NURS 660 Exam 4 | Questions and
Answers Plus Rationales | 2026
Update | 100% Correct
1. Which mechanism primarily contributes to systolic heart failure?
A. Impaired ventricular relaxation
B. Reduced myocardial contractility
C. Increased ventricular compliance
D. Decreased preload
Answer: B
Rationale: Systolic HF is characterized by reduced ejection fraction due to impaired
contractility.
2. Which biomarker is most specific for diagnosing acute myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I
D. BNP
Answer: C
Rationale: Troponin I is highly specific for myocardial cell injury.
3. Long-standing hypertension leads to which structural cardiac change?
A. Ventricular dilation
B. Eccentric hypertrophy
C. Concentric hypertrophy
D. Septal thinning
Answer: C
Rationale: Chronic pressure overload causes concentric LV hypertrophy.
,4. Which condition increases afterload the most?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypovolemia
D. Bradycardia
Answer: B
Rationale: Aortic stenosis significantly increases resistance to ventricular ejection.
5. What is the primary cause of cardiogenic shock?
A. Decreased systemic vascular resistance
B. Loss of myocardial pump function
C. Hypovolemia
D. Sepsis
Answer: B
Rationale: Cardiogenic shock results from failure of the heart to pump effectively.
5. What is the primary cause of cardiogenic shock?
A. Decreased systemic vascular resistance
B. Loss of myocardial pump function
C. Hypovolemia
D. Sepsis
Answer: B
Rationale: Cardiogenic shock occurs when the heart cannot pump effectively, resulting in
inadequate tissue perfusion despite adequate volume.
6. Which condition most significantly increases left ventricular afterload?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypovolemia
D. Bradycardia
Answer: B
Rationale: Aortic stenosis creates resistance to ventricular ejection, markedly increasing
afterload.
7. Long-standing hypertension most commonly results in which cardiac adaptation?
A. Ventricular dilation
, B. Eccentric hypertrophy
C. Concentric hypertrophy
D. Reduced wall thickness
Answer: C
Rationale: Chronic pressure overload causes concentric hypertrophy due to increased wall
thickness.
8. Which biomarker is most specific for myocardial cell injury?
A. CK-MB
B. Myoglobin
C. Troponin I
D. BNP
Answer: C
Rationale: Troponin I is highly specific and sensitive for myocardial injury.
9. A reduced ejection fraction indicates dysfunction during which phase of the cardiac
cycle?
A. Diastole
B. Ventricular filling
C. Systole
D. Isovolumetric relaxation
Answer: C
Rationale: Ejection fraction reflects systolic pumping ability.
10. Which compensatory mechanism initially maintains cardiac output in heart failure?
A. Decreased sympathetic stimulation
B. Renin-angiotensin-aldosterone activation
C. Reduced preload
D. Decreased heart rate
Answer: B
Rationale: RAAS activation increases volume and preload to temporarily maintain cardiac
output.
Pulmonary
Answers Plus Rationales | 2026
Update | 100% Correct
1. Which mechanism primarily contributes to systolic heart failure?
A. Impaired ventricular relaxation
B. Reduced myocardial contractility
C. Increased ventricular compliance
D. Decreased preload
Answer: B
Rationale: Systolic HF is characterized by reduced ejection fraction due to impaired
contractility.
2. Which biomarker is most specific for diagnosing acute myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I
D. BNP
Answer: C
Rationale: Troponin I is highly specific for myocardial cell injury.
3. Long-standing hypertension leads to which structural cardiac change?
A. Ventricular dilation
B. Eccentric hypertrophy
C. Concentric hypertrophy
D. Septal thinning
Answer: C
Rationale: Chronic pressure overload causes concentric LV hypertrophy.
,4. Which condition increases afterload the most?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypovolemia
D. Bradycardia
Answer: B
Rationale: Aortic stenosis significantly increases resistance to ventricular ejection.
5. What is the primary cause of cardiogenic shock?
A. Decreased systemic vascular resistance
B. Loss of myocardial pump function
C. Hypovolemia
D. Sepsis
Answer: B
Rationale: Cardiogenic shock results from failure of the heart to pump effectively.
5. What is the primary cause of cardiogenic shock?
A. Decreased systemic vascular resistance
B. Loss of myocardial pump function
C. Hypovolemia
D. Sepsis
Answer: B
Rationale: Cardiogenic shock occurs when the heart cannot pump effectively, resulting in
inadequate tissue perfusion despite adequate volume.
6. Which condition most significantly increases left ventricular afterload?
A. Mitral regurgitation
B. Aortic stenosis
C. Hypovolemia
D. Bradycardia
Answer: B
Rationale: Aortic stenosis creates resistance to ventricular ejection, markedly increasing
afterload.
7. Long-standing hypertension most commonly results in which cardiac adaptation?
A. Ventricular dilation
, B. Eccentric hypertrophy
C. Concentric hypertrophy
D. Reduced wall thickness
Answer: C
Rationale: Chronic pressure overload causes concentric hypertrophy due to increased wall
thickness.
8. Which biomarker is most specific for myocardial cell injury?
A. CK-MB
B. Myoglobin
C. Troponin I
D. BNP
Answer: C
Rationale: Troponin I is highly specific and sensitive for myocardial injury.
9. A reduced ejection fraction indicates dysfunction during which phase of the cardiac
cycle?
A. Diastole
B. Ventricular filling
C. Systole
D. Isovolumetric relaxation
Answer: C
Rationale: Ejection fraction reflects systolic pumping ability.
10. Which compensatory mechanism initially maintains cardiac output in heart failure?
A. Decreased sympathetic stimulation
B. Renin-angiotensin-aldosterone activation
C. Reduced preload
D. Decreased heart rate
Answer: B
Rationale: RAAS activation increases volume and preload to temporarily maintain cardiac
output.
Pulmonary
