Galen: NSG 3850 / NSG3850 Pathophysiology II Exam 2 | Complete Questions & Answers | 100% Updated 2026.

Galen College of Nursing NSG 3850 / NSG3850 Pathophysiology II Exam 2 | Complete Questions & Answers | 100% Updated 2026 ### 1. A patient receives morphine after thoracic surgery and develops slow, shallow respirations. Which pathophysiologic change is most consistent with hypoventilation? A. Insufficient alveolar ventilation causes increased PaCO₂ and hypoxemia. B. Pulmonary blood flow increases enough to produce respiratory alkalosis. C. Excessive alveolar ventilation causes PaCO₂ to fall below 35 mm Hg. D. Normal oxygen-carrying capacity is preserved while only tissue use of oxygen is impaired. ### 2. Which patient factor in the uploaded notes can depress the central respiratory drive and contribute directly to hypoventilation? A. Morphine or barbiturate use. B. High-altitude exposure. C. A recent episode of anxiety with rapid breathing. D. A type III hypersensitivity reaction in the alveoli. ### 3. A patient is breathing rapidly because of severe anxiety. Which arterial blood gas trend is expected from the pathophysiology of hyperventilation? A. PaO₂ falls because ventilation is absent. B. Hemoglobin concentration falls because oxygen-carrying capacity is reduced. C. PaCO₂ decreases to less than 35 mm Hg. D. PaCO₂ rises above 45 mm Hg. ### 4. Which statement best distinguishes hypoxemia from hypoxia? A. Hypoxemia is decreased tissue oxygen use, whereas hypoxia is low PaCO₂. B. Hypoxemia is an airway disease, whereas hypoxia is always a blood-clot disorder. C. Hypoxemia is low cardiac output, whereas hypoxia is increased hemoglobin. D. Hypoxemia is deficient oxygen in the blood, whereas hypoxia is decreased tissue oxygenation. ### 5. A patient at high altitude has a decreased PaO₂ but normal oxygen-carrying capacity. Which type of hypoxia is described? A. Circulatory hypoxia. B. Hypoxic hypoxia. C. Anemic hypoxia. D. Histotoxic hypoxia. ### 6. A patient has a markedly low hemoglobin level and reduced oxygen-carrying capacity. Which type of hypoxia is most consistent with the notes? A. Histotoxic hypoxia. B. Circulatory hypoxia. C. Anemic hypoxia. D. Hypoxic hypoxia. ### 7. A patient in shock has normal oxygen-carrying capacity but greatly reduced blood flow to the tissues. Which form of hypoxia is present? A. Circulatory hypoxia. B. Histotoxic hypoxia. C. Anemic hypoxia. D. Hypoxic hypoxia. ### 8. A worker exposed to cyanide has oxygen available in the blood, but the tissues cannot use it. Which form of hypoxia does this represent? A. Histotoxic hypoxia. B. Hypoxic hypoxia. C. Circulatory hypoxia. D. Anemic hypoxia. ### 9. Which group of findings represents early manifestations of hypoxemia in the uploaded review? A. Bradycardia, extreme restlessness, and dyspnea only. B. Restlessness, anxiety, tachycardia, and tachypnea. C. Hemarthrosis, petechiae, and prolonged PTT. D. JVD, ascites, and hepatomegaly. ### 10. A patient has a recent onset of cough, low-grade fever, sore throat, fatigue, and postnasal drip. Which disorder is most consistent with these findings? A. Acute bronchitis. B. Chronic venous insufficiency. C. Cardiac tamponade. D. Aortic stenosis. ### 11. What is the key pathophysiologic process in acute bronchitis? A. Alveolar walls are permanently destroyed by proteolytic enzymes. B. An arterial clot eliminates perfusion to a limb. C. Fluid accumulates in the pericardial sac and restricts ventricular filling. D. Acute inflammation narrows the tracheobronchial airways through capillary dilation, fluid exudation, inflammatory-cell infiltration, and increased mucus. ### 12. Why may a chest radiograph be obtained in a patient with suspected acute bronchitis? A. To confirm that the mitral valve is stenotic. B. To identify a venous stasis ulcer. C. To measure platelet adhesion. D. To distinguish a usually normal bronchitis radiograph from pneumonia with pulmonary infiltrates. ### 13. A long-term smoker has a productive cough for more than 3 months in each of 2 successive years. Which diagnosis best matches the uploaded criteria? A. Pleurisy. B. Acute bronchitis. C. Chronic bronchitis, Type B COPD. D. Sarcoidosis. ### 14. Which exposure is identified as the major cause of chronic bronchitis in the uploaded notes? A. Aortic valve calcification. B. Cigarette smoking, accounting for about 90% of cases. C. Cyanide exposure. D. Vitamin K deficiency. ### 15. A patient