HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A m m m m
LL CORRECT. m
1. Uponmadmissionmassessment,mthemnursemhearsmammurmurmlocatedmatmthemfifthmintercostal mspa
ce,mmidclavicular mline.mThemclientmasks,m“Whatmdoesmthatmmean?”mThemnursemwillmbasemhermanswer mo
nmwhichmofmthemfollowing mphysiologicmprinciples?
A) “Youmhavembeenmexposedmtomanminfectionmthatmwentmintomyourmbloodmstream.”
B) “Youmhavemamheartmvalvemthatmismdiseased.”
C) “Youmheartmhasmbeenmpumping myourmbloodmsomhard,mthatmthempressuremhasmdamagedmyourmva
lves.”
D) “Your mheartmhasmenlarged,msomnaturallymyourmvalvesmhadmtomenlargemasmwell.”
Ans: B
Feedback:
Turbulencemismoftenmaccompaniedmbymvibrationsmofmthembloodmandmsurrounding mcardio
vascular mstructures.mSomemofmthesemvibrationsmareminmthemaudiblemrangemandmcanmbemheardmusing mamst
ethoscope.mFormexample,mamheartmmurmurmresultsmfrommturbulentmflowmthroughmamdiseasedmheartmva
lve.mThemother mdistractorsmaremnotmfeasible.
2. Amclientmismdiagnosedmwithmanmabdominalmaortic
aneurysmmthatmthemphysicianmjustmwantsmtom“watch”mformnow.mWhenmteaching mthemclientmaboutmsigns/
symptomsmtomwatchmfor,mthemnursemwillmbasemthemteaching monmwhichmofmthemfollowing mphysiologicalmp
rinciples?
A) Smallmdiameter mofmthismvesselmwillmcausemitmtomrupturemmoremreadily.
B) Themlarger mthemaneurysm,mthemlessmtensionmplacedmonmthemvessel.
C) Asmthemaneurysmmgrows,mmoremtensionmismplacedmonmthemvesselmwall,mwhichmincreasesmthemris
kmformrupture.
D) Themprimarymcausemformrupturemrelatesmtomincreaseminmabdominalmpressuremsuchmasmstraining
m tom havem a m bowel m movement.
Ans: C
Feedback:
Becausemthempressuremismequalmthroughout,mthemtensionminmthempartmofmthemballoonmwi
thmthemsmaller mradiusmismlessmthanmthemtensionminmthemsectionmwithmthemlarger mradius.mThemsamemholds
m truem for m anm arterial maneurysm m inmwhichm them tensionm andm riskm ofm rupturem increasemasm them aneurysm m
growsminmsize.mWallmtensionmisminverselymrelatedmtomwallmthickness,msuchmthatmthemthicker mthemvesselm
wall,mthemlower mthemtension,mandmvicemversa.mAlthoughmarteriesmhavemamthicker mmuscular mwallmthanmv
eins,mtheirmdistensibilitymallowsmthemmtomstoremsomemofmthembloodmthatmismejectedmfrommthemheartmdu
ring msystole,mproviding mformcontinuousmflowmthroughmthemcapillariesmasmthemheartmrelaxesmduring mdias
tole.
,HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A m m m m
LL CORRECT. m
3. Amclientmhasmenteredmhypovolemicmshockmafter mmassivembloodmlossminmamcarmaccident.mMany
m ofm them client'sm peripheral mbloodm vesselsm havem consequentlym collapsed.m Howmdoesm them Laplacem lawm
accountmformthismpathophysiologicmphenomenon?
A) Bloodmpressuremismnomlonger mablemtomovercomemvesselmwallmtension.
B) Decreasing mvesselmradiimhasmcausedmamdecreaseminmbloodmpressure.
C) Wallmthicknessmofmsmallmvesselsmhasmdecreasedmduemtomhypotension.
D) Decreasesminmwallmtensionmandmbloodmpressuremhavemcausedmamsuddenmincreaseminmvesselmrad
ii.
