response
Answer: D
Conceptual Explanation: Atherosclerosis begins with endothelial dysfunction, followed by
lipid accumulation and inflammation within the vessel wall.
