NSG 530 EXAM 2 – WILKES ADVANCED PATHOPHYSIOLOGY
(2026) ACTUAL QUESTIONS & STUDY GUIDE | GUARANTEE
PASS
Below is Part 1 of an original graduate-level practice examination for
NSG 530 – Advanced Pathophysiology..
NSG 530 – Advanced Pathophysiology
Practice Examination – Exam 2 (Part 1)
Course: NSG 530 – Advanced Pathophysiology
Institution: Wilkes University
Date: August 2026
(Original Practice Study Guide)
Table of Contents (Part 1)
1. Cardiovascular System (Questions 1–15)
2. Respiratory System (Questions 16–30)
Section I – Cardiovascular System
Question 1 (Multiple Choice)
A 67-year-old patient with long-standing hypertension develops left ventricular hypertrophy.
What is the primary physiological reason for this adaptation?
A. Increased preload from blood loss
B. Increased afterload requiring greater myocardial force
C. Reduced cardiac output from dehydration
D. Increased parasympathetic stimulation
Correct Answer: B
Rationale:
Hypertension increases systemic vascular resistance (afterload). The left ventricle must generate
,greater pressure to eject blood, leading to concentric hypertrophy. Although initially
compensatory, prolonged hypertrophy decreases ventricular compliance and may eventually
contribute to heart failure.
Question 2 (Multiple Choice)
Which biomarker is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Cardiac troponin I
D. Lactate dehydrogenase
Correct Answer: C
Rationale:
Cardiac troponin I is highly sensitive and specific for myocardial cell injury. It remains elevated
for several days after myocardial infarction, making it the preferred laboratory marker for
diagnosis.
Question 3 (Short Answer)
Explain why prolonged myocardial ischemia results in irreversible myocardial cell death.
Correct Answer:
Prolonged ischemia deprives myocardial cells of oxygen, resulting in ATP depletion, failure of
ion pumps, intracellular calcium accumulation, membrane disruption, and activation of
degradative enzymes, ultimately causing irreversible necrosis.
Rationale:
Cardiac muscle has a high oxygen demand and minimal anaerobic capacity. Persistent
interruption of coronary blood flow produces irreversible injury within approximately 20–40
minutes.
Question 4 (Multiple Choice)
Which heart failure finding is most associated with left-sided ventricular failure?
A. Hepatomegaly
,B. Peripheral edema
C. Pulmonary edema
D. Jugular venous distention
Correct Answer: C
Rationale:
Left ventricular failure causes blood to back up into the pulmonary circulation, increasing
pulmonary capillary hydrostatic pressure and leading to pulmonary edema and dyspnea.
Question 5 (Multiple Choice)
The Frank-Starling mechanism states that:
A. Heart rate determines stroke volume.
B. Increased ventricular filling increases stroke volume up to an optimal point.
C. Contractility depends only on sympathetic stimulation.
D. Stroke volume decreases with increased preload.
Correct Answer: B
Rationale:
As ventricular filling increases, myocardial fibers stretch and generate stronger contractions.
Excessive stretch, however, decreases efficiency and contributes to heart failure.
Question 6 (Multiple Choice)
Which electrolyte abnormality most commonly produces peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale:
, Hyperkalemia alters myocardial membrane excitability, producing characteristic tall peaked T
waves and increasing the risk of life-threatening arrhythmias.
Question 7 (Short Answer)
Describe the role of the renin-angiotensin-aldosterone system (RAAS) in heart failure.
Correct Answer:
Reduced cardiac output decreases renal perfusion, activating RAAS. Angiotensin II causes
vasoconstriction, while aldosterone promotes sodium and water retention. These responses
temporarily maintain blood pressure but worsen fluid overload and ventricular remodeling.
Rationale:
Persistent RAAS activation contributes significantly to progression of chronic heart failure.
Question 8 (Multiple Choice)
Which valve disorder classically produces a systolic ejection murmur?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid stenosis
D. Pulmonic regurgitation
Correct Answer: B
Rationale:
Aortic stenosis creates turbulent blood flow during ventricular systole as blood passes through
the narrowed valve.
