NUR 2063: Essentials of Pathophysiology Exam 2 Actual
Exam 2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular System Pathophysiology (Q1-Q20)
Q1: A 72-year-old male with a history of myocardial infarction presents with progressive
dyspnea on exertion, fatigue, and orthopnea. Physical examination reveals bilateral
crackles, an S3 gallop, and jugular venous distension. Which pathophysiological
mechanism best explains these findings?
A. Impaired ventricular relaxation and decreased compliance leading to diastolic
dysfunction
B. Decreased myocardial contractility with reduced ejection fraction causing pulmonary
and systemic congestion
C. Valvular stenosis obstructing forward blood flow and causing pressure overload
D. Increased systemic vascular resistance without myocardial involvement
C. Decreased myocardial contractility with reduced ejection fraction causing pulmonary
and systemic congestion [CORRECT]
,Correct Answer: C
Rationale: This patient exhibits classic manifestations of systolic heart failure (HFrEF),
characterized by decreased contractility, reduced ejection fraction (<40%), and
symptoms of both left-sided (dyspnea, crackles, orthopnea, S3) and right-sided (JVD)
failure. The S3 gallop represents rapid ventricular filling into a dilated,
volume-overloaded ventricle. Option A describes diastolic heart failure (HFpEF), which
typically presents with preserved EF and symptoms of congestion without significant
dilation. Option C describes valvular stenosis, which would present with murmurs rather
than an S3. Option D describes isolated hypertension without heart failure. [100%
VERIFIED – Rasmussen NUR2063]
Q2: A 58-year-old female with long-standing hypertension presents with preserved
ejection fraction (55%) but demonstrates impaired ventricular filling, elevated left
ventricular end-diastolic pressure, and symptoms of exercise intolerance without
significant ventricular dilation. Which type of heart failure is most consistent with these
findings?
A. Dilated cardiomyopathy with systolic dysfunction
B. Hypertrophic cardiomyopathy with outflow obstruction
C. Diastolic heart failure with preserved ejection fraction
D. Restrictive cardiomyopathy with amyloid deposition
C. Diastolic heart failure with preserved ejection fraction [CORRECT]
Correct Answer: C
,Rationale: Diastolic heart failure (HFpEF) is characterized by preserved ejection fraction
(≥50%) with impaired ventricular relaxation and increased stiffness, leading to elevated
filling pressures and symptoms of congestion without significant systolic dysfunction or
chamber dilation. The patient's long-standing hypertension caused concentric left
ventricular hypertrophy, reducing compliance. Option A (dilated cardiomyopathy)
presents with reduced EF and ventricular dilation. Option B (HCM) typically presents in
younger patients with dynamic outflow obstruction and sudden cardiac death risk.
Option D (restrictive cardiomyopathy) involves myocardial infiltration (amyloid, sarcoid)
causing rigid ventricles but is less common than HFpEF in hypertensive patients. [100%
VERIFIED – Rasmussen NUR2063]
Q3: A patient with chronic heart failure develops increased peripheral edema,
hepatomegaly, ascites, and elevated jugular venous pressure, but pulmonary congestion
has improved. Which hemodynamic shift has most likely occurred?
A. Progression from left-sided to biventricular failure with right-sided predominance
B. Development of isolated pulmonary hypertension
C. Acute mitral regurgitation causing left atrial dilation
D. Conversion to high-output heart failure
A. Progression from left-sided to biventricular failure with right-sided predominance
[CORRECT]
Correct Answer: A
, Rationale: The shift from pulmonary congestion to systemic venous congestion
(peripheral edema, hepatomegaly, ascites, JVD) indicates progression from isolated
left-sided failure to biventricular failure with right-sided predominance. Chronic
left-sided failure increases pulmonary vascular resistance, leading to pulmonary
hypertension and subsequent right ventricular hypertrophy and failure (cor pulmonale).
Option B (isolated pulmonary hypertension) would worsen pulmonary symptoms, not
improve them. Option C (acute mitral regurgitation) would cause acute pulmonary
edema. Option D (high-output failure) presents with warm extremities and is associated
with conditions like hyperthyroidism or AV fistulas, not these findings. [100% VERIFIED –
Rasmussen NUR2063]
Q4: A 45-year-old African American male has blood pressure consistently measuring
168/104 mmHg. Laboratory studies reveal low plasma renin activity, normal serum
potassium, and no evidence of renal artery stenosis or pheochromocytoma. Which
classification and mechanism best fit this presentation?
A. Secondary hypertension due to primary hyperaldosteronism
B. Primary (essential) hypertension with multifactorial etiology including sodium
sensitivity and vascular remodeling
C. Malignant hypertension with fibrinoid necrosis of arterioles
D. White coat hypertension with episodic elevation only
B. Primary (essential) hypertension with multifactorial etiology including sodium
sensitivity and vascular remodeling [CORRECT]
Correct Answer: B
Exam 2026/2027 – Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular System Pathophysiology (Q1-Q20)
Q1: A 72-year-old male with a history of myocardial infarction presents with progressive
dyspnea on exertion, fatigue, and orthopnea. Physical examination reveals bilateral
crackles, an S3 gallop, and jugular venous distension. Which pathophysiological
mechanism best explains these findings?
