NURS 611 Advanced Pathophysiology Week 4 - Cardiovascular and
Pulmonary Systems 2026 |Maryville
1. In the development of atherosclerosis, what is the primary role of oxidized
LDL cholesterol?
A. It promotes smooth muscle cell relaxation.
B. It inhibits the migration of monocytes into the intima.
C. It causes endothelial injury and is engulfed by macrophages to form foam cells.
D. It decreases the production of inflammatory cytokines.
Answer: C
Rationale: LDL becomes trapped in the subendothelial space where it is oxidized. This
oxidation triggers an immune response where macrophages ingest the LDL, turning into
foam cells, which are the hallmark of early atherosclerotic lesions.
2. A patient with stable angina experiences chest pain during exertion. What is
the underlying pathophysiology?
A. A mismatch between myocardial oxygen demand and supply due to a fixed obstruction.
B. Vasospasm of the coronary arteries at rest.
C. Complete occlusion of a coronary artery by a thrombus.
D. Inflammation of the pericardial sac.
Answer: A
Rationale: Stable angina occurs when a fixed atherosclerotic plaque limits blood flow.
During exertion, the heart’s demand for oxygen increases, but the narrowed vessel cannot
provide adequate supply, leading to ischemia.
,3. Which biomarker is most specific for myocardial infarction and remains
elevated for up to 10-14 days?
A. Creatine Kinase-MB (CK-MB)
B. Myoglobin
C. Troponin I/T
D. Lactate Dehydrogenase (LDH)
Answer: C
Rationale: Cardiac Troponins (I and T) are highly specific to cardiac muscle injury and are
the gold standard for diagnosing MI. They stay elevated longer than CK-MB, which usually
returns to baseline in 48-72 hours.
4. What is the primary mechanism by which chronic hypertension leads to Left
Ventricular Hypertrophy (LVH)?
A. Increased preload due to fluid retention.
B. Decreased heart rate leading to compensatory stretching.
C. Increased afterload causing increased wall tension and myocyte growth.
D. Direct toxic effects of catecholamines on the myocardium.
Answer: C
Rationale: Hypertension increases systemic vascular resistance (afterload). The left
ventricle must work harder to pump blood against this resistance, leading to adaptive
hypertrophy of the myocytes.
5. In Heart Failure with Preserved Ejection Fraction (HFpEF), the primary
problem is:
A. Diastolic dysfunction resulting in impaired ventricular filling.
B. Impaired contractility of the left ventricle.
C. An ejection fraction below 40%.
D. Dilation of the ventricular chambers.
Answer: A
, Rationale: HFpEF is characterized by a stiff or non-compliant ventricle that cannot fill
properly during diastole, even though its pumping ability (systole) remains relatively
normal.
6. Which hormone is released by the ventricles in response to increased wall
stretch and serves as a diagnostic marker for heart failure?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
C. Angiotensin II
D. B-type Natriuretic Peptide (BNP)
Answer: D
Rationale: BNP is secreted by the ventricles in response to high pressure or volume
expansion. It promotes diuresis and vasodilation to counteract the effects of the RAAS.
7. A patient presents with a mid-diastolic murmur heard best at the apex. This is
most indicative of:
A. Mitral Stenosis
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Regurgitation
Answer: A
Rationale: Mitral stenosis obstructs blood flow from the left atrium to the left ventricle
during diastole, creating a low-pitched rumbling murmur at the apex.
Pulmonary Systems 2026 |Maryville
1. In the development of atherosclerosis, what is the primary role of oxidized
LDL cholesterol?
A. It promotes smooth muscle cell relaxation.
B. It inhibits the migration of monocytes into the intima.
C. It causes endothelial injury and is engulfed by macrophages to form foam cells.
D. It decreases the production of inflammatory cytokines.
Answer: C
Rationale: LDL becomes trapped in the subendothelial space where it is oxidized. This
oxidation triggers an immune response where macrophages ingest the LDL, turning into
foam cells, which are the hallmark of early atherosclerotic lesions.
2. A patient with stable angina experiences chest pain during exertion. What is
the underlying pathophysiology?
A. A mismatch between myocardial oxygen demand and supply due to a fixed obstruction.
B. Vasospasm of the coronary arteries at rest.
C. Complete occlusion of a coronary artery by a thrombus.
D. Inflammation of the pericardial sac.
Answer: A
Rationale: Stable angina occurs when a fixed atherosclerotic plaque limits blood flow.
During exertion, the heart’s demand for oxygen increases, but the narrowed vessel cannot
provide adequate supply, leading to ischemia.
,3. Which biomarker is most specific for myocardial infarction and remains
elevated for up to 10-14 days?
A. Creatine Kinase-MB (CK-MB)
B. Myoglobin
C. Troponin I/T
D. Lactate Dehydrogenase (LDH)
Answer: C
Rationale: Cardiac Troponins (I and T) are highly specific to cardiac muscle injury and are
the gold standard for diagnosing MI. They stay elevated longer than CK-MB, which usually
returns to baseline in 48-72 hours.
4. What is the primary mechanism by which chronic hypertension leads to Left
Ventricular Hypertrophy (LVH)?
A. Increased preload due to fluid retention.
B. Decreased heart rate leading to compensatory stretching.
C. Increased afterload causing increased wall tension and myocyte growth.
D. Direct toxic effects of catecholamines on the myocardium.
Answer: C
Rationale: Hypertension increases systemic vascular resistance (afterload). The left
ventricle must work harder to pump blood against this resistance, leading to adaptive
hypertrophy of the myocytes.
5. In Heart Failure with Preserved Ejection Fraction (HFpEF), the primary
problem is:
A. Diastolic dysfunction resulting in impaired ventricular filling.
B. Impaired contractility of the left ventricle.
C. An ejection fraction below 40%.
D. Dilation of the ventricular chambers.
Answer: A
, Rationale: HFpEF is characterized by a stiff or non-compliant ventricle that cannot fill
properly during diastole, even though its pumping ability (systole) remains relatively
normal.
6. Which hormone is released by the ventricles in response to increased wall
stretch and serves as a diagnostic marker for heart failure?
A. Aldosterone
B. Antidiuretic Hormone (ADH)
C. Angiotensin II
D. B-type Natriuretic Peptide (BNP)
Answer: D
Rationale: BNP is secreted by the ventricles in response to high pressure or volume
expansion. It promotes diuresis and vasodilation to counteract the effects of the RAAS.
7. A patient presents with a mid-diastolic murmur heard best at the apex. This is
most indicative of:
A. Mitral Stenosis
B. Aortic Stenosis
C. Aortic Regurgitation
D. Mitral Regurgitation
Answer: A
Rationale: Mitral stenosis obstructs blood flow from the left atrium to the left ventricle
during diastole, creating a low-pitched rumbling murmur at the apex.
