NR 283 PATHOPHYSIOLOGY EXAM
2B REVIEW: 350 REAL EXAM
QUESTIONS WITH CORRECT
ANSWERS & DETAILED RATIONALES
– CHAMBERLAIN 2026/2027
Cardiovascular Disorders
1. A patient reports chest pain that occurs only during exertion and is relieved
by rest. Which type of angina does this describe?
A) Stable Angina
B) Unstable Angina
C) Variant Angina
D) Silent Ischemia
Answer: A) Stable Angina
Rationale: Stable angina occurs predictably with physical activity or stress and is
relieved by rest or nitroglycerin. It reflects fixed atherosclerotic plaques limiting
coronary blood flow. Unlike unstable angina, it does not occur at rest or increase in
severity unexpectedly.
2. Unstable angina differs from stable angina because:
A) It occurs unpredictably
B) Pain is more severe or prolonged
C) It may indicate impending myocardial infarction
D) All of the above
Answer: D) All of the above
Rationale: Unstable angina is unpredictable, may occur at rest, and signals a higher
risk of myocardial infarction. It often involves ruptured plaques and partial
thrombosis, making immediate evaluation and treatment critical.
,3. Which is a modifiable risk factor for myocardial infarction?
A) Age
B) Gender
C) Hypertension
D) Family history
Answer: C) Hypertension
Rationale: Modifiable risk factors can be changed or managed, including
hypertension, smoking, diabetes, high cholesterol, and lifestyle habits. Non-
modifiable factors such as age, gender, and genetics cannot be altered.
4. Which pathophysiologic mechanism is most responsible for myocardial
ischemia?
A) Decreased oxygen supply due to coronary artery blockage
B) Increased cardiac output
C) Hypervolemia
D) Bradycardia
Answer: A) Decreased oxygen supply due to coronary artery blockage
Rationale: Myocardial ischemia occurs when oxygen delivery via coronary arteries
cannot meet myocardial demand. This is most often caused by atherosclerosis or
plaque rupture.
5. A patient with left-sided heart failure is likely to present with:
A) Peripheral edema
B) Pulmonary congestion
C) Jugular venous distension
D) Hepatomegaly
Answer: B) Pulmonary congestion
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary edema, dyspnea, and orthopnea. Right-sided failure primarily causes
systemic congestion and peripheral edema.
6. Right-sided heart failure most commonly results from:
A) Chronic pulmonary disease
B) Hypertension
,C) Aortic stenosis
D) Myocardial infarction
Answer: A) Chronic pulmonary disease
Rationale: Right-sided heart failure often arises from pulmonary hypertension
secondary to chronic lung diseases (cor pulmonale), leading to systemic venous
congestion.
7. Which compensatory mechanism involves the heart enlarging in response to
chronic volume overload?
A) Tachycardia
B) Ventricular remodeling
C) Peripheral vasoconstriction
D) Increased erythropoiesis
Answer: B) Ventricular remodeling
Rationale: Chronic volume or pressure overload leads to ventricular hypertrophy and
dilation (remodeling), which initially maintains cardiac output but eventually
contributes to heart failure progression.
8. Cardiac output is calculated as:
A) HR × BP
B) Stroke volume × Heart rate
C) Preload × Afterload
D) Contractility × Heart rate
Answer: B) Stroke volume × Heart rate
Rationale: Cardiac output (CO) is the volume of blood pumped by the heart per
minute, calculated as CO = Stroke Volume (SV) × Heart Rate (HR).
9. A patient presents with severe polyuria (12 L/day) and intense polydipsia
following a traumatic brain injury. The urine specific gravity is 1.002. Which
mechanism explains this condition?
A) Excessive secretion of antidiuretic hormone causing water retention
B) Insufficient insulin production leading to osmotic diuresis from hyperglycemia
C) Destruction of the posterior pituitary leading to a deficiency in antidiuretic
hormone
, D) Structural damage to the renal glomerulus causing massive protein loss
Answer: C) Destruction of the posterior pituitary leading to a deficiency in
antidiuretic hormone
Rationale: Traumatic brain injury can damage the hypothalamus or posterior
pituitary gland, arresting the synthesis or release of ADH, resulting in Central
Diabetes Insipidus. Without ADH, the aquaporin channels in the collecting ducts
remain closed, preventing water reabsorption, leaving urine highly dilute and
triggering dehydration and compensatory thirst.
10. A 65-year-old man with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to his back. Blood pressure is
180/100 mmHg in the right arm and 100/60 mmHg in the left arm. Which is the
most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection
Rationale: Aortic dissection presents with sudden, severe, tearing chest pain
radiating to the back, with pulse deficits or blood pressure differential between arms.
Risk factors include hypertension and connective tissue disorders.
11. A 55-year-old man with a history of hypertension presents with chest pain
that occurs with exertion and resolves with rest. ECG during pain shows ST-
segment depression. Which is the most likely diagnosis?
A) Stable angina
B) Unstable angina
C) Prinzmetal angina
D) Non-ST elevation myocardial infarction
Answer: A) Stable angina
Rationale: Stable angina is characterized by chest pain with exertion that resolves
with rest and is due to fixed coronary artery stenosis. ECG shows ST depression
during pain.
