NUR 641EA Exam 2 V2 | NUR 641EA Advanced
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 2) | Grand Canyon University
1. A nurse educator is lecturing on the adverse effects associated with ACE inhibitors. Which
of the following should be highlighted as potential clinical manifestations? (Select all that
apply)
A. Persistent nonproductive cough
B. Hypokalemia
C. Angioedema
D. Hyperkalemia
E. Hypotension
F. Hypernatremia
Correct Answer: A,C,D,E
Explanation: ACE inhibitors prevent the breakdown of bradykinin, which often leads to a
dry, persistent cough in susceptible patients. They also inhibit aldosterone secretion, which
can lead to the retention of potassium (hyperkalemia) rather than its excretion.
Angioedema is a rare but life-threatening emergency caused by increased vascular
permeability, while hypotension is a common initial response to the reduction in systemic
vascular resistance.
,2. Which pathophysiological mechanism is primarily responsible for the development of
pulmonary edema in a patient with left-sided heart failure?
A. Increased pulmonary capillary oncotic pressure
B. Increased pulmonary capillary hydrostatic pressure
C. Decreased pulmonary capillary hydrostatic pressure
D. Decreased alveolar surface tension
Correct Answer: B
Explanation: In left-sided heart failure, the left ventricle fails to pump blood efficiently into
the systemic circulation, leading to a backup of blood into the left atrium and pulmonary
veins. This backup increases the hydrostatic pressure within the pulmonary capillaries,
forcing fluid into the interstitial spaces and alveoli. This mechanism is distinct from
changes in oncotic pressure, which usually relate to protein levels in the blood.
3. A patient is diagnosed with Type 2 Diabetes Mellitus. What are the key pathophysiological
features of this condition? (Select all that apply)
A. Absolute insulin deficiency due to beta-cell destruction
B. Insulin resistance in peripheral tissues
C. Inappropriate hepatic glucose production
D. Decreased beta-cell secretion of insulin over time
E. Increased glucagon secretion
,Correct Answer: B,C,D,E
Explanation: Type 2 Diabetes is characterized by a combination of insulin resistance and a
relative, rather than absolute, insulin deficiency. The liver contributes to hyperglycemia
through excessive glucose production even when blood sugar levels are high. Over time,
the pancreas loses its ability to compensate, leading to decreased insulin secretion and
alpha-cell dysfunction that increases glucagon levels.
4. When evaluating a patient for chronic obstructive pulmonary disease (COPD), the nurse
educator explains that the primary cause of airflow limitation is:
A. Reversible bronchospasm
B. Small airway fibrosis and alveolar destruction
C. Increased lung elastic recoil
D. Excessive surfactant production
Correct Answer: B
Explanation: COPD is characterized by chronic inflammation that leads to structural
changes including small airway remodeling and fibrosis. The destruction of the alveolar
walls (emphysema) reduces the surface area for gas exchange and causes a loss of elastic
recoil. Unlike asthma, which involves reversible bronchospasm, the airflow limitation in
COPD is typically progressive and not fully reversible.
, 5. A patient with atrial fibrillation is prescribed Warfarin. Which lab value must be monitored
to ensure therapeutic efficacy and safety?
A. aPTT (activated Partial Thromboplastin Time)
B. Platelet count
C. Bleeding time
D. INR (International Normalized Ratio)
Correct Answer: D
Explanation: The International Normalized Ratio (INR) is the standard measurement used
to monitor the effectiveness of Warfarin therapy. Warfarin works by inhibiting Vitamin K-
dependent clotting factors, and the INR provides a consistent result regardless of the
thromboplastin reagent used by different labs. While aPTT is used for heparin, it is not the
standard for monitoring oral vitamin K antagonists.
6. A student asks about the Renin-Angiotensin-Aldosterone System (RAAS). In what order do
the following events occur after a drop in blood pressure?