with chronic bronchitis has persistent hypoxemia. Which compensatory hematologic change is expected? A. Secondary polycythemia from increased red blood cell production. B. Factor VIII deficiency. C. Loss of von Willebrand factor. D. Thrombocytopenia from reduced megakaryocytes. ### 16. Which sequence best explains development of cor pulmonale in chronic bronchitis? A. Systemic hypotension causes left ventricular dilation and aortic regurgitation. B. Pleural fluid directly narrows the coronary arteries. C. Platelet destruction causes pulmonary edema and left atrial enlargement. D. Hypoxia and hypercarbia increase pulmonary vascular resistance, causing pulmonary hypertension and eventually right ventricular dilation/right-sided heart failure. ### 17. A thin patient with progressive exertional dyspnea uses accessory muscles, has pursed-lip breathing and a barrel chest, and has minimal cough. Which disorder is most consistent? A. Chronic bronchitis, Type B COPD. B. Acute bronchitis. C. Pleural effusion. D. Emphysema, Type A COPD. ### 18. Which structural change is central to emphysema pathophysiology? A. Fibrotic narrowing of the mitral valve. B. Destruction of alveolar walls with loss of elastic tissue and air trapping. C. Inflammation limited to the trachea with no distal airway changes. D. Fluid accumulation between pericardial layers. ### 19. A younger adult develops emphysema without the usual age pattern. Which inherited abnormality from the notes should the examiner consider? A. Factor IX deficiency. B. Von Willebrand factor excess. C. HLA-B27 absence. D. Alpha-1 antitrypsin deficiency. ### 20. Why is pursed-lip breathing beneficial in emphysema according to the course review? A. It prolongs exhalation so more air can leave before small airways collapse. B. It increases venous pressure to prevent edema. C. It produces pulmonary vasoconstriction to raise PaCO₂. D. It causes platelet adhesion at injured vessels. ### 21. A patient has noncaseating granulomas, dry cough, enlarged lymph nodes, hypercalcemia, and uveitis. Which diagnosis is most consistent? A. Mitral regurgitation. B. Acute bronchitis. C. Buerger disease. D. Sarcoidosis. ### 22. A nonsmoker develops fever, dry cough, dyspnea, crackles, and hypoxemia several hours after inhaling an organic antigen. Which disorder best fits? A. Stable angina. B. Hypersensitivity pneumonitis. C. Chronic venous insufficiency. D. Mitral valve prolapse. ### 23. What immune mechanism is described for hypersensitivity pneumonitis? A. A type III hypersensitivity reaction in which antigen-antibody complexes injure alveolar walls. B. An IgE-independent coronary plaque rupture. C. An autoimmune destruction of platelets only. D. An X-linked factor VIII deficiency. ### 24. A patient has sudden dyspnea, unilateral absent breath sounds, hyperresonance, and chest pain. Which disorder is most consistent? A. Pleural effusion. B. Thrombocytopenia. C. Mitral stenosis. D. Pneumothorax. ### 25. Which finding most strongly suggests a tension pneumothorax rather than a simple pneumothorax? A. Dull percussion with decreased tactile fremitus. B. Pain relieved by ambulation and leg elevation. C. A low-pitched diastolic murmur at the apex. D. Tracheal/mediastinal shift with hypotension and severe tachycardia. ### 26. Which chest-tube action is consistent with the pneumothorax management instructions in the uploaded notes? A. Raise the drainage system above the chest to improve suction. B. Keep the drainage system below the chest and do not routinely clamp the tube. C. Massage the insertion site vigorously to clear the tube. D. Clamp the tube whenever the patient ambulates. ### 27. A patient with severe heart failure develops fluid in the pleural cavity. How is this type of pleural effusion classified in the notes? A. An empyema. B. A transudative pleural effusion. C. A hemothorax. D. A chylothorax. ### 28. Which physical assessment pattern is most consistent with pleural effusion? A. Pursed-lip breathing with barrel chest and minimal cough. B. Hyperresonance with tracheal shift and subcutaneous emphysema. C. White-blue-red finger color changes triggered by cold. D. Dyspnea, pleuritic pain, decreased chest movement, absent breath sounds, dull percussion, and decreased tactile fremitus. ### 29. A patient with a severe spinal/chest-wall deformity develops rapid shallow breathing, hypercapnia, hypoxemia, and reduced pulmonary function tests. Which