NSG 5140 WEEK 9 FINAL EXAM
QUESTIONS AND ANSWERS
1. What is the primary mechanism of action of the Renin-Angiotensin-Aldosterone System
(RAAS) in response to decreased renal perfusion?
A. Induction of systemic vasodilation to improve blood flow
B. Release of Renin which eventually leads to Angiotensin II production for
vasoconstriction and sodium retention
C. Inhibition of Antidiuretic Hormone (ADH) to decrease fluid volume
D. Direct stimulation of Beta-1 receptors in the heart to increase heart rate
Answer: B
Conceptual Explanation: When renal perfusion decreases, the juxtaglomerular cells
release renin. Renin converts angiotensinogen to angiotensin I, which is converted to
angiotensin II by ACE. Angiotensin II causes potent vasoconstriction and stimulates
aldosterone release, leading to sodium and water retention.
,2. In left-sided heart failure, why do patients frequently experience paroxysmal nocturnal
dyspnea?
A. Due to the failure of the right ventricle to pump blood to the lungs
B. Systemic venous congestion causing pedal edema
C. Redistribution of body fluid from the lower extremities to the lungs when lying flat
D. Excessive production of erythropoietin causing hyperviscosity
Answer: C
Conceptual Explanation: Left-sided heart failure leads to increased pulmonary capillary
hydrostatic pressure. When a patient lies flat, interstitial fluid from the legs is redistributed
to the pulmonary circulation, worsening pulmonary congestion.
3. Which clinical finding is most characteristic of right-sided heart failure?
A. Pulmonary crackles and orthopnea
B. Jugular venous distention (JVD) and peripheral edema
C. Frothy pink-tinged sputum
D. Decreased cardiac output leading to cool, clammy skin
Answer: B
Conceptual Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation, leading to increased pressure in the vena cava, resulting in
JVD, hepatomegaly, and peripheral edema.
, 4. Which cardiac biomarker is considered the most sensitive and specific for diagnosing an
acute myocardial infarction?
A. Cardiac Troponin I or T
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Creatine Kinase-MB (CK-MB)
Answer: A
Conceptual Explanation: Cardiac Troponins are highly specific to myocardial tissue and
remain elevated for several days, making them the gold standard for MI diagnosis
compared to CK-MB or myoglobin.
5. The pathophysiology of emphysema involves which of the following processes?
A. Hyperplasia of mucus-secreting goblet cells
B. Reversible airway bronchoconstriction due to allergens
C. Destruction of alveolar walls and loss of elastic recoil
D. Fibrotic scarring of the lung parenchyma following infection
Answer: C
Conceptual Explanation: Emphysema is characterized by the permanent enlargement of
gas-exchange airways and destruction of alveolar walls, primarily due to an imbalance
between proteases and antiproteases (like alpha-1 antitrypsin).
QUESTIONS AND ANSWERS
1. What is the primary mechanism of action of the Renin-Angiotensin-Aldosterone System
(RAAS) in response to decreased renal perfusion?
A. Induction of systemic vasodilation to improve blood flow
B. Release of Renin which eventually leads to Angiotensin II production for
vasoconstriction and sodium retention
C. Inhibition of Antidiuretic Hormone (ADH) to decrease fluid volume
D. Direct stimulation of Beta-1 receptors in the heart to increase heart rate
Answer: B
Conceptual Explanation: When renal perfusion decreases, the juxtaglomerular cells
release renin. Renin converts angiotensinogen to angiotensin I, which is converted to
angiotensin II by ACE. Angiotensin II causes potent vasoconstriction and stimulates
aldosterone release, leading to sodium and water retention.
,2. In left-sided heart failure, why do patients frequently experience paroxysmal nocturnal
dyspnea?
A. Due to the failure of the right ventricle to pump blood to the lungs
B. Systemic venous congestion causing pedal edema
C. Redistribution of body fluid from the lower extremities to the lungs when lying flat
D. Excessive production of erythropoietin causing hyperviscosity
Answer: C
Conceptual Explanation: Left-sided heart failure leads to increased pulmonary capillary
hydrostatic pressure. When a patient lies flat, interstitial fluid from the legs is redistributed
to the pulmonary circulation, worsening pulmonary congestion.
3. Which clinical finding is most characteristic of right-sided heart failure?
A. Pulmonary crackles and orthopnea
B. Jugular venous distention (JVD) and peripheral edema
C. Frothy pink-tinged sputum
D. Decreased cardiac output leading to cool, clammy skin
Answer: B
Conceptual Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation, leading to increased pressure in the vena cava, resulting in
JVD, hepatomegaly, and peripheral edema.
, 4. Which cardiac biomarker is considered the most sensitive and specific for diagnosing an
acute myocardial infarction?
A. Cardiac Troponin I or T
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Creatine Kinase-MB (CK-MB)
Answer: A
Conceptual Explanation: Cardiac Troponins are highly specific to myocardial tissue and
remain elevated for several days, making them the gold standard for MI diagnosis
compared to CK-MB or myoglobin.
5. The pathophysiology of emphysema involves which of the following processes?
A. Hyperplasia of mucus-secreting goblet cells
B. Reversible airway bronchoconstriction due to allergens
C. Destruction of alveolar walls and loss of elastic recoil
D. Fibrotic scarring of the lung parenchyma following infection
Answer: C
Conceptual Explanation: Emphysema is characterized by the permanent enlargement of
gas-exchange airways and destruction of alveolar walls, primarily due to an imbalance
between proteases and antiproteases (like alpha-1 antitrypsin).
