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NURS 5315
Advanced Pathophysiology
Exam 3 Practice Exam
Cardiovascular, Respiratory, and Renal Disorders; clinical case questions
emphasizing mechanisms, distinguishing findings, diagnostic patterns, and
progression.
100 A-D 100
Practice Questions Multiple Choice Explained Answers
Original study and revision material • PassPoint Pro
, NURS 5315 • Exam 3 Practice Exam
Exam 3 Practice Exam
Focus: Cardiovascular, Respiratory, and Renal Disorders; clinical case questions emphasizing mechanisms,
distinguishing findings, diagnostic patterns, and progression.
Instructions: Choose the single best answer from A–D for every question. Complete the questions first, then use
the answer key and detailed explanations at the end.
1. A patient complains of palpitations and has an irregularly irregular pulse. The clinician
identifies which primary mechanism?
A. Disorganized atrial electrical activity abolishes coordinated atrial contraction
B. Incompetent mitral closure allows left ventricular blood to return to the atrium in systole
C. Pericardial pressure restricts ventricular filling and lowers stroke volume
D. Sustained ischemia causes myocardial cell death and release of intracellular proteins
2. A smoker develops progressive dyspnea with a hyperinflated chest. Which mechanism
connects the clinical findings?
A. Thromboembolic obstruction causes ventilation-perfusion mismatch and increases right ventricular afterload
B. Alveolar wall destruction reduces elastic recoil and causes air trapping
C. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
D. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
3. An older patient with longstanding hypertension has exertional dyspnea but normal
ejection fraction. Which underlying process best explains the findings?
A. Inflammatory vasodilation and capillary leak reduce effective vascular tone
B. Critical pump failure reduces cardiac output despite elevated filling pressure
C. A stiff noncompliant ventricle elevates filling pressure despite preserved contraction
D. Calcific valve narrowing imposes pressure overload on the left ventricle
4. A patient has severe hypertension, confusion, and acute kidney dysfunction. Which
mechanism connects the clinical findings?
A. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
B. Reversible airway smooth-muscle constriction and inflammatory edema obstruct airflow
C. Thromboembolic obstruction causes ventilation-perfusion mismatch and increases right ventricular afterload
D. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
5. An older patient with longstanding hypertension has exertional dyspnea but normal
ejection fraction. Which diagnostic signature is most consistent with these findings?
A. Echocardiography may show preserved ejection fraction and diastolic dysfunction
B. Echocardiography shows a reduced ejection fraction
C. Low systemic vascular resistance and elevated lactate may be present
D. Echocardiography shows increased transvalvular velocity and reduced valve area
UTA • Advanced Pathophysiology • PassPoint Pro Page 2
, NURS 5315 • Exam 3 Practice Exam
6. A patient with severe bacterial pneumonia is hypotensive with warm extremities early in
shock. Which eventual outcome is most closely linked with this process?
A. Syncope angina and heart failure can progress
B. Refractory hypotension and multiorgan failure may develop
C. Progressive ventricular remodeling may cause worsening failure
D. Atrial fibrillation and recurrent pulmonary edema may develop
7. A patient after chest trauma develops hypotension, distended neck veins, and muffled
heart sounds. Which pathophysiologic mechanism most directly accounts for this
presentation?
A. Fixed coronary narrowing creates supply-demand mismatch during exertion without acute necrosis
B. Disorganized atrial electrical activity abolishes coordinated atrial contraction
C. Pericardial pressure restricts ventricular filling and lowers stroke volume
D. Sustained ischemia causes myocardial cell death and release of intracellular proteins
8. A trauma patient has sudden hypotension, unilateral absent breath sounds, and
worsening respiratory distress. Which investigation result would most support the working
explanation?
A. Fractional excretion of sodium is often below 1 percent in uncomplicated cases
B. Chest imaging may show lobar or focal airspace opacity
C. Sleep testing reveals repeated obstructive apneas and hypopneas
D. Clinical diagnosis is supported by unilateral absent breath sounds and hemodynamic compromise
9. A patient with diabetes has persistent low eGFR and anemia. Which diagnostic signature
is most consistent with these findings?
A. Reduced eGFR for at least three months with albuminuria or structural damage
B. Proteinuria above 3.5 grams per day with hypoalbuminemia
C. Red blood cell casts and dysmorphic erythrocytes appear in urine
D. Fractional excretion of sodium is often elevated after established ischemic injury
10. A patient has episodic wheeze and breathlessness after allergen exposure. What is the
most likely causal pathway?
A. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
B. Reversible airway smooth-muscle constriction and inflammatory edema obstruct airflow
C. Alveolar wall destruction reduces elastic recoil and causes air trapping
D. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
11. A patient with severe dehydration develops rising creatinine and oliguria. Which
investigation result would most support the working explanation?
A. Chest imaging may show lobar or focal airspace opacity
B. Clinical diagnosis is supported by unilateral absent breath sounds and hemodynamic compromise
C. Fractional excretion of sodium is often below 1 percent in uncomplicated cases
D. Sleep testing reveals repeated obstructive apneas and hypopneas
UTA • Advanced Pathophysiology • PassPoint Pro Page 3
NURS 5315
Advanced Pathophysiology
Exam 3 Practice Exam
Cardiovascular, Respiratory, and Renal Disorders; clinical case questions
emphasizing mechanisms, distinguishing findings, diagnostic patterns, and
progression.
