NURS 6501 ADVANCED PATHOPHYSIOLOGY WALDEN UNIVERSITY
MIDTERM EXAM ACTUAL EXAM AND PRACTICE EXAM TEST BANK |
ACCURATE AND VERIFIED QUESTIONS WITH DETAILED ANSWERS |
GUARANTEED PASS | GRADED A
A 65-year-old male with longstanding uncontrolled HTN presents to the office for evaluation of syncope.
His vital signs are temperature=98.3, Pulse=85, RR=17, BP=165/85. Physical examination reveals a fourth
heart sound and a 4/6 crescendo-decrescendo murmur heard at the right upper sternal border with
radiation to the carotid arteries. His ECG reveals enlarged QRS waves, consistent with left ventricular
hypertrophy. What is the most likely cause of his syncopal episodes?
A. Mitral regurgitation
B. Mitral Stenosis
C. Aortic regurgitation
D. Aortic stenosis - correct answer✨✔✔ Aortic stenosis
A 63-year-old female presents to the emergency room with sudden onset of severe chest and back pain.
She describes the pain as sharp and different from her anginal pain. Her past medical history is positive
for HTN X 20 years. VS: HR 105, BP 160/105, RR 17. On physical examination, the NP notices that her
pedal and radial pulses are not equal. What is the most likely cause of her chest pain?
A. Unstable angina
B. Aortic dissection
C. Prinzmetal angina
D. Acute myocardial infarction - correct answer✨✔✔ Aortic dissection
A 45-year-old male collapsed suddenly while playing basketball. Bystander CPR and defibrillation was
performed using an automatic external defibrillator or AED. When EMS arrived, the gentleman was
awake and alert. The recorded rhythm strip on the AED shows tachycardia with AV dissociation (rate,
approximately 220 bpm). Which arrhythmia induced his arrest?
,A. Nonsustained supraventricular tachycardia
B. Sustained wide complex atrial tachycardia
C. Wide complex ventricular tachycardia
D. Narrow complex ventricular tachycardia - correct answer✨✔✔ Wide complex tachycardia
A 44-year-old previously healthy male presents to the office complaining of increasing dyspnea on
exertion and exercise intolerance over the last six months. The NP order a chest XRAY and transthoracic
echocardiogram. The chest XRAY shows an enlarged heart and mild pulmonary edema. The
echocardiogram reveals four-chamber cardiac dilation with an ejection fraction of 30% and mitral and
tricuspid valve regurgitation. The patient is referred to the cardiologist who orders a CAT scan of the
coronary arteries which is negative for obstructive coronary artery disease. What is the most likely
underlying cause of the dyspnea?
A. Idiopathic dilated cardiomyopathy
B. Rheumatic heart disease
C. Hemochromatosis
D. Chagas disease - correct answer✨✔✔ Idiopathic dilated cardiomyopathy
A 72-year-old female with a known cardiac history of coronary artery disease presents to the emergency
room following a syncopal episode. She received a stent to the right coronary artery in 2017 and was
noted to have an ejection fraction of 40% at that time. A 12 lead ECG reveals a regular rhythm with a
rate of 35. What is the most likely cause of her bradycardia?
A. Blocked pathway at or below the AV node
B. Blocked pathway at or below the SA node
C. Reentry pathway at or near the SA node
D. Reentry pathway at or near the AV node - correct answer✨✔✔ Blocked pathway at or below the AV
node
A 43-year-old female is ten years post prosthetic aortic valve replacement secondary to infective
endocarditis. Which of the following valvular conditions would be an expected finding?
,A. Paravalvular leak
B. Aortic stenosis
C. Aortic valve embolization
D. Aortic regurgitation - correct answer✨✔✔ Aortic stenosis
A 50-year-old male is admitted an acute myocardial infarction. His ejection fraction is noted to be 30%.
He develops shortness of breath and his physical exam reveals crackles bilaterally. The bedside CXR
indicates pulmonary edema. Which of the following best describes the pathological cause of the edema?
A. Increased hydrostatic pressure
B. Decreased plasma osmotic pressure
C. Increased cardiac output
D. Decreased central venous pressure - correct answer✨✔✔ Increased hydrostatic pressure
The direction of blood flow and the clinical severity of symptoms in Tetralogy of Fallot is determined
primarily by the:
A. Presence of an atrial septal defect
B. Diameter of the tricuspid valve
C. Size of the left ventricle
D. Degree of pulmonary stenosis - correct answer✨✔✔ Degree of Pulmonary stenosis
A 36-year-old female presents to the ED with the chief complaint of acute SOB and anxiety that started
suddenly 2 to 3 hours ago while she was working around the house. She denies chest pain. Her PMH is
unremarkable. She takes oral contraceptives, but no other medications. Vital signs are
temperature=99.1, RR=34, BP=148/90, pulse=100. Oxygen saturation is 94% on room air. Laboratory
tests reveal WBC=7.1, Hgb=12.2, Hct=37.3, Na+=138, K+=4.7, Cl=109, HCO3=25, BUN=14, Cr=0.9,
glucose=106. ABGs are obtained and reveal pH=7.52, HCO3=20, PaCO2=26, PaO2=70. CXR and ECG are
normal. What type of acid base disorder does the patient suffer from?
