2026 NURS 617–ADVANCED PHYSIOLOGY AND
PATHOPHYSIOLOGY EXAM 2|150+Qs&As|A+GRADE
During the cardiac cycle, which structure directly delivers action potential to
the ventricular myocardium?
a. Sinoatrial (SA) node
b. Atrioventricular (AV) node
c. Purkinje fibers
d. Bundle branches
c. Purkinje fibers
Each cardiac action potential travels from the SA node to the AV node to the
bundle of His (AV bundle), through the bundle branches, and finally to the
Purkinje fibers and the ventricular myocardium, where the impulse is stopped.
The cardiac electrical impulse normally begins spontaneously in the sinoatrial
(SA) node because it:
a. Has a superior location in the right atrium.
b. Is the only area of the heart capable of spontaneous depolarization.
c. Has rich sympathetic innervation via the vagus nerve.
d. Depolarizes more rapidly than other automatic cells of the heart
d. Depolarizes more rapidly than other automatic cells of the heart
The electrical impulse normally begins in the SA node because its cells
depolarize more rapidly than other automatic cells.
,What can shorten the conduction time of action potential through the
atrioventricular (AV) node?
a. Parasympathetic nervous system
b. Catecholamines
c. Vagal stimulation
d. Sinoatrial node (SA)
b. Catecholamines
Catecholamines speed the heart rate, shorten the conduction time through the
AV node, and increase the rhythmicity of the AV pacemaker fibers.
If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute)
can the atrioventricular (AV) node depolarize?
a. 60 to 70
b. 40 to 60
c. 30 to 40
d. 10 to 20
b. 40 to 60
If the SA node is damaged, then the AV node will become the heart's
pacemaker at a rate of approximately 40 to 60 spontaneous depolarizations
per minute.
Within a physiologic range, what does an increase in left ventricular end-
diastolic volume (preload) result in?
a. Increase in force of contraction
,b. Decrease in refractory time
c. Increase in afterload
d. Decrease in repolarization
a. Increase in force of contraction
This concept is expressed in the Frank-Starling law; the cardiac muscle, like
other muscles, increases its strength of contraction when it is stretched.
As stated in the Frank-Starling law, a direct relationship exists between the
_____ of the blood in the heart at the end of diastole and the _____ of contraction
during the next systole.
a. Pressure; force
b. Volume; strength
c. Viscosity; force
d. Viscosity; strength
b. Volume; strength
As stated in the Frank-Starling law, the volume of blood in the heart at the end
of diastole (the length of its muscle fibers) is directly related to the force
(strength) of contraction during the next systole.
What physical sign is the result of turbulent blood flow through a vessel?
a. Increased blood pressure during periods of stress b. Bounding pulse felt on
palpation
c. Cyanosis observed on excretion
d. Murmur heard on auscultation
, d. Murmur heard on auscultation
Where flow is obstructed, the vessel turns or blood flows over rough surfaces.
The flow becomes turbulent with whorls or eddy currents that produce noise,
causing a murmur to be heard on auscultation, such as occurs during blood
pressure measurement with a sphygomanometer.
What is the initiating event that leads to the development of atherosclerosis?
a. Release of the inflammatory cytokines
b. Macrophages adhere to vessel walls.
c. Injury to the endothelial cells that line the artery walls
d. Release of the platelet-deprived growth factor
c. Injury to the endothelial cells that line the artery walls
Atherosclerosis begins with an injury to the endothelial cells that line the
arterial walls. Possible causes of endothelial injury include the common risk
factors for atherosclerosis, such as smoking, hypertension, diabetes, increased
levels of low-density lipoprotein (LDL), decreased levels of high-density
lipoprotein (HDL), and autoimmunity.
What is the effect of oxidized low-density lipoproteins (LDLs) in
atherosclerosis?
a. LDLs cause smooth muscle proliferation.
b. LDLs cause regression of atherosclerotic plaques. c. LDLs increase levels of
inflammatory cytokines.
d. LDLs direct macrophages to the site in the endothelium.
