NSG 3850 Pathophysiology II Exam 3 | Questions with
Answers & Explanations
1. A patient with left-sided heart failure develops pulmonary crackles and dyspnea. Which
mechanism best explains these findings?
A. Decreased systemic vascular resistance
B. Increased pulmonary capillary hydrostatic pressure
C. Increased plasma oncotic pressure
D. Decreased pulmonary blood flow
Answer: B. Increased pulmonary capillary hydrostatic pressure
Left-sided heart failure causes blood to back up into the pulmonary circulation, increasing
pulmonary capillary hydrostatic pressure and promoting fluid movement into the interstitial
tissue and alveoli.
2. Which finding is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Hemoptysis
Answer: C. Peripheral edema and jugular venous distention
,Right-sided heart failure causes systemic venous congestion, producing peripheral edema,
hepatomegaly, ascites, and jugular venous distention.
3. A patient experiences an acute myocardial infarction. Which cellular change occurs first
when myocardial blood flow is severely reduced?
A. Irreversible membrane rupture
B. ATP depletion
C. Extensive fibrosis
D. Ventricular aneurysm
Answer: B. ATP depletion
Ischemia decreases oxygen delivery, impairing oxidative phosphorylation and causing ATP
depletion. Prolonged ischemia eventually results in irreversible cellular injury and necrosis.
4. Which laboratory marker is most specific for myocardial injury?
A. BNP
B. Troponin
C. LDL
D. D-dimer
Answer: B. Troponin
Cardiac troponins are highly sensitive and specific markers of myocardial injury and are
commonly used to evaluate suspected acute coronary syndrome.
,5. Which pathophysiologic change is primarily responsible for stable angina?
A. Complete coronary artery occlusion
B. Temporary myocardial oxygen supply-demand mismatch
C. Permanent myocardial necrosis
D. Pulmonary vascular obstruction
Answer: B. Temporary myocardial oxygen supply-demand mismatch
Stable angina usually results from fixed coronary atherosclerotic narrowing combined with
increased myocardial oxygen demand, particularly during exertion.
6. Atherosclerosis develops primarily because of:
A. Destruction of red blood cells
B. Lipid accumulation and inflammatory changes within arterial walls
C. Excessive venous pressure
D. Increased platelet production alone
Answer: B. Lipid accumulation and inflammatory changes within arterial walls
Atherosclerosis involves endothelial injury, lipid deposition, inflammation, smooth-muscle
proliferation, and plaque formation within arterial walls.
7. Which change occurs in the vascular system during chronic hypertension?
, A. Decreased systemic vascular resistance
B. Vascular remodeling and increased arterial stiffness
C. Decreased cardiac workload
D. Increased arterial compliance
Answer: B. Vascular remodeling and increased arterial stiffness
Chronic hypertension promotes vascular smooth-muscle hypertrophy, remodeling, and
stiffness, which further increases vascular resistance and cardiac workload.
8. A patient with an abdominal aortic aneurysm is at greatest risk for which complication?
A. Pulmonary embolism
B. Aortic rupture and internal hemorrhage
C. Pneumothorax
D. Acute pancreatitis
Answer: B. Aortic rupture and internal hemorrhage
An aneurysm weakens and dilates the arterial wall. Rupture can cause massive internal
bleeding and potentially fatal hypovolemic shock.
9. Which pathophysiologic process occurs during deep vein thrombosis (DVT)?
A. Arterial vasodilation
B. Formation of a thrombus within a vein
Answers & Explanations
1. A patient with left-sided heart failure develops pulmonary crackles and dyspnea. Which
mechanism best explains these findings?
A. Decreased systemic vascular resistance
B. Increased pulmonary capillary hydrostatic pressure
C. Increased plasma oncotic pressure
D. Decreased pulmonary blood flow
Answer: B. Increased pulmonary capillary hydrostatic pressure
Left-sided heart failure causes blood to back up into the pulmonary circulation, increasing
pulmonary capillary hydrostatic pressure and promoting fluid movement into the interstitial
tissue and alveoli.
2. Which finding is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Pink frothy sputum
C. Peripheral edema and jugular venous distention
D. Hemoptysis
Answer: C. Peripheral edema and jugular venous distention
,Right-sided heart failure causes systemic venous congestion, producing peripheral edema,
hepatomegaly, ascites, and jugular venous distention.
3. A patient experiences an acute myocardial infarction. Which cellular change occurs first
when myocardial blood flow is severely reduced?
A. Irreversible membrane rupture
B. ATP depletion
C. Extensive fibrosis
D. Ventricular aneurysm
Answer: B. ATP depletion
Ischemia decreases oxygen delivery, impairing oxidative phosphorylation and causing ATP
depletion. Prolonged ischemia eventually results in irreversible cellular injury and necrosis.
4. Which laboratory marker is most specific for myocardial injury?
A. BNP
B. Troponin
C. LDL
D. D-dimer
Answer: B. Troponin
Cardiac troponins are highly sensitive and specific markers of myocardial injury and are
commonly used to evaluate suspected acute coronary syndrome.
,5. Which pathophysiologic change is primarily responsible for stable angina?
A. Complete coronary artery occlusion
B. Temporary myocardial oxygen supply-demand mismatch
C. Permanent myocardial necrosis
D. Pulmonary vascular obstruction
Answer: B. Temporary myocardial oxygen supply-demand mismatch
Stable angina usually results from fixed coronary atherosclerotic narrowing combined with
increased myocardial oxygen demand, particularly during exertion.
6. Atherosclerosis develops primarily because of:
A. Destruction of red blood cells
B. Lipid accumulation and inflammatory changes within arterial walls
C. Excessive venous pressure
D. Increased platelet production alone
Answer: B. Lipid accumulation and inflammatory changes within arterial walls
Atherosclerosis involves endothelial injury, lipid deposition, inflammation, smooth-muscle
proliferation, and plaque formation within arterial walls.
7. Which change occurs in the vascular system during chronic hypertension?
, A. Decreased systemic vascular resistance
B. Vascular remodeling and increased arterial stiffness
C. Decreased cardiac workload
D. Increased arterial compliance
Answer: B. Vascular remodeling and increased arterial stiffness
Chronic hypertension promotes vascular smooth-muscle hypertrophy, remodeling, and
stiffness, which further increases vascular resistance and cardiac workload.
8. A patient with an abdominal aortic aneurysm is at greatest risk for which complication?
A. Pulmonary embolism
B. Aortic rupture and internal hemorrhage
C. Pneumothorax
D. Acute pancreatitis
Answer: B. Aortic rupture and internal hemorrhage
An aneurysm weakens and dilates the arterial wall. Rupture can cause massive internal
bleeding and potentially fatal hypovolemic shock.
9. Which pathophysiologic process occurs during deep vein thrombosis (DVT)?
A. Arterial vasodilation
B. Formation of a thrombus within a vein