A. Aldosterone release -> Renin release -> Angiotensin I -> Angiotensin II
B. Renin release -> Angiotensin I -> Angiotensin II -> Aldosterone release
C. Angiotensin II -> Renin release -> Angiotensin I -> Aldosterone release
D. Renin release -> Aldosterone release -> Angiotensin I -> Angiotensin II
Correct Answer: B
Pathophysiology and Pharmacology for Nurse
Educators | Actual Q&A with Rationale (NUR641EA
Exam 2) | Grand Canyon University
1. A nurse educator is lecturing on the adverse effects associated with ACE inhibitors. Which
of the following should be highlighted as potential clinical manifestations? (Select all that
apply)
A. Persistent nonproductive cough
B. Hypokalemia
C. Angioedema
D. Hyperkalemia
E. Hypotension
F. Hypernatremia
Correct Answer: A,C,D,E
Explanation: ACE inhibitors prevent the breakdown of bradykinin, which often leads to a
dry, persistent cough in susceptible patients. They also inhibit aldosterone secretion, which
can lead to the retention of potassium (hyperkalemia) rather than its excretion.
Angioedema is a rare but life-threatening emergency caused by increased vascular
permeability, while hypotension is a common initial response to the reduction in systemic
vascular resistance.
,2. Which pathophysiological mechanism is primarily responsible for the development of
pulmonary edema in a patient with left-sided heart failure?
A. Increased pulmonary capillary oncotic pressure
B. Increased pulmonary capillary hydrostatic pressure
C. Decreased pulmonary capillary hydrostatic pressure
D. Decreased alveolar surface tension
Correct Answer: B
Explanation: In left-sided heart failure, the left ventricle fails to pump blood efficiently into
the systemic circulation, leading to a backup of blood into the left atrium and pulmonary
veins. This backup increases the hydrostatic pressure within the pulmonary capillaries,
forcing fluid into the interstitial spaces and alveoli. This mechanism is distinct from
changes in oncotic pressure, which usually relate to protein levels in the blood.
3. A patient is diagnosed with Type 2 Diabetes Mellitus. What are the key pathophysiological
features of this condition? (Select all that apply)
A. Absolute insulin deficiency due to beta-cell destruction
B. Insulin resistance in peripheral tissues
C. Inappropriate hepatic glucose production
D. Decreased beta-cell secretion of insulin over time
E. Increased glucagon secretion
,Correct Answer: B,C,D,E
Explanation: Type 2 Diabetes is characterized by a combination of insulin resistance and a
relative, rather than absolute, insulin deficiency. The liver contributes to hyperglycemia
through excessive glucose production even when blood sugar levels are high. Over time,
the pancreas loses its ability to compensate, leading to decreased insulin secretion and
alpha-cell dysfunction that increases glucagon levels.
4. When evaluating a patient for chronic obstructive pulmonary disease (COPD), the nurse
educator explains that the primary cause of airflow limitation is:
A. Reversible bronchospasm
B. Small airway fibrosis and alveolar destruction
C. Increased lung elastic recoil
D. Excessive surfactant production
Correct Answer: B
Explanation: COPD is characterized by chronic inflammation that leads to structural
changes including small airway remodeling and fibrosis. The destruction of the alveolar
walls (emphysema) reduces the surface area for gas exchange and causes a loss of elastic
recoil. Unlike asthma, which involves reversible bronchospasm, the airflow limitation in
COPD is typically progressive and not fully reversible.
, 5. A patient with atrial fibrillation is prescribed Warfarin. Which lab value must be monitored
to ensure therapeutic efficacy and safety?
A. aPTT (activated Partial Thromboplastin Time)
B. Platelet count
C. Bleeding time
D. INR (International Normalized Ratio)
Correct Answer: D
Explanation: The International Normalized Ratio (INR) is the standard measurement used
to monitor the effectiveness of Warfarin therapy. Warfarin works by inhibiting Vitamin K-
dependent clotting factors, and the INR provides a consistent result regardless of the
thromboplastin reagent used by different labs. While aPTT is used for heparin, it is not the
standard for monitoring oral vitamin K antagonists.
6. A student asks about the Renin-Angiotensin-Aldosterone System (RAAS). In what order do
the following events occur after a drop in blood pressure?
A. Aldosterone release -> Renin release -> Angiotensin I -> Angiotensin II
B. Renin release -> Angiotensin I -> Angiotensin II -> Aldosterone release
C. Angiotensin II -> Renin release -> Angiotensin I -> Aldosterone release
D. Renin release -> Aldosterone release -> Angiotensin I -> Angiotensin II
Correct Answer: B
