NUR 631 ADVANCED
PATHOPHYSIOLOGY EXAM 4
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with heart failure exhibits a decreased ejection fraction of 30%. Which type of
heart failure is this characteristic of?
A. Diastolic heart failure
B. Right-sided heart failure only
C. Systolic heart failure
D. High-output heart failure
Answer: C
Conceptual Explanation: Systolic heart failure is characterized by a reduced ejection
fraction (HFrEF), typically less than 40%, indicating impaired ventricular contraction and
reduced stroke volume.
2. Which compensatory mechanism in heart failure leads to increased systemic vascular
resistance (SVR) and workload for the heart?
A. Release of B-type Natriuretic Peptide (BNP)
B. Parasympathetic nervous system activation
,C. Nitric oxide vasodilation
D. Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Answer: D
Conceptual Explanation: RAAS activation leads to the production of Angiotensin II, a
potent vasoconstrictor that increases SVR, and Aldosterone, which increases fluid volume,
both increasing cardiac workload.
3. A patient presents with jugular venous distention, peripheral edema, and hepatomegaly.
These findings are most suggestive of:
A. Right-sided heart failure
B. Left-sided heart failure
C. Acute respiratory distress syndrome
D. Mitral valve stenosis
Answer: A
Conceptual Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation, leading to peripheral edema, JVD, and organ congestion
(hepatomegaly).
4. In the development of atherosclerosis, which cell type transforms into ‘foam cells’ after
ingesting oxidized LDL?
A. Neutrophils
, B. Macrophages
C. Endothelial cells
D. Smooth muscle cells
Answer: B
Conceptual Explanation: Macrophages ingest oxidized LDL in the subendothelial space
and become foam cells, which are the hallmark of early fatty streaks in atherosclerosis.
5. What is the primary pathophysiological defect in Prinzmetal (variant) angina?
A. Fixed atherosclerotic plaque
B. Increased myocardial oxygen demand during exercise
C. Rupture of an unstable plaque
D. Coronary artery vasospasm
Answer: D
Conceptual Explanation: Prinzmetal angina is caused by transient vasospasm of a
coronary artery, often occurring at rest and usually in the morning.
6. Which valvular disorder is characterized by a mid-systolic click followed by a late systolic
murmur?
A. Mitral valve prolapse
B. Mitral regurgitation
PATHOPHYSIOLOGY EXAM 4
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with heart failure exhibits a decreased ejection fraction of 30%. Which type of
heart failure is this characteristic of?
A. Diastolic heart failure
B. Right-sided heart failure only
C. Systolic heart failure
D. High-output heart failure
Answer: C
Conceptual Explanation: Systolic heart failure is characterized by a reduced ejection
fraction (HFrEF), typically less than 40%, indicating impaired ventricular contraction and
reduced stroke volume.
2. Which compensatory mechanism in heart failure leads to increased systemic vascular
resistance (SVR) and workload for the heart?
A. Release of B-type Natriuretic Peptide (BNP)
B. Parasympathetic nervous system activation
,C. Nitric oxide vasodilation
D. Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Answer: D
Conceptual Explanation: RAAS activation leads to the production of Angiotensin II, a
potent vasoconstrictor that increases SVR, and Aldosterone, which increases fluid volume,
both increasing cardiac workload.
3. A patient presents with jugular venous distention, peripheral edema, and hepatomegaly.
These findings are most suggestive of:
A. Right-sided heart failure
B. Left-sided heart failure
C. Acute respiratory distress syndrome
D. Mitral valve stenosis
Answer: A
Conceptual Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation, leading to peripheral edema, JVD, and organ congestion
(hepatomegaly).
4. In the development of atherosclerosis, which cell type transforms into ‘foam cells’ after
ingesting oxidized LDL?
A. Neutrophils
, B. Macrophages
C. Endothelial cells
D. Smooth muscle cells
Answer: B
Conceptual Explanation: Macrophages ingest oxidized LDL in the subendothelial space
and become foam cells, which are the hallmark of early fatty streaks in atherosclerosis.
5. What is the primary pathophysiological defect in Prinzmetal (variant) angina?
A. Fixed atherosclerotic plaque
B. Increased myocardial oxygen demand during exercise
C. Rupture of an unstable plaque
D. Coronary artery vasospasm
Answer: D
Conceptual Explanation: Prinzmetal angina is caused by transient vasospasm of a
coronary artery, often occurring at rest and usually in the morning.
6. Which valvular disorder is characterized by a mid-systolic click followed by a late systolic
murmur?
A. Mitral valve prolapse
B. Mitral regurgitation
