WGU D115 Advanced Pathophysiology for the Advanced Nurse Exam 2026 with
Questions & Verified Answers
Cardiovascular System
Q1. A patient presents with dyspnea and an echocardiogram reveals an ejection
fraction of 25%. Which finding confirms systolic heart failure?
A. Preserved ejection fraction
B. Reduced contractility
C. Impaired ventricular contraction
D. Ventricular stiffness
✅ Correct Answer: C. Impaired ventricular contraction
,Rationale: Systolic heart failure involves impaired contraction of the left ventricle,
leading to reduced ejection fraction (typically <40%).
Q2. Which laboratory finding is the gold standard for diagnosing heart failure?
A. Troponin I
B. CK-MB
C. BNP
D. CRP
✅ Correct Answer: C. BNP
Rationale: BNP is released from ventricular myocytes in response to increased
wall tension or stretch. A BNP >100 pg/mL suggests heart failure.
Q3. A patient with chronic kidney disease develops anemia. What is the primary
pathophysiologic mechanism?
,A. Iron deficiency from poor absorption
B. Vitamin B12 malabsorption
C. Reduced erythropoietin production
D. Increased red blood cell destruction
✅ Correct Answer: C. Reduced erythropoietin production
Rationale: The kidneys produce erythropoietin. In CKD, loss of functional renal
mass leads to EPO deficiency and normocytic, normochromic anemia.
Q4. Which electrolyte abnormality is most concerning in a patient taking digoxin?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
, D. Hypermagnesemia
✅ Correct Answer: A. Hypokalemia
Rationale: Low serum potassium increases the risk of digoxin toxicity and life-
threatening arrhythmias.
Q5. Which statement correctly differentiates systolic from diastolic heart failure?
A. Only systolic failure causes pulmonary edema
B. Systolic failure has reduced ejection fraction; diastolic has preserved ejection
fraction
C. Diastolic failure requires higher BNP levels for diagnosis
D. Both have equal prognoses
✅ Correct Answer: B. Systolic failure has reduced EF; diastolic has preserved EF
Questions & Verified Answers
Cardiovascular System
Q1. A patient presents with dyspnea and an echocardiogram reveals an ejection
fraction of 25%. Which finding confirms systolic heart failure?
A. Preserved ejection fraction
B. Reduced contractility
C. Impaired ventricular contraction
D. Ventricular stiffness
✅ Correct Answer: C. Impaired ventricular contraction
,Rationale: Systolic heart failure involves impaired contraction of the left ventricle,
leading to reduced ejection fraction (typically <40%).
Q2. Which laboratory finding is the gold standard for diagnosing heart failure?
A. Troponin I
B. CK-MB
C. BNP
D. CRP
✅ Correct Answer: C. BNP
Rationale: BNP is released from ventricular myocytes in response to increased
wall tension or stretch. A BNP >100 pg/mL suggests heart failure.
Q3. A patient with chronic kidney disease develops anemia. What is the primary
pathophysiologic mechanism?
,A. Iron deficiency from poor absorption
B. Vitamin B12 malabsorption
C. Reduced erythropoietin production
D. Increased red blood cell destruction
✅ Correct Answer: C. Reduced erythropoietin production
Rationale: The kidneys produce erythropoietin. In CKD, loss of functional renal
mass leads to EPO deficiency and normocytic, normochromic anemia.
Q4. Which electrolyte abnormality is most concerning in a patient taking digoxin?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
, D. Hypermagnesemia
✅ Correct Answer: A. Hypokalemia
Rationale: Low serum potassium increases the risk of digoxin toxicity and life-
threatening arrhythmias.
Q5. Which statement correctly differentiates systolic from diastolic heart failure?
A. Only systolic failure causes pulmonary edema
B. Systolic failure has reduced ejection fraction; diastolic has preserved ejection
fraction
C. Diastolic failure requires higher BNP levels for diagnosis
D. Both have equal prognoses
✅ Correct Answer: B. Systolic failure has reduced EF; diastolic has preserved EF
