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NURS 5315 Advanced Pathophysiology – (Exam 3) 50 Original
Questions with Answers and Rationales UPDATED!!!
Cardiovascular, Hematologic, and Respiratory
1. A patient with chronic left-sided heart failure develops
dyspnea, orthopnea, and crackles on auscultation. The
primary mechanism of these symptoms is:
A) Decreased right ventricular preload
B) Increased pulmonary capillary hydrostatic pressure
C) Systemic venous congestion
D) Decreased pulmonary vascular resistance
Answer: B) Increased pulmonary capillary hydrostatic
pressure
Rationale: Left ventricular failure increases left atrial and
pulmonary venous pressures, causing fluid transudation into
the pulmonary interstitium and alveoli, leading to
pulmonary edema.
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2. The most common cause of right-sided heart failure is:
A) Pulmonary embolism
B) Left-sided heart failure
C) Tricuspid stenosis
D) Cor pulmonale
Answer: B) Left-sided heart failure
Rationale: Chronic left-sided failure leads to pulmonary
hypertension and increased right ventricular afterload,
eventually causing right ventricular failure.
3. A patient with aortic stenosis is most likely to develop
which type of heart failure?
A) Diastolic heart failure
B) Systolic heart failure
C) High-output heart failure
D) Right-sided heart failure
Answer: A) Diastolic heart failure
Rationale: Aortic stenosis causes pressure overload and
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concentric hypertrophy, leading to impaired diastolic filling
(diastolic dysfunction).
4. In systolic heart failure, the ejection fraction is typically:
A) Greater than 50%
B) Less than 40%
C) Normal
D) Greater than 70%
Answer: B) Less than 40%
Rationale: Systolic dysfunction is characterized by reduced
contractility and ejection fraction (HFrEF), usually <40%.
5. The primary compensatory mechanism in early heart
failure is:
A) Decreased heart rate
B) Activation of the sympathetic nervous system and renin-
angiotensin-aldosterone system
C) Increased parasympathetic tone
D) Decreased preload
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Answer: B) Activation of the sympathetic nervous system
and renin-angiotensin-aldosterone system
Rationale: Decreased cardiac output triggers sympathetic
and RAAS activation to maintain perfusion, but chronic
activation worsens remodeling.
6. A patient with heart failure develops pitting edema in the
lower extremities and hepatomegaly. This is most suggestive
of:
A) Left-sided heart failure
B) Right-sided heart failure
C) Pulmonary edema
D) Cardiogenic shock
Answer: B) Right-sided heart failure
Rationale: Right ventricular failure causes systemic venous
congestion, leading to peripheral edema, hepatomegaly,
and ascites.
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NURS 5315 Advanced Pathophysiology – (Exam 3) 50 Original
Questions with Answers and Rationales UPDATED!!!
Cardiovascular, Hematologic, and Respiratory
1. A patient with chronic left-sided heart failure develops
dyspnea, orthopnea, and crackles on auscultation. The
primary mechanism of these symptoms is:
A) Decreased right ventricular preload
B) Increased pulmonary capillary hydrostatic pressure
C) Systemic venous congestion
D) Decreased pulmonary vascular resistance
Answer: B) Increased pulmonary capillary hydrostatic
pressure
Rationale: Left ventricular failure increases left atrial and
pulmonary venous pressures, causing fluid transudation into
the pulmonary interstitium and alveoli, leading to
pulmonary edema.
1|Page
, Page |2
2. The most common cause of right-sided heart failure is:
A) Pulmonary embolism
B) Left-sided heart failure
C) Tricuspid stenosis
D) Cor pulmonale
Answer: B) Left-sided heart failure
Rationale: Chronic left-sided failure leads to pulmonary
hypertension and increased right ventricular afterload,
eventually causing right ventricular failure.
3. A patient with aortic stenosis is most likely to develop
which type of heart failure?
A) Diastolic heart failure
B) Systolic heart failure
C) High-output heart failure
D) Right-sided heart failure
Answer: A) Diastolic heart failure
Rationale: Aortic stenosis causes pressure overload and
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concentric hypertrophy, leading to impaired diastolic filling
(diastolic dysfunction).
4. In systolic heart failure, the ejection fraction is typically:
A) Greater than 50%
B) Less than 40%
C) Normal
D) Greater than 70%
Answer: B) Less than 40%
Rationale: Systolic dysfunction is characterized by reduced
contractility and ejection fraction (HFrEF), usually <40%.
5. The primary compensatory mechanism in early heart
failure is:
A) Decreased heart rate
B) Activation of the sympathetic nervous system and renin-
angiotensin-aldosterone system
C) Increased parasympathetic tone
D) Decreased preload
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Answer: B) Activation of the sympathetic nervous system
and renin-angiotensin-aldosterone system
Rationale: Decreased cardiac output triggers sympathetic
and RAAS activation to maintain perfusion, but chronic
activation worsens remodeling.
6. A patient with heart failure develops pitting edema in the
lower extremities and hepatomegaly. This is most suggestive
of:
A) Left-sided heart failure
B) Right-sided heart failure
C) Pulmonary edema
D) Cardiogenic shock
Answer: B) Right-sided heart failure
Rationale: Right ventricular failure causes systemic venous
congestion, leading to peripheral edema, hepatomegaly,
and ascites.
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