NSG 3850 PathoPhySioloGy for NurSeS ii
Section I: Cardiovascular System
1. A patient presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. The ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery is
most likely affected?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Answer: B. Right coronary artery
ratioNale: ST elevation in II, III, and aVF indicates an inferior wall myocardial infarction,
typically supplied by the right coronary artery.
2. Which pathophysiologic process is responsible for the development of atherosclerosis?
A. Hypercoagulability
B. Endothelial injury and lipid accumulation
C. Acute inflammation only
D. Vasospasm
Answer: B. Endothelial injury and lipid accumulation
ratioNale: Atherosclerosis begins with endothelial damage, allowing LDL cholesterol to
accumulate and trigger an inflammatory response.
3. A patient with chronic heart failure presents with dyspnea, peripheral edema, and
orthopnea. Which compensatory mechanism is primarily responsible for ventricular
remodeling?
A. Activation of the renin-angiotensin-aldosterone system (RAAS)
B. Increased parasympathetic stimulation
, C. Vasodilation due to nitric oxide
D. Hypoventilation
Answer: A. Activation of the renin-angiotensin-aldosterone system (RAAS)
ratioNale: RAAS activation increases fluid retention and blood pressure but promotes cardiac
remodeling over time.
Section II: Respiratory System
4. Which of the following best explains hypoxemia in a patient with COPD?
A. Decreased alveolar oxygen pressure
B. Impaired alveolar ventilation and V/Q mismatch
C. Hyperventilation
D. Pulmonary embolism only
Answer: B. Impaired alveolar ventilation and V/Q mismatch
ratioNale: In COPD, damaged alveoli and airway obstruction reduce oxygen exchange, causing
ventilation-perfusion mismatch.
5. A patient presents with sudden onset shortness of breath and pleuritic chest pain. A CT
scan confirms a pulmonary embolism. Which physiologic mechanism explains the hypoxemia?
A. Diffusion limitation
B. Shunting of blood through non-ventilated areas
C. Decreased cardiac output
D. Hypercapnia
Answer: B. Shunting of blood through non-ventilated areas
ratioNale: A pulmonary embolism blocks blood flow to portions of the lung, creating a
perfusion defect that leads to hypoxemia.
Section III: Renal System
6. A patient has elevated BUN and creatinine with oliguria. Urinalysis shows muddy brown
casts. What is the most likely cause?
A. Prerenal azotemia
B. Acute tubular necrosis (ATN)
C. Glomerulonephritis
D. Urinary tract obstruction
Section I: Cardiovascular System
1. A patient presents with chest pain radiating to the left arm, diaphoresis, and shortness of
breath. The ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery is
most likely affected?
A. Left anterior descending artery
B. Right coronary artery
C. Left circumflex artery
D. Posterior descending artery
Answer: B. Right coronary artery
ratioNale: ST elevation in II, III, and aVF indicates an inferior wall myocardial infarction,
typically supplied by the right coronary artery.
2. Which pathophysiologic process is responsible for the development of atherosclerosis?
A. Hypercoagulability
B. Endothelial injury and lipid accumulation
C. Acute inflammation only
D. Vasospasm
Answer: B. Endothelial injury and lipid accumulation
ratioNale: Atherosclerosis begins with endothelial damage, allowing LDL cholesterol to
accumulate and trigger an inflammatory response.
3. A patient with chronic heart failure presents with dyspnea, peripheral edema, and
orthopnea. Which compensatory mechanism is primarily responsible for ventricular
remodeling?
A. Activation of the renin-angiotensin-aldosterone system (RAAS)
B. Increased parasympathetic stimulation
, C. Vasodilation due to nitric oxide
D. Hypoventilation
Answer: A. Activation of the renin-angiotensin-aldosterone system (RAAS)
ratioNale: RAAS activation increases fluid retention and blood pressure but promotes cardiac
remodeling over time.
Section II: Respiratory System
4. Which of the following best explains hypoxemia in a patient with COPD?
A. Decreased alveolar oxygen pressure
B. Impaired alveolar ventilation and V/Q mismatch
C. Hyperventilation
D. Pulmonary embolism only
Answer: B. Impaired alveolar ventilation and V/Q mismatch
ratioNale: In COPD, damaged alveoli and airway obstruction reduce oxygen exchange, causing
ventilation-perfusion mismatch.
5. A patient presents with sudden onset shortness of breath and pleuritic chest pain. A CT
scan confirms a pulmonary embolism. Which physiologic mechanism explains the hypoxemia?
A. Diffusion limitation
B. Shunting of blood through non-ventilated areas
C. Decreased cardiac output
D. Hypercapnia
Answer: B. Shunting of blood through non-ventilated areas
ratioNale: A pulmonary embolism blocks blood flow to portions of the lung, creating a
perfusion defect that leads to hypoxemia.
Section III: Renal System
6. A patient has elevated BUN and creatinine with oliguria. Urinalysis shows muddy brown
casts. What is the most likely cause?
A. Prerenal azotemia
B. Acute tubular necrosis (ATN)
C. Glomerulonephritis
D. Urinary tract obstruction