2B REVIEW: 350 REAL EXAM
QUESTIONS WITH CORRECT
ANSWERS & DETAILED RATIONALES
– CHAMBERLAIN 2026/2027
Cardiovascular Disorders
1. A patient reports chest pain that occurs only during exertion and is relieved
by rest. Which type of angina does this describe?
A) Stable Angina
B) Unstable Angina
C) Variant Angina
D) Silent Ischemia
Answer: A) Stable Angina
Rationale: Stable angina occurs predictably with physical activity or stress and is
relieved by rest or nitroglycerin. It reflects fixed atherosclerotic plaques limiting
coronary blood flow. Unlike unstable angina, it does not occur at rest or increase in
severity unexpectedly.
2. Unstable angina differs from stable angina because:
A) It occurs unpredictably
B) Pain is more severe or prolonged
C) It may indicate impending myocardial infarction
D) All of the above
Answer: D) All of the above
Rationale: Unstable angina is unpredictable, may occur at rest, and signals a higher
risk of myocardial infarction. It often involves ruptured plaques and partial
thrombosis, making immediate evaluation and treatment critical.
,3. Which is a modifiable risk factor for myocardial infarction?
A) Age
B) Gender
C) Hypertension
D) Family history
Answer: C) Hypertension
Rationale: Modifiable risk factors can be changed or managed, including
hypertension, smoking, diabetes, high cholesterol, and lifestyle habits. Non-
modifiable factors such as age, gender, and genetics cannot be altered.
4. Which pathophysiologic mechanism is most responsible for myocardial
ischemia?
A) Decreased oxygen supply due to coronary artery blockage
B) Increased cardiac output
C) Hypervolemia
D) Bradycardia
Answer: A) Decreased oxygen supply due to coronary artery blockage
Rationale: Myocardial ischemia occurs when oxygen delivery via coronary arteries
cannot meet myocardial demand. This is most often caused by atherosclerosis or
plaque rupture.
5. A patient with left-sided heart failure is likely to present with:
A) Peripheral edema
B) Pulmonary congestion
C) Jugular venous distension
D) Hepatomegaly
Answer: B) Pulmonary congestion
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary edema, dyspnea, and orthopnea. Right-sided failure primarily causes
systemic congestion and peripheral edema.
6. Right-sided heart failure most commonly results from:
A) Chronic pulmonary disease
B) Hypertension
,C) Aortic stenosis
D) Myocardial infarction
Answer: A) Chronic pulmonary disease
Rationale: Right-sided heart failure often arises from pulmonary hypertension
secondary to chronic lung diseases (cor pulmonale), leading to systemic venous
congestion.
7. Which compensatory mechanism involves the heart enlarging in response to
chronic volume overload?
A) Tachycardia
B) Ventricular remodeling
C) Peripheral vasoconstriction
D) Increased erythropoiesis
Answer: B) Ventricular remodeling
Rationale: Chronic volume or pressure overload leads to ventricular hypertrophy and
dilation (remodeling), which initially maintains cardiac output but eventually
contributes to heart failure progression.
8. Cardiac output is calculated as:
A) HR × BP
B) Stroke volume × Heart rate
C) Preload × Afterload
D) Contractility × Heart rate
Answer: B) Stroke volume × Heart rate
Rationale: Cardiac output (CO) is the volume of blood pumped by the heart per
minute, calculated as CO = Stroke Volume (SV) × Heart Rate (HR).
9. A patient presents with severe polyuria (12 L/day) and intense polydipsia
following a traumatic brain injury. The urine specific gravity is 1.002. Which
mechanism explains this condition?
A) Excessive secretion of antidiuretic hormone causing water retention
B) Insufficient insulin production leading to osmotic diuresis from hyperglycemia
C) Destruction of the posterior pituitary leading to a deficiency in antidiuretic
hormone
, D) Structural damage to the renal glomerulus causing massive protein loss
Answer: C) Destruction of the posterior pituitary leading to a deficiency in
antidiuretic hormone
Rationale: Traumatic brain injury can damage the hypothalamus or posterior
pituitary gland, arresting the synthesis or release of ADH, resulting in Central
Diabetes Insipidus. Without ADH, the aquaporin channels in the collecting ducts
remain closed, preventing water reabsorption, leaving urine highly dilute and
triggering dehydration and compensatory thirst.
10. A 65-year-old man with a history of hypertension presents with sudden
onset of severe, tearing chest pain radiating to his back. Blood pressure is
180/100 mmHg in the right arm and 100/60 mmHg in the left arm. Which is the
most likely diagnosis?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Answer: C) Aortic dissection
Rationale: Aortic dissection presents with sudden, severe, tearing chest pain
radiating to the back, with pulse deficits or blood pressure differential between arms.
Risk factors include hypertension and connective tissue disorders.
11. A 55-year-old man with a history of hypertension presents with chest pain
that occurs with exertion and resolves with rest. ECG during pain shows ST-
segment depression. Which is the most likely diagnosis?
A) Stable angina
B) Unstable angina
C) Prinzmetal angina
D) Non-ST elevation myocardial infarction
Answer: A) Stable angina
Rationale: Stable angina is characterized by chest pain with exertion that resolves
with rest and is due to fixed coronary artery stenosis. ECG shows ST depression
during pain.
