NR 507 Final Exam - Advanced
Pathophysiology (2026/2027) Actual
Questions & Answers (Chamberlain)
100% Guarantee Pass | 200 Verified
Questions - 134 Questions with
Answers.
1. A patient with chronic heart failure has a reduced ejection fraction.
Which compensatory mechanism initially maintains cardiac output but
ultimately increases myocardial oxygen demand?
A) Downregulation of beta-1 adrenergic receptors
B) Activation of the renin-angiotensin-aldosterone system (RAAS)
C) Increased atrial natriuretic peptide secretion
D) Enhanced parasympathetic tone
Correct Answer: B
Rationale: In heart failure, reduced cardiac output triggers RAAS
activation, causing vasoconstriction and sodium/water retention, which
increases preload and afterload. This initially supports cardiac output via
, the Frank-Starling mechanism but increases wall stress and myocardial
oxygen demand. Downregulation of beta-1 receptors is a compensatory
response but does not increase oxygen demand initially; atrial natriuretic
peptide opposes RAAS; parasympathetic tone is reduced, not enhanced .
2. A patient with chronic obstructive pulmonary disease (COPD) develops
cor pulmonale. Which of the following best explains the pathogenesis?
A) Hypoxic pulmonary vasoconstriction leading to pulmonary
hypertension and right ventricular hypertrophy
B) Systemic hypertension causing left ventricular failure
C) Increased pulmonary blood flow due to left-to-right shunt
D) Pulmonary embolism causing acute right heart strain
Correct Answer: A
Rationale: In COPD, chronic hypoxia causes pulmonary arteriolar
vasoconstriction, leading to pulmonary hypertension, increased right
ventricular afterload, and eventually right ventricular hypertrophy and
failure (cor pulmonale). Systemic hypertension affects the left ventricle,
not the right; left-to-right shunts are not related to COPD; pulmonary
embolism is an acute cause, not the chronic mechanism in COPD .
, 3. A patient with chronic liver disease has prolonged prothrombin time
(PT) and activated partial thromboplastin time (aPTT). Which of the
following is the primary mechanism?
A) Decreased synthesis of clotting factors II, VII, IX, and X
B) Increased synthesis of protein C and S
C) Thrombocytopenia due to splenic sequestration
D) Vitamin K deficiency due to biliary obstruction
Correct Answer: A
Rationale: The liver synthesizes most coagulation factors, including the
vitamin K-dependent factors (II, VII, IX, X). In chronic liver disease,
decreased synthesis leads to prolonged PT and aPTT. Increased protein
C/S would cause a hypercoagulable state; thrombocytopenia affects
platelet count, not PT/aPTT; vitamin K deficiency may occur but the
primary mechanism is impaired hepatic synthesis .
4. Which of the following is the most common cause of infective
endocarditis?
A) Staphylococcus aureus
,
B) Streptococcus viridans
C) Enterococcus faecalis
D) Coagulase-negative staphylococci
Correct Answer: B
Rationale: Streptococcus viridans is the most common cause of subacute
infective endocarditis, particularly in patients with pre-existing valvular
disease. Staphylococcus aureus is the most common cause of acute
infective endocarditis and is associated with intravenous drug use and
prosthetic valves.
5. A patient is diagnosed with left-sided heart failure. Which
pathophysiological change is most likely to occur?
A) Jugular venous distention
B) Peripheral edema
C) Pulmonary congestion and edema
Pathophysiology (2026/2027) Actual
Questions & Answers (Chamberlain)
100% Guarantee Pass | 200 Verified
Questions - 134 Questions with
Answers.
1. A patient with chronic heart failure has a reduced ejection fraction.
Which compensatory mechanism initially maintains cardiac output but
ultimately increases myocardial oxygen demand?
A) Downregulation of beta-1 adrenergic receptors
B) Activation of the renin-angiotensin-aldosterone system (RAAS)
C) Increased atrial natriuretic peptide secretion
D) Enhanced parasympathetic tone
Correct Answer: B
Rationale: In heart failure, reduced cardiac output triggers RAAS
activation, causing vasoconstriction and sodium/water retention, which
increases preload and afterload. This initially supports cardiac output via
, the Frank-Starling mechanism but increases wall stress and myocardial
oxygen demand. Downregulation of beta-1 receptors is a compensatory
response but does not increase oxygen demand initially; atrial natriuretic
peptide opposes RAAS; parasympathetic tone is reduced, not enhanced .
2. A patient with chronic obstructive pulmonary disease (COPD) develops
cor pulmonale. Which of the following best explains the pathogenesis?
A) Hypoxic pulmonary vasoconstriction leading to pulmonary
hypertension and right ventricular hypertrophy
B) Systemic hypertension causing left ventricular failure
C) Increased pulmonary blood flow due to left-to-right shunt
D) Pulmonary embolism causing acute right heart strain
Correct Answer: A
Rationale: In COPD, chronic hypoxia causes pulmonary arteriolar
vasoconstriction, leading to pulmonary hypertension, increased right
ventricular afterload, and eventually right ventricular hypertrophy and
failure (cor pulmonale). Systemic hypertension affects the left ventricle,
not the right; left-to-right shunts are not related to COPD; pulmonary
embolism is an acute cause, not the chronic mechanism in COPD .
, 3. A patient with chronic liver disease has prolonged prothrombin time
(PT) and activated partial thromboplastin time (aPTT). Which of the
following is the primary mechanism?
A) Decreased synthesis of clotting factors II, VII, IX, and X
B) Increased synthesis of protein C and S
C) Thrombocytopenia due to splenic sequestration
D) Vitamin K deficiency due to biliary obstruction
Correct Answer: A
Rationale: The liver synthesizes most coagulation factors, including the
vitamin K-dependent factors (II, VII, IX, X). In chronic liver disease,
decreased synthesis leads to prolonged PT and aPTT. Increased protein
C/S would cause a hypercoagulable state; thrombocytopenia affects
platelet count, not PT/aPTT; vitamin K deficiency may occur but the
primary mechanism is impaired hepatic synthesis .
4. Which of the following is the most common cause of infective
endocarditis?
A) Staphylococcus aureus
,
B) Streptococcus viridans
C) Enterococcus faecalis
D) Coagulase-negative staphylococci
Correct Answer: B
Rationale: Streptococcus viridans is the most common cause of subacute
infective endocarditis, particularly in patients with pre-existing valvular
disease. Staphylococcus aureus is the most common cause of acute
infective endocarditis and is associated with intravenous drug use and
prosthetic valves.
5. A patient is diagnosed with left-sided heart failure. Which
pathophysiological change is most likely to occur?
A) Jugular venous distention
B) Peripheral edema
C) Pulmonary congestion and edema
