NURS 7470 Exam 3 Practice
Questions | Verified Answers,
Complete Solutions
**1. A 65-year-old patient with a history of hypertension presents with
shortness of breath and peripheral edema. Which pathophysiological
mechanism best explains the progression from chronic hypertension to
heart failure?**
A. Decreased cardiac contractility due to myocardial infarction.
B. Increased workload on the heart leading to myocardial remodeling.
C. Inadequate relaxation of the ventricles due to valvular stenosis.
D. Excessive vasoconstriction leading to decreased afterload.
**Answer: B**
**Rationale:** Chronic hypertension increases the workload on the left
ventricle. To compensate, the myocardium hypertrophies (remodels).
Over time, this remodeling becomes maladaptive, leading to diastolic
dysfunction and eventually systolic failure .
**2. A patient is diagnosed with an autoimmune disorder. What is the
fundamental pathophysiological issue in this condition?**
A. The immune system is underactive, failing to fight infections.
B. The immune system attacks the body's own healthy cells and tissues.
,C. There is an overproduction of antibodies against environmental
allergens.
D. A virus causes a direct cytolytic effect on immune cells.
**Answer: B**
**Rationale:** Autoimmune disorders are characterized by a
breakdown of self-tolerance, where the immune system fails to
recognize "self" from "non-self" and mounts an immune response
against its own cells and tissues .
**3. A patient with Chronic Obstructive Pulmonary Disease (COPD) has
difficulty exhaling. What is the primary structural change in the lungs
that causes this?**
A. Fibrosis and thickening of the alveolar membrane.
B. Chronic bronchoconstriction of the large airways.
C. Destruction of the alveolar walls and loss of elastic recoil.
D. Excessive surfactant production leading to decreased compliance.
**Answer: C**
**Rationale:** The key pathophysiological processes in COPD are
emphysema (destruction of alveolar walls) and chronic bronchitis. The
loss of elastic recoil from alveolar destruction prevents the airways
from staying open during exhalation, leading to air trapping .
**4. In a patient with hyperthyroidism, which cardiovascular change
would the practitioner expect to see?**
A. Decreased heart rate and decreased cardiac output.
,B. Bradycardia and prolonged QT interval.
C. Increased heart rate and increased cardiac output.
D. Vasodilation and significant hypotension.
**Answer: C**
**Rationale:** Excessive thyroid hormones (hyperthyroidism)
stimulate beta-adrenergic receptors, increasing the heart rate and
myocardial contractility, which results in an elevated cardiac output .
**5. The chronic inflammation seen in Rheumatoid Arthritis (RA)
primarily leads to:**
A. Degeneration of articular cartilage due to mechanical stress.
B. Excessive bone deposition leading to joint stiffness.
C. Destruction of cartilage, bone erosion, and joint deformity.
D. Ischemia of the synovial membrane.
**Answer: C**
**Rationale:** In RA, the inflammatory process (driven by cytokines
like TNF-alpha) leads to synovitis, which subsequently causes pannus
formation. The pannus invades and destroys cartilage and erodes
underlying bone, leading to permanent joint deformities .
**6. A patient with chronic kidney disease (CKD) is found to be anemic.
What is the most likely pathophysiological cause?**
A. Iron deficiency due to poor dietary intake.
B. Chronic blood loss from uremic gastritis.
, C. Decreased production of erythropoietin by the kidneys.
D. Increased destruction of red blood cells by the spleen.
**Answer: C**
**Rationale:** The kidneys produce erythropoietin (EPO), which
stimulates red blood cell production in the bone marrow. In CKD, the
damaged kidneys cannot produce enough EPO, leading to anemia .
**7. A patient presents with pain crisis due to sickle cell disease. The
pain is primarily caused by:**
A. Hemolysis of red blood cells releasing inflammatory mediators.
B. Vaso-occlusion leading to ischemia and tissue hypoxia.
C. Neuropathic damage from chronic hyperviscosity.
D. Autoimmune destruction of joint cartilage.
**Answer: B**
**Rationale:** In sickle cell disease, deoxygenated hemoglobin S
polymerizes, causing red blood cells to become rigid and sickle-shaped.
These cells obstruct blood flow in small vessels (vaso-occlusion), leading
to ischemia, infarction, and severe pain .
