Pathophysiology Nursing 2026 Clinical Case
Study Practice Questions Disease
Mechanisms Patient Assessment Clinical
Manifestations Diagnostic Interpretation
Nursing Decisions
SECTION 1: CARDIOVASCULAR PATHOPHYSIOLOGY CLINICAL
CASES (1–25)
1. A 68-year-old client presents with crushing chest pain radiating to the left
arm, diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction, which is typically caused by occlusion of the right coronary
artery.
2. A 55-year-old client with a history of hypertension presents with sudden
tearing chest pain radiating to the back. Blood pressure is 180/100 mmHg,
and a pulsating mass is palpated in the abdomen. Which condition should the
nurse suspect?
A. Myocardial infarction
B. Abdominal aortic aneurysm
C. Pulmonary embolism
D. Pericarditis
,Rationale: Sudden tearing chest pain radiating to the back with a pulsating
abdominal mass indicates an abdominal aortic aneurysm. Deep palpation should be
avoided.
3. A 72-year-old client with heart failure presents with jugular venous
distension, hepatomegaly, and bilateral pitting edema. Which type of heart
failure is most likely?
A. Left-sided heart failure
B. Right-sided heart failure
C. Systolic heart failure
D. Diastolic heart failure
Rationale: Jugular venous distension, hepatomegaly, and peripheral edema are
classic signs of right-sided heart failure due to systemic venous congestion.
4. A 65-year-old client with heart failure presents with crackles in the lungs,
pink frothy sputum, and orthopnea. Which type of heart failure is most
likely?
A. Left-sided heart failure
B. Right-sided heart failure
C. Cor pulmonale
D. Pericarditis
Rationale: Crackles, pink frothy sputum, and orthopnea are classic signs of left-
sided heart failure due to pulmonary congestion.
5. A 45-year-old client presents with fever, pleuritic chest pain that worsens
with inspiration, and a pericardial friction rub. Which condition should the
nurse suspect?
A. Myocardial infarction
B. Pericarditis
,C. Pulmonary embolism
D. Aortic dissection
Rationale: Fever, pleuritic chest pain, and a pericardial friction rub are classic
signs of pericarditis.
6. A 60-year-old client presents with sudden shortness of breath, pleuritic
chest pain, and tachycardia after recent surgery. Which condition should the
nurse suspect?
A. Pneumonia
B. Pulmonary embolism
C. Myocardial infarction
D. Pericarditis
Rationale: Sudden shortness of breath, pleuritic chest pain, and tachycardia after
surgery are classic signs of pulmonary embolism.
7. A 70-year-old client presents with dizziness, syncope, and a systolic
murmur at the right sternal border radiating to the carotids. Which condition
should the nurse suspect?
A. Mitral stenosis
B. Aortic stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Dizziness, syncope, and a systolic murmur at the right sternal border
radiating to the carotids are classic signs of aortic stenosis.
8. A 55-year-old client presents with exertional dyspnea, orthopnea, and a
diastolic murmur at the apex. Which condition should the nurse suspect?
A. Aortic stenosis
B. Mitral stenosis
, C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Exertional dyspnea, orthopnea, and a diastolic murmur at the apex are
classic signs of mitral stenosis.
9. A 50-year-old client presents with fatigue, palpitations, and a holosystolic
murmur at the apex radiating to the axilla. Which condition should the nurse
suspect?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Fatigue, palpitations, and a holosystolic murmur at the apex radiating
to the axilla are classic signs of mitral regurgitation.
10. A 60-year-old client presents with bounding pulses, a widened pulse
pressure, and a diastolic murmur at the left sternal border. Which condition
should the nurse suspect?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Bounding pulses, widened pulse pressure, and a diastolic murmur at the
left sternal border are classic signs of aortic regurgitation.
11. A 65-year-old client presents with sudden onset of severe chest pain,
hypotension, and jugular venous distension. Which condition should the nurse
suspect?