Ans: A
Feedback:
Inmcirculatorymshock,mtheremismamdecreaseminmbloodmvolumemandmvesselmradii,malong mwi
thmamdropminmbloodmpressure.mAsmamresult,mmanymofmthemsmallmvesselsmcollapsemasmbloodmpressuremdr
opsmtomthempointmwheremitmcanmnomlonger movercomemthemwallmtension.mDecreasesminmvesselmwallmradi
imdomnotmcausemthemdecreaseminmbloodmpressure,mandmwallmthicknessmgenerallymremainsmstatic.
4. Whichmofmthemfollowing mstatementsmaboutmvascular mcompliancemismaccurate?
A) Arteriesmaremmuchmmoremdistensiblemthanmveins.
B) Veinsmcanmactmasmamreservoir mfor mstoring mlargemquantitiesmofmblood.
C) Arteriesmhavemthickmmuscular mwallsmthatmconstrictmtightly,mtherebymejecting mbloodmwithoutm
storing mitmformlater muse.
D) Amcontinuousmflowmthroughmthemcapillariesmoccursmprimarilymduring msystole.
Ans: B
Feedback:
Themmostmdistensiblemofmallmvesselsmaremthemveins,mwhichmcanmincreasemtheirmvolumem
withmonlymslightmchangesminmpressure,mallowing mthemmtomfunctionmasmamreservoir mformstoring mlargemqu
antitiesmofmbloodmthatmcanmbemreturnedmtomthemcirculationmwhenmitmismneeded.mAlthoughmarteriesmhav
emamthicker mmuscular mwallmthanmveins,mtheirmdistensibilitymallowsmthemmtomstoremsomemofmthembloodm
thatmismejectedmfrommthemheartmduring msystole,mproviding mformcontinuousmflowmthroughmthemcapillarie
smasmthemheartmrelaxesmduring mdiastole.
5. Inmthemdaysmfollowing mamtoothmcleaning mandmrootmcanal,mamclientmhasmdevelopedmanminfection
m ofm them thin,m three-
mlayeredm membranem thatm linesm them heartmandm coversm them valves.m Whatm ismthism client'smmostm likelymdi
agnosis?
,HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A
m m m m
LL CORRECT. m
A) Pericarditis
B) Endocarditis
C) Myocarditis
D) Vasculitis
Ans: BmFeedback:
Themendocardiummismamthin,mthree-
layeredmmembranemthatmlinesmthemheartmandmcoversmthemvalves;minfectionmofmthismpartmofmthemheartmis
m consequentlym referredm tom asm endocarditis.
6. Following mseveralmweeksmofmincreasing mfatiguemandmamsubsequentmdiagnosticmworkup,mamclien
tmhasmbeenmdiagnosedmwithmmitralmvalvemregurgitation.mFailuremofmthismheartmvalvemwouldmhavemwhic
hmofmthemfollowing mconsequences?
A) Backupmofmbloodmfrommthemrightmatriummintomthemsuperior mvenamcava
B) Backflowmfrommthemrightmventriclemtomthemrightmatriummduring msystole
C) InhibitionmofmthemSAmnode'smnormalmactionmpotential
D) BackflowmfrommthemleftmventriclemtomthemleftmatriummAns: D
Feedback:
Themmitralmvalvemseparatesmthemleftmventriclemfrommthemleftmatrium;mfailuremofmthismvalvemwouldmcau
sembackflowmfrommthemformer mtomthemlatter mduring msystole.mValvemfunctionmdoesmnotmdirectlymaffectmc
ardiacmcontractility.
7. Heartmmusclemdiffersmfrommskeletalmmusclemtissuembymbeing mablemtomgenerate:
A) Contractions
B) Calciumminflux
C) Actionmpotentials
D) Sarcomerembinding
Ans: C mFeedback:
, HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A
m m m m
LL CORRECT. m
Heartmmuscle,mormthemmyocardium,mismuniquemamong mother mmusclesminmthatmitmismcapablemofmgener
ating mandmrapidly
m m m m m
CTICE QUESTIONS AND ANSWERS) A m m m m
LL CORRECT. m
1. Uponmadmissionmassessment,mthemnursemhearsmammurmurmlocatedmatmthemfifthmintercostal mspa
ce,mmidclavicular mline.mThemclientmasks,m“Whatmdoesmthatmmean?”mThemnursemwillmbasemhermanswer mo
nmwhichmofmthemfollowing mphysiologicmprinciples?
