NURS 611 EXAM 2
Advanced Pathophysiology
Patho Test Bank — Actual Exam Complete
226 Real Exam Questions
and Correct Detailed Answers with Rationales
Already Graded A+
Maryville University
NURS 611 — Advanced Pathophysiology
Graduate Nursing Education
Exam 2: Cardiovascular & Hematologic Pathophysiology
TOTAL QUESTIONS 226
SECTIONS 11
FORMAT Multiple Choice (A-D)
COGNITIVE LEVELS 30% Recall / 50% Application / 20% Analysis
STYLE 75% Scenario-based / 25% Direct Recall
VALIDATION Verified A+ with Detailed Rationales
This comprehensive test bank covers cardiovascular structure & function, hypertension, atherosclerosis, acute coronary
syndromes, heart failure, dysrhythmias, valvular/pericardial/vascular disorders, RBC/WBC/platelet pathophysiology,
coagulation disorders, shock states, and multisystem integration. Each question includes pathophysiologic mechanism
explanations, hemodynamic basis, hematologic pathway reasoning, compensatory response analysis, and clinical
correlation aligned with advanced practice nursing standards.
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 1
Maryville University | Graduate Nursing
, Table of Contents
Section 1: Cardiovascular Structure and Function
Cardiac Anatomy, Conduction System, Cardiac Cycle, & Hemodynamics
Q1-Q20
Section 2: Hypertension and Atherosclerosis
Primary/Secondary HTN, Endothelial Dysfunction, & Plaque Formation
Q21-Q36
Section 3: Coronary Artery Disease and Acute Coronary Syndromes
Angina, STEMI, NSTEMI, & Myocardial Infarction
Q37-Q57
Section 4: Heart Failure and Cardiomyopathies
Systolic vs. Diastolic, Left vs. Right, & Dilated/Hypertrophic/Restrictive
Q58-Q80
Section 5: Dysrhythmias and Conduction Disorders
Atrial, Ventricular, AV Blocks, & Channelopathies
Q81-Q96
Section 6: Valvular, Pericardial, and Vascular Disorders
Stenosis, Regurgitation, Endocarditis, Tamponade, PAD, PVD, & VTE
Q97-Q113
Section 7: Hematologic Pathophysiology - RBC Disorders
Anemias: Iron, B12, Folate, Aplastic, Hemolytic, & Polycythemia
Q114-Q136
Section 8: Hematologic Pathophysiology - WBC and Platelet Disorders
Leukemias, Lymphomas, Myeloma, Neutropenia, & Thrombocytopenia
Q137-Q159
Section 9: Coagulation and Bleeding Disorders
DIC, Hemophilia, VWD, HIT, & Thrombophilia
Q160-Q177
Section 10: Shock States and Multisystem Integration
Hypovolemic, Cardiogenic, Distributive, Obstructive, & MODS
Q178-Q200
Section 11: Clinical Application and Differential Diagnosis
Case-Based Cardiovascular and Hematologic Integration
Q201-Q226
Note: Section question ranges reflect actual question positions in this test bank. All 226 questions are
sequentially numbered Q1 through Q226 with detailed rationales including pathophysiologic mechanisms,
hemodynamic/hematologic basis, compensatory responses, and clinical correlations aligned with Maryville
University NURS 611 Exam 2 content domains.
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 2
Maryville University | Graduate Nursing
, Section 1: Cardiovascular Structure and Function
Cardiac Anatomy, Conduction System, Cardiac Cycle, & Hemodynamics
Q1-Q20
Q1: A 54-year-old male presents for a routine physical. The advanced practice nurse understands that
the left coronary artery primarily supplies which portion of the cardiac conduction system, making it
most vulnerable during a proximal left anterior descending occlusion?
A. SA node only
B. AV node and Bundle of His
C. Left bundle branch and anterior fascicle [CORRECT]
D. Right bundle branch only
Correct Answer: C
Rationale: The left coronary artery (specifically the LAD) supplies the anterior portion of the left
ventricle, the anterior two-thirds of the interventricular septum, the left bundle branch, and the anterior
fascicle of the left bundle. The RCA supplies the SA node in 60% of people (right-dominant circulation)
and the AV node in 90% of people. Knowing this anatomy explains why LAD occlusions cause left
bundle branch blocks and anterior fascicular dysfunction, while RCA occlusions produce inferior MI with
AV nodal blocks.
