1|Page
**NURS 6501 MODULE 6 TEST 2026/2027 |
ADVANCED PATHOPHYSIOLOGY | 200+
PRACTICE QUESTIONS WITH VERIFIED
ANSWERS & RATIONALES | WALDEN
UNIVERSITY | GRADED A+**
## SECTION 1: CARDIOVASCULAR PATHOPHYSIOLOGY (Questions 1–50)
**1. A patient with heart failure has a reduced ejection fraction (HFrEF) of 35%.
The nurse understands that the initial compensatory mechanism activated by
decreased cardiac output is:**
A. Increased vagal tone
B. Decreased renin release
C. Sympathetic nervous system activation (increased HR, contractility,
vasoconstriction)
D. Natriuretic peptide release
**Correct Answer: C**
**Rationale:** The initial compensatory response to decreased cardiac output is
activation of the sympathetic nervous system, which increases heart rate,
myocardial contractility, and systemic vasoconstriction (via alpha-1 receptors) to
maintain perfusion.
,2|Page
---
**2. A patient with chronic heart failure develops peripheral edema, jugular venous
distension, and hepatomegaly. This indicates:**
A. Left-sided heart failure (primarily)
B. Right-sided heart failure (primarily)
C. High-output heart failure
D. Cardiogenic shock
**Correct Answer: B**
**Rationale:** Right-sided heart failure presents with signs of systemic venous
congestion: peripheral edema, JVD, hepatomegaly (tender, enlarged liver), ascites,
and weight gain. Left-sided failure presents with pulmonary congestion (dyspnea,
crackles, orthopnea).
---
**3. A patient with left-sided heart failure reports waking up suddenly at night
gasping for air. This is called:**
A. Orthopnea
B. Paroxysmal nocturnal dyspnea (PND)
C. Platypnea
D. Trepopnea
,3|Page
**Correct Answer: B**
**Rationale:** PND is sudden, severe shortness of breath that awakens the patient
from sleep, usually 1-2 hours after lying down. It results from fluid redistribution
from the lower extremities to the pulmonary circulation when supine. Orthopnea
(A) is dyspnea when lying flat that improves with sitting up.
---
**4. A patient with heart failure has crackles (rales) on lung auscultation and an S3
gallop. The nurse understands that an S3 gallop is caused by:**
A. Atrial contraction against a stiff ventricle
B. Rapid deceleration of blood into a noncompliant ventricle
C. Mitral valve prolapse
D. Aortic stenosis
**Correct Answer: B**
**Rationale:** An S3 gallop (ventricular gallop) occurs when blood rapidly
decelerates into a dilated or noncompliant ventricle during early diastole. It is often
a sign of heart failure or volume overload. S4 (atrial gallop) is from atrial
contraction against a stiff ventricle (hypertrophy).
---
, 4|Page
**5. A patient presents with chest pain radiating to the jaw, diaphoresis, and
nausea. An EKG shows ST-segment elevation in leads II, III, and aVF. This
indicates:**
A. Anteroseptal MI
B. Lateral wall MI
C. Inferior wall MI
D. Posterior MI
**Correct Answer: C**
**Rationale:** ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction (usually due to right coronary artery occlusion). Inferior MIs
may be associated with bradycardia and right ventricular infarction.
---
**6. A patient with chronic hypertension develops left ventricular hypertrophy. The
nurse understands that this is an example of which type of cellular adaptation?**
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
**NURS 6501 MODULE 6 TEST 2026/2027 |
ADVANCED PATHOPHYSIOLOGY | 200+
PRACTICE QUESTIONS WITH VERIFIED
ANSWERS & RATIONALES | WALDEN
UNIVERSITY | GRADED A+**
## SECTION 1: CARDIOVASCULAR PATHOPHYSIOLOGY (Questions 1–50)
**1. A patient with heart failure has a reduced ejection fraction (HFrEF) of 35%.
The nurse understands that the initial compensatory mechanism activated by
decreased cardiac output is:**
A. Increased vagal tone
B. Decreased renin release
C. Sympathetic nervous system activation (increased HR, contractility,
vasoconstriction)
D. Natriuretic peptide release
**Correct Answer: C**
**Rationale:** The initial compensatory response to decreased cardiac output is
activation of the sympathetic nervous system, which increases heart rate,
myocardial contractility, and systemic vasoconstriction (via alpha-1 receptors) to
maintain perfusion.
,2|Page
---
**2. A patient with chronic heart failure develops peripheral edema, jugular venous
distension, and hepatomegaly. This indicates:**
A. Left-sided heart failure (primarily)
B. Right-sided heart failure (primarily)
C. High-output heart failure
D. Cardiogenic shock
**Correct Answer: B**
**Rationale:** Right-sided heart failure presents with signs of systemic venous
congestion: peripheral edema, JVD, hepatomegaly (tender, enlarged liver), ascites,
and weight gain. Left-sided failure presents with pulmonary congestion (dyspnea,
crackles, orthopnea).
---
**3. A patient with left-sided heart failure reports waking up suddenly at night
gasping for air. This is called:**
A. Orthopnea
B. Paroxysmal nocturnal dyspnea (PND)
C. Platypnea
D. Trepopnea
,3|Page
**Correct Answer: B**
**Rationale:** PND is sudden, severe shortness of breath that awakens the patient
from sleep, usually 1-2 hours after lying down. It results from fluid redistribution
from the lower extremities to the pulmonary circulation when supine. Orthopnea
(A) is dyspnea when lying flat that improves with sitting up.
---
**4. A patient with heart failure has crackles (rales) on lung auscultation and an S3
gallop. The nurse understands that an S3 gallop is caused by:**
A. Atrial contraction against a stiff ventricle
B. Rapid deceleration of blood into a noncompliant ventricle
C. Mitral valve prolapse
D. Aortic stenosis
**Correct Answer: B**
**Rationale:** An S3 gallop (ventricular gallop) occurs when blood rapidly
decelerates into a dilated or noncompliant ventricle during early diastole. It is often
a sign of heart failure or volume overload. S4 (atrial gallop) is from atrial
contraction against a stiff ventricle (hypertrophy).
---
, 4|Page
**5. A patient presents with chest pain radiating to the jaw, diaphoresis, and
nausea. An EKG shows ST-segment elevation in leads II, III, and aVF. This
indicates:**
A. Anteroseptal MI
B. Lateral wall MI
C. Inferior wall MI
D. Posterior MI
**Correct Answer: C**
**Rationale:** ST elevation in leads II, III, and aVF indicates an inferior wall
myocardial infarction (usually due to right coronary artery occlusion). Inferior MIs
may be associated with bradycardia and right ventricular infarction.
---
**6. A patient with chronic hypertension develops left ventricular hypertrophy. The
nurse understands that this is an example of which type of cellular adaptation?**
A. Atrophy
B. Hypertrophy
C. Hyperplasia
D. Metaplasia