**8. Which of the following best describes the primary defect in Type 2
Diabetes Mellitus?**
A. Autoimmune destruction of pancreatic beta cells.
B. Insulin resistance in peripheral tissues and impaired insulin secretion.
C. Excessive production of glucagon by the alpha cells.
Questions | Verified Answers,
Complete Solutions
**1. A 65-year-old patient with a history of hypertension presents with
shortness of breath and peripheral edema. Which pathophysiological
mechanism best explains the progression from chronic hypertension to
heart failure?**
A. Decreased cardiac contractility due to myocardial infarction.
B. Increased workload on the heart leading to myocardial remodeling.
C. Inadequate relaxation of the ventricles due to valvular stenosis.
D. Excessive vasoconstriction leading to decreased afterload.
**Answer: B**
**Rationale:** Chronic hypertension increases the workload on the left
ventricle. To compensate, the myocardium hypertrophies (remodels).
Over time, this remodeling becomes maladaptive, leading to diastolic
dysfunction and eventually systolic failure .
**2. A patient is diagnosed with an autoimmune disorder. What is the
fundamental pathophysiological issue in this condition?**
A. The immune system is underactive, failing to fight infections.
B. The immune system attacks the body's own healthy cells and tissues.
,C. There is an overproduction of antibodies against environmental
allergens.
D. A virus causes a direct cytolytic effect on immune cells.
**Answer: B**
**Rationale:** Autoimmune disorders are characterized by a
breakdown of self-tolerance, where the immune system fails to
recognize "self" from "non-self" and mounts an immune response
against its own cells and tissues .
**3. A patient with Chronic Obstructive Pulmonary Disease (COPD) has
difficulty exhaling. What is the primary structural change in the lungs
that causes this?**
A. Fibrosis and thickening of the alveolar membrane.
B. Chronic bronchoconstriction of the large airways.
C. Destruction of the alveolar walls and loss of elastic recoil.
D. Excessive surfactant production leading to decreased compliance.
**Answer: C**
**Rationale:** The key pathophysiological processes in COPD are
emphysema (destruction of alveolar walls) and chronic bronchitis. The
loss of elastic recoil from alveolar destruction prevents the airways
from staying open during exhalation, leading to air trapping .
**4. In a patient with hyperthyroidism, which cardiovascular change
would the practitioner expect to see?**
A. Decreased heart rate and decreased cardiac output.
,B. Bradycardia and prolonged QT interval.
C. Increased heart rate and increased cardiac output.
D. Vasodilation and significant hypotension.
**Answer: C**
**Rationale:** Excessive thyroid hormones (hyperthyroidism)
stimulate beta-adrenergic receptors, increasing the heart rate and
myocardial contractility, which results in an elevated cardiac output .
**5. The chronic inflammation seen in Rheumatoid Arthritis (RA)
primarily leads to:**
A. Degeneration of articular cartilage due to mechanical stress.
B. Excessive bone deposition leading to joint stiffness.
C. Destruction of cartilage, bone erosion, and joint deformity.
D. Ischemia of the synovial membrane.
**Answer: C**
**Rationale:** In RA, the inflammatory process (driven by cytokines
like TNF-alpha) leads to synovitis, which subsequently causes pannus
formation. The pannus invades and destroys cartilage and erodes
underlying bone, leading to permanent joint deformities .
**6. A patient with chronic kidney disease (CKD) is found to be anemic.
What is the most likely pathophysiological cause?**
A. Iron deficiency due to poor dietary intake.
B. Chronic blood loss from uremic gastritis.
, C. Decreased production of erythropoietin by the kidneys.
D. Increased destruction of red blood cells by the spleen.
**Answer: C**
**Rationale:** The kidneys produce erythropoietin (EPO), which
stimulates red blood cell production in the bone marrow. In CKD, the
damaged kidneys cannot produce enough EPO, leading to anemia .
**7. A patient presents with pain crisis due to sickle cell disease. The
pain is primarily caused by:**
A. Hemolysis of red blood cells releasing inflammatory mediators.
B. Vaso-occlusion leading to ischemia and tissue hypoxia.
C. Neuropathic damage from chronic hyperviscosity.
D. Autoimmune destruction of joint cartilage.
**Answer: B**
**Rationale:** In sickle cell disease, deoxygenated hemoglobin S
polymerizes, causing red blood cells to become rigid and sickle-shaped.
These cells obstruct blood flow in small vessels (vaso-occlusion), leading
to ischemia, infarction, and severe pain .
**8. Which of the following best describes the primary defect in Type 2
Diabetes Mellitus?**
A. Autoimmune destruction of pancreatic beta cells.
B. Insulin resistance in peripheral tissues and impaired insulin secretion.
C. Excessive production of glucagon by the alpha cells.
