Regis NU 650 Midterm Actual
Exam| 230 Questions| With
Complete Solutions
Course
Regis NU 650
1. A 68-year-old man with hypertension and diabetes
presents with crushing substernal chest pain radiating to the
left arm. Which pathophysiologic process most commonly
causes an acute ST-segment elevation myocardial infarction
(STEMI)?
A. Coronary artery vasospasm without plaque rupture
B. Progressive narrowing of the coronary artery over many years without thrombosis
C. Rupture of an atherosclerotic plaque followed by thrombus formation and complete coronary
artery occlusion
D. Right ventricular hypertrophy
Answer: C
Rationale:
Most STEMIs occur when an unstable atherosclerotic plaque ruptures, exposing subendothelial
material that activates platelets and the coagulation cascade. The resulting thrombus acutely
occludes the coronary artery, causing myocardial ischemia and necrosis.
2. Which electrolyte abnormality places a patient at the
highest immediate risk for ventricular dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 103 mEq/L
,D. Calcium 9.1 mg/dL
Answer: B
Rationale:
Hypokalemia increases myocardial irritability and may cause premature ventricular contractions,
ventricular tachycardia, ventricular fibrillation, flattened T waves, and U waves.
3. Which assessment finding is most characteristic of left-
sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary crackles with orthopnea
D. Ascites
Answer: C
Rationale:
Left ventricular failure causes pulmonary venous congestion, producing dyspnea, orthopnea,
paroxysmal nocturnal dyspnea, crackles, and pulmonary edema.
4. A patient with diabetic ketoacidosis (DKA) would most
likely present with which combination of findings?
A. Hypoglycemia, bradycardia, metabolic alkalosis
B. Hyperglycemia, metabolic acidosis, ketonemia
C. Hypercalcemia, respiratory alkalosis
D. Hyponatremia without hyperglycemia
Answer: B
,Rationale:
DKA results from severe insulin deficiency leading to lipolysis, ketone production, metabolic
acidosis, hyperglycemia, dehydration, and electrolyte abnormalities.
5. Which statement best explains why chronic hypertension
eventually causes left ventricular hypertrophy?
A. Increased preload reduces myocardial workload.
B. Increased afterload forces the left ventricle to generate greater pressure over time.
C. Coronary vasospasm enlarges myocardial fibers.
D. Increased venous return causes right ventricular enlargement.
Answer: B
Rationale:
Persistent hypertension increases systemic vascular resistance (afterload). The left ventricle
compensates by thickening its muscle mass, producing concentric hypertrophy.
6. Which laboratory value is the best indicator of renal
filtration function?
A. AST
B. Serum Creatinine
C. Hemoglobin
D. Platelet Count
Answer: B
Rationale:
Serum creatinine closely reflects glomerular filtration rate (GFR). Rising creatinine usually
indicates declining kidney function.
, 7. A patient develops fever, tachycardia, hypotension, and
elevated serum lactate after a urinary tract infection. Which
condition is most likely occurring?
A. Cardiogenic shock
B. Septic shock
C. Neurogenic shock
D. Hypovolemic shock
Answer: B
Rationale:
Septic shock results from dysregulated systemic inflammation causing vasodilation, capillary
leak, tissue hypoperfusion, hypotension, and elevated lactate despite fluid resuscitation.
8. Which acid-base imbalance would most likely occur after
prolonged vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: C
Rationale:
Vomiting causes loss of gastric hydrochloric acid, leading to increased serum bicarbonate and
metabolic alkalosis.
Exam| 230 Questions| With
Complete Solutions
Course
Regis NU 650
1. A 68-year-old man with hypertension and diabetes
presents with crushing substernal chest pain radiating to the
left arm. Which pathophysiologic process most commonly
causes an acute ST-segment elevation myocardial infarction
(STEMI)?
A. Coronary artery vasospasm without plaque rupture
B. Progressive narrowing of the coronary artery over many years without thrombosis
C. Rupture of an atherosclerotic plaque followed by thrombus formation and complete coronary
artery occlusion
D. Right ventricular hypertrophy
Answer: C
Rationale:
Most STEMIs occur when an unstable atherosclerotic plaque ruptures, exposing subendothelial
material that activates platelets and the coagulation cascade. The resulting thrombus acutely
occludes the coronary artery, causing myocardial ischemia and necrosis.
2. Which electrolyte abnormality places a patient at the
highest immediate risk for ventricular dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 103 mEq/L
,D. Calcium 9.1 mg/dL
Answer: B
Rationale:
Hypokalemia increases myocardial irritability and may cause premature ventricular contractions,
ventricular tachycardia, ventricular fibrillation, flattened T waves, and U waves.
3. Which assessment finding is most characteristic of left-
sided heart failure?
A. Hepatomegaly
B. Peripheral edema
C. Pulmonary crackles with orthopnea
D. Ascites
Answer: C
Rationale:
Left ventricular failure causes pulmonary venous congestion, producing dyspnea, orthopnea,
paroxysmal nocturnal dyspnea, crackles, and pulmonary edema.
4. A patient with diabetic ketoacidosis (DKA) would most
likely present with which combination of findings?
A. Hypoglycemia, bradycardia, metabolic alkalosis
B. Hyperglycemia, metabolic acidosis, ketonemia
C. Hypercalcemia, respiratory alkalosis
D. Hyponatremia without hyperglycemia
Answer: B
,Rationale:
DKA results from severe insulin deficiency leading to lipolysis, ketone production, metabolic
acidosis, hyperglycemia, dehydration, and electrolyte abnormalities.
5. Which statement best explains why chronic hypertension
eventually causes left ventricular hypertrophy?
A. Increased preload reduces myocardial workload.
B. Increased afterload forces the left ventricle to generate greater pressure over time.
C. Coronary vasospasm enlarges myocardial fibers.
D. Increased venous return causes right ventricular enlargement.
Answer: B
Rationale:
Persistent hypertension increases systemic vascular resistance (afterload). The left ventricle
compensates by thickening its muscle mass, producing concentric hypertrophy.
6. Which laboratory value is the best indicator of renal
filtration function?
A. AST
B. Serum Creatinine
C. Hemoglobin
D. Platelet Count
Answer: B
Rationale:
Serum creatinine closely reflects glomerular filtration rate (GFR). Rising creatinine usually
indicates declining kidney function.
, 7. A patient develops fever, tachycardia, hypotension, and
elevated serum lactate after a urinary tract infection. Which
condition is most likely occurring?
A. Cardiogenic shock
B. Septic shock
C. Neurogenic shock
D. Hypovolemic shock
Answer: B
Rationale:
Septic shock results from dysregulated systemic inflammation causing vasodilation, capillary
leak, tissue hypoperfusion, hypotension, and elevated lactate despite fluid resuscitation.
8. Which acid-base imbalance would most likely occur after
prolonged vomiting?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: C
Rationale:
Vomiting causes loss of gastric hydrochloric acid, leading to increased serum bicarbonate and
metabolic alkalosis.