Q2: During cardiac catheterization, contrast injection reveals the artery supplying the AV node in this
right-dominant patient. Which vessel is the advanced practice nurse observing?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery at the crux cordis [CORRECT]
D. Posterior descending artery arising from the LCX
Correct Answer: C
Rationale: In approximately 90% of the population (right-dominant), the right coronary artery gives rise
to the posterior descending artery at the crux cordis and supplies the AV node via the AV nodal branch.
The SA node is supplied by the RCA in 60% of individuals. In left-dominant circulation (10%), the LCX
gives rise to the PDA and supplies the AV node. This dominance determines ECG changes during
inferior MI and predicts AV block risk.
Q3: A patient's ECG shows a wide QRS complex with a left bundle branch block pattern. The nurse
understands this conduction delay occurs in a fiber system that normally conducts action potentials at
what velocity?
A. 0.5 m/s (slowest conduction)
B. 1-2 m/s
C. 2-4 m/s (fastest conduction in the heart) [CORRECT]
D. 0.05 m/s (AV nodal velocity)
Correct Answer: C
Rationale: The Purkinje fiber system conducts action potentials at the fastest velocity in the heart,
approximately 2-4 m/s, allowing rapid and nearly synchronous ventricular depolarization. The AV node
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 3
Maryville University | Graduate Nursing
, conducts slowest (0.05 m/s) which creates the necessary delay for atrial systole to complete ventricular
filling. Bundle branch blocks slow conduction through the affected fascicle, causing asynchronous
depolarization and a widened QRS (>120 ms).
Q4: A 67-year-old female with a history of myocardial infarction has evidence of papillary muscle
dysfunction. Which valve is most likely affected, and which papillary muscle is most vulnerable due to
its single blood supply?
A. Tricuspid valve; septal papillary muscle
B. Mitral valve; anterolateral papillary muscle
C. Mitral valve; posteromedial papillary muscle [CORRECT]
D. Tricuspid valve; anterior papillary muscle
Correct Answer: C
Rationale: The posteromedial papillary muscle of the mitral valve is supplied solely by the posterior
descending artery (PDA), making it vulnerable to ischemia during inferior MI and prone to rupture. The
anterolateral papillary muscle has dual blood supply from the LAD and LCX, making it more resistant to
ischemia. Papillary muscle dysfunction causes mitral regurgitation, often detected as a new holosystolic
murmur post-MI.
Q5: During the cardiac cycle, the aortic valve opens when left ventricular pressure exceeds aortic
pressure. Which phase of the cardiac cycle does this event mark?
A. Atrial systole
B. Isovolumetric contraction
C. Rapid ejection [CORRECT]
D. Isovolumetric relaxation
Correct Answer: C
Rationale: When LV pressure exceeds aortic pressure, the aortic valve opens and the ventricle enters
the rapid ejection phase of systole. Isovolumetric contraction precedes this event (all valves closed,
pressure rising). Isovolumetric relaxation occurs after semilunar valve closure but before AV valve
opening. Approximately 70% of stroke volume is ejected during the rapid ejection phase, with the
remaining 30% during reduced ejection.