A. Myocardial infarction
Study Practice Questions Disease
Mechanisms Patient Assessment Clinical
Manifestations Diagnostic Interpretation
Nursing Decisions
SECTION 1: CARDIOVASCULAR PATHOPHYSIOLOGY CLINICAL
CASES (1–25)
1. A 68-year-old client presents with crushing chest pain radiating to the left
arm, diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and
aVF. Which coronary artery is most likely occluded?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Left main coronary artery
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction, which is typically caused by occlusion of the right coronary
artery.
2. A 55-year-old client with a history of hypertension presents with sudden
tearing chest pain radiating to the back. Blood pressure is 180/100 mmHg,
and a pulsating mass is palpated in the abdomen. Which condition should the
nurse suspect?
A. Myocardial infarction
B. Abdominal aortic aneurysm
C. Pulmonary embolism
D. Pericarditis
,Rationale: Sudden tearing chest pain radiating to the back with a pulsating
abdominal mass indicates an abdominal aortic aneurysm. Deep palpation should be
avoided.
3. A 72-year-old client with heart failure presents with jugular venous
distension, hepatomegaly, and bilateral pitting edema. Which type of heart
failure is most likely?
A. Left-sided heart failure
B. Right-sided heart failure
C. Systolic heart failure
D. Diastolic heart failure
Rationale: Jugular venous distension, hepatomegaly, and peripheral edema are
classic signs of right-sided heart failure due to systemic venous congestion.
4. A 65-year-old client with heart failure presents with crackles in the lungs,
pink frothy sputum, and orthopnea. Which type of heart failure is most
likely?
A. Left-sided heart failure
B. Right-sided heart failure
C. Cor pulmonale
D. Pericarditis
Rationale: Crackles, pink frothy sputum, and orthopnea are classic signs of left-
sided heart failure due to pulmonary congestion.
5. A 45-year-old client presents with fever, pleuritic chest pain that worsens
with inspiration, and a pericardial friction rub. Which condition should the
nurse suspect?
A. Myocardial infarction
B. Pericarditis
,C. Pulmonary embolism
D. Aortic dissection
Rationale: Fever, pleuritic chest pain, and a pericardial friction rub are classic
signs of pericarditis.
6. A 60-year-old client presents with sudden shortness of breath, pleuritic
chest pain, and tachycardia after recent surgery. Which condition should the
nurse suspect?
A. Pneumonia
B. Pulmonary embolism
C. Myocardial infarction
D. Pericarditis
Rationale: Sudden shortness of breath, pleuritic chest pain, and tachycardia after
surgery are classic signs of pulmonary embolism.
7. A 70-year-old client presents with dizziness, syncope, and a systolic
murmur at the right sternal border radiating to the carotids. Which condition
should the nurse suspect?
A. Mitral stenosis
B. Aortic stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Dizziness, syncope, and a systolic murmur at the right sternal border
radiating to the carotids are classic signs of aortic stenosis.
8. A 55-year-old client presents with exertional dyspnea, orthopnea, and a
diastolic murmur at the apex. Which condition should the nurse suspect?
A. Aortic stenosis
B. Mitral stenosis
, C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Exertional dyspnea, orthopnea, and a diastolic murmur at the apex are
classic signs of mitral stenosis.
9. A 50-year-old client presents with fatigue, palpitations, and a holosystolic
murmur at the apex radiating to the axilla. Which condition should the nurse
suspect?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Fatigue, palpitations, and a holosystolic murmur at the apex radiating
to the axilla are classic signs of mitral regurgitation.
10. A 60-year-old client presents with bounding pulses, a widened pulse
pressure, and a diastolic murmur at the left sternal border. Which condition
should the nurse suspect?
A. Aortic stenosis
B. Mitral stenosis
C. Mitral regurgitation
D. Aortic regurgitation
Rationale: Bounding pulses, widened pulse pressure, and a diastolic murmur at the
left sternal border are classic signs of aortic regurgitation.
11. A 65-year-old client presents with sudden onset of severe chest pain,
hypotension, and jugular venous distension. Which condition should the nurse
suspect?
A. Myocardial infarction