disorder is most consistent? A. Vasospastic angina. B. Hemophilia. C. Kyphoscoliosis. D. Aortic regurgitation. ### 30. Which clinical pattern is characteristic of ankylosing spondylitis in the respiratory review? A. Leg pain is worse with walking and relieved by dependency. B. Chest pain is relieved only by nitroglycerin. C. Back stiffness is worse after rest and improves with exercise, with decreased rib movement and limited chest expansion. D. Cough is productive for more than 3 months for 2 years. ### 31. Which patient is specifically identified as being at increased risk for pneumonia? A. A patient with stable mitral valve prolapse and no pulmonary symptoms. B. A young adult with isolated Raynaud attacks. C. A patient with an uncomplicated varicose vein. D. An older adult with a diminished gag reflex. ### 32. A chest x-ray shows parenchymal infiltrates in a patient with fever, cough, crackles, and purulent sputum. Which diagnosis is most supported? A. Pneumonia. B. Pleurisy without lung inflammation. C. Raynaud phenomenon. D. Acute bronchitis with a normal radiograph. ### 33. An immunocompromised patient with HIV develops an opportunistic pneumonia. Which organism is highlighted in the Exam 2 review? A. HLA-B27. B. Group A streptococcus causing rheumatic fever. C. Cyanide. D. Pneumocystis jiroveci. ### 34. Which test is identified as the definitive confirmation of pulmonary tuberculosis in the uploaded review? A. Sputum culture demonstrating the acid-fast organism. B. An ankle-brachial index. C. A serum BNP level. D. A normal chest radiograph. ### 35. A patient has sharp unilateral chest pain that worsens with deep breathing, coughing, or sneezing and decreases when the breath is held. Which diagnosis is most consistent? A. Aortic stenosis. B. Chronic venous insufficiency. C. Stable angina. D. Pleurisy. ### 36. Which statement best distinguishes a thrombus from an embolus? A. A thrombus is fluid in the pleural cavity, while an embolus is air in the pericardium. B. A thrombus is a stationary clot; an embolus travels and lodges at a distal site. C. A thrombus occurs only in arteries, while an embolus occurs only in veins. D. A thrombus is always infectious, while an embolus is always congenital. ### 37. A patient has leg pain with activity that improves with rest, a cool extremity, and diminished perfusion. Which type of thrombotic problem is most consistent? A. Pleural effusion. B. Arterial obstruction/thrombus. C. Mitral valve prolapse. D. Venous thrombus with impaired return. ### 38. A patient has unilateral calf tenderness, warmth, and swelling. Which process is most consistent with the venous pattern in the notes? A. Raynaud syndrome. B. Aortic stenosis. C. Acute arterial occlusion. D. Deep venous thrombosis with impaired venous return. ### 39. Which diagnostic study is listed as first-line for suspected DVT in the Unit 4 notes? A. Transbronchial biopsy. B. Doppler/duplex ultrasound. C. Bronchoscopy. D. Cardiac stress test. ### 40. Which group of risk factors best reflects the mechanisms associated with DVT in the notes? A. Only high altitude, anxiety, and fever. B. Only low HDL and aortic valve calcification. C. Endothelial damage, venous stasis, and altered clotting from factors such as surgery, immobilization, pregnancy, sepsis, birth control, or cancer. D. Only uveitis, hypercalcemia, and hilar adenopathy. ### 41. A patient with a DVT suddenly develops shortness of breath, tachypnea, and chest pain. Which complication should be suspected? A. Mitral valve prolapse. B. Pulmonary embolism. C. Pleurisy from a viral infection only. D. Chronic pericarditis. ### 42. An embolus leaves the left side of the heart and travels into the systemic circulation. Which major complication is highlighted? A. A cerebral arterial embolus causing stroke. B. A tension pneumothorax. C. A pleural effusion from lymphatic blockage. D. A pulmonary embolus caused by entry into the right heart. ### 43. A patient has pain and redness along an IV vein with a palpable ropelike area. What intervention is emphasized for suspected phlebitis? A. Begin chest-tube suction. B. Remove the IV catheter, apply warm compresses, elevate the limb, and monitor the site. C. Massage the area vigorously to break up any clot. D. Keep the limb dependent and apply ice continuously. ### 44. Cold exposure causes sudden constriction of arterial smooth muscle with transient obstruction to flow. Which mechanism is