100 A-D 100
Practice Questions Multiple Choice Explained Answers
Original study and revision material • PassPoint Pro
, NURS 5315 • Exam 3 Practice Exam
Exam 3 Practice Exam
Focus: Cardiovascular, Respiratory, and Renal Disorders; clinical case questions emphasizing mechanisms,
distinguishing findings, diagnostic patterns, and progression.
Instructions: Choose the single best answer from A–D for every question. Complete the questions first, then use
the answer key and detailed explanations at the end.
1. A patient complains of palpitations and has an irregularly irregular pulse. The clinician
identifies which primary mechanism?
A. Disorganized atrial electrical activity abolishes coordinated atrial contraction
B. Incompetent mitral closure allows left ventricular blood to return to the atrium in systole
C. Pericardial pressure restricts ventricular filling and lowers stroke volume
D. Sustained ischemia causes myocardial cell death and release of intracellular proteins
2. A smoker develops progressive dyspnea with a hyperinflated chest. Which mechanism
connects the clinical findings?
A. Thromboembolic obstruction causes ventilation-perfusion mismatch and increases right ventricular afterload
B. Alveolar wall destruction reduces elastic recoil and causes air trapping
C. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
D. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
3. An older patient with longstanding hypertension has exertional dyspnea but normal
ejection fraction. Which underlying process best explains the findings?
A. Inflammatory vasodilation and capillary leak reduce effective vascular tone
B. Critical pump failure reduces cardiac output despite elevated filling pressure
C. A stiff noncompliant ventricle elevates filling pressure despite preserved contraction
D. Calcific valve narrowing imposes pressure overload on the left ventricle
4. A patient has severe hypertension, confusion, and acute kidney dysfunction. Which
mechanism connects the clinical findings?
A. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
B. Reversible airway smooth-muscle constriction and inflammatory edema obstruct airflow
C. Thromboembolic obstruction causes ventilation-perfusion mismatch and increases right ventricular afterload
D. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
5. An older patient with longstanding hypertension has exertional dyspnea but normal
ejection fraction. Which diagnostic signature is most consistent with these findings?
A. Echocardiography may show preserved ejection fraction and diastolic dysfunction
B. Echocardiography shows a reduced ejection fraction
C. Low systemic vascular resistance and elevated lactate may be present
D. Echocardiography shows increased transvalvular velocity and reduced valve area
UTA • Advanced Pathophysiology • PassPoint Pro Page 2
, NURS 5315 • Exam 3 Practice Exam
6. A patient with severe bacterial pneumonia is hypotensive with warm extremities early in
shock. Which eventual outcome is most closely linked with this process?
A. Syncope angina and heart failure can progress
B. Refractory hypotension and multiorgan failure may develop
C. Progressive ventricular remodeling may cause worsening failure
D. Atrial fibrillation and recurrent pulmonary edema may develop
7. A patient after chest trauma develops hypotension, distended neck veins, and muffled
heart sounds. Which pathophysiologic mechanism most directly accounts for this
presentation?
A. Fixed coronary narrowing creates supply-demand mismatch during exertion without acute necrosis
B. Disorganized atrial electrical activity abolishes coordinated atrial contraction
C. Pericardial pressure restricts ventricular filling and lowers stroke volume
D. Sustained ischemia causes myocardial cell death and release of intracellular proteins
8. A trauma patient has sudden hypotension, unilateral absent breath sounds, and
worsening respiratory distress. Which investigation result would most support the working
explanation?
A. Fractional excretion of sodium is often below 1 percent in uncomplicated cases
B. Chest imaging may show lobar or focal airspace opacity
C. Sleep testing reveals repeated obstructive apneas and hypopneas
D. Clinical diagnosis is supported by unilateral absent breath sounds and hemodynamic compromise
9. A patient with diabetes has persistent low eGFR and anemia. Which diagnostic signature
is most consistent with these findings?
A. Reduced eGFR for at least three months with albuminuria or structural damage
B. Proteinuria above 3.5 grams per day with hypoalbuminemia
C. Red blood cell casts and dysmorphic erythrocytes appear in urine
D. Fractional excretion of sodium is often elevated after established ischemic injury
10. A patient has episodic wheeze and breathlessness after allergen exposure. What is the
most likely causal pathway?
A. Abrupt marked blood pressure elevation overwhelms autoregulation and damages endothelium
B. Reversible airway smooth-muscle constriction and inflammatory edema obstruct airflow
C. Alveolar wall destruction reduces elastic recoil and causes air trapping
D. Inflammatory alveolar-capillary injury causes protein-rich edema and impaired gas exchange
11. A patient with severe dehydration develops rising creatinine and oliguria. Which
investigation result would most support the working explanation?
A. Chest imaging may show lobar or focal airspace opacity
B. Clinical diagnosis is supported by unilateral absent breath sounds and hemodynamic compromise
C. Fractional excretion of sodium is often below 1 percent in uncomplicated cases
D. Sleep testing reveals repeated obstructive apneas and hypopneas
UTA • Advanced Pathophysiology • PassPoint Pro Page 3
