NR283 EXAM 3 PATHOPHYSIOLOGY
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS. JUST
RELEASED
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Upon
auscultation, crackles are heard in the lung bases. Which condition is most likely?
A. Right-sided Heart Failure
B. Cardiac Tamponade
C. Pulmonary Embolism
D. Left-sided Heart Failure
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and symptoms like crackles,
dyspnea, and orthopnea.
2. Which clinical manifestation is a hallmark of right-sided heart failure?
A. Pulmonary edema
,B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Decreased peripheral pulses
Answer: C
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
manifesting as peripheral edema, hepatomegaly, and jugular venous distention (JVD).
3. What is the primary underlying mechanism of Prinzmetal (variant) angina?
A. Fixed atherosclerotic plaque
B. Increased myocardial oxygen demand during exercise
C. Coronary artery vasospasm
D. Rupture of a vulnerable plaque
Answer: C
Conceptual Explanation: Prinzmetal angina is caused by vasospasm of the coronary
arteries, often occurring at rest and at the same time of day.
4. During an acute myocardial infarction, which cardiac biomarker is most specific and stays
elevated for the longest period?
A. CK-MB
B. Troponin I or T
, C. Myoglobin
D. C-reactive protein
Answer: B
Conceptual Explanation: Troponins are highly specific to cardiac muscle injury and can
remain elevated for 1-2 weeks, unlike CK-MB which drops after 48-72 hours.
5. In the development of atherosclerosis, what is the initial step following endothelial injury?
A. Formation of a fibrous cap
B. Oxidation of LDL and recruitment of macrophages
C. Platelet aggregation
D. Calcification of the vessel wall
Answer: B
Conceptual Explanation: After endothelial injury, LDL enters the vessel wall, becomes
oxidized, and triggers an inflammatory response where macrophages ingest LDL to become
foam cells.
6. A patient with a history of IV drug use presents with a new heart murmur, splinter
hemorrhages, and Osler nodes. What is the suspected diagnosis?
A. Pericarditis
B. Rheumatic Heart Disease
C. Infective Endocarditis
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS. JUST
RELEASED
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Upon
auscultation, crackles are heard in the lung bases. Which condition is most likely?
A. Right-sided Heart Failure
B. Cardiac Tamponade
C. Pulmonary Embolism
D. Left-sided Heart Failure
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and symptoms like crackles,
dyspnea, and orthopnea.
2. Which clinical manifestation is a hallmark of right-sided heart failure?
A. Pulmonary edema
,B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Decreased peripheral pulses
Answer: C
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
manifesting as peripheral edema, hepatomegaly, and jugular venous distention (JVD).
3. What is the primary underlying mechanism of Prinzmetal (variant) angina?
A. Fixed atherosclerotic plaque
B. Increased myocardial oxygen demand during exercise
C. Coronary artery vasospasm
D. Rupture of a vulnerable plaque
Answer: C
Conceptual Explanation: Prinzmetal angina is caused by vasospasm of the coronary
arteries, often occurring at rest and at the same time of day.
4. During an acute myocardial infarction, which cardiac biomarker is most specific and stays
elevated for the longest period?
A. CK-MB
B. Troponin I or T
, C. Myoglobin
D. C-reactive protein
Answer: B
Conceptual Explanation: Troponins are highly specific to cardiac muscle injury and can
remain elevated for 1-2 weeks, unlike CK-MB which drops after 48-72 hours.
5. In the development of atherosclerosis, what is the initial step following endothelial injury?
A. Formation of a fibrous cap
B. Oxidation of LDL and recruitment of macrophages
C. Platelet aggregation
D. Calcification of the vessel wall
Answer: B
Conceptual Explanation: After endothelial injury, LDL enters the vessel wall, becomes
oxidized, and triggers an inflammatory response where macrophages ingest LDL to become
foam cells.
6. A patient with a history of IV drug use presents with a new heart murmur, splinter
hemorrhages, and Osler nodes. What is the suspected diagnosis?
A. Pericarditis
B. Rheumatic Heart Disease
C. Infective Endocarditis
