,NSG3850/NSG 3850 Exam 2 | Advanced
1. An increase in filtration of fluid from pulmonary capillaries into the interstitium occurs with which of
the following pressure changes?
A) Increased capillary colloid osmotic pressure
B) Increased capillary hydrostatic pressure
C) Decreased capillary hydrostatic pressure
D) Decreased interstitial colloid osmotic pressure
Correct Answer: B) Increased capillary hydrostatic pressure
Rationale: When capillary hydrostatic pressure exceeds capillary colloid osmotic pressure, fluid moves
from the capillary into the interstitium. Increased colloid osmotic pressure (A) would pull fluid into the
capillary. Decreased hydrostatic pressure (C) and decreased interstitial colloid pressure (D) would both
reduce fluid movement out of the capillary.
2. The amount of gas remaining in the lungs after a maximal expiration is termed which of the following?
A) Functional residual capacity
B) Residual volume
C) Expiratory reserve volume
D) Vital capacity
Correct Answer: B) Residual volume
Rationale: Residual volume is the volume of air remaining in the lungs after a maximal expiration,
preventing lung collapse. Functional residual capacity (A) is the volume at the end of a normal
expiration. Expiratory reserve volume (C) is the amount exhaled beyond tidal volume. Vital capacity (D)
is the total volume exhaled during maximal expiration.
3. All obstructive pulmonary disorders share which of the following core pathophysiologic features?
A) Decreased lung compliance
B) Resistance to airflow
,C) Decreased residual volumes
D) Hyper-responsiveness to allergens
Correct Answer: B) Resistance to airflow
Rationale: Obstructive disorders are characterized by increased resistance to airflow due to airway
narrowing from inflammation, mucus, or bronchospasm. Decreased lung compliance (A) is a hallmark of
restrictive disorders. Residual volumes (C) are typically increased, not decreased, in obstructive disease.
Hyper-responsiveness (D) is specific to asthma, not all obstructive disorders.
4. A patient with a long-standing history of poorly controlled hypertension develops left ventricular
hypertrophy. This adaptive change is best classified as which of the following?
A) Pathologic hypertrophy
B) Physiologic hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: A) Pathologic hypertrophy
Rationale: Left ventricular hypertrophy in response to chronic hypertension is pathologic hypertrophy,
as it results from increased afterload and can lead to heart failure if sustained. Physiologic hypertrophy
(B) occurs with exercise training. Hyperplasia (C) is an increase in cell number. Metaplasia (D) is a change
in cell type.
5. In a patient with heart failure, an ejection fraction of 28% is most consistent with which of the
following classifications?
A) Heart failure with preserved ejection fraction (HFpEF)
B) Heart failure with reduced ejection fraction (HFrEF)
C) Diastolic heart failure
D) High-output heart failure
Correct Answer: B) Heart failure with reduced ejection fraction (HFrEF)
, Rationale: HFrEF is defined as an ejection fraction of 40% or less, indicating impaired systolic function.
HFpEF (A) is defined as an EF of 50% or greater. Diastolic heart failure (C) is synonymous with HFpEF.
High-output heart failure (D) occurs in conditions with increased metabolic demand and typically
presents with a normal or high EF.
6. Which of the following clinical findings is classically associated with right-sided heart failure?
A) Pulmonary crackles and dyspnea
B) Jugular venous distension and peripheral edema
C) Orthopnea and paroxysmal nocturnal dyspnea
D) Pink, frothy sputum
Correct Answer: B) Jugular venous distension and peripheral edema
Rationale: Right-sided heart failure results in systemic venous congestion, leading to jugular venous
distension, peripheral edema, hepatomegaly, and ascites. Pulmonary crackles (A), orthopnea (C), and
pink frothy sputum (D) are manifestations of left-sided heart failure.
7. The classic triad of hypotension, muffled heart sounds, and distended neck veins is characteristic of
which of the following conditions?
A) Cardiac tamponade
B) Tension pneumothorax
C) Pulmonary embolism
D) Acute myocardial infarction
Correct Answer: A) Cardiac tamponade
Rationale: Beck's triad—hypotension, muffled heart sounds, and jugular venous distension—is the
classic presentation of cardiac tamponade, caused by compression of the heart from accumulated fluid
in the pericardial sac. Tension pneumothorax (B) presents with tracheal deviation and absent breath
sounds. Pulmonary embolism (C) presents with sudden dyspnea and hypoxia. MI (D) presents with chest
pain and EKG changes.
