NUR 376 Exam 2 V2 | NUR 376 Applied
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 2) | Concordia
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Which
pathophysiological mechanism most likely explains these symptoms?
A. Right-sided heart failure causing systemic venous congestion
B. Pulmonary embolism causing a ventilation-perfusion mismatch
C. Chronic obstructive pulmonary disease causing air trapping
D. Left-sided heart failure causing pulmonary venous congestion
Correct Answer: D
Left-sided heart failure leads to an increase in pulmonary capillary hydrostatic pressure,
which forces fluid into the alveolar spaces. This process results in pulmonary edema,
manifesting as dyspnea and orthopnea. The backup of blood from the left ventricle into the
lungs is the primary driver of these respiratory symptoms.
2. Which clinical manifestation is specifically associated with right-sided heart failure rather
than left-sided heart failure?
A. Crackles in the lungs
B. Peripheral edema
C. Cough with frothy sputum
,D. Orthopnea
Correct Answer: B
Right-sided heart failure results in the inability of the right ventricle to provide adequate
blood flow into the pulmonary circulation. This leads to systemic venous congestion, which
is evidenced by peripheral edema, jugular venous distention, and hepatomegaly. In
contrast, crackles and frothy sputum are characteristic of pulmonary congestion seen in
left-sided failure.
3. In the development of atherosclerosis, what is the significance of ‘foam cells’?
A. They are neutrophils that have arrived to clear infection
B. They are macrophages that have engulfed oxidized LDL cholesterol
C. They are smooth muscle cells that have migrated to the adventitia
D. They are endothelial cells that have lost their selective permeability
Correct Answer: B
Foam cells are formed when macrophages ingest oxidized low-density lipoproteins (LDL)
within the vessel wall. These cells accumulate and form the ‘fatty streak,’ which is the
earliest visible lesion of atherosclerosis. Their presence triggers further inflammatory
responses and contributes to the growth of the atherosclerotic plaque.
4. A patient with chronic bronchitis displays a productive cough and cyanosis. What is the
underlying pathophysiology of the ‘Blue Bloater’ profile?
A. Destruction of alveolar walls and loss of elastic recoil
, B. Airway obstruction caused by chronic inflammation and goblet cell hyperplasia
C. Hypersensitivity reaction leading to bronchoconstriction
D. Decreased surfactant production in the terminal bronchioles
Correct Answer: B
Chronic bronchitis is characterized by the hypersecretion of mucus and chronic
productive cough for at least three months. This lead to airway obstruction and significant
ventilation-perfusion mismatching. The resulting hypoxemia and hypercapnia lead to the
cyanotic appearance often described as a ‘blue bloater.’
5. When evaluating a patient for an acute myocardial infarction, which biomarkers and
diagnostic findings are considered standard for confirmation?
A. Elevated Troponin I and T
B. ST-segment elevation on a 12-lead ECG
C. Elevated Creatine Kinase-MB (CK-MB)
D. All of the above
E. Presence of Myoglobin in the serum
Correct Answer: D
Diagnosis of acute myocardial infarction relies on a combination of clinical history, ECG
changes, and elevated cardiac biomarkers. Troponins are the most specific markers for
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 2) | Concordia
1. A patient presents with dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Which
pathophysiological mechanism most likely explains these symptoms?
A. Right-sided heart failure causing systemic venous congestion
B. Pulmonary embolism causing a ventilation-perfusion mismatch
C. Chronic obstructive pulmonary disease causing air trapping
D. Left-sided heart failure causing pulmonary venous congestion
Correct Answer: D
Left-sided heart failure leads to an increase in pulmonary capillary hydrostatic pressure,
which forces fluid into the alveolar spaces. This process results in pulmonary edema,
manifesting as dyspnea and orthopnea. The backup of blood from the left ventricle into the
lungs is the primary driver of these respiratory symptoms.
2. Which clinical manifestation is specifically associated with right-sided heart failure rather
than left-sided heart failure?
A. Crackles in the lungs
B. Peripheral edema
C. Cough with frothy sputum
,D. Orthopnea
Correct Answer: B
Right-sided heart failure results in the inability of the right ventricle to provide adequate
blood flow into the pulmonary circulation. This leads to systemic venous congestion, which
is evidenced by peripheral edema, jugular venous distention, and hepatomegaly. In
contrast, crackles and frothy sputum are characteristic of pulmonary congestion seen in
left-sided failure.
3. In the development of atherosclerosis, what is the significance of ‘foam cells’?
A. They are neutrophils that have arrived to clear infection
B. They are macrophages that have engulfed oxidized LDL cholesterol
C. They are smooth muscle cells that have migrated to the adventitia
D. They are endothelial cells that have lost their selective permeability
Correct Answer: B
Foam cells are formed when macrophages ingest oxidized low-density lipoproteins (LDL)
within the vessel wall. These cells accumulate and form the ‘fatty streak,’ which is the
earliest visible lesion of atherosclerosis. Their presence triggers further inflammatory
responses and contributes to the growth of the atherosclerotic plaque.
4. A patient with chronic bronchitis displays a productive cough and cyanosis. What is the
underlying pathophysiology of the ‘Blue Bloater’ profile?
A. Destruction of alveolar walls and loss of elastic recoil
, B. Airway obstruction caused by chronic inflammation and goblet cell hyperplasia
C. Hypersensitivity reaction leading to bronchoconstriction
D. Decreased surfactant production in the terminal bronchioles
Correct Answer: B
Chronic bronchitis is characterized by the hypersecretion of mucus and chronic
productive cough for at least three months. This lead to airway obstruction and significant
ventilation-perfusion mismatching. The resulting hypoxemia and hypercapnia lead to the
cyanotic appearance often described as a ‘blue bloater.’
5. When evaluating a patient for an acute myocardial infarction, which biomarkers and
diagnostic findings are considered standard for confirmation?
A. Elevated Troponin I and T
B. ST-segment elevation on a 12-lead ECG
C. Elevated Creatine Kinase-MB (CK-MB)
D. All of the above
E. Presence of Myoglobin in the serum
Correct Answer: D
Diagnosis of acute myocardial infarction relies on a combination of clinical history, ECG
changes, and elevated cardiac biomarkers. Troponins are the most specific markers for
