Assessment Exam | 2026/2027 Edition (PDF)
**1. A patient with left-sided heart failure most likely presents with which symptom?**
A) Peripheral edema
B) Jugular venous distention
C) Pulmonary crackles
D) Hepatosplenomegaly
**Correct Answer:** C) Pulmonary crackles
**Rationale:** Left-sided heart failure leads to pulmonary congestion because the left ventricle cannot
effectively pump blood forward, causing blood to back up into the lungs. This results in crackles,
shortness of breath, and orthopnea. Peripheral edema and JVD are signs of right-sided heart failure.
Hepatosplenomegaly occurs with chronic right-sided failure due to liver congestion.
**2. Which electrolyte imbalance is most associated with Trousseau and Chvostek signs?**
A) Hyperkalemia
B) Hypercalcemia
C) Hypocalcemia
D) Hypernatremia
**Correct Answer:** C) Hypocalcemia
**Rationale:** Trousseau's sign (carpal spasm with blood pressure cuff inflation) and Chvostek's sign
(facial twitching upon tapping the facial nerve) are classic signs of hypocalcemia. Calcium is essential for
nerve and muscle function; low levels increase neuromuscular excitability.
**3. A patient with COPD retains CO₂. Which acid–base imbalance is expected?**
A) Respiratory alkalosis
,B) Respiratory acidosis
C) Metabolic acidosis
D) Metabolic alkalosis
**Correct Answer:** B) Respiratory acidosis
**Rationale:** COPD causes impaired gas exchange and CO₂ retention (hypercapnia). CO₂ combines
with water to form carbonic acid, lowering pH and causing respiratory acidosis. The kidneys may
compensate by retaining bicarbonate.
**4. What is the primary cause of myocardial infarction?**
A) Viral myocarditis
B) Coronary artery rupture
C) Atherosclerotic plaque rupture with thrombosis
D) Hypertrophic cardiomyopathy
**Correct Answer:** C) Atherosclerotic plaque rupture with thrombosis
**Rationale:** Myocardial infarction occurs when an atherosclerotic plaque ruptures, leading to platelet
aggregation and thrombus formation that completely occludes a coronary artery. This causes ischemia
and necrosis of the myocardial tissue supplied by that vessel.
**5. A patient with chronic kidney disease presents with anemia due to lack of:**
A) Erythropoietin
B) Platelets
C) Albumin
D) Renin
**Correct Answer:** A) Erythropoietin
, **Rationale:** The kidneys produce erythropoietin (EPO), which stimulates red blood cell production in
the bone marrow. In chronic kidney disease, damaged kidneys produce less EPO, leading to anemia. This
is a hallmark complication of renal failure.
**6. Wheezing in asthma is caused by:**
A) Alveolar collapse
B) Bronchoconstriction
C) Pleural effusion
D) Pulmonary fibrosis
**Correct Answer:** B) Bronchoconstriction
**Rationale:** Asthma is characterized by chronic airway inflammation, bronchial hyperresponsiveness,
and bronchoconstriction. Narrowing of the airways produces turbulent airflow, resulting in the
characteristic high-pitched whistling sound known as wheezing.
**7. A patient with liver cirrhosis develops ascites due to:**
A) Hypernatremia
B) Increased albumin
C) Portal hypertension
D) Excess aldosterone
**Correct Answer:** C) Portal hypertension
**Rationale:** Portal hypertension in cirrhosis increases hydrostatic pressure in the splanchnic
capillaries, forcing fluid into the peritoneal cavity. Decreased albumin (not increased) contributes to
reduced oncotic pressure. Aldosterone excess can exacerbate fluid retention but is not the primary
cause.
**8. Which respiratory finding indicates pneumothorax?**
A) Bilateral crackles