, Test bank Applied Pathophysiology for the
Advanced Practice Nurse 2nd Edition by
Lucie Dlugasch; Lachel Story Chapter 1-14
1. A 55-year-old male presents with crushing chest pain radiating to the left
arm. ECG shows ST elevation in leads II, III, aVF. Which coronary artery is most
likely occluded?
A) Left anterior descending (LAD)
B) *Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Left main coronary artery
Answer: B
Rationale: Inferior wall MI (leads II, III, aVF) is typically caused by RCA occlusion.
LAD causes anterior; LCx causes lateral.
2. A 68-year-old female with heart failure has an ejection fraction of 30%.
Which pathophysiologic mechanism best explains her reduced cardiac output?
A) Increased afterload
B) *Decreased contractility (systolic dysfunction)
C) Impaired diastolic filling
D) Pericardial constriction
Answer: B
Rationale: HFrEF (EF <40%) is characterized by impaired contractility, reducing
stroke volume and cardiac output.
,3. A patient with COPD has chronic hypoxemia and hypercapnia. Which acid-
base disturbance is expected?
A) Metabolic acidosis
B) *Respiratory acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis
Answer: B
Rationale: Alveolar hypoventilation leads to CO2 retention, causing respiratory
acidosis with compensatory metabolic alkalosis.
4. A 45-year-old male with type 1 diabetes presents with polyuria, polydipsia,
and Kussmaul respirations. Blood glucose 450 mg/dL, pH 7.20, HCO3 12 mEq/L.
Which condition is most likely?
A) Hyperglycemic hyperosmolar state (HHS)
B) *Diabetic ketoacidosis (DKA)
C) Lactic acidosis
D) Hypoglycemia
Answer: B
Rationale: DKA is characterized by hyperglycemia, ketosis, and anion-gap metabolic
acidosis; Kussmaul respirations compensate.
5. A 72-year-old male with CKD stage 5 has a potassium of 6.5 mEq/L. Which
ECG finding is most characteristic?
A) Prominent U waves
B) *Peaked T waves
, C) Prolonged QT interval
D) ST depression
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and sine waves. U
waves are hypokalemia.
6. A patient with acute pancreatitis has a serum calcium of 7.2 mg/dL. Which
mechanism explains this finding?
A) Hypoparathyroidism
B) *Fat saponification
C) Vitamin D deficiency
D) Renal failure
Answer: B
Rationale: Pancreatic enzymes break down fat, and calcium binds to fatty acids
(saponification), causing hypocalcemia.
7. A 60-year-old female presents with fatigue, weight gain, cold intolerance, and
bradycardia. TSH is elevated, free T4 is low. Which diagnosis is most likely?
A) Hyperthyroidism
B) *Primary hypothyroidism (Hashimoto’s)
C) Secondary hypothyroidism
D) Subclinical hyperthyroidism
Answer: B
Rationale: Elevated TSH with low free T4 indicates primary hypothyroidism, often
autoimmune (Hashimoto’s).
Advanced Practice Nurse 2nd Edition by
Lucie Dlugasch; Lachel Story Chapter 1-14
1. A 55-year-old male presents with crushing chest pain radiating to the left
arm. ECG shows ST elevation in leads II, III, aVF. Which coronary artery is most
likely occluded?
A) Left anterior descending (LAD)
B) *Right coronary artery (RCA)
C) Left circumflex (LCx)
D) Left main coronary artery
Answer: B
Rationale: Inferior wall MI (leads II, III, aVF) is typically caused by RCA occlusion.
LAD causes anterior; LCx causes lateral.
2. A 68-year-old female with heart failure has an ejection fraction of 30%.
Which pathophysiologic mechanism best explains her reduced cardiac output?
A) Increased afterload
B) *Decreased contractility (systolic dysfunction)
C) Impaired diastolic filling
D) Pericardial constriction
Answer: B
Rationale: HFrEF (EF <40%) is characterized by impaired contractility, reducing
stroke volume and cardiac output.
,3. A patient with COPD has chronic hypoxemia and hypercapnia. Which acid-
base disturbance is expected?
A) Metabolic acidosis
B) *Respiratory acidosis
C) Respiratory alkalosis
D) Metabolic alkalosis
Answer: B
Rationale: Alveolar hypoventilation leads to CO2 retention, causing respiratory
acidosis with compensatory metabolic alkalosis.
4. A 45-year-old male with type 1 diabetes presents with polyuria, polydipsia,
and Kussmaul respirations. Blood glucose 450 mg/dL, pH 7.20, HCO3 12 mEq/L.
Which condition is most likely?
A) Hyperglycemic hyperosmolar state (HHS)
B) *Diabetic ketoacidosis (DKA)
C) Lactic acidosis
D) Hypoglycemia
Answer: B
Rationale: DKA is characterized by hyperglycemia, ketosis, and anion-gap metabolic
acidosis; Kussmaul respirations compensate.
5. A 72-year-old male with CKD stage 5 has a potassium of 6.5 mEq/L. Which
ECG finding is most characteristic?
A) Prominent U waves
B) *Peaked T waves
, C) Prolonged QT interval
D) ST depression
Answer: B
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and sine waves. U
waves are hypokalemia.
6. A patient with acute pancreatitis has a serum calcium of 7.2 mg/dL. Which
mechanism explains this finding?
A) Hypoparathyroidism
B) *Fat saponification
C) Vitamin D deficiency
D) Renal failure
Answer: B
Rationale: Pancreatic enzymes break down fat, and calcium binds to fatty acids
(saponification), causing hypocalcemia.
7. A 60-year-old female presents with fatigue, weight gain, cold intolerance, and
bradycardia. TSH is elevated, free T4 is low. Which diagnosis is most likely?
A) Hyperthyroidism
B) *Primary hypothyroidism (Hashimoto’s)
C) Secondary hypothyroidism
D) Subclinical hyperthyroidism
Answer: B
Rationale: Elevated TSH with low free T4 indicates primary hypothyroidism, often
autoimmune (Hashimoto’s).