1. An increase in filtration of fluid from pulmonary capillaries into the interstitium occurs with which of
the following pressure changes?
A) Increased capillary colloid osmotic pressure
B) Increased capillary hydrostatic pressure
C) Decreased capillary hydrostatic pressure
D) Decreased interstitial colloid osmotic pressure
Correct Answer: B) Increased capillary hydrostatic pressure
Rationale: When capillary hydrostatic pressure exceeds capillary colloid osmotic pressure, fluid moves
from the capillary into the interstitium. Increased colloid osmotic pressure (A) would pull fluid into the
capillary. Decreased hydrostatic pressure (C) and decreased interstitial colloid pressure (D) would both
reduce fluid movement out of the capillary.
2. The amount of gas remaining in the lungs after a maximal expiration is termed which of the following?
A) Functional residual capacity
B) Residual volume
C) Expiratory reserve volume
D) Vital capacity
Correct Answer: B) Residual volume
Rationale: Residual volume is the volume of air remaining in the lungs after a maximal expiration,
preventing lung collapse. Functional residual capacity (A) is the volume at the end of a normal
expiration. Expiratory reserve volume (C) is the amount exhaled beyond tidal volume. Vital capacity (D)
is the total volume exhaled during maximal expiration.
3. All obstructive pulmonary disorders share which of the following core pathophysiologic features?
A) Decreased lung compliance
B) Resistance to airflow
,C) Decreased residual volumes
D) Hyper-responsiveness to allergens
Correct Answer: B) Resistance to airflow
Rationale: Obstructive disorders are characterized by increased resistance to airflow due to airway
narrowing from inflammation, mucus, or bronchospasm. Decreased lung compliance (A) is a hallmark of
restrictive disorders. Residual volumes (C) are typically increased, not decreased, in obstructive disease.
Hyper-responsiveness (D) is specific to asthma, not all obstructive disorders.
4. A patient with a long-standing history of poorly controlled hypertension develops left ventricular
hypertrophy. This adaptive change is best classified as which of the following?
A) Pathologic hypertrophy
B) Physiologic hypertrophy
C) Hyperplasia
D) Metaplasia
Correct Answer: A) Pathologic hypertrophy
Rationale: Left ventricular hypertrophy in response to chronic hypertension is pathologic hypertrophy,
as it results from increased afterload and can lead to heart failure if sustained. Physiologic hypertrophy
(B) occurs with exercise training. Hyperplasia (C) is an increase in cell number. Metaplasia (D) is a change
in cell type.
5. In a patient with heart failure, an ejection fraction of 28% is most consistent with which of the
following classifications?
A) Heart failure with preserved ejection fraction (HFpEF)
B) Heart failure with reduced ejection fraction (HFrEF)
C) Diastolic heart failure
D) High-output heart failure
Correct Answer: B) Heart failure with reduced ejection fraction (HFrEF)
, Rationale: HFrEF is defined as an ejection fraction of 40% or less, indicating impaired systolic function.
HFpEF (A) is defined as an EF of 50% or greater. Diastolic heart failure (C) is synonymous with HFpEF.
High-output heart failure (D) occurs in conditions with increased metabolic demand and typically
presents with a normal or high EF.
6. Which of the following clinical findings is classically associated with right-sided heart failure?
A) Pulmonary crackles and dyspnea
B) Jugular venous distension and peripheral edema
C) Orthopnea and paroxysmal nocturnal dyspnea
D) Pink, frothy sputum
Correct Answer: B) Jugular venous distension and peripheral edema
Rationale: Right-sided heart failure results in systemic venous congestion, leading to jugular venous
distension, peripheral edema, hepatomegaly, and ascites. Pulmonary crackles (A), orthopnea (C), and
pink frothy sputum (D) are manifestations of left-sided heart failure.
7. The classic triad of hypotension, muffled heart sounds, and distended neck veins is characteristic of
which of the following conditions?
A) Cardiac tamponade
B) Tension pneumothorax
C) Pulmonary embolism
D) Acute myocardial infarction
Correct Answer: A) Cardiac tamponade
Rationale: Beck's triad—hypotension, muffled heart sounds, and jugular venous distension—is the
classic presentation of cardiac tamponade, caused by compression of the heart from accumulated fluid
in the pericardial sac. Tension pneumothorax (B) presents with tracheal deviation and absent breath
sounds. Pulmonary embolism (C) presents with sudden dyspnea and hypoxia. MI (D) presents with chest
pain and EKG changes.
