NSG530 Exam 2 V1 | NSG 530 Advanced
Pathophysiology | Wilkes University
1. A patient with long-standing hypertension presents with symptoms of heart failure. Which
mechanism primarily drives the development of left ventricular hypertrophy in this patient?
A. Increased afterload causing adaptive remodeling
B. Increased preload due to fluid retention
C. Decreased myocardial oxygen demand
D. Direct toxic effects of angiotensin II on myocytes
Answer: A
Rationale: Hypertension increases the systemic vascular resistance, which represents the
afterload the left ventricle must overcome to eject blood. In response to this chronic
workload, the myocardium undergoes adaptive hypertrophic changes to maintain cardiac
output. Over time, this remodeling can lead to decreased compliance and eventual heart
failure.
2. A 65-year-old patient with a history of smoking presents with a chronic productive cough
and exertional dyspnea. Pathological examination reveals goblet cell hyperplasia and
bronchial edema. Which condition is most likely?
A. Emphysema
B. Chronic bronchitis
,C. Asthma
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis is clinically defined by a productive cough lasting at least
three months over two consecutive years. The pathophysiology involves mucus gland
hyperplasia and increased goblet cell production in the airway epithelium. This differs
from emphysema, which primarily involves the destruction of alveolar walls and loss of
elastic recoil.
3. In the early stages of septic shock, why does the patient often exhibit warm, flushed skin
despite a drop in blood pressure?
A. Compensatory vasoconstriction in the periphery
B. Decreased capillary permeability preventing fluid leak
C. Increased stroke volume from sympathetic stimulation
D. Massive systemic vasodilation caused by inflammatory mediators
Answer: D
Rationale: Septic shock is characterized by a distributive pattern where inflammatory
cytokines cause widespread vasodilation. This leads to a decrease in systemic vascular
resistance and the characteristic warm skin often seen in the hyperdynamic phase. As the
shock progresses and cardiac output fails, the skin may eventually become cool and
clammy.
, 4. Which laboratory finding is most characteristic of iron deficiency anemia in an adult
patient?
A. Increased mean corpuscular volume (MCV)
B. Decreased total iron-binding capacity (TIBC)
C. Elevated serum ferritin levels
D. Microcytic, hypochromic red blood cells
Answer: D
Rationale: Iron deficiency anemia results in the production of smaller red blood cells that
contain less hemoglobin, leading to a microcytic and hypochromic appearance. In this state,
TIBC typically increases as the body attempts to capture more iron, while ferritin levels
decrease due to depleted stores. This is the most common form of nutritional anemia
worldwide.
5. A patient with a pulmonary embolism develops acute right heart failure. What is the
primary pathophysiological reason for this occurrence?
A. Left ventricular infarction due to hypoxia
B. Sudden increase in pulmonary vascular resistance
C. Systemic hypertension causing backward flow
D. Decreased venous return to the right atrium
Answer: B
Pathophysiology | Wilkes University
1. A patient with long-standing hypertension presents with symptoms of heart failure. Which
mechanism primarily drives the development of left ventricular hypertrophy in this patient?
A. Increased afterload causing adaptive remodeling
B. Increased preload due to fluid retention
C. Decreased myocardial oxygen demand
D. Direct toxic effects of angiotensin II on myocytes
Answer: A
Rationale: Hypertension increases the systemic vascular resistance, which represents the
afterload the left ventricle must overcome to eject blood. In response to this chronic
workload, the myocardium undergoes adaptive hypertrophic changes to maintain cardiac
output. Over time, this remodeling can lead to decreased compliance and eventual heart
failure.
2. A 65-year-old patient with a history of smoking presents with a chronic productive cough
and exertional dyspnea. Pathological examination reveals goblet cell hyperplasia and
bronchial edema. Which condition is most likely?
A. Emphysema
B. Chronic bronchitis
,C. Asthma
D. Bronchiectasis
Answer: B
Rationale: Chronic bronchitis is clinically defined by a productive cough lasting at least
three months over two consecutive years. The pathophysiology involves mucus gland
hyperplasia and increased goblet cell production in the airway epithelium. This differs
from emphysema, which primarily involves the destruction of alveolar walls and loss of
elastic recoil.
3. In the early stages of septic shock, why does the patient often exhibit warm, flushed skin
despite a drop in blood pressure?
A. Compensatory vasoconstriction in the periphery
B. Decreased capillary permeability preventing fluid leak
C. Increased stroke volume from sympathetic stimulation
D. Massive systemic vasodilation caused by inflammatory mediators
Answer: D
Rationale: Septic shock is characterized by a distributive pattern where inflammatory
cytokines cause widespread vasodilation. This leads to a decrease in systemic vascular
resistance and the characteristic warm skin often seen in the hyperdynamic phase. As the
shock progresses and cardiac output fails, the skin may eventually become cool and
clammy.
, 4. Which laboratory finding is most characteristic of iron deficiency anemia in an adult
patient?
A. Increased mean corpuscular volume (MCV)
B. Decreased total iron-binding capacity (TIBC)
C. Elevated serum ferritin levels
D. Microcytic, hypochromic red blood cells
Answer: D
Rationale: Iron deficiency anemia results in the production of smaller red blood cells that
contain less hemoglobin, leading to a microcytic and hypochromic appearance. In this state,
TIBC typically increases as the body attempts to capture more iron, while ferritin levels
decrease due to depleted stores. This is the most common form of nutritional anemia
worldwide.
5. A patient with a pulmonary embolism develops acute right heart failure. What is the
primary pathophysiological reason for this occurrence?
A. Left ventricular infarction due to hypoxia
B. Sudden increase in pulmonary vascular resistance
C. Systemic hypertension causing backward flow
D. Decreased venous return to the right atrium
Answer: B