Q6: A patient in the ICU has a pulmonary artery catheter showing elevated preload. According to the
Frank-Starling mechanism, increased preload results in increased stroke volume because:
A. Increased sarcomere stretch increases calcium sensitivity of troponin C, enhancing cross-bridge
formation [CORRECT]
B. Decreased sarcomere length increases the velocity of shortening
C. Increased afterload automatically reduces with higher preload
D. Sympathetic stimulation increases heart rate to compensate
Correct Answer: A
Rationale: The Frank-Starling mechanism states that increased ventricular filling stretches sarcomeres
toward their optimal length (2.0-2.2 microns), increasing calcium sensitivity of troponin C and enhancing
cross-bridge formation. This produces a stronger contraction and greater stroke volume without requiring
neural input. The mechanism operates on the steep portion of the ventricular function curve under
normal physiologic conditions, but flattens at high preload where further stretch does not augment
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 4
Maryville University | Graduate Nursing
Advanced Pathophysiology
Patho Test Bank — Actual Exam Complete
226 Real Exam Questions
and Correct Detailed Answers with Rationales
Already Graded A+
Maryville University
NURS 611 — Advanced Pathophysiology
Graduate Nursing Education
Exam 2: Cardiovascular & Hematologic Pathophysiology
TOTAL QUESTIONS 226
SECTIONS 11
FORMAT Multiple Choice (A-D)
COGNITIVE LEVELS 30% Recall / 50% Application / 20% Analysis
STYLE 75% Scenario-based / 25% Direct Recall
VALIDATION Verified A+ with Detailed Rationales
This comprehensive test bank covers cardiovascular structure & function, hypertension, atherosclerosis, acute coronary
syndromes, heart failure, dysrhythmias, valvular/pericardial/vascular disorders, RBC/WBC/platelet pathophysiology,
coagulation disorders, shock states, and multisystem integration. Each question includes pathophysiologic mechanism
explanations, hemodynamic basis, hematologic pathway reasoning, compensatory response analysis, and clinical
correlation aligned with advanced practice nursing standards.
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 1
Maryville University | Graduate Nursing
, Table of Contents
Section 1: Cardiovascular Structure and Function
Cardiac Anatomy, Conduction System, Cardiac Cycle, & Hemodynamics
Q1-Q20
Section 2: Hypertension and Atherosclerosis
Primary/Secondary HTN, Endothelial Dysfunction, & Plaque Formation
Q21-Q36
Section 3: Coronary Artery Disease and Acute Coronary Syndromes
Angina, STEMI, NSTEMI, & Myocardial Infarction
Q37-Q57
Section 4: Heart Failure and Cardiomyopathies
Systolic vs. Diastolic, Left vs. Right, & Dilated/Hypertrophic/Restrictive
Q58-Q80
Section 5: Dysrhythmias and Conduction Disorders
Atrial, Ventricular, AV Blocks, & Channelopathies
Q81-Q96
Section 6: Valvular, Pericardial, and Vascular Disorders
Stenosis, Regurgitation, Endocarditis, Tamponade, PAD, PVD, & VTE
Q97-Q113
Section 7: Hematologic Pathophysiology - RBC Disorders
Anemias: Iron, B12, Folate, Aplastic, Hemolytic, & Polycythemia
Q114-Q136
Section 8: Hematologic Pathophysiology - WBC and Platelet Disorders
Leukemias, Lymphomas, Myeloma, Neutropenia, & Thrombocytopenia
Q137-Q159
Section 9: Coagulation and Bleeding Disorders
DIC, Hemophilia, VWD, HIT, & Thrombophilia
Q160-Q177
Section 10: Shock States and Multisystem Integration
Hypovolemic, Cardiogenic, Distributive, Obstructive, & MODS
Q178-Q200
Section 11: Clinical Application and Differential Diagnosis
Case-Based Cardiovascular and Hematologic Integration
Q201-Q226
Note: Section question ranges reflect actual question positions in this test bank. All 226 questions are
sequentially numbered Q1 through Q226 with detailed rationales including pathophysiologic mechanisms,
hemodynamic/hematologic basis, compensatory responses, and clinical correlations aligned with Maryville
University NURS 611 Exam 2 content domains.
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 2
Maryville University | Graduate Nursing
, Section 1: Cardiovascular Structure and Function
Cardiac Anatomy, Conduction System, Cardiac Cycle, & Hemodynamics
Q1-Q20
Q1: A 54-year-old male presents for a routine physical. The advanced practice nurse understands that
the left coronary artery primarily supplies which portion of the cardiac conduction system, making it
most vulnerable during a proximal left anterior descending occlusion?
A. SA node only
B. AV node and Bundle of His
C. Left bundle branch and anterior fascicle [CORRECT]
D. Right bundle branch only
Correct Answer: C
Rationale: The left coronary artery (specifically the LAD) supplies the anterior portion of the left
ventricle, the anterior two-thirds of the interventricular septum, the left bundle branch, and the anterior
fascicle of the left bundle. The RCA supplies the SA node in 60% of people (right-dominant circulation)
and the AV node in 90% of people. Knowing this anatomy explains why LAD occlusions cause left
bundle branch blocks and anterior fascicular dysfunction, while RCA occlusions produce inferior MI with
AV nodal blocks.
