Clinical Pathophysiology Made Ridiculously
Simple: Color Edition
3rd Edition
Author(s)Aaron Berkowitz MD PhD
TEST BANK
1
Reference: Ch. 1: Anatomical Overview — Coronary Blood
Supply
Question Stem: A 62-year-old man with chest pain is diagnosed
with an acute myocardial infarction involving the posterior
descending artery (PDA). Which region of the heart is most
likely affected, and which nursing assessment is most important
immediately?
A. Anterolateral left ventricle; monitor for hypotension.
B. Inferior (diaphragmatic) surface of left ventricle; monitor for
bradycardia and hypotension.
C. Anterior septum; monitor for acute pulmonary edema.
D. Lateral wall; monitor for carotid bruits.
,Correct Answer: B
Rationales:
• Correct (B): PDA infarcts commonly produce inferior
(diaphragmatic) LV involvement; inferior MI often
stimulates vagal tone causing bradycardia and hypotension
— immediate nursing monitoring should target HR and
perfusion. (Berkowitz: coronary distribution and clinical
consequences).
• A: Anterolateral LV is supplied by LAD/LCx; while
hypotension matters, bradycardia is less specific for PDA
infarct.
• C: Anterior septal MI more commonly causes LV pump
failure and pulmonary edema, not classic inferior/vagal
bradycardia.
• D: Lateral wall ischemia (LCx) does not selectively predict
carotid bruits; carotid assessment is unrelated to
immediate MI complications.
Teaching Point: Inferior (PDA) MIs often cause vagal-mediated
bradycardia and hypotension.
Citation: Berkowitz, 2023, Ch. 1: Anatomical Overview
2
Reference: Ch. 1: Heart Failure — Left Heart Failure
,Question Stem: A patient with chronic hypertension presents
with dyspnea on exertion, orthopnea, and bibasilar crackles.
Which pathophysiologic mechanism best explains these
findings?
A. Right ventricular volume overload causing systemic venous
congestion.
B. Left ventricular systolic or diastolic dysfunction increasing
pulmonary capillary hydrostatic pressure.
C. Pulmonary embolism causing sudden increase in pulmonary
artery pressure.
D. Primary pulmonary parenchymal disease with decreased
oncotic pressure.
Correct Answer: B
Rationales:
• Correct (B): Left heart failure (systolic or diastolic) raises LV
end-diastolic pressure → increased pulmonary capillary
hydrostatic pressure → pulmonary edema, dyspnea,
orthopnea. (Berkowitz: left HF physiology).
• A: Right ventricular overload causes systemic congestion
(JVD, hepatic congestion), not predominant pulmonary
crackles and orthopnea.
• C: Pulmonary embolism can cause acute dyspnea but
usually presents abruptly and may not explain chronic
orthopnea and bilateral crackles.
, • D: Pulmonary parenchymal disease can cause crackles but
decreased oncotic pressure is unrelated to classic HF
presentation.
Teaching Point: Left HF increases pulmonary capillary
hydrostatic pressure, producing pulmonary edema and
orthopnea.
Citation: Berkowitz, 2023, Ch. 1: Heart Failure — Left Heart
Failure
3
Reference: Ch. 1: Preload, Afterload, and Treatment of Heart
Failure
Question Stem: A patient with acute decompensated heart
failure has pulmonary edema. Which immediate nursing action
most directly reduces preload and improves pulmonary
congestion?
A. Start a beta-blocker to reduce heart rate.
B. Administer IV loop diuretic (e.g., furosemide) and consider
nitrates.
C. Increase IV fluids to improve renal perfusion.
D. Begin an ACE inhibitor and observe for 24 hours.
Correct Answer: B
Rationales:
Simple: Color Edition
3rd Edition
Author(s)Aaron Berkowitz MD PhD
TEST BANK
1
Reference: Ch. 1: Anatomical Overview — Coronary Blood
Supply
Question Stem: A 62-year-old man with chest pain is diagnosed
with an acute myocardial infarction involving the posterior
descending artery (PDA). Which region of the heart is most
likely affected, and which nursing assessment is most important
immediately?
A. Anterolateral left ventricle; monitor for hypotension.
B. Inferior (diaphragmatic) surface of left ventricle; monitor for
bradycardia and hypotension.
C. Anterior septum; monitor for acute pulmonary edema.
D. Lateral wall; monitor for carotid bruits.
,Correct Answer: B
Rationales:
• Correct (B): PDA infarcts commonly produce inferior
(diaphragmatic) LV involvement; inferior MI often
stimulates vagal tone causing bradycardia and hypotension
— immediate nursing monitoring should target HR and
perfusion. (Berkowitz: coronary distribution and clinical
consequences).
• A: Anterolateral LV is supplied by LAD/LCx; while
hypotension matters, bradycardia is less specific for PDA
infarct.
• C: Anterior septal MI more commonly causes LV pump
failure and pulmonary edema, not classic inferior/vagal
bradycardia.
• D: Lateral wall ischemia (LCx) does not selectively predict
carotid bruits; carotid assessment is unrelated to
immediate MI complications.
Teaching Point: Inferior (PDA) MIs often cause vagal-mediated
bradycardia and hypotension.
Citation: Berkowitz, 2023, Ch. 1: Anatomical Overview
2
Reference: Ch. 1: Heart Failure — Left Heart Failure
,Question Stem: A patient with chronic hypertension presents
with dyspnea on exertion, orthopnea, and bibasilar crackles.
Which pathophysiologic mechanism best explains these
findings?
A. Right ventricular volume overload causing systemic venous
congestion.
B. Left ventricular systolic or diastolic dysfunction increasing
pulmonary capillary hydrostatic pressure.
C. Pulmonary embolism causing sudden increase in pulmonary
artery pressure.
D. Primary pulmonary parenchymal disease with decreased
oncotic pressure.
Correct Answer: B
Rationales:
• Correct (B): Left heart failure (systolic or diastolic) raises LV
end-diastolic pressure → increased pulmonary capillary
hydrostatic pressure → pulmonary edema, dyspnea,
orthopnea. (Berkowitz: left HF physiology).
• A: Right ventricular overload causes systemic congestion
(JVD, hepatic congestion), not predominant pulmonary
crackles and orthopnea.
• C: Pulmonary embolism can cause acute dyspnea but
usually presents abruptly and may not explain chronic
orthopnea and bilateral crackles.
, • D: Pulmonary parenchymal disease can cause crackles but
decreased oncotic pressure is unrelated to classic HF
presentation.
Teaching Point: Left HF increases pulmonary capillary
hydrostatic pressure, producing pulmonary edema and
orthopnea.
Citation: Berkowitz, 2023, Ch. 1: Heart Failure — Left Heart
Failure
3
Reference: Ch. 1: Preload, Afterload, and Treatment of Heart
Failure
Question Stem: A patient with acute decompensated heart
failure has pulmonary edema. Which immediate nursing action
most directly reduces preload and improves pulmonary
congestion?
A. Start a beta-blocker to reduce heart rate.
B. Administer IV loop diuretic (e.g., furosemide) and consider
nitrates.
C. Increase IV fluids to improve renal perfusion.
D. Begin an ACE inhibitor and observe for 24 hours.
Correct Answer: B
Rationales:
