1
NURS 807 Pathophysiology
and Pharmacology Physical
Examination Test Question
Bank
Difficulty Level: Advanced/Hard
Target Audience: Graduate Nursing Students (DNP/APRN Level)
Section 1: Cardiovascular System Assessment and Pharmacology
1. A 67-year-old male with a history of chronic hypertension presents with a
blood pressure of 180/110 mmHg. The nurse practitioner understands that the
primary mechanism contributing to his elevated diastolic pressure involves:
A. Decreased cardiac output
B. Increased systemic vascular resistance
C. Reduced stroke volume
D. Decreased venous return
Correct Answer: B
Rationale: Elevated diastolic pressure is primarily driven by increased systemic
vascular resistance (afterload). In chronic hypertension, arteriolar remodeling and
, 2
increased sympathetic tone contribute to elevated peripheral resistance, which
maintains elevated diastolic pressure. Cardiac output and stroke volume may be
normal or decreased in chronic hypertension.
2. A patient on furosemide therapy for heart failure should be monitored for
which of the following electrolyte imbalances?
A. Hyperkalemia and hypernatremia
B. Hypokalemia and hyponatremia
C. Hypercalcemia and hypomagnesemia
D. Hyperphosphatemia and hypokalemia
Correct Answer: B
Rationale: Loop diuretics such as furosemide inhibit the Na⁺-K⁺-2Cl⁻ cotransporter
in the thick ascending limb, causing increased excretion of sodium, potassium,
chloride, and water. This leads to hypokalemia and hyponatremia, requiring
careful monitoring and often potassium supplementation.
, 3
3. A patient presents with jugular venous distention, bilateral crackles on
auscultation, and 3+ pitting edema to the lower extremities. The nurse
practitioner should prioritize which assessment finding?
A. Capillary refill time
B. S3 gallop on cardiac auscultation
C. Blood pressure in both arms
D. Pupillary response
Correct Answer: B
Rationale: The S3 gallop is a significant marker of volume overload and ventricular
dysfunction in heart failure. While jugular venous distention and edema indicate
fluid retention, the presence of an S3 gallop specifically indicates decompensated
heart failure and requires immediate intervention for acute decompensation.
4. When assessing a patient with suspected deep vein thrombosis, which of the
following findings is most concerning?
A. Unilateral calf tenderness
B. Bilateral pedal edema
, 4
C. Warmth and erythema of the affected extremity
D. Positive Homans sign
Correct Answer: C
Rationale: Warmth and erythema in a unilateral extremity are hallmark signs of
inflammation associated with DVT and suggest active thrombosis. While Homans
sign and calf tenderness may be present, warmth and erythema are more
consistent indicators of the inflammatory response accompanying DVT and carry
high risk of pulmonary embolism.
5. A patient on digoxin for atrial fibrillation presents with nausea, vomiting, and
yellow-green visual halos. The nurse practitioner should:
A. Increase the digoxin dose
B. Order a serum digoxin level and potassium level
C. Administer calcium channel blockers
D. Discontinue digoxin and administer atropine
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances are classic signs of digoxin
toxicity. Serum digoxin levels and potassium levels must be assessed immediately.
NURS 807 Pathophysiology
and Pharmacology Physical
Examination Test Question
Bank
Difficulty Level: Advanced/Hard
Target Audience: Graduate Nursing Students (DNP/APRN Level)
Section 1: Cardiovascular System Assessment and Pharmacology
1. A 67-year-old male with a history of chronic hypertension presents with a
blood pressure of 180/110 mmHg. The nurse practitioner understands that the
primary mechanism contributing to his elevated diastolic pressure involves:
A. Decreased cardiac output
B. Increased systemic vascular resistance
C. Reduced stroke volume
D. Decreased venous return
Correct Answer: B
Rationale: Elevated diastolic pressure is primarily driven by increased systemic
vascular resistance (afterload). In chronic hypertension, arteriolar remodeling and
, 2
increased sympathetic tone contribute to elevated peripheral resistance, which
maintains elevated diastolic pressure. Cardiac output and stroke volume may be
normal or decreased in chronic hypertension.
2. A patient on furosemide therapy for heart failure should be monitored for
which of the following electrolyte imbalances?
A. Hyperkalemia and hypernatremia
B. Hypokalemia and hyponatremia
C. Hypercalcemia and hypomagnesemia
D. Hyperphosphatemia and hypokalemia
Correct Answer: B
Rationale: Loop diuretics such as furosemide inhibit the Na⁺-K⁺-2Cl⁻ cotransporter
in the thick ascending limb, causing increased excretion of sodium, potassium,
chloride, and water. This leads to hypokalemia and hyponatremia, requiring
careful monitoring and often potassium supplementation.
, 3
3. A patient presents with jugular venous distention, bilateral crackles on
auscultation, and 3+ pitting edema to the lower extremities. The nurse
practitioner should prioritize which assessment finding?
A. Capillary refill time
B. S3 gallop on cardiac auscultation
C. Blood pressure in both arms
D. Pupillary response
Correct Answer: B
Rationale: The S3 gallop is a significant marker of volume overload and ventricular
dysfunction in heart failure. While jugular venous distention and edema indicate
fluid retention, the presence of an S3 gallop specifically indicates decompensated
heart failure and requires immediate intervention for acute decompensation.
4. When assessing a patient with suspected deep vein thrombosis, which of the
following findings is most concerning?
A. Unilateral calf tenderness
B. Bilateral pedal edema
, 4
C. Warmth and erythema of the affected extremity
D. Positive Homans sign
Correct Answer: C
Rationale: Warmth and erythema in a unilateral extremity are hallmark signs of
inflammation associated with DVT and suggest active thrombosis. While Homans
sign and calf tenderness may be present, warmth and erythema are more
consistent indicators of the inflammatory response accompanying DVT and carry
high risk of pulmonary embolism.
5. A patient on digoxin for atrial fibrillation presents with nausea, vomiting, and
yellow-green visual halos. The nurse practitioner should:
A. Increase the digoxin dose
B. Order a serum digoxin level and potassium level
C. Administer calcium channel blockers
D. Discontinue digoxin and administer atropine
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances are classic signs of digoxin
toxicity. Serum digoxin levels and potassium levels must be assessed immediately.