A) “Youmhavembeenmexposedmtomanminfectionmthatmwentmintomyourmbloodmstream.”
B) “Youmhavemamheartmvalvemthatmismdiseased.”
C) “Youmheartmhasmbeenmpumping myourmbloodmsomhard,mthatmthempressuremhasmdamagedmyourmva
lves.”
D) “Your mheartmhasmenlarged,msomnaturallymyourmvalvesmhadmtomenlargemasmwell.”
Ans: B
Feedback:
Turbulencemismoftenmaccompaniedmbymvibrationsmofmthembloodmandmsurrounding mcardio
vascular mstructures.mSomemofmthesemvibrationsmareminmthemaudiblemrangemandmcanmbemheardmusing mamst
ethoscope.mFormexample,mamheartmmurmurmresultsmfrommturbulentmflowmthroughmamdiseasedmheartmva
lve.mThemother mdistractorsmaremnotmfeasible.
2. Amclientmismdiagnosedmwithmanmabdominalmaortic
aneurysmmthatmthemphysicianmjustmwantsmtom“watch”mformnow.mWhenmteaching mthemclientmaboutmsigns/
symptomsmtomwatchmfor,mthemnursemwillmbasemthemteaching monmwhichmofmthemfollowing mphysiologicalmp
rinciples?
A) Smallmdiameter mofmthismvesselmwillmcausemitmtomrupturemmoremreadily.
B) Themlarger mthemaneurysm,mthemlessmtensionmplacedmonmthemvessel.
C) Asmthemaneurysmmgrows,mmoremtensionmismplacedmonmthemvesselmwall,mwhichmincreasesmthemris
kmformrupture.
D) Themprimarymcausemformrupturemrelatesmtomincreaseminmabdominalmpressuremsuchmasmstraining
m tom havem a m bowel m movement.
Ans: C
Feedback:
Becausemthempressuremismequalmthroughout,mthemtensionminmthempartmofmthemballoonmwi
thmthemsmaller mradiusmismlessmthanmthemtensionminmthemsectionmwithmthemlarger mradius.mThemsamemholds
m truem for m anm arterial maneurysm m inmwhichm them tensionm andm riskm ofm rupturem increasemasm them aneurysm m
growsminmsize.mWallmtensionmisminverselymrelatedmtomwallmthickness,msuchmthatmthemthicker mthemvesselm
wall,mthemlower mthemtension,mandmvicemversa.mAlthoughmarteriesmhavemamthicker mmuscular mwallmthanmv
eins,mtheirmdistensibilitymallowsmthemmtomstoremsomemofmthembloodmthatmismejectedmfrommthemheartmdu
ring msystole,mproviding mformcontinuousmflowmthroughmthemcapillariesmasmthemheartmrelaxesmduring mdias
tole.
,HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A m m m m
LL CORRECT. m
3. Amclientmhasmenteredmhypovolemicmshockmafter mmassivembloodmlossminmamcarmaccident.mMany
m ofm them client'sm peripheral mbloodm vesselsm havem consequentlym collapsed.m Howmdoesm them Laplacem lawm
accountmformthismpathophysiologicmphenomenon?
A) Bloodmpressuremismnomlonger mablemtomovercomemvesselmwallmtension.
B) Decreasing mvesselmradiimhasmcausedmamdecreaseminmbloodmpressure.
C) Wallmthicknessmofmsmallmvesselsmhasmdecreasedmduemtomhypotension.
D) Decreasesminmwallmtensionmandmbloodmpressuremhavemcausedmamsuddenmincreaseminmvesselmrad
ii.
