NUR 5461/NUR5461 Module 2 V1 |
Cardiovascular and Hematologic System
Q&A with Rationale | William Paterson
University
1. A patient presents with paroxysmal nocturnal dyspnea and orthopnea. Which condition is
most likely indicated by these symptoms?
A. Right-sided heart failure
B. Peripheral Artery Disease
C. Left-sided heart failure
D. Chronic Obstructive Pulmonary Disease
Correct Answer: C
Expert Explanation: Left-sided heart failure leads to pulmonary congestion because the
left ventricle cannot effectively pump blood into the systemic circulation. This causes fluid
to back up into the lungs, resulting in respiratory distress when lying flat. Clinical
assessment often reveals rales or crackles during lung auscultation.
2. Which laboratory value is most specific for myocardial injury in the setting of an acute
myocardial infarction?
A. Troponin I
B. C-reactive protein (CRP)
,C. Creatine Kinase (CK)
D. Brain Natriuretic Peptide (BNP)
Correct Answer: A
Expert Explanation: Troponin I is a highly sensitive and specific biomarker for cardiac
muscle damage. Levels typically rise within 3 to 6 hours after the onset of myocardial
injury and remain elevated for several days. Unlike CK-MB, Troponin is not found in
significant quantities in skeletal muscle, making it the gold standard for MI diagnosis.
3. A patient with heart failure has a Brain Natriuretic Peptide (BNP) level of 800 pg/mL. What
does this level primarily indicate?
A. Significant ventricular wall stretch
B. Acute renal failure
C. High risk for pulmonary embolism
D. Normal cardiac function
Correct Answer: A
Expert Explanation: BNP is a hormone secreted by the ventricles in response to high
pressure or volume expansion. A level of 800 pg/mL is significantly elevated and suggests
worsening heart failure or fluid overload. Clinicians use this marker to differentiate
between cardiac and pulmonary causes of dyspnea.
, 4. Which classification of medication is the first-line treatment for reducing afterload in
patients with heart failure?
A. Beta-blockers
B. Loop Diuretics
C. Calcium Channel Blockers
D. ACE Inhibitors
Correct Answer: D
Expert Explanation: ACE inhibitors block the conversion of angiotensin I to angiotensin II,
which is a potent vasoconstrictor. By inhibiting this process, these drugs cause vasodilation
and reduce the resistance the heart must pump against, known as afterload. This therapy
has been shown to improve survival rates and slow the progression of cardiac remodeling.
5. What is the hallmark symptom of Peripheral Artery Disease (PAD) during physical activity?
A. Intermittent claudication
B. Pitting edema
C. Dependent rubor
D. Varicose veins
Correct Answer: A
Expert Explanation: Intermittent claudication is characterized by muscle pain or
cramping that occurs during exercise and is relieved by rest. It is caused by inadequate
Cardiovascular and Hematologic System
Q&A with Rationale | William Paterson
University
1. A patient presents with paroxysmal nocturnal dyspnea and orthopnea. Which condition is
most likely indicated by these symptoms?
A. Right-sided heart failure
B. Peripheral Artery Disease
C. Left-sided heart failure
D. Chronic Obstructive Pulmonary Disease
Correct Answer: C
Expert Explanation: Left-sided heart failure leads to pulmonary congestion because the
left ventricle cannot effectively pump blood into the systemic circulation. This causes fluid
to back up into the lungs, resulting in respiratory distress when lying flat. Clinical
assessment often reveals rales or crackles during lung auscultation.
2. Which laboratory value is most specific for myocardial injury in the setting of an acute
myocardial infarction?
A. Troponin I
B. C-reactive protein (CRP)
,C. Creatine Kinase (CK)
D. Brain Natriuretic Peptide (BNP)
Correct Answer: A
Expert Explanation: Troponin I is a highly sensitive and specific biomarker for cardiac
muscle damage. Levels typically rise within 3 to 6 hours after the onset of myocardial
injury and remain elevated for several days. Unlike CK-MB, Troponin is not found in
significant quantities in skeletal muscle, making it the gold standard for MI diagnosis.
3. A patient with heart failure has a Brain Natriuretic Peptide (BNP) level of 800 pg/mL. What
does this level primarily indicate?
A. Significant ventricular wall stretch
B. Acute renal failure
C. High risk for pulmonary embolism
D. Normal cardiac function
Correct Answer: A
Expert Explanation: BNP is a hormone secreted by the ventricles in response to high
pressure or volume expansion. A level of 800 pg/mL is significantly elevated and suggests
worsening heart failure or fluid overload. Clinicians use this marker to differentiate
between cardiac and pulmonary causes of dyspnea.
, 4. Which classification of medication is the first-line treatment for reducing afterload in
patients with heart failure?
A. Beta-blockers
B. Loop Diuretics
C. Calcium Channel Blockers
D. ACE Inhibitors
Correct Answer: D
Expert Explanation: ACE inhibitors block the conversion of angiotensin I to angiotensin II,
which is a potent vasoconstrictor. By inhibiting this process, these drugs cause vasodilation
and reduce the resistance the heart must pump against, known as afterload. This therapy
has been shown to improve survival rates and slow the progression of cardiac remodeling.
5. What is the hallmark symptom of Peripheral Artery Disease (PAD) during physical activity?
A. Intermittent claudication
B. Pitting edema
C. Dependent rubor
D. Varicose veins
Correct Answer: A
Expert Explanation: Intermittent claudication is characterized by muscle pain or
cramping that occurs during exercise and is relieved by rest. It is caused by inadequate
