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Rasmussen Pathophysiology NUR 2063 Essentials
Exam 2 Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: Cardiovascular Pathophysiology — Questions 1-18]
Q1: A patient with a history of smoking and hyperlipidemia presents with stable angina. The
nurse understands that the primary underlying pathophysiological mechanism of this patient's
pain is:
A. Coronary artery vasospasm
B. Fixed atherosclerotic plaque occlusion
C. Temporary thrombus formation
D. Embolization of plaque fragments
Correct Answer: B
Rationale: Stable angina is typically caused by a fixed atherosclerotic plaque that partially
occludes a coronary artery, reducing blood flow during times of increased oxygen demand (e.g.,
exertion). This supply-demand mismatch results in myocardial ischemia and chest pain. Option A
describes Prinzmetal's (variant) angina, which is caused by vasospasm. Option C is more
characteristic of unstable angina or acute myocardial infarction where a thrombus complicates a
ruptured plaque. Option D would lead to an acute infarction, not stable, predictable angina.
Q2: Which assessment finding is most characteristic of left-sided heart failure?
A. Hepatomegaly
B. Ascites
C. Bilateral ankle edema
D. Pulmonary crackles
Correct Answer: D
,2
Rationale: Left-sided heart failure results in the backup of blood into the left atrium and
pulmonary vasculature, causing pulmonary congestion and edema. This manifests as dyspnea on
exertion, orthopnea, and pulmonary crackles upon auscultation. Options A, B, and C are classic
signs of right-sided heart failure, which occurs due to backward failure into the systemic venous
circulation, leading to systemic venous congestion and fluid retention in the body's tissues and
organs.
Q3: A patient is diagnosed with primary hypertension. The nurse explains that in the vast
majority of cases, the etiology is:
A. Known renal pathology
B. Idiopathic (essential)
C. Caused by an adrenal tumor
D. Due to coarctation of the aorta
Correct Answer: B
Rationale: Primary (essential) hypertension accounts for approximately 90-95% of all
hypertension cases and has no identifiable single cause, though it is associated with genetic,
environmental, and lifestyle factors. Options A and C refer to secondary hypertension, which has
a specific identifiable cause such as renal artery stenosis or pheochromocytoma. Option D is a
structural congenital defect that causes secondary hypertension, typically diagnosed earlier in
life.
Q4: The nurse is caring for a patient with infective endocarditis. Which clinical manifestation
would the nurse expect to find that is highly specific to this condition?
A. Janeway lesions
B. Splinter hemorrhages
C. Osler nodes
D. All of the above
Correct Answer: D
,3
Rationale: Infective endocarditis is characterized by the formation of vegetations on heart valves,
which can embolize to various parts of the body. Janeway lesions (painless macules on
palms/soles), splinter hemorrhages (small linear streaks under nails), and Osler nodes (tender,
painful nodules on fingers/toes) are all classic immunologic or embolic manifestations of this
disease process. While they can appear in other conditions, their presence (especially a
combination) strongly suggests endocarditis in the context of fever and a new murmur.
Q5: A patient presents to the Emergency Department with severe chest pain unrelieved by rest.
The ECG shows ST-segment elevation in leads V1-V4. The nurse recognizes this indicates:
A. Non-ST-elevation myocardial infarction (NSTEMI)
B. Anterior wall ST-elevation myocardial infarction (STEMI)
C. Inferior wall STEMI
D. Unstable angina
Correct Answer: B
Rationale: ST-segment elevation in leads V1 through V4 corresponds to the anterior wall of the
left ventricle, supplied by the left anterior descending (LAD) artery. This is a classic sign of an
anterior STEMI, which is a transmural ischemic injury requiring immediate reperfusion therapy.
Option A would show ST depression or T-wave inversion without elevation. Option C involves
leads II, III, and aVF. Option D usually presents with transient ST changes or normal ECG but
does not show persistent ST elevation.