Ans: A
Feedback:
Inmcirculatorymshock,mtheremismamdecreaseminmbloodmvolumemandmvesselmradii,malong mwi
thmamdropminmbloodmpressure.mAsmamresult,mmanymofmthemsmallmvesselsmcollapsemasmbloodmpressuremdr
opsmtomthempointmwheremitmcanmnomlonger movercomemthemwallmtension.mDecreasesminmvesselmwallmradi
imdomnotmcausemthemdecreaseminmbloodmpressure,mandmwallmthicknessmgenerallymremainsmstatic.
4. Whichmofmthemfollowing mstatementsmaboutmvascular mcompliancemismaccurate?
A) Arteriesmaremmuchmmoremdistensiblemthanmveins.
B) Veinsmcanmactmasmamreservoir mfor mstoring mlargemquantitiesmofmblood.
C) Arteriesmhavemthickmmuscular mwallsmthatmconstrictmtightly,mtherebymejecting mbloodmwithoutm
storing mitmformlater muse.
D) Amcontinuousmflowmthroughmthemcapillariesmoccursmprimarilymduring msystole.
Ans: B
Feedback:
Themmostmdistensiblemofmallmvesselsmaremthemveins,mwhichmcanmincreasemtheirmvolumem
withmonlymslightmchangesminmpressure,mallowing mthemmtomfunctionmasmamreservoir mformstoring mlargemqu
antitiesmofmbloodmthatmcanmbemreturnedmtomthemcirculationmwhenmitmismneeded.mAlthoughmarteriesmhav
emamthicker mmuscular mwallmthanmveins,mtheirmdistensibilitymallowsmthemmtomstoremsomemofmthembloodm
thatmismejectedmfrommthemheartmduring msystole,mproviding mformcontinuousmflowmthroughmthemcapillarie
smasmthemheartmrelaxesmduring mdiastole.
5. Inmthemdaysmfollowing mamtoothmcleaning mandmrootmcanal,mamclientmhasmdevelopedmanminfection
m ofm them thin,m three-
mlayeredm membranem thatm linesm them heartmandm coversm them valves.m Whatm ismthism client'smmostm likelymdi
agnosis?
,HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A
m m m m
LL CORRECT. m
A) Pericarditis
B) Endocarditis
C) Myocarditis
D) Vasculitis
Ans: BmFeedback:
Themendocardiummismamthin,mthree-
layeredmmembranemthatmlinesmthemheartmandmcoversmthemvalves;minfectionmofmthismpartmofmthemheartmis
m consequentlym referredm tom asm endocarditis.
6. Following mseveralmweeksmofmincreasing mfatiguemandmamsubsequentmdiagnosticmworkup,mamclien
tmhasmbeenmdiagnosedmwithmmitralmvalvemregurgitation.mFailuremofmthismheartmvalvemwouldmhavemwhic
hmofmthemfollowing mconsequences?
A) Backupmofmbloodmfrommthemrightmatriummintomthemsuperior mvenamcava
B) Backflowmfrommthemrightmventriclemtomthemrightmatriummduring msystole
C) InhibitionmofmthemSAmnode'smnormalmactionmpotential
D) BackflowmfrommthemleftmventriclemtomthemleftmatriummAns: D
Feedback:
Themmitralmvalvemseparatesmthemleftmventriclemfrommthemleftmatrium;mfailuremofmthismvalvemwouldmcau
sembackflowmfrommthemformer mtomthemlatter mduring msystole.mValvemfunctionmdoesmnotmdirectlymaffectmc
ardiacmcontractility.
7. Heartmmusclemdiffersmfrommskeletalmmusclemtissuembymbeing mablemtomgenerate:
A) Contractions
B) Calciumminflux
C) Actionmpotentials
D) Sarcomerembinding
Ans: C mFeedback:
, HESI ADVANCED PATHOPHYSIOLOGY V2( 100 PRA
m m m m m
CTICE QUESTIONS AND ANSWERS) A
m m m m
LL CORRECT. m
Heartmmuscle,mormthemmyocardium,mismuniquemamong mother mmusclesminmthatmitmismcapablemofmgener
ating mandmrapidly
