NURS4015
Pathophysiology, Pharmacology, and Physical
Assessment
Final Exam Prep
2026
(With Solutions)
Multiple Choice Questions (MCQs)
A 55-year-old patient presents with chest pain radiating to the left arm. Troponin
levels are elevated. Which pathophysiological process is most likely responsible?
a) Vasospasm of coronary arteries
b) Myocardial ischemia due to atherosclerotic plaque rupture
c) Pericarditis
d) Pulmonary embolism
Answer: b) Myocardial ischemia due to atherosclerotic plaque rupture
Rationale: Elevated troponin indicates myocardial injury, commonly caused by
ischemia from atherosclerotic plaque rupture and thrombus formation.
Which pharmacologic agent is most appropriate for acute management of
anaphylaxis?
a) Diphenhydramine
b) Epinephrine
c) Prednisone
d) Albuterol
,Answer: b) Epinephrine
Rationale: Epinephrine rapidly reverses airway constriction and hypotension in
anaphylaxis by stimulating alpha and beta-adrenergic receptors.
When performing a cardiac assessment, which heart sound is best associated with
left ventricular failure?
a) S1
b) S2
c) S3
d) S4
Answer: c) S3
Rationale: S3 gallop reflects increased left ventricular filling pressures often seen in
heart failure.
A patient’s drug regimen includes digoxin. Which electrolyte imbalance increases
the risk of digoxin toxicity?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Low potassium potentiates digoxin binding to myocardial cells, increasing
toxicity risk.
In chronic kidney disease, which medication should be used cautiously to avoid
accumulation and toxicity?
,a) Morphine
b) Acetaminophen
c) Metformin
d) Ibuprofen
Answer: a) Morphine
Rationale: Morphine metabolites accumulate in renal impairment, risking respiratory
depression.
True/False Questions
True or False: Beta-blockers decrease cardiac output by blocking beta-1 receptors
in the heart.
Answer: True
Rationale: Beta-blockers reduce heart rate and contractility via beta-1 receptor
antagonism, decreasing cardiac output.
True or False: A widened pulse pressure is commonly seen in patients with aortic
regurgitation.
Answer: True
Rationale: Regurgitation causes increased stroke volume and runoff, widening pulse
pressure.
True or False: The Glasgow Coma Scale (GCS) evaluates motor, verbal, and ocular
responses for neurologic assessment.
Answer: True
Rationale: GCS assesses consciousness level using these three parameters.
, True or False: NSAIDs are the first-line treatment for heart failure.
Answer: False
Rationale: NSAIDs can worsen heart failure by causing fluid retention.
True or False: Pharmacokinetics describes what the drug does to the body.
Answer: False
Rationale: Pharmacokinetics describes what the body does to the drug (absorption,
distribution, metabolism, excretion).
Short Answer Questions
Explain the significance of Kussmaul breathing in metabolic acidosis.
Answer: Kussmaul breathing is a deep, labored respiratory pattern that helps lower
blood CO2 levels to compensate for metabolic acidosis by increasing respiratory
acid elimination.
What clinical signs would you expect in a patient with hyperthyroidism during
physical assessment?
Answer: Signs may include tachycardia, fine tremor, heat intolerance, weight loss,
exophthalmos, and hyperreflexia.
Describe the pathophysiological mechanism of atrial fibrillation.
Answer: Atrial fibrillation results from disorganized atrial electrical signals causing
ineffective atrial contraction and irregular ventricular response.
List three adverse effects of corticosteroid therapy.
Answer: Hypertension, hyperglycemia, osteoporosis.
Pathophysiology, Pharmacology, and Physical
Assessment
Final Exam Prep
2026
(With Solutions)
Multiple Choice Questions (MCQs)
A 55-year-old patient presents with chest pain radiating to the left arm. Troponin
levels are elevated. Which pathophysiological process is most likely responsible?
a) Vasospasm of coronary arteries
b) Myocardial ischemia due to atherosclerotic plaque rupture
c) Pericarditis
d) Pulmonary embolism
Answer: b) Myocardial ischemia due to atherosclerotic plaque rupture
Rationale: Elevated troponin indicates myocardial injury, commonly caused by
ischemia from atherosclerotic plaque rupture and thrombus formation.
Which pharmacologic agent is most appropriate for acute management of
anaphylaxis?
a) Diphenhydramine
b) Epinephrine
c) Prednisone
d) Albuterol
,Answer: b) Epinephrine
Rationale: Epinephrine rapidly reverses airway constriction and hypotension in
anaphylaxis by stimulating alpha and beta-adrenergic receptors.
When performing a cardiac assessment, which heart sound is best associated with
left ventricular failure?
a) S1
b) S2
c) S3
d) S4
Answer: c) S3
Rationale: S3 gallop reflects increased left ventricular filling pressures often seen in
heart failure.
A patient’s drug regimen includes digoxin. Which electrolyte imbalance increases
the risk of digoxin toxicity?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypercalcemia
Answer: b) Hypokalemia
Rationale: Low potassium potentiates digoxin binding to myocardial cells, increasing
toxicity risk.
In chronic kidney disease, which medication should be used cautiously to avoid
accumulation and toxicity?
,a) Morphine
b) Acetaminophen
c) Metformin
d) Ibuprofen
Answer: a) Morphine
Rationale: Morphine metabolites accumulate in renal impairment, risking respiratory
depression.
True/False Questions
True or False: Beta-blockers decrease cardiac output by blocking beta-1 receptors
in the heart.
Answer: True
Rationale: Beta-blockers reduce heart rate and contractility via beta-1 receptor
antagonism, decreasing cardiac output.
True or False: A widened pulse pressure is commonly seen in patients with aortic
regurgitation.
Answer: True
Rationale: Regurgitation causes increased stroke volume and runoff, widening pulse
pressure.
True or False: The Glasgow Coma Scale (GCS) evaluates motor, verbal, and ocular
responses for neurologic assessment.
Answer: True
Rationale: GCS assesses consciousness level using these three parameters.
, True or False: NSAIDs are the first-line treatment for heart failure.
Answer: False
Rationale: NSAIDs can worsen heart failure by causing fluid retention.
True or False: Pharmacokinetics describes what the drug does to the body.
Answer: False
Rationale: Pharmacokinetics describes what the body does to the drug (absorption,
distribution, metabolism, excretion).
Short Answer Questions
Explain the significance of Kussmaul breathing in metabolic acidosis.
Answer: Kussmaul breathing is a deep, labored respiratory pattern that helps lower
blood CO2 levels to compensate for metabolic acidosis by increasing respiratory
acid elimination.
What clinical signs would you expect in a patient with hyperthyroidism during
physical assessment?
Answer: Signs may include tachycardia, fine tremor, heat intolerance, weight loss,
exophthalmos, and hyperreflexia.
Describe the pathophysiological mechanism of atrial fibrillation.
Answer: Atrial fibrillation results from disorganized atrial electrical signals causing
ineffective atrial contraction and irregular ventricular response.
List three adverse effects of corticosteroid therapy.
Answer: Hypertension, hyperglycemia, osteoporosis.