being described? A. Alveolar destruction. B. Valvular incompetence. C. Vasospasm. D. Pleural transudation. ### 45. Which description best distinguishes atherosclerosis from arteriosclerosis in the uploaded notes? A. Atherosclerosis occurs only in the lungs while arteriosclerosis occurs only in the heart. B. Atherosclerosis is a venous disorder and arteriosclerosis is a platelet disorder. C. Atherosclerosis is always congenital while arteriosclerosis is always infectious. D. Atherosclerosis involves plaque buildup in medium and large arteries, whereas arteriosclerosis refers to thickening, hardening, and narrowing of arteries. ### 46. A patient has an ankle-brachial index below 1. How is this interpreted in the uploaded notes? A. It proves a patient has pneumonia. B. It supports abnormal arterial perfusion and is considered a concerning finding. C. It confirms normal venous return. D. It indicates normal platelet function. ### 47. Which risk-factor combination is most strongly associated with aneurysm formation in the uploaded material? A. Only factor VIII deficiency and thrombocytopenia. B. Atherosclerosis, chronic hypertension, smoking, advanced age, and male sex. C. Low body weight, normal blood pressure, and young age. D. Only acute bronchitis and pleurisy. ### 48. Which finding should raise immediate concern for aneurysm rupture? A. Mild cough with a normal chest x-ray. B. A painless white-blue-red color sequence in the fingers. C. Sudden severe pain with hypotension, tachycardia, and shock. D. Pain that improves with exercise after spinal rest. ### 49. What is the defining vascular abnormality in an arteriovenous malformation? A. An abnormal direct communication between arteries and veins. B. A calcified aortic valve that fails to open. C. A platelet count below 150,000. D. An air leak into the pleural space. ### 50. Why is hypertension often called the “silent killer” in the uploaded notes? A. It may have few symptoms while uncontrolled pressure can lead to CAD, renal failure, stroke, angina, and MI. B. It always causes a loud murmur before organ damage occurs. C. It is always secondary to pneumonia. D. It causes only venous edema and never arterial injury. ### 51. A blood pressure is greater than 180 systolic or 120 diastolic with evidence of end-organ damage. How is this classified in the notes? A. Chronic venous insufficiency. B. Simple orthostatic hypotension. C. Stable angina. D. Hypertensive emergency/crisis. ### 52. Which blood-pressure change meets the uploaded definition of orthostatic hypotension? A. Any isolated BP reading above 140/90. B. A pulse-pressure widening with high systolic and low diastolic pressure. C. An increase in systolic pressure of 20 mm Hg after lying down. D. A drop in systolic pressure greater than 20 mm Hg or diastolic pressure greater than 10 mm Hg within 3 minutes of standing. ### 53. A patient exposed to cold develops fingers that turn white, then blue, then red as blood flow returns. Which diagnosis is most consistent? A. Mitral regurgitation. B. Raynaud syndrome/phenomenon. C. Buerger disease with fixed occlusion. D. Chronic bronchitis. ### 54. Which teaching is most appropriate for a patient with Raynaud phenomenon based on the uploaded notes? A. Take aspirin and ibuprofen routinely to prevent attacks. B. Use nicotine to reduce attacks. C. Avoid cold exposure, nicotine, and vasoconstricting decongestants; keep hands and feet warm and dry. D. Keep the extremities exposed to cold to improve tolerance. ### 55. A smoker has progressive inflammatory occlusion of small and medium arteries and veins of the extremities with ischemic pain and diminished pulses. Which disorder is most consistent? A. Mitral valve stenosis. B. Buerger disease (thromboangiitis obliterans). C. Sarcoidosis. D. Pleurisy. ### 56. Which pathophysiologic change is central to varicose veins? A. Impaired venous return raises capillary pressure and produces limb edema and dilated tortuous veins. B. Alveolar destruction traps air and forms bullae. C. Aortic valve calcification narrows left-ventricular outflow. D. Coronary vasospasm produces myocardial ischemia at rest. ### 57. A patient has sudden pallor, pulselessness, paresthesia, paralysis, severe pain, and a cool limb. Which condition is a medical emergency? A. Simple varicose veins. B. Acute peripheral arterial occlusion. C. Stable angina. D. Chronic venous insufficiency. ### 58. What positioning action is