NUR 3123 Pathophysiology & Pharmacology
Comprehensive Final Exam (Qns & Ans)
2025
Question 1
A 62‑year‑old patient presents with septic shock. Laboratory
findings indicate hypotension with warm skin and an increased
cardiac output. Which mediator is most directly responsible for
the profound vasodilation seen in septic shock?
A. Endothelin‑1
B. Nitric oxide
C. Angiotensin II
D. Vasopressin
ANS: B. Nitric oxide
Rationale: In sepsis, activated macrophages release high levels
of nitric oxide, which causes marked vasodilation and contributes
©2025
,to hypotension. Endothelin‑1 and angiotensin II are
vasoconstrictors, and vasopressin is used therapeutically to
counteract vasodilation.
---
Question 2
A 65‑year‑old patient with congestive heart failure is initiated on
an ACE inhibitor. Which mechanism best explains the beneficial
effects of this drug in heart failure?
A. Increased aldosterone secretion
B. Reduction in angiotensin II levels leading to vasodilation and
decreased afterload
C. Enhanced sympathetic stimulation
D. Potentiation of endothelin activity
ANS: B. Reduction in angiotensin II levels leading to
vasodilation and decreased afterload
Rationale: ACE inhibitors block the formation of angiotensin
II, leading to vasodilation, decreased preload and afterload, and
subsequent improvement in cardiac output and survival in heart
failure patients.
---
©2025
, Question 3
A patient with heart failure is started on a beta-blocker that
provides proven mortality benefits and also has additional
alpha‑blocking properties. Which of the following medications is
most likely prescribed?
A. Metoprolol
B. Propranolol
C. Carvedilol
D. Atenolol
ANS: C. Carvedilol
Rationale: Carvedilol has both beta‑blocking and
alpha‑blocking effects, which results in reduced heart rate,
decreased blood pressure, and improved left ventricular function,
making it especially beneficial in heart failure management.
---
Question 4
Long‑term systemic corticosteroid therapy is associated with
several adverse effects. Which of the following is a
well‑documented complication of prolonged corticosteroid use?
©2025
, A. Osteoporosis
B. Hyperthyroidism
C. Weight loss
D. Bradycardia
ANS: A. Osteoporosis
Rationale: Prolonged corticosteroid therapy leads to decreased
bone formation and increased bone resorption, resulting in
osteoporosis. Other common adverse effects include
hyperglycemia, weight gain, and immunosuppression.
---
Question 5
Thrombolytic therapy in the management of myocardial infarction
works primarily through which mechanism?
A. Inhibition of platelet aggregation
B. Dissolution of blood clots by activating plasminogen
C. Stabilization of atherosclerotic plaques
D. Inhibition of thromboxane A2 synthesis
ANS: B. Dissolution of blood clots by activating plasminogen
©2025
Comprehensive Final Exam (Qns & Ans)
2025
Question 1
A 62‑year‑old patient presents with septic shock. Laboratory
findings indicate hypotension with warm skin and an increased
cardiac output. Which mediator is most directly responsible for
the profound vasodilation seen in septic shock?
A. Endothelin‑1
B. Nitric oxide
C. Angiotensin II
D. Vasopressin
ANS: B. Nitric oxide
Rationale: In sepsis, activated macrophages release high levels
of nitric oxide, which causes marked vasodilation and contributes
©2025
,to hypotension. Endothelin‑1 and angiotensin II are
vasoconstrictors, and vasopressin is used therapeutically to
counteract vasodilation.
---
Question 2
A 65‑year‑old patient with congestive heart failure is initiated on
an ACE inhibitor. Which mechanism best explains the beneficial
effects of this drug in heart failure?
A. Increased aldosterone secretion
B. Reduction in angiotensin II levels leading to vasodilation and
decreased afterload
C. Enhanced sympathetic stimulation
D. Potentiation of endothelin activity
ANS: B. Reduction in angiotensin II levels leading to
vasodilation and decreased afterload
Rationale: ACE inhibitors block the formation of angiotensin
II, leading to vasodilation, decreased preload and afterload, and
subsequent improvement in cardiac output and survival in heart
failure patients.
---
©2025
, Question 3
A patient with heart failure is started on a beta-blocker that
provides proven mortality benefits and also has additional
alpha‑blocking properties. Which of the following medications is
most likely prescribed?
A. Metoprolol
B. Propranolol
C. Carvedilol
D. Atenolol
ANS: C. Carvedilol
Rationale: Carvedilol has both beta‑blocking and
alpha‑blocking effects, which results in reduced heart rate,
decreased blood pressure, and improved left ventricular function,
making it especially beneficial in heart failure management.
---
Question 4
Long‑term systemic corticosteroid therapy is associated with
several adverse effects. Which of the following is a
well‑documented complication of prolonged corticosteroid use?
©2025
, A. Osteoporosis
B. Hyperthyroidism
C. Weight loss
D. Bradycardia
ANS: A. Osteoporosis
Rationale: Prolonged corticosteroid therapy leads to decreased
bone formation and increased bone resorption, resulting in
osteoporosis. Other common adverse effects include
hyperglycemia, weight gain, and immunosuppression.
---
Question 5
Thrombolytic therapy in the management of myocardial infarction
works primarily through which mechanism?
A. Inhibition of platelet aggregation
B. Dissolution of blood clots by activating plasminogen
C. Stabilization of atherosclerotic plaques
D. Inhibition of thromboxane A2 synthesis
ANS: B. Dissolution of blood clots by activating plasminogen
©2025
