NUR 376 Exam 2 V1 | NUR 376 Applied
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 2) | Concordia
1. A patient presents with a blood pressure of 165/95 mmHg on two separate clinical
occasions. Which pathophysiological mechanism most likely contributes to this sustained
elevation in blood pressure?
A. Decreased secretion of aldosterone leading to sodium excretion
B. Upregulation of the Renin-Angiotensin-Aldosterone System (RAAS)
C. Increased production of nitric oxide by vascular endothelial cells
D. Enhanced baroreceptor sensitivity resulting in bradycardia
Correct Answer: B
The Renin-Angiotensin-Aldosterone System (RAAS) plays a critical role in long-term blood
pressure regulation through vasoconstriction and sodium retention. Chronic overactivity of
this system is a primary driver in the development and maintenance of essential
hypertension. This process leads to increased systemic vascular resistance and blood
volume, contributing to the high pressure readings observed.
2. When assessing a patient with suspected left-sided heart failure, which clinical
manifestation should the nurse prioritize as a primary indicator of pulmonary congestion?
A. Peripheral edema in the lower extremities
,B. Orthopnea and paroxysmal nocturnal dyspnea
C. Jugular venous distension (JVD)
D. Hepatomegaly and ascites
Correct Answer: B
Left-sided heart failure occurs when the left ventricle fails to pump blood efficiently,
causing blood to back up into the pulmonary circulation. This leads to pulmonary edema,
which manifests clinically as orthopnea and paroxysmal nocturnal dyspnea. In contrast,
peripheral edema and JVD are more commonly associated with right-sided heart failure
and systemic venous congestion.
3. A 68-year-old male with a history of myocardial infarction (MI) is diagnosed with systolic
heart failure. What is the fundamental cellular pathophysiology associated with this
condition?
A. Inadequate ventricular relaxation and filling during diastole
B. Increased myocardial contractility due to catecholamine release
C. Normal stroke volume with increased heart rate
D. Impaired contractility and reduced ejection fraction
Correct Answer: D
Systolic heart failure is characterized by a decrease in the contractility of the heart muscle,
often following an MI that has damaged cardiac myocytes. This reduction in contractile
, force results in a low ejection fraction, typically below 40%. The heart is unable to generate
enough force to eject an adequate volume of blood into the systemic circulation.
4. Atherosclerosis is a multifaceted disease process involving chronic inflammation. Which of
the following factors are recognized as non-modifiable risk factors in the progression of this
condition?
A. Type 2 Diabetes Mellitus
B. Cigarette Smoking
C. Sedentary Lifestyle
D. Family History and Genetics
E. Hyperlipidemia
F. Hypertension
Correct Answer: D
Non-modifiable risk factors are those that cannot be altered through lifestyle changes or
medical intervention. Family history and genetic predisposition significantly influence an
individual’s susceptibility to atherosclerosis regardless of lifestyle. Other factors like
smoking and sedentary habits are modifiable through behavioral changes and
pharmacological treatments.
5. Following an acute myocardial infarction, the release of which cardiac biomarker is
considered the gold standard for diagnosing myocardial necrosis?
A. Creatine Kinase-MB (CK-MB)
Pathophysiology | Actual Q&A with
Rationale (NUR376 Exam 2) | Concordia
1. A patient presents with a blood pressure of 165/95 mmHg on two separate clinical
occasions. Which pathophysiological mechanism most likely contributes to this sustained
elevation in blood pressure?
A. Decreased secretion of aldosterone leading to sodium excretion
B. Upregulation of the Renin-Angiotensin-Aldosterone System (RAAS)
C. Increased production of nitric oxide by vascular endothelial cells
D. Enhanced baroreceptor sensitivity resulting in bradycardia
Correct Answer: B
The Renin-Angiotensin-Aldosterone System (RAAS) plays a critical role in long-term blood
pressure regulation through vasoconstriction and sodium retention. Chronic overactivity of
this system is a primary driver in the development and maintenance of essential
hypertension. This process leads to increased systemic vascular resistance and blood
volume, contributing to the high pressure readings observed.
2. When assessing a patient with suspected left-sided heart failure, which clinical
manifestation should the nurse prioritize as a primary indicator of pulmonary congestion?
A. Peripheral edema in the lower extremities
,B. Orthopnea and paroxysmal nocturnal dyspnea
C. Jugular venous distension (JVD)
D. Hepatomegaly and ascites
Correct Answer: B
Left-sided heart failure occurs when the left ventricle fails to pump blood efficiently,
causing blood to back up into the pulmonary circulation. This leads to pulmonary edema,
which manifests clinically as orthopnea and paroxysmal nocturnal dyspnea. In contrast,
peripheral edema and JVD are more commonly associated with right-sided heart failure
and systemic venous congestion.
3. A 68-year-old male with a history of myocardial infarction (MI) is diagnosed with systolic
heart failure. What is the fundamental cellular pathophysiology associated with this
condition?
A. Inadequate ventricular relaxation and filling during diastole
B. Increased myocardial contractility due to catecholamine release
C. Normal stroke volume with increased heart rate
D. Impaired contractility and reduced ejection fraction
Correct Answer: D
Systolic heart failure is characterized by a decrease in the contractility of the heart muscle,
often following an MI that has damaged cardiac myocytes. This reduction in contractile
, force results in a low ejection fraction, typically below 40%. The heart is unable to generate
enough force to eject an adequate volume of blood into the systemic circulation.
4. Atherosclerosis is a multifaceted disease process involving chronic inflammation. Which of
the following factors are recognized as non-modifiable risk factors in the progression of this
condition?
A. Type 2 Diabetes Mellitus
B. Cigarette Smoking
C. Sedentary Lifestyle
D. Family History and Genetics
E. Hyperlipidemia
F. Hypertension
Correct Answer: D
Non-modifiable risk factors are those that cannot be altered through lifestyle changes or
medical intervention. Family history and genetic predisposition significantly influence an
individual’s susceptibility to atherosclerosis regardless of lifestyle. Other factors like
smoking and sedentary habits are modifiable through behavioral changes and
pharmacological treatments.
5. Following an acute myocardial infarction, the release of which cardiac biomarker is
considered the gold standard for diagnosing myocardial necrosis?
A. Creatine Kinase-MB (CK-MB)