emphasized for acute peripheral arterial occlusion? A. Use cold packs directly on the ischemic limb. B. Place the patient prone with the limb flexed. C. Elevate the limb above the heart continuously. D. Keep the affected limb dependent rather than elevating it. ### 59. A patient receiving heparin for DVT develops an uncontrolled nosebleed. Which antidote is identified in the course notes? A. Calcium gluconate. B. Desmopressin. C. Protamine sulfate. D. Vitamin K. ### 60. Which finding is most typical of chronic venous insufficiency? A. Aching and edema that improve with ambulation and elevation, with brown hemosiderin staining and possible medial-malleolus ulceration. B. A loud systolic murmur radiating to the neck. C. A cool pale limb with absent pulses that worsens with elevation and improves only with rest. D. A barrel chest with pursed-lip breathing. ### 61. A patient has petechiae, purpura, spontaneous nosebleeds, and a platelet count below 150,000. Which disorder pattern is most consistent? A. Aortic stenosis. B. Hypersensitivity pneumonitis. C. Thrombocytopenia. D. Hemophilia with normal platelet count. ### 62. Which statement best describes immune thrombocytopenic purpura in the uploaded notes? A. It is a calcific aortic-valve disorder. B. It is a restrictive lung disease caused by organic antigens. C. It is caused by absent factor VIII with normal platelet function. D. It is commonly autoimmune and involves antibody-mediated destruction of platelets, producing petechiae and easy bruising. ### 63. A male patient has recurrent hemarthrosis, easy bruising, a prolonged PTT, and a normal platelet count. Which disorder is most likely? A. Hemophilia caused by factor VIII or IX deficiency. B. Thrombocytopenia. C. Von Willebrand disease from excess VWF. D. Raynaud syndrome. ### 64. A patient has lifelong mucosal bleeding and impaired platelet adhesion from deficient von Willebrand factor. Which treatment is specifically listed? A. Furosemide as the primary hemostatic treatment. B. Albuterol. C. Desmopressin to increase factor VIII/von Willebrand-related activity. D. Rifampin. ### 65. Which mechanism produces lymphedema in the Unit 4 notes? A. Coronary thrombosis decreases myocardial oxygen supply. B. Hyperventilation lowers PaCO₂. C. A calcified valve blocks left-ventricular outflow. D. Obstruction of normal lymph flow causes protein-rich interstitial fluid accumulation, inflammation, adipose hypertrophy, and fibrotic change. ### 66. Which finding favors arterial insufficiency over venous insufficiency? A. Pain that improves with walking and leg elevation. B. Warm thickened skin with edema and brown hemosiderin staining. C. A pink-red ulcer near the medial malleolus. D. A cool limb with diminished pulses, pallor, sharp activity-related pain, and glossy skin. ### 67. Which laboratory marker is commonly listed as elevated when thromboembolism is suspected? A. D-dimer. B. HLA-B27 only. C. BNP only. D. Von Willebrand factor only. ### 68. A patient has chest pressure during exertion that resolves with rest and nitroglycerin. Which pattern is most consistent? A. Cardiac tamponade with hypotension and JVD. B. Stable angina caused by fixed atherosclerotic coronary narrowing. C. Vasospastic angina occurring unpredictably at rest. D. Acute pericarditis relieved by lying flat. ### 69. A patient has unpredictable episodes of angina while resting, unrelated to exercise or emotional strain. Which mechanism is most likely? A. Fixed venous obstruction from DVT. B. Pericardial fluid compressing the right atrium. C. Coronary vasospasm causing vasospastic/variant angina. D. Alveolar mucus plugging from chronic bronchitis. ### 70. What is the central pathophysiologic problem in acute coronary syndrome as described in the uploaded notes? A. The mitral valve prolapses without affecting coronary flow. B. The pleural cavity fills with lymph fluid. C. Platelets are destroyed by autoantibodies. D. Myocardial oxygen demand exceeds supply because atherosclerotic coronary narrowing predisposes to thrombosis and vasospasm. ### 71. Which event produces myocardial infarction according to the review? A. Complete/prolonged coronary occlusion, often from thrombus on disrupted atherosclerotic plaque, causing irreversible myocardial cell death. B. Brief reversible ischemia that resolves with rest without tissue death. C. Transient finger vasospasm from cold exposure. D. Venous valve incompetence in the