NSG 3280 Pathophysiology Exam 3 – Galen College
of Nursing Actual Exam 2026/2027 | Detailed
Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Cardiovascular Disorders | Q1 – Q10
Section 2 | Respiratory Disorders | Q11 – Q20
Section 3 | Renal & Urinary Disorders | Q21 – Q30
Section 4 | Gastrointestinal Disorders | Q31 – Q40
Section 5 | Endocrine & Metabolic Disorders | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: CARDIOVASCULAR DISORDERS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old man with a history of hypertension presents to the emergency department
with crushing substernal chest pain radiating to his left jaw and arm. His ECG shows
ST-segment elevation in leads V1 through V4, and troponin I is elevated. Which
pathophysiologic process is occurring?
A. Coronary artery vasospasm without thrombosis
B. Acute plaque rupture with thrombotic occlusion of the left anterior descending artery
✓ CORRECT
C. Progressive atherosclerotic narrowing without acute thrombosis
D. Demand ischemia from severe anemia
Correct Answer: B
,Rationale: ST-elevation in anterior leads with elevated troponin indicates transmural
infarction from acute thrombotic occlusion, typically of the LAD. Vasospastic angina
usually causes transient ST changes without sustained troponin elevation. Progressive
narrowing alone causes stable angina, not STEMI.
Question 2 of 50
A 55-year-old woman has progressive dyspnea on exertion and orthopnea. On
examination, she has a holosystolic murmur at the apex radiating to the axilla.
Echocardiogram shows a regurgitant jet into the left atrium. Which hemodynamic
consequence is most likely?
A. Decreased left ventricular preload
B. Increased forward cardiac output
C. Decreased left atrial pressure
D. Increased left atrial pressure with pulmonary congestion ✓ CORRECT
Correct Answer: D
Rationale: Mitral regurgitation allows backward flow into the left atrium during systole,
elevating atrial pressure and transmitting hydrostatic pressure to pulmonary capillaries.
Forward output decreases rather than increases, and preload increases due to volume
overload.
Question 3 of 50
A 42-year-old man with a history of intravenous drug use presents with fever, chills, and
a new harsh systolic murmur at the left sternal border. Blood cultures grow
Staphylococcus aureus, and vegetations are visible on the tricuspid valve. Which
complication is he at highest risk for?
A. Septic pulmonary emboli ✓ CORRECT
B. Systemic arterial emboli to the brain
C. Aortic root abscess
, D. Mitral valve chordae rupture
Correct Answer: A
Rationale: Tricuspid valve endocarditis in intravenous drug users frequently seeds the
pulmonary circulation through the right heart, causing septic emboli and pulmonary
abscesses. Systemic emboli and left-sided complications are less common with
right-sided involvement.
Question 4 of 50
A 72-year-old man with atrial fibrillation who is not anticoagulated suddenly develops
left-sided weakness and aphasia. CT scan of the brain shows no hemorrhage. Which
pathophysiologic mechanism caused his stroke?
A. Carotid artery dissection
B. Lacunar infarction from lipohyalinosis
C. Thrombus formation in the left atrial appendage with embolization ✓ CORRECT
D. Rupture of a saccular aneurysm
Correct Answer: C
Rationale: In atrial fibrillation, blood stasis in the left atrial appendage promotes
thrombus formation that can embolize to cerebral arteries. Dissection and aneurysm
rupture cause different stroke mechanisms, and lipohyalinosis is associated with
chronic hypertension rather than arrhythmia.
Question 5 of 50
A 60-year-old man with peripheral arterial disease reports calf pain after walking two
blocks that resolves completely with rest. His dorsalis pedis pulses are diminished.
Which pathophysiologic process explains his symptoms?
