NR 507 Weeks 4–5: Advanced Pathophysiology of Cardiovascular and
Respiratory Systems 2026 |Chamberlain
1. A patient presents with dyspnea on exertion, orthopnea, and paroxysmal
nocturnal dyspnea. Which underlying pathophysiology is most likely?
A. Right-sided heart failure causing systemic congestion
B. Left-sided heart failure causing pulmonary congestion
C. Peripheral artery disease causing claudication
D. Pulmonary embolism causing dead space ventilation
Answer: B
Rationale: Left-sided heart failure results in blood backing up into the pulmonary
circulation, leading to symptoms of pulmonary edema such as dyspnea and orthopnea.
2. Which clinical manifestation is uniquely associated with right-sided heart
failure?
A. Jugular venous distention
B. Productive cough with pink frothy sputum
C. Pulmonary crackles
D. Orthopnea
Answer: A
Rationale: Right-sided heart failure causes blood to back up into the systemic venous
system, leading to jugular venous distention (JVD), hepatomegaly, and peripheral edema.
,3. In the renin-angiotensin-aldosterone system (RAAS), what is the primary
effect of Angiotensin II on blood vessels?
A. Systemic vasoconstriction
B. Increased capillary permeability
C. Systemic vasodilation
D. Decreased peripheral resistance
Answer: A
Rationale: Angiotensin II is a potent vasoconstrictor that increases systemic vascular
resistance and blood pressure.
4. A patient with long-standing hypertension is diagnosed with left ventricular
hypertrophy. This is an example of which type of cellular adaptation?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: Hypertrophy is an increase in the size of cells (in this case, cardiac myocytes) in
response to increased workload/pressure.
5. What is the primary pathophysiological mechanism behind stable angina?
A. Predictable myocardial ischemia due to a fixed atherosclerotic plaque
B. Sudden rupture of an unstable plaque with thrombus
C. Vasospasm of the coronary arteries at rest
D. Complete occlusion of the coronary artery leading to necrosis
Answer: A
Rationale: Stable angina occurs when myocardial oxygen demand exceeds supply due to
fixed narrowing, usually during physical exertion.
, 6. Which laboratory value is the most specific indicator of myocardial infarction
(MI)?
A. Troponin I
B. C-reactive protein (CRP)
C. Creatine Kinase (CK-MB)
D. Brain Natriuretic Peptide (BNP)
Answer: A
Rationale: Cardiac troponins (I and T) are highly specific to myocardial tissue and are the
preferred markers for diagnosing MI.
7. A patient is diagnosed with Mitral Stenosis. Which chamber of the heart will
likely undergo the most significant pressure increase?
A. Left Ventricle
B. Left Atrium
C. Right Ventricle
D. Aorta
Answer: B
Rationale: In mitral stenosis, the opening of the mitral valve is narrowed, impeding blood
flow from the left atrium to the left ventricle, causing left atrial pressure to rise.
8. Which type of cardiomyopathy is characterized by massive ventricular
hypertrophy and is a leading cause of sudden cardiac death in young athletes?
A. Dilated cardiomyopathy
B. Restrictive cardiomyopathy
C. Hypertrophic obstructive cardiomyopathy
D. Peripartum cardiomyopathy
Answer: C
Rationale: Hypertrophic obstructive cardiomyopathy (HOCM) involves asymmetric septal
hypertrophy which can cause outflow obstruction and arrhythmias.
Respiratory Systems 2026 |Chamberlain
1. A patient presents with dyspnea on exertion, orthopnea, and paroxysmal
nocturnal dyspnea. Which underlying pathophysiology is most likely?
A. Right-sided heart failure causing systemic congestion
B. Left-sided heart failure causing pulmonary congestion
C. Peripheral artery disease causing claudication
D. Pulmonary embolism causing dead space ventilation
Answer: B
Rationale: Left-sided heart failure results in blood backing up into the pulmonary
circulation, leading to symptoms of pulmonary edema such as dyspnea and orthopnea.
2. Which clinical manifestation is uniquely associated with right-sided heart
failure?
A. Jugular venous distention
B. Productive cough with pink frothy sputum
C. Pulmonary crackles
D. Orthopnea
Answer: A
Rationale: Right-sided heart failure causes blood to back up into the systemic venous
system, leading to jugular venous distention (JVD), hepatomegaly, and peripheral edema.
,3. In the renin-angiotensin-aldosterone system (RAAS), what is the primary
effect of Angiotensin II on blood vessels?
A. Systemic vasoconstriction
B. Increased capillary permeability
C. Systemic vasodilation
D. Decreased peripheral resistance
Answer: A
Rationale: Angiotensin II is a potent vasoconstrictor that increases systemic vascular
resistance and blood pressure.
4. A patient with long-standing hypertension is diagnosed with left ventricular
hypertrophy. This is an example of which type of cellular adaptation?
A. Hyperplasia
B. Hypertrophy
C. Atrophy
D. Metaplasia
Answer: B
Rationale: Hypertrophy is an increase in the size of cells (in this case, cardiac myocytes) in
response to increased workload/pressure.
5. What is the primary pathophysiological mechanism behind stable angina?
A. Predictable myocardial ischemia due to a fixed atherosclerotic plaque
B. Sudden rupture of an unstable plaque with thrombus
C. Vasospasm of the coronary arteries at rest
D. Complete occlusion of the coronary artery leading to necrosis
Answer: A
Rationale: Stable angina occurs when myocardial oxygen demand exceeds supply due to
fixed narrowing, usually during physical exertion.
, 6. Which laboratory value is the most specific indicator of myocardial infarction
(MI)?
A. Troponin I
B. C-reactive protein (CRP)
C. Creatine Kinase (CK-MB)
D. Brain Natriuretic Peptide (BNP)
Answer: A
Rationale: Cardiac troponins (I and T) are highly specific to myocardial tissue and are the
preferred markers for diagnosing MI.
7. A patient is diagnosed with Mitral Stenosis. Which chamber of the heart will
likely undergo the most significant pressure increase?
A. Left Ventricle
B. Left Atrium
C. Right Ventricle
D. Aorta
Answer: B
Rationale: In mitral stenosis, the opening of the mitral valve is narrowed, impeding blood
flow from the left atrium to the left ventricle, causing left atrial pressure to rise.
8. Which type of cardiomyopathy is characterized by massive ventricular
hypertrophy and is a leading cause of sudden cardiac death in young athletes?
A. Dilated cardiomyopathy
B. Restrictive cardiomyopathy
C. Hypertrophic obstructive cardiomyopathy
D. Peripartum cardiomyopathy
Answer: C
Rationale: Hypertrophic obstructive cardiomyopathy (HOCM) involves asymmetric septal
hypertrophy which can cause outflow obstruction and arrhythmias.