legs. ### 72. Which chest-pain pattern is most concerning for myocardial infarction rather than stable angina? A. Brief exertional discomfort that resolves promptly with rest. B. Severe crushing pain lasting more than 15 minutes and not relieved by rest or nitroglycerin. C. Aching leg pain that improves with elevation. D. Sharp pleuritic pain relieved by holding the breath. ### 73. Which lipid profile pattern is listed as a coronary risk pattern in the course review? A. Total cholesterol below 100 with HDL above 80. B. Only elevated platelet count with normal cholesterol. C. Normal lipids with isolated low sodium. D. Total cholesterol above 200, LDL above 130, triglycerides above 150, and HDL below 40. ### 74. A patient with mitral stenosis becomes dyspneic and develops atrial enlargement and atrial fibrillation. What is the underlying flow problem? A. The aortic valve leaks from the aorta into the left ventricle during diastole. B. The tricuspid valve prolapses into the right atrium. C. Narrowing of the mitral valve impairs flow from the left atrium to the left ventricle, causing left-atrial and pulmonary congestion. D. A thrombus blocks a deep leg vein. ### 75. Which auscultatory finding is emphasized for mitral stenosis? A. A high-pitched blowing diastolic murmur with wide pulse pressure. B. A low-pitched diastolic murmur heard at the apex. C. A pericardial friction rub that improves with leaning forward. D. A loud harsh systolic murmur radiating to the neck. ### 76. Which finding in mitral stenosis should prompt concern for worsening pulmonary congestion? A. A painless white-blue-red finger sequence. B. Brown staining around the medial malleolus. C. Pink frothy sputum with severe shortness of breath. D. A normal ECG at rest with exertional chest pain only. ### 77. What is the defining structural change in mitral valve prolapse? A. The pericardium scars and prevents ventricular filling. B. The mitral leaflets bulge/displace into the left atrium during ventricular systole. C. The aortic valve cusps calcify and block systolic outflow. D. The mitral leaflets fuse and fail to open in diastole. ### 78. Which heart sound is most associated with mitral valve prolapse in the notes? A. No extra heart sound is ever present. B. A pericardial friction rub. C. A low-pitched diastolic rumble only. D. A midsystolic click/murmur. ### 79. Which statement correctly describes mitral regurgitation? A. During diastole, the mitral valve remains permanently open without backflow. B. During systole, the aortic valve prevents all blood from leaving the left ventricle. C. During ventricular systole, blood flows backward from the left ventricle into the left atrium because the valve does not close completely. D. During diastole, blood flows from the aorta back into the left ventricle. ### 80. Which murmur pattern is characteristic of mitral regurgitation in the uploaded notes? A. A loud high-pitched pansystolic/blowing murmur at the apex radiating toward the left axilla. B. A loud harsh systolic murmur radiating to the neck. C. A high-pitched diastolic murmur with head bobbing and wide pulse pressure. D. A low-pitched diastolic rumble at the apex. ### 81. An older adult has calcified aortic cusps, exertional syncope, a low systolic blood pressure, and a loud harsh systolic murmur radiating to the neck. Which disorder is most likely? A. Aortic stenosis. B. Acute pericarditis. C. Mitral valve prolapse. D. Aortic regurgitation. ### 82. Which complication is specifically linked to advanced aortic stenosis? A. Chronic venous ulceration of the medial malleolus. B. Primary spontaneous pneumothorax. C. Left ventricular hypertrophy with ischemia and possible left-sided heart failure. D. Type III hypersensitivity pneumonitis. ### 83. Which hemodynamic pattern best matches aortic regurgitation? A. Low systolic and low diastolic pressure with no pulse-pressure change. B. Isolated pulmonary hypertension with no left-sided findings. C. Normal pressure with only venous edema. D. High systolic pressure, low diastolic pressure, and a widened pulse pressure from diastolic backflow into the left ventricle. ### 84. Which murmur is associated with aortic regurgitation in the uploaded notes? A. A high-pitched blowing diastolic murmur. B. A midsystolic click only. C. A low-pitched diastolic rumble at the apex. D. A harsh systolic murmur radiating to the neck. ### 85. A patient develops valvular scarring after an