Q6: A patient with deep vein thrombosis (DVT) is at risk for Post-Thrombotic Syndrome. The
nurse knows this is caused by:
A. Recurrent embolization to the lungs
B. Destruction of venous valves leading to chronic venous insufficiency
C. Infection of the thrombus
D. Arterial ischemia of the affected limb
Correct Answer: B
, 4
Rationale: Post-Thrombotic Syndrome occurs when a DVT causes inflammation and scarring
that damages the venous valves. These incompetent valves fail to prevent backflow, leading to
chronic venous hypertension, edema, pain, and potentially skin ulcers. Option A would cause
pulmonary issues, not chronic limb problems. Option C refers to septic thrombophlebitis, a
complication of the acute phase. Option D is incorrect because DVT affects the venous system,
not arterial flow.
Q7: When teaching a patient about pericarditis, the nurse explains that the classic chest pain
finding is:
A. Substernal, crushing pressure radiating to the jaw
B. Pleuritic, sharp pain relieved by sitting forward
C. Burning epigastric pain relieved by antacids
D. Tearing pain radiating to the back
Correct Answer: B
Rationale: Pericarditis is inflammation of the pericardial sac. The pain is typically pleuritic
(worse with inspiration) and sharp/stabbing. It is positional, often relieved by leaning forward
(which reduces friction between the layers) and worsened by lying supine. Option A describes
myocardial ischemia. Option C is typical of gastroesophageal reflux. Option D is characteristic
of aortic dissection.
Q8: A patient with rheumatic fever as a child now presents with mitral stenosis. The
pathophysiology of this valve disorder involves:
A. Leaflet thickening and commissural fusion
B. Chordae tendineae rupture
C. Dilatation of the valve annulus
D. Bacterial vegetations
Correct Answer: A
Rationale: Rheumatic heart disease results from an autoimmune reaction to Group A
Streptococcus infection, leading to repeated inflammation. Over years, this causes the valve
Rasmussen Pathophysiology NUR 2063 Essentials
Exam 2 Actual Exam 2026/2027 – Complete
Exam-Style Questions with Detailed Rationales |
Pass Guaranteed – A+ Graded
[SECTION 1: Cardiovascular Pathophysiology — Questions 1-18]
Q1: A patient with a history of smoking and hyperlipidemia presents with stable angina. The
nurse understands that the primary underlying pathophysiological mechanism of this patient's
pain is:
A. Coronary artery vasospasm
B. Fixed atherosclerotic plaque occlusion
C. Temporary thrombus formation
D. Embolization of plaque fragments
Correct Answer: B
Rationale: Stable angina is typically caused by a fixed atherosclerotic plaque that partially
occludes a coronary artery, reducing blood flow during times of increased oxygen demand (e.g.,
exertion). This supply-demand mismatch results in myocardial ischemia and chest pain. Option A
describes Prinzmetal's (variant) angina, which is caused by vasospasm. Option C is more
characteristic of unstable angina or acute myocardial infarction where a thrombus complicates a
ruptured plaque. Option D would lead to an acute infarction, not stable, predictable angina.
Q2: Which assessment finding is most characteristic of left-sided heart failure?
A. Hepatomegaly
B. Ascites
C. Bilateral ankle edema
D. Pulmonary crackles
Correct Answer: D
,2
Rationale: Left-sided heart failure results in the backup of blood into the left atrium and
pulmonary vasculature, causing pulmonary congestion and edema. This manifests as dyspnea on
exertion, orthopnea, and pulmonary crackles upon auscultation. Options A, B, and C are classic
signs of right-sided heart failure, which occurs due to backward failure into the systemic venous
circulation, leading to systemic venous congestion and fluid retention in the body's tissues and
organs.