A. Acute arterial thrombosis with tissue necrosis
B. Fixed arterial stenosis causing demand ischemia during exertion ✓ CORRECT
C. Vasospastic disorder triggered by cold exposure
of Nursing Actual Exam 2026/2027 | Detailed
Rationales | Complete Exam-Style Questions | Pass
Guaranteed – A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Cardiovascular Disorders | Q1 – Q10
Section 2 | Respiratory Disorders | Q11 – Q20
Section 3 | Renal & Urinary Disorders | Q21 – Q30
Section 4 | Gastrointestinal Disorders | Q31 – Q40
Section 5 | Endocrine & Metabolic Disorders | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: CARDIOVASCULAR DISORDERS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 68-year-old man with a history of hypertension presents to the emergency department
with crushing substernal chest pain radiating to his left jaw and arm. His ECG shows
ST-segment elevation in leads V1 through V4, and troponin I is elevated. Which
pathophysiologic process is occurring?
A. Coronary artery vasospasm without thrombosis
B. Acute plaque rupture with thrombotic occlusion of the left anterior descending artery
✓ CORRECT
C. Progressive atherosclerotic narrowing without acute thrombosis
D. Demand ischemia from severe anemia
Correct Answer: B
,Rationale: ST-elevation in anterior leads with elevated troponin indicates transmural
infarction from acute thrombotic occlusion, typically of the LAD. Vasospastic angina
usually causes transient ST changes without sustained troponin elevation. Progressive
narrowing alone causes stable angina, not STEMI.
Question 2 of 50
A 55-year-old woman has progressive dyspnea on exertion and orthopnea. On
examination, she has a holosystolic murmur at the apex radiating to the axilla.
Echocardiogram shows a regurgitant jet into the left atrium. Which hemodynamic
consequence is most likely?
A. Decreased left ventricular preload
B. Increased forward cardiac output
C. Decreased left atrial pressure
D. Increased left atrial pressure with pulmonary congestion ✓ CORRECT
Correct Answer: D
Rationale: Mitral regurgitation allows backward flow into the left atrium during systole,
elevating atrial pressure and transmitting hydrostatic pressure to pulmonary capillaries.
Forward output decreases rather than increases, and preload increases due to volume
overload.
Question 3 of 50
A 42-year-old man with a history of intravenous drug use presents with fever, chills, and
a new harsh systolic murmur at the left sternal border. Blood cultures grow
Staphylococcus aureus, and vegetations are visible on the tricuspid valve. Which
complication is he at highest risk for?
A. Septic pulmonary emboli ✓ CORRECT
B. Systemic arterial emboli to the brain
C. Aortic root abscess
, D. Mitral valve chordae rupture
Correct Answer: A
Rationale: Tricuspid valve endocarditis in intravenous drug users frequently seeds the
pulmonary circulation through the right heart, causing septic emboli and pulmonary
abscesses. Systemic emboli and left-sided complications are less common with
right-sided involvement.
Question 4 of 50
A 72-year-old man with atrial fibrillation who is not anticoagulated suddenly develops
left-sided weakness and aphasia. CT scan of the brain shows no hemorrhage. Which
pathophysiologic mechanism caused his stroke?
A. Carotid artery dissection
B. Lacunar infarction from lipohyalinosis
C. Thrombus formation in the left atrial appendage with embolization ✓ CORRECT
D. Rupture of a saccular aneurysm
Correct Answer: C
Rationale: In atrial fibrillation, blood stasis in the left atrial appendage promotes
thrombus formation that can embolize to cerebral arteries. Dissection and aneurysm
rupture cause different stroke mechanisms, and lipohyalinosis is associated with
chronic hypertension rather than arrhythmia.
Question 5 of 50
A 60-year-old man with peripheral arterial disease reports calf pain after walking two
blocks that resolves completely with rest. His dorsalis pedis pulses are diminished.
Which pathophysiologic process explains his symptoms?
A. Acute arterial thrombosis with tissue necrosis
B. Fixed arterial stenosis causing demand ischemia during exertion ✓ CORRECT
C. Vasospastic disorder triggered by cold exposure
