NURS 611 Exam 2 V3 | NURS 611
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 2
2026)
1. Which of the following compensatory mechanisms is primarily responsible for the
development of cardiac hypertrophy in patients with chronic hypertension?
A. Parasympathetic nervous system activation
B. Peripheral vasodilation causing reduced afterload
C. Decreased release of brain natriuretic peptide (BNP)
D. Stimulation of the renin-angiotensin-aldosterone system (RAAS)
Correct Answer: D
Rationale: The chronic elevation of systemic blood pressure triggers the RAAS, leading to
increased levels of angiotensin II, which acts as a growth factor for cardiac myocytes. This
process results in structural remodeling and the thickening of the ventricular walls to
overcome high afterload. Over time, this hypertrophy can lead to decreased compliance
and eventual heart failure.
2. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and hemoptysis.
Which pathophysiological condition should the examiner suspect first?
A. Chronic obstructive pulmonary disease exacerbation
,B. Pulmonary embolism
C. Stable angina pectoris
D. Atelectasis
Correct Answer: B
Rationale: The triad of pleuritic pain, dyspnea, and hemoptysis is classic for pulmonary
embolism, often caused by a dislodged deep vein thrombus. This condition leads to an area
of the lung being ventilated but not perfused, creating a V/Q mismatch. Immediate
intervention is required to prevent right ventricular failure and sudden death.
3. Which statement best describes the pathophysiology of emphysema?
A. Hypersecretion of mucus and chronic productive cough
B. Reversible airway obstruction caused by bronchial hyperresponsiveness
C. Permanent enlargement of gas-exchange airways and destruction of alveolar walls
D. Infection and inflammation of the lower respiratory tract parenchymal tissue
Correct Answer: C
Rationale: Emphysema is characterized by the destruction of elastin in the alveolar walls,
typically due to an imbalance between proteases and antiproteases. This results in the loss
of elastic recoil and the collapse of small airways during expiration, leading to air trapping.
Unlike chronic bronchitis, the primary issue is structural destruction rather than mucus
production.
, 4. What is the primary hemodynamic change observed during the initial stage of hypovolemic
shock?
A. Decreased systemic vascular resistance (SVR)
B. Increased pulmonary capillary wedge pressure (PCWP)
C. Bradycardia due to vagal stimulation
D. Decreased cardiac output and venous return
Correct Answer: D
Rationale: Hypovolemic shock begins with a significant loss of intravascular volume,
which reduces the amount of blood returning to the heart. This decrease in preload leads to
a direct reduction in stroke volume and overall cardiac output. Compensatory mechanisms
like tachycardia and increased SVR follow to maintain perfusion to vital organs.
5. A clinician is reviewing the lab results of a patient with Acute Kidney Injury (AKI). A FeNa
(Fractional Excretion of Sodium) of less than 1% most likely indicates:
A. Prerenal azotemia
B. Postrenal obstruction
C. Acute tubular necrosis (ATN)
D. Intrarenal inflammation
Correct Answer: A
Advanced Pathophysiology | Maryville
University of St. Louis | 2026 Q&A with
Rationale (Maryville NURS611 Exam 2
2026)
1. Which of the following compensatory mechanisms is primarily responsible for the
development of cardiac hypertrophy in patients with chronic hypertension?
A. Parasympathetic nervous system activation
B. Peripheral vasodilation causing reduced afterload
C. Decreased release of brain natriuretic peptide (BNP)
D. Stimulation of the renin-angiotensin-aldosterone system (RAAS)
Correct Answer: D
Rationale: The chronic elevation of systemic blood pressure triggers the RAAS, leading to
increased levels of angiotensin II, which acts as a growth factor for cardiac myocytes. This
process results in structural remodeling and the thickening of the ventricular walls to
overcome high afterload. Over time, this hypertrophy can lead to decreased compliance
and eventual heart failure.
2. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and hemoptysis.
Which pathophysiological condition should the examiner suspect first?
A. Chronic obstructive pulmonary disease exacerbation
,B. Pulmonary embolism
C. Stable angina pectoris
D. Atelectasis
Correct Answer: B
Rationale: The triad of pleuritic pain, dyspnea, and hemoptysis is classic for pulmonary
embolism, often caused by a dislodged deep vein thrombus. This condition leads to an area
of the lung being ventilated but not perfused, creating a V/Q mismatch. Immediate
intervention is required to prevent right ventricular failure and sudden death.
3. Which statement best describes the pathophysiology of emphysema?
A. Hypersecretion of mucus and chronic productive cough
B. Reversible airway obstruction caused by bronchial hyperresponsiveness
C. Permanent enlargement of gas-exchange airways and destruction of alveolar walls
D. Infection and inflammation of the lower respiratory tract parenchymal tissue
Correct Answer: C
Rationale: Emphysema is characterized by the destruction of elastin in the alveolar walls,
typically due to an imbalance between proteases and antiproteases. This results in the loss
of elastic recoil and the collapse of small airways during expiration, leading to air trapping.
Unlike chronic bronchitis, the primary issue is structural destruction rather than mucus
production.
, 4. What is the primary hemodynamic change observed during the initial stage of hypovolemic
shock?
A. Decreased systemic vascular resistance (SVR)
B. Increased pulmonary capillary wedge pressure (PCWP)
C. Bradycardia due to vagal stimulation
D. Decreased cardiac output and venous return
Correct Answer: D
Rationale: Hypovolemic shock begins with a significant loss of intravascular volume,
which reduces the amount of blood returning to the heart. This decrease in preload leads to
a direct reduction in stroke volume and overall cardiac output. Compensatory mechanisms
like tachycardia and increased SVR follow to maintain perfusion to vital organs.
5. A clinician is reviewing the lab results of a patient with Acute Kidney Injury (AKI). A FeNa
(Fractional Excretion of Sodium) of less than 1% most likely indicates:
A. Prerenal azotemia
B. Postrenal obstruction
C. Acute tubular necrosis (ATN)
D. Intrarenal inflammation
Correct Answer: A