Q3: A patient is diagnosed with primary hypertension. The nurse explains that in the vast
majority of cases, the etiology is:
A. Known renal pathology
B. Idiopathic (essential)
C. Caused by an adrenal tumor
D. Due to coarctation of the aorta
Correct Answer: B
Rationale: Primary (essential) hypertension accounts for approximately 90-95% of all
hypertension cases and has no identifiable single cause, though it is associated with genetic,
environmental, and lifestyle factors. Options A and C refer to secondary hypertension, which has
a specific identifiable cause such as renal artery stenosis or pheochromocytoma. Option D is a
structural congenital defect that causes secondary hypertension, typically diagnosed earlier in
life.
Q4: The nurse is caring for a patient with infective endocarditis. Which clinical manifestation
would the nurse expect to find that is highly specific to this condition?
A. Janeway lesions
B. Splinter hemorrhages
C. Osler nodes
D. All of the above
Correct Answer: D
,3
Rationale: Infective endocarditis is characterized by the formation of vegetations on heart valves,
which can embolize to various parts of the body. Janeway lesions (painless macules on
palms/soles), splinter hemorrhages (small linear streaks under nails), and Osler nodes (tender,
painful nodules on fingers/toes) are all classic immunologic or embolic manifestations of this
disease process. While they can appear in other conditions, their presence (especially a
combination) strongly suggests endocarditis in the context of fever and a new murmur.
Q5: A patient presents to the Emergency Department with severe chest pain unrelieved by rest.
The ECG shows ST-segment elevation in leads V1-V4. The nurse recognizes this indicates:
A. Non-ST-elevation myocardial infarction (NSTEMI)
B. Anterior wall ST-elevation myocardial infarction (STEMI)
C. Inferior wall STEMI
D. Unstable angina
Correct Answer: B
Rationale: ST-segment elevation in leads V1 through V4 corresponds to the anterior wall of the
left ventricle, supplied by the left anterior descending (LAD) artery. This is a classic sign of an
anterior STEMI, which is a transmural ischemic injury requiring immediate reperfusion therapy.
Option A would show ST depression or T-wave inversion without elevation. Option C involves
leads II, III, and aVF. Option D usually presents with transient ST changes or normal ECG but
does not show persistent ST elevation.
Q6: A patient with deep vein thrombosis (DVT) is at risk for Post-Thrombotic Syndrome. The
nurse knows this is caused by:
A. Recurrent embolization to the lungs
B. Destruction of venous valves leading to chronic venous insufficiency
C. Infection of the thrombus
D. Arterial ischemia of the affected limb
Correct Answer: B
, 4
Rationale: Post-Thrombotic Syndrome occurs when a DVT causes inflammation and scarring
that damages the venous valves. These incompetent valves fail to prevent backflow, leading to
chronic venous hypertension, edema, pain, and potentially skin ulcers. Option A would cause
pulmonary issues, not chronic limb problems. Option C refers to septic thrombophlebitis, a
complication of the acute phase. Option D is incorrect because DVT affects the venous system,
not arterial flow.
Q7: When teaching a patient about pericarditis, the nurse explains that the classic chest pain
finding is:
A. Substernal, crushing pressure radiating to the jaw
B. Pleuritic, sharp pain relieved by sitting forward
C. Burning epigastric pain relieved by antacids
D. Tearing pain radiating to the back
Correct Answer: B
Rationale: Pericarditis is inflammation of the pericardial sac. The pain is typically pleuritic
(worse with inspiration) and sharp/stabbing. It is positional, often relieved by leaning forward
(which reduces friction between the layers) and worsened by lying supine. Option A describes
myocardial ischemia. Option C is typical of gastroesophageal reflux. Option D is characteristic
of aortic dissection.
Q8: A patient with rheumatic fever as a child now presents with mitral stenosis. The
pathophysiology of this valve disorder involves:
A. Leaflet thickening and commissural fusion
B. Chordae tendineae rupture
C. Dilatation of the valve annulus
D. Bacterial vegetations
Correct Answer: A
Rationale: Rheumatic heart disease results from an autoimmune reaction to Group A
Streptococcus infection, leading to repeated inflammation. Over years, this causes the valve