Question 9 (Multiple Choice)
Atherosclerosis begins primarily with:
A. Ventricular hypertrophy
B. Endothelial injury
C. Platelet deficiency
(2026) ACTUAL QUESTIONS & STUDY GUIDE | GUARANTEE
PASS
Below is Part 1 of an original graduate-level practice examination for
NSG 530 – Advanced Pathophysiology..
NSG 530 – Advanced Pathophysiology
Practice Examination – Exam 2 (Part 1)
Course: NSG 530 – Advanced Pathophysiology
Institution: Wilkes University
Date: August 2026
(Original Practice Study Guide)
Table of Contents (Part 1)
1. Cardiovascular System (Questions 1–15)
2. Respiratory System (Questions 16–30)
Section I – Cardiovascular System
Question 1 (Multiple Choice)
A 67-year-old patient with long-standing hypertension develops left ventricular hypertrophy.
What is the primary physiological reason for this adaptation?
A. Increased preload from blood loss
B. Increased afterload requiring greater myocardial force
C. Reduced cardiac output from dehydration
D. Increased parasympathetic stimulation
Correct Answer: B
Rationale:
Hypertension increases systemic vascular resistance (afterload). The left ventricle must generate
,greater pressure to eject blood, leading to concentric hypertrophy. Although initially
compensatory, prolonged hypertrophy decreases ventricular compliance and may eventually
contribute to heart failure.
Question 2 (Multiple Choice)
Which biomarker is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Cardiac troponin I
D. Lactate dehydrogenase
Correct Answer: C
Rationale:
Cardiac troponin I is highly sensitive and specific for myocardial cell injury. It remains elevated
for several days after myocardial infarction, making it the preferred laboratory marker for
diagnosis.
Question 3 (Short Answer)
Explain why prolonged myocardial ischemia results in irreversible myocardial cell death.
Correct Answer:
Prolonged ischemia deprives myocardial cells of oxygen, resulting in ATP depletion, failure of
ion pumps, intracellular calcium accumulation, membrane disruption, and activation of
degradative enzymes, ultimately causing irreversible necrosis.
Rationale:
Cardiac muscle has a high oxygen demand and minimal anaerobic capacity. Persistent
interruption of coronary blood flow produces irreversible injury within approximately 20–40
minutes.
Question 4 (Multiple Choice)
Which heart failure finding is most associated with left-sided ventricular failure?
A. Hepatomegaly
,B. Peripheral edema
C. Pulmonary edema
D. Jugular venous distention
Correct Answer: C
Rationale:
Left ventricular failure causes blood to back up into the pulmonary circulation, increasing
pulmonary capillary hydrostatic pressure and leading to pulmonary edema and dyspnea.
Question 5 (Multiple Choice)
The Frank-Starling mechanism states that:
A. Heart rate determines stroke volume.
B. Increased ventricular filling increases stroke volume up to an optimal point.
C. Contractility depends only on sympathetic stimulation.
D. Stroke volume decreases with increased preload.
Correct Answer: B
Rationale:
As ventricular filling increases, myocardial fibers stretch and generate stronger contractions.
Excessive stretch, however, decreases efficiency and contributes to heart failure.
Question 6 (Multiple Choice)
Which electrolyte abnormality most commonly produces peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale:
, Hyperkalemia alters myocardial membrane excitability, producing characteristic tall peaked T
waves and increasing the risk of life-threatening arrhythmias.
Question 7 (Short Answer)
Describe the role of the renin-angiotensin-aldosterone system (RAAS) in heart failure.
Correct Answer:
Reduced cardiac output decreases renal perfusion, activating RAAS. Angiotensin II causes
vasoconstriction, while aldosterone promotes sodium and water retention. These responses
temporarily maintain blood pressure but worsen fluid overload and ventricular remodeling.
Rationale:
Persistent RAAS activation contributes significantly to progression of chronic heart failure.
Question 8 (Multiple Choice)
Which valve disorder classically produces a systolic ejection murmur?
A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid stenosis
D. Pulmonic regurgitation
Correct Answer: B
Rationale:
Aortic stenosis creates turbulent blood flow during ventricular systole as blood passes through
the narrowed valve.
Question 9 (Multiple Choice)
Atherosclerosis begins primarily with:
A. Ventricular hypertrophy
B. Endothelial injury
C. Platelet deficiency