A. Respiratory alkalosis
B. Respiratory acidosis
, C. Metabolic alkalosis
D. Metabolic acidosis - correct answer✨✔✔ Respiratory alkalosis
A 65-year-old male is brought for care by his wife because of headache, nausea, and fatigue. PMH is
significant for small cell carcinoma of the lung diagnosed approximately 2 years ago. He also has a
history of TIA (6 years ago) and mild CHF. Vital signs are as follow: temperature=99.8F, RR=18,
BP=140/88, pulse=76. On examination, he is awake but somewhat lethargic. Physical examination is
unremarkable. Laboratory tests reveal the following: WBC=8.3, Hgb/Hct=10.2/30.7, glucose=106, serum
Na+=121 mEq/L, K+=4.3, BUN/Cr= 7.0/0.4. What is the most likely diagnosis?
A. Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)
B. Diabetic ketoacidosis
C. Diabetes Insipidus
D. Compensated diastolic congestive heart failure - correct answer✨✔✔ SIADH
Leo is a 40-year-old male who presents to the clinic with complaints of shortness of breath while doing
yard work. He states he has had worsening of the shortness of breath throughout the summer. He states
when he was younger, he had shortness of breath and coughed a lot at night. He was given an inhaler
for a few years, but he hasn't had any trouble since he was about nine years old. Which findings are
most suggestive of a diagnosis of asthma?
A 4-year-old child appears listless for the last week. He complains of pain when he is picked up by his
mother, and he is irritable when touching his arms or legs. Several large ecchymotic lesions have
appeared on his right thigh and left shoulder. A complete blood count reveals a HgB=10.2, Hct=30.5%,
MCV=96fL, platelet count of 45,000/ML, and WBC count of 13,990/ML. Examination of the peripheral
blood smear reveals numerous blasts. The blasts lack peroxidase-positive granules but do contain
periodic acid-Schiff (PAS)-positive aggregates and stain positively for TdT. Flow cytometry shows the
phenotype of blasts to be CD19+, CD3-, and sIg-. What is the most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML) - correct answer✨✔✔ Acute lymphblastic leukemia
MIDTERM EXAM ACTUAL EXAM AND PRACTICE EXAM TEST BANK |
ACCURATE AND VERIFIED QUESTIONS WITH DETAILED ANSWERS |
GUARANTEED PASS | GRADED A
A 65-year-old male with longstanding uncontrolled HTN presents to the office for evaluation of syncope.
His vital signs are temperature=98.3, Pulse=85, RR=17, BP=165/85. Physical examination reveals a fourth
heart sound and a 4/6 crescendo-decrescendo murmur heard at the right upper sternal border with
radiation to the carotid arteries. His ECG reveals enlarged QRS waves, consistent with left ventricular
hypertrophy. What is the most likely cause of his syncopal episodes?
A. Mitral regurgitation
B. Mitral Stenosis
C. Aortic regurgitation
D. Aortic stenosis - correct answer✨✔✔ Aortic stenosis
A 63-year-old female presents to the emergency room with sudden onset of severe chest and back pain.
She describes the pain as sharp and different from her anginal pain. Her past medical history is positive
for HTN X 20 years. VS: HR 105, BP 160/105, RR 17. On physical examination, the NP notices that her
pedal and radial pulses are not equal. What is the most likely cause of her chest pain?
A. Unstable angina
B. Aortic dissection
C. Prinzmetal angina
D. Acute myocardial infarction - correct answer✨✔✔ Aortic dissection
A 45-year-old male collapsed suddenly while playing basketball. Bystander CPR and defibrillation was
performed using an automatic external defibrillator or AED. When EMS arrived, the gentleman was
awake and alert. The recorded rhythm strip on the AED shows tachycardia with AV dissociation (rate,
approximately 220 bpm). Which arrhythmia induced his arrest?
,A. Nonsustained supraventricular tachycardia
B. Sustained wide complex atrial tachycardia
C. Wide complex ventricular tachycardia
D. Narrow complex ventricular tachycardia - correct answer✨✔✔ Wide complex tachycardia
A 44-year-old previously healthy male presents to the office complaining of increasing dyspnea on
exertion and exercise intolerance over the last six months. The NP order a chest XRAY and transthoracic
echocardiogram. The chest XRAY shows an enlarged heart and mild pulmonary edema. The
echocardiogram reveals four-chamber cardiac dilation with an ejection fraction of 30% and mitral and
tricuspid valve regurgitation. The patient is referred to the cardiologist who orders a CAT scan of the
coronary arteries which is negative for obstructive coronary artery disease. What is the most likely
underlying cause of the dyspnea?