PATHOPHYSIOLOGY EXAM 2|150+Qs&As|A+GRADE
During the cardiac cycle, which structure directly delivers action potential to
the ventricular myocardium?
a. Sinoatrial (SA) node
b. Atrioventricular (AV) node
c. Purkinje fibers
d. Bundle branches
c. Purkinje fibers
Each cardiac action potential travels from the SA node to the AV node to the
bundle of His (AV bundle), through the bundle branches, and finally to the
Purkinje fibers and the ventricular myocardium, where the impulse is stopped.
The cardiac electrical impulse normally begins spontaneously in the sinoatrial
(SA) node because it:
a. Has a superior location in the right atrium.
b. Is the only area of the heart capable of spontaneous depolarization.
c. Has rich sympathetic innervation via the vagus nerve.
d. Depolarizes more rapidly than other automatic cells of the heart
d. Depolarizes more rapidly than other automatic cells of the heart
The electrical impulse normally begins in the SA node because its cells
depolarize more rapidly than other automatic cells.
,What can shorten the conduction time of action potential through the
atrioventricular (AV) node?
a. Parasympathetic nervous system
b. Catecholamines
c. Vagal stimulation
d. Sinoatrial node (SA)
b. Catecholamines
Catecholamines speed the heart rate, shorten the conduction time through the
AV node, and increase the rhythmicity of the AV pacemaker fibers.
If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute)
can the atrioventricular (AV) node depolarize?
a. 60 to 70
b. 40 to 60
c. 30 to 40
d. 10 to 20
b. 40 to 60
If the SA node is damaged, then the AV node will become the heart's
pacemaker at a rate of approximately 40 to 60 spontaneous depolarizations
per minute.
Within a physiologic range, what does an increase in left ventricular end-
diastolic volume (preload) result in?
a. Increase in force of contraction
,b. Decrease in refractory time
c. Increase in afterload
d. Decrease in repolarization
a. Increase in force of contraction
This concept is expressed in the Frank-Starling law; the cardiac muscle, like
other muscles, increases its strength of contraction when it is stretched.
As stated in the Frank-Starling law, a direct relationship exists between the
_____ of the blood in the heart at the end of diastole and the _____ of contraction
during the next systole.
a. Pressure; force
b. Volume; strength
c. Viscosity; force
d. Viscosity; strength
b. Volume; strength
As stated in the Frank-Starling law, the volume of blood in the heart at the end
of diastole (the length of its muscle fibers) is directly related to the force
(strength) of contraction during the next systole.
What physical sign is the result of turbulent blood flow through a vessel?
a. Increased blood pressure during periods of stress b. Bounding pulse felt on
palpation
c. Cyanosis observed on excretion
d. Murmur heard on auscultation
, d. Murmur heard on auscultation
Where flow is obstructed, the vessel turns or blood flows over rough surfaces.
The flow becomes turbulent with whorls or eddy currents that produce noise,
causing a murmur to be heard on auscultation, such as occurs during blood
pressure measurement with a sphygomanometer.
What is the initiating event that leads to the development of atherosclerosis?
a. Release of the inflammatory cytokines
b. Macrophages adhere to vessel walls.
c. Injury to the endothelial cells that line the artery walls
d. Release of the platelet-deprived growth factor
c. Injury to the endothelial cells that line the artery walls
Atherosclerosis begins with an injury to the endothelial cells that line the
arterial walls. Possible causes of endothelial injury include the common risk
factors for atherosclerosis, such as smoking, hypertension, diabetes, increased
levels of low-density lipoprotein (LDL), decreased levels of high-density
lipoprotein (HDL), and autoimmunity.
What is the effect of oxidized low-density lipoproteins (LDLs) in
atherosclerosis?
a. LDLs cause smooth muscle proliferation.
b. LDLs cause regression of atherosclerotic plaques. c. LDLs increase levels of
inflammatory cytokines.
d. LDLs direct macrophages to the site in the endothelium.