inadequately treated streptococcal infection. Which disorder is described? A. Pleural effusion. B. Rheumatic endocarditis/rheumatic heart disease. C. Atherosclerosis. D. Infective endocarditis from IV drug use. ### 86. What is the best preventive measure emphasized for rheumatic endocarditis? A. Begin anticoagulation for every sore throat. B. Promptly treat streptococcal pharyngitis and complete the prescribed antibiotics. C. Avoid all exercise for life. D. Use long-term chest-tube suction. ### 87. A patient with IV drug use has fever, a new murmur, petechiae, and positive blood cultures. Which diagnosis is most consistent? A. Stable angina. B. Raynaud syndrome. C. Infective endocarditis with valvular vegetations. D. Mitral valve prolapse without infection. ### 88. Why can infective endocarditis cause stroke or other systemic injury? A. Pleural fluid migrates directly into cerebral arteries. B. All patients develop severe thrombocytopenia. C. The valve permanently stops producing red blood cells. D. Vegetations can fragment and embolize to distant vessels. ### 89. Which step is emphasized before initiating antibiotics in suspected infective endocarditis? A. Administer warfarin before collecting any laboratory samples. B. Obtain blood cultures. C. Begin vigorous exercise testing. D. Perform a thoracentesis first. ### 90. A patient with a pericardial effusion becomes hypotensive with muffled heart sounds and JVD. What complication is most likely? A. Cardiac tamponade. B. Stable angina. C. Buerger disease. D. Chronic bronchitis. ### 91. What is the immediate definitive treatment listed for unstable cardiac tamponade? A. Emergency pericardiocentesis or surgical drainage. B. Sublingual nitroglycerin only. C. Long-term rifampin therapy. D. Compression stockings and ambulation. ### 92. A patient has sharp pleuritic chest pain that is worse lying flat and with inspiration but improves when sitting up and leaning forward. Which disorder is most likely? A. Deep venous thrombosis. B. Acute pericarditis. C. Stable angina. D. Aortic stenosis. ### 93. Which finding is most consistent with chronic constrictive pericarditis? A. Only hemarthrosis and prolonged PTT. B. Only a white-blue-red change of the fingertips. C. Only a productive morning cough and wheezing. D. Fatigue, dyspnea, edema, ascites, JVD, and other signs of right-sided heart failure. ### 94. Which diagnostic marker is emphasized as elevated in heart failure? A. BNP. B. D-dimer as the primary HF marker. C. Von Willebrand factor. D. HLA-B27. ### 95. A patient with left-sided heart failure has pulmonary congestion. Which findings are backward effects of left-sided failure? A. White-blue-red fingers triggered by cold. B. Dyspnea, orthopnea, nocturnal dyspnea, crackles, cyanosis, and possible frothy sputum. C. Hemarthrosis and mucosal bleeding. D. JVD, hepatomegaly, ascites, and dependent edema only. ### 96. Which findings represent the forward effects of left-sided heart failure? A. Peripheral edema, hepatomegaly, JVD, and ascites from systemic venous backup. B. Fatigue, oliguria, tachycardia, restlessness, confusion, and anxiety from reduced cardiac output and tissue perfusion. C. Petechiae and purpura from low platelets. D. Hyperresonance and unilateral absent breath sounds. ### 97. What is identified as the most common cause of right-sided heart failure in the uploaded notes? A. Hemophilia. B. Raynaud phenomenon. C. Left ventricular/left-sided heart failure. D. Acute bronchitis. ### 98. Which assessment pattern best fits right-sided heart failure? A. A low-pitched diastolic murmur with pulmonary venous hypertension only. B. Acute pleuritic pain that improves with leaning forward only. C. JVD, peripheral edema, weight gain, ascites, hepatomegaly, RUQ discomfort, and fatigue. D. Pursed-lip breathing, barrel chest, and minimal cough only. ### 99. A patient has combined pulmonary congestion and systemic edema after left-sided failure progressed to right-sided failure. Which term best describes this state? A. Hypersensitivity pneumonitis. B. Stable angina. C. Acute arterial occlusion. D. Biventricular heart failure. ### 100. Which daily-weight change should a patient with heart failure be taught to report according to the uploaded notes? A. A gain of about 2–3 lb in 24 hours or 5 lb in a week. B. Weight change is not useful in heart failure. C. Only weight gain greater than 20 lb in one day. D. Any loss of 1 ounce in a month.