A. Impaired ventricular relaxation and decreased compliance leading to diastolic
dysfunction
B. Decreased myocardial contractility with reduced ejection fraction causing pulmonary
and systemic congestion
C. Valvular stenosis obstructing forward blood flow and causing pressure overload
D. Increased systemic vascular resistance without myocardial involvement
C. Decreased myocardial contractility with reduced ejection fraction causing pulmonary
and systemic congestion [CORRECT]
,Correct Answer: C
Rationale: This patient exhibits classic manifestations of systolic heart failure (HFrEF),
characterized by decreased contractility, reduced ejection fraction (<40%), and
symptoms of both left-sided (dyspnea, crackles, orthopnea, S3) and right-sided (JVD)
failure. The S3 gallop represents rapid ventricular filling into a dilated,
volume-overloaded ventricle. Option A describes diastolic heart failure (HFpEF), which
typically presents with preserved EF and symptoms of congestion without significant
dilation. Option C describes valvular stenosis, which would present with murmurs rather
than an S3. Option D describes isolated hypertension without heart failure. [100%
VERIFIED – Rasmussen NUR2063]
Q2: A 58-year-old female with long-standing hypertension presents with preserved
ejection fraction (55%) but demonstrates impaired ventricular filling, elevated left
ventricular end-diastolic pressure, and symptoms of exercise intolerance without
significant ventricular dilation. Which type of heart failure is most consistent with these
findings?
A. Dilated cardiomyopathy with systolic dysfunction
B. Hypertrophic cardiomyopathy with outflow obstruction
C. Diastolic heart failure with preserved ejection fraction
D. Restrictive cardiomyopathy with amyloid deposition
C. Diastolic heart failure with preserved ejection fraction [CORRECT]
Correct Answer: C
,Rationale: Diastolic heart failure (HFpEF) is characterized by preserved ejection fraction
(≥50%) with impaired ventricular relaxation and increased stiffness, leading to elevated
filling pressures and symptoms of congestion without significant systolic dysfunction or
chamber dilation. The patient's long-standing hypertension caused concentric left
ventricular hypertrophy, reducing compliance. Option A (dilated cardiomyopathy)
presents with reduced EF and ventricular dilation. Option B (HCM) typically presents in
younger patients with dynamic outflow obstruction and sudden cardiac death risk.
Option D (restrictive cardiomyopathy) involves myocardial infiltration (amyloid, sarcoid)
causing rigid ventricles but is less common than HFpEF in hypertensive patients. [100%
VERIFIED – Rasmussen NUR2063]
Q3: A patient with chronic heart failure develops increased peripheral edema,
hepatomegaly, ascites, and elevated jugular venous pressure, but pulmonary congestion
has improved. Which hemodynamic shift has most likely occurred?
A. Progression from left-sided to biventricular failure with right-sided predominance
B. Development of isolated pulmonary hypertension
C. Acute mitral regurgitation causing left atrial dilation
D. Conversion to high-output heart failure
A. Progression from left-sided to biventricular failure with right-sided predominance
[CORRECT]
Correct Answer: A
, Rationale: The shift from pulmonary congestion to systemic venous congestion
(peripheral edema, hepatomegaly, ascites, JVD) indicates progression from isolated
left-sided failure to biventricular failure with right-sided predominance. Chronic
left-sided failure increases pulmonary vascular resistance, leading to pulmonary
hypertension and subsequent right ventricular hypertrophy and failure (cor pulmonale).
Option B (isolated pulmonary hypertension) would worsen pulmonary symptoms, not
improve them. Option C (acute mitral regurgitation) would cause acute pulmonary
edema. Option D (high-output failure) presents with warm extremities and is associated
with conditions like hyperthyroidism or AV fistulas, not these findings. [100% VERIFIED –
Rasmussen NUR2063]
Q4: A 45-year-old African American male has blood pressure consistently measuring
168/104 mmHg. Laboratory studies reveal low plasma renin activity, normal serum
potassium, and no evidence of renal artery stenosis or pheochromocytoma. Which
classification and mechanism best fit this presentation?
A. Secondary hypertension due to primary hyperaldosteronism
B. Primary (essential) hypertension with multifactorial etiology including sodium
sensitivity and vascular remodeling
C. Malignant hypertension with fibrinoid necrosis of arterioles
D. White coat hypertension with episodic elevation only
B. Primary (essential) hypertension with multifactorial etiology including sodium
sensitivity and vascular remodeling [CORRECT]
Correct Answer: B