A. Idiopathic dilated cardiomyopathy
B. Rheumatic heart disease
C. Hemochromatosis
D. Chagas disease - correct answer✨✔✔ Idiopathic dilated cardiomyopathy
A 72-year-old female with a known cardiac history of coronary artery disease presents to the emergency
room following a syncopal episode. She received a stent to the right coronary artery in 2017 and was
noted to have an ejection fraction of 40% at that time. A 12 lead ECG reveals a regular rhythm with a
rate of 35. What is the most likely cause of her bradycardia?
A. Blocked pathway at or below the AV node
B. Blocked pathway at or below the SA node
C. Reentry pathway at or near the SA node
D. Reentry pathway at or near the AV node - correct answer✨✔✔ Blocked pathway at or below the AV
node
A 43-year-old female is ten years post prosthetic aortic valve replacement secondary to infective
endocarditis. Which of the following valvular conditions would be an expected finding?
,A. Paravalvular leak
B. Aortic stenosis
C. Aortic valve embolization
D. Aortic regurgitation - correct answer✨✔✔ Aortic stenosis
A 50-year-old male is admitted an acute myocardial infarction. His ejection fraction is noted to be 30%.
He develops shortness of breath and his physical exam reveals crackles bilaterally. The bedside CXR
indicates pulmonary edema. Which of the following best describes the pathological cause of the edema?
A. Increased hydrostatic pressure
B. Decreased plasma osmotic pressure
C. Increased cardiac output
D. Decreased central venous pressure - correct answer✨✔✔ Increased hydrostatic pressure
The direction of blood flow and the clinical severity of symptoms in Tetralogy of Fallot is determined
primarily by the:
A. Presence of an atrial septal defect
B. Diameter of the tricuspid valve
C. Size of the left ventricle
D. Degree of pulmonary stenosis - correct answer✨✔✔ Degree of Pulmonary stenosis
A 36-year-old female presents to the ED with the chief complaint of acute SOB and anxiety that started
suddenly 2 to 3 hours ago while she was working around the house. She denies chest pain. Her PMH is
unremarkable. She takes oral contraceptives, but no other medications. Vital signs are
temperature=99.1, RR=34, BP=148/90, pulse=100. Oxygen saturation is 94% on room air. Laboratory
tests reveal WBC=7.1, Hgb=12.2, Hct=37.3, Na+=138, K+=4.7, Cl=109, HCO3=25, BUN=14, Cr=0.9,
glucose=106. ABGs are obtained and reveal pH=7.52, HCO3=20, PaCO2=26, PaO2=70. CXR and ECG are
normal. What type of acid base disorder does the patient suffer from?
A. Respiratory alkalosis
B. Respiratory acidosis
, C. Metabolic alkalosis
D. Metabolic acidosis - correct answer✨✔✔ Respiratory alkalosis
A 65-year-old male is brought for care by his wife because of headache, nausea, and fatigue. PMH is
significant for small cell carcinoma of the lung diagnosed approximately 2 years ago. He also has a
history of TIA (6 years ago) and mild CHF. Vital signs are as follow: temperature=99.8F, RR=18,
BP=140/88, pulse=76. On examination, he is awake but somewhat lethargic. Physical examination is
unremarkable. Laboratory tests reveal the following: WBC=8.3, Hgb/Hct=10.2/30.7, glucose=106, serum
Na+=121 mEq/L, K+=4.3, BUN/Cr= 7.0/0.4. What is the most likely diagnosis?
A. Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)
B. Diabetic ketoacidosis
C. Diabetes Insipidus
D. Compensated diastolic congestive heart failure - correct answer✨✔✔ SIADH
Leo is a 40-year-old male who presents to the clinic with complaints of shortness of breath while doing
yard work. He states he has had worsening of the shortness of breath throughout the summer. He states
when he was younger, he had shortness of breath and coughed a lot at night. He was given an inhaler
for a few years, but he hasn't had any trouble since he was about nine years old. Which findings are
most suggestive of a diagnosis of asthma?
A 4-year-old child appears listless for the last week. He complains of pain when he is picked up by his
mother, and he is irritable when touching his arms or legs. Several large ecchymotic lesions have
appeared on his right thigh and left shoulder. A complete blood count reveals a HgB=10.2, Hct=30.5%,
MCV=96fL, platelet count of 45,000/ML, and WBC count of 13,990/ML. Examination of the peripheral
blood smear reveals numerous blasts. The blasts lack peroxidase-positive granules but do contain
periodic acid-Schiff (PAS)-positive aggregates and stain positively for TdT. Flow cytometry shows the
phenotype of blasts to be CD19+, CD3-, and sIg-. What is the most likely diagnosis?
A. Acute lymphoblastic leukemia (ALL)
B. Chronic lymphocytic leukemia (CLL)
C. Acute myelogenous leukemia (AML)
D. Chronic myelogenous leukemia (CML) - correct answer✨✔✔ Acute lymphblastic leukemia
