NURS 5220 EXAM 3 REVIEW -
ADVANCED PATHOPHYSIOLOGY
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. Which mechanism best describes the pathophysiology of Heart Failure with Preserved
Ejection Fraction (HFpEF)?
A. Reduced contractility of the left ventricle
B. Primary failure of the mitral valve
C. Dilation of the left ventricular cavity
D. Impaired ventricular relaxation and decreased compliance
Answer: D
Conceptual Explanation: HFpEF is characterized by diastolic dysfunction where the
ventricle is stiff and cannot fill properly, despite a normal or near-normal ejection fraction.
2. In the renin-angiotensin-aldosterone system (RAAS), which enzyme is responsible for
converting Angiotensin I to Angiotensin II?
A. Renin
B. Angiotensinogen
C. Angiotensin-converting enzyme (ACE)
,D. Aldosterone synthase
Answer: C
Conceptual Explanation: ACE, primarily found in the lungs, converts Angiotensin I into
the potent vasoconstrictor Angiotensin II.
3. A patient with Aortic Stenosis is most likely to exhibit which type of murmur?
A. Mid-diastolic rumble with an opening snap
B. Holosystolic murmur at the apex radiating to the axilla
C. Diastolic decrescendo murmur at the left sternal border
D. Crescendo-decrescendo systolic murmur at the right upper sternal border
Answer: D
Conceptual Explanation: Aortic stenosis produces a harsh systolic crescendo-
decrescendo murmur heard best at the right 2nd intercostal space.
4. What is the primary role of oxidized LDL in the development of atherosclerosis?
A. It triggers macrophage recruitment and foam cell formation
B. It promotes vasodilation of the tunica media
C. It stabilizes the fibrous cap of the plaque
D. It inhibits the migration of smooth muscle cells
Answer: A
, Conceptual Explanation: Oxidized LDL is engulfed by macrophages, which then become
foam cells, a key component of the fatty streak in atherosclerosis.
5. Which of the following is a hallmark of Prinzmetal (Variant) Angina?
A. Pain triggered by physical exertion
B. Pain relieved by rest only
C. ST-segment depression on EKG during pain
D. Coronary artery vasospasm occurring at rest
Answer: D
Conceptual Explanation: Prinzmetal angina is caused by vasospasm rather than
atherosclerotic narrowing and typically occurs at rest, often at night.
6. Hypertrophic Cardiomyopathy (HCM) is most commonly associated with which genetic
finding?
A. X-linked recessive dystrophin deficiency
B. Trisomy 21
C. Mutations in sarcomere proteins
D. Deficiency in alpha-1 antitrypsin
Answer: C
Conceptual Explanation: HCM is frequently an autosomal dominant condition caused by
mutations in genes encoding contractile proteins of the cardiac sarcomere.
ADVANCED PATHOPHYSIOLOGY
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. Which mechanism best describes the pathophysiology of Heart Failure with Preserved
Ejection Fraction (HFpEF)?
A. Reduced contractility of the left ventricle
B. Primary failure of the mitral valve
C. Dilation of the left ventricular cavity
D. Impaired ventricular relaxation and decreased compliance
Answer: D
Conceptual Explanation: HFpEF is characterized by diastolic dysfunction where the
ventricle is stiff and cannot fill properly, despite a normal or near-normal ejection fraction.
2. In the renin-angiotensin-aldosterone system (RAAS), which enzyme is responsible for
converting Angiotensin I to Angiotensin II?
A. Renin
B. Angiotensinogen
C. Angiotensin-converting enzyme (ACE)
,D. Aldosterone synthase
Answer: C
Conceptual Explanation: ACE, primarily found in the lungs, converts Angiotensin I into
the potent vasoconstrictor Angiotensin II.
3. A patient with Aortic Stenosis is most likely to exhibit which type of murmur?
A. Mid-diastolic rumble with an opening snap
B. Holosystolic murmur at the apex radiating to the axilla
C. Diastolic decrescendo murmur at the left sternal border
D. Crescendo-decrescendo systolic murmur at the right upper sternal border
Answer: D
Conceptual Explanation: Aortic stenosis produces a harsh systolic crescendo-
decrescendo murmur heard best at the right 2nd intercostal space.
4. What is the primary role of oxidized LDL in the development of atherosclerosis?
A. It triggers macrophage recruitment and foam cell formation
B. It promotes vasodilation of the tunica media
C. It stabilizes the fibrous cap of the plaque
D. It inhibits the migration of smooth muscle cells
Answer: A
, Conceptual Explanation: Oxidized LDL is engulfed by macrophages, which then become
foam cells, a key component of the fatty streak in atherosclerosis.
5. Which of the following is a hallmark of Prinzmetal (Variant) Angina?
A. Pain triggered by physical exertion
B. Pain relieved by rest only
C. ST-segment depression on EKG during pain
D. Coronary artery vasospasm occurring at rest
Answer: D
Conceptual Explanation: Prinzmetal angina is caused by vasospasm rather than
atherosclerotic narrowing and typically occurs at rest, often at night.
6. Hypertrophic Cardiomyopathy (HCM) is most commonly associated with which genetic
finding?
A. X-linked recessive dystrophin deficiency
B. Trisomy 21
C. Mutations in sarcomere proteins
D. Deficiency in alpha-1 antitrypsin
Answer: C
Conceptual Explanation: HCM is frequently an autosomal dominant condition caused by
mutations in genes encoding contractile proteins of the cardiac sarcomere.