Q2: During cardiac catheterization, contrast injection reveals the artery supplying the AV node in this
right-dominant patient. Which vessel is the advanced practice nurse observing?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery at the crux cordis [CORRECT]
D. Posterior descending artery arising from the LCX
Correct Answer: C
Rationale: In approximately 90% of the population (right-dominant), the right coronary artery gives rise
to the posterior descending artery at the crux cordis and supplies the AV node via the AV nodal branch.
The SA node is supplied by the RCA in 60% of individuals. In left-dominant circulation (10%), the LCX
gives rise to the PDA and supplies the AV node. This dominance determines ECG changes during
inferior MI and predicts AV block risk.
Q3: A patient's ECG shows a wide QRS complex with a left bundle branch block pattern. The nurse
understands this conduction delay occurs in a fiber system that normally conducts action potentials at
what velocity?
A. 0.5 m/s (slowest conduction)
B. 1-2 m/s
C. 2-4 m/s (fastest conduction in the heart) [CORRECT]
D. 0.05 m/s (AV nodal velocity)
Correct Answer: C
Rationale: The Purkinje fiber system conducts action potentials at the fastest velocity in the heart,
approximately 2-4 m/s, allowing rapid and nearly synchronous ventricular depolarization. The AV node
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 3
Maryville University | Graduate Nursing
, conducts slowest (0.05 m/s) which creates the necessary delay for atrial systole to complete ventricular
filling. Bundle branch blocks slow conduction through the affected fascicle, causing asynchronous
depolarization and a widened QRS (>120 ms).
Q4: A 67-year-old female with a history of myocardial infarction has evidence of papillary muscle
dysfunction. Which valve is most likely affected, and which papillary muscle is most vulnerable due to
its single blood supply?
A. Tricuspid valve; septal papillary muscle
B. Mitral valve; anterolateral papillary muscle
C. Mitral valve; posteromedial papillary muscle [CORRECT]
D. Tricuspid valve; anterior papillary muscle
Correct Answer: C
Rationale: The posteromedial papillary muscle of the mitral valve is supplied solely by the posterior
descending artery (PDA), making it vulnerable to ischemia during inferior MI and prone to rupture. The
anterolateral papillary muscle has dual blood supply from the LAD and LCX, making it more resistant to
ischemia. Papillary muscle dysfunction causes mitral regurgitation, often detected as a new holosystolic
murmur post-MI.
Q5: During the cardiac cycle, the aortic valve opens when left ventricular pressure exceeds aortic
pressure. Which phase of the cardiac cycle does this event mark?
A. Atrial systole
B. Isovolumetric contraction
C. Rapid ejection [CORRECT]
D. Isovolumetric relaxation
Correct Answer: C
Rationale: When LV pressure exceeds aortic pressure, the aortic valve opens and the ventricle enters
the rapid ejection phase of systole. Isovolumetric contraction precedes this event (all valves closed,
pressure rising). Isovolumetric relaxation occurs after semilunar valve closure but before AV valve
opening. Approximately 70% of stroke volume is ejected during the rapid ejection phase, with the
remaining 30% during reduced ejection.
Q6: A patient in the ICU has a pulmonary artery catheter showing elevated preload. According to the
Frank-Starling mechanism, increased preload results in increased stroke volume because:
A. Increased sarcomere stretch increases calcium sensitivity of troponin C, enhancing cross-bridge
formation [CORRECT]
B. Decreased sarcomere length increases the velocity of shortening
C. Increased afterload automatically reduces with higher preload
D. Sympathetic stimulation increases heart rate to compensate
Correct Answer: A
Rationale: The Frank-Starling mechanism states that increased ventricular filling stretches sarcomeres
toward their optimal length (2.0-2.2 microns), increasing calcium sensitivity of troponin C and enhancing
cross-bridge formation. This produces a stronger contraction and greater stroke volume without requiring
neural input. The mechanism operates on the steep portion of the ventricular function curve under
normal physiologic conditions, but flattens at high preload where further stretch does not augment
NURS 611 Exam 2 - Advanced Pathophysiology Test Bank Page 4
Maryville University | Graduate Nursing
