NUR2063/NUR 2063 Exam 3 V3 |
Essentials of Pathophysiology Q&A with
Rationale | Rasmussen University
1. A patient presents with jugular venous distention (JVD), peripheral edema, and
hepatomegaly. Which condition is most consistent with these clinical findings?
A. Left-sided heart failure
B. Acute Myocardial Infarction
C. Right-sided heart failure
D. Pulmonary Stenosis
Correct Answer: C
Rationale: Right-sided heart failure leads to systemic venous congestion because the right
ventricle is unable to pump blood effectively into the pulmonary circulation. This causes
blood to back up into the superior and inferior vena cavae, resulting in JVD, liver
enlargement, and dependent edema. In contrast, left-sided heart failure primarily results in
pulmonary congestion and respiratory symptoms.
2. Which of the following compensatory mechanisms is activated in response to a decrease in
cardiac output to maintain blood pressure?
A. Parasympathetic nervous system activation
B. Release of Atrial Natriuretic Peptide (ANP)
,C. Decreased peripheral vascular resistance
D. Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Correct Answer: D
Rationale: When cardiac output falls, the kidneys detect decreased perfusion and release
renin, which initiates the RAAS cascade. This leads to vasoconstriction via Angiotensin II
and water/sodium retention via Aldosterone to increase blood volume and pressure. These
mechanisms are vital for short-term survival but can be detrimental in chronic heart failure
states.
3. A patient with Chronic Obstructive Pulmonary Disease (COPD) is characterized by which
underlying pathophysiology?
A. Reversible airway bronchoconstriction
B. Excessive fluid accumulation in the alveoli
C. Acute inflammation of the pleural lining
D. Persistent airflow limitation and alveolar destruction
Correct Answer: D
Rationale: COPD involves chronic bronchitis and emphysema which result in permanent
damage to the airways and lung parenchyma. Emphysema specifically involves the
destruction of alveolar walls, leading to decreased surface area for gas exchange. Unlike
asthma, the airflow obstruction in COPD is typically progressive and not fully reversible.
, 4. What is the primary cause of the ‘Pink Puffer’ appearance in patients with emphysema?
A. Maintenance of oxygen levels through hyperventilation
B. Excessive mucus production and cyanosis
C. Hypoventilation and carbon dioxide retention
D. Fluid overload and systemic edema
Correct Answer: A
Rationale: Patients with emphysema are often called ‘pink puffers’ because they
hyperventilate to maintain relatively normal blood oxygen levels, giving them a flushed
appearance. This increased work of breathing uses a significant amount of energy, often
leading to a thin, cachectic physical build. This is distinguished from ‘blue bloaters’ (chronic
bronchitis) who suffer from cyanosis and fluid retention.
5. Which electrolyte imbalance is a patient most at risk for when developing acute kidney
injury (AKI) in the oliguric phase?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Correct Answer: D
Essentials of Pathophysiology Q&A with
Rationale | Rasmussen University
1. A patient presents with jugular venous distention (JVD), peripheral edema, and
hepatomegaly. Which condition is most consistent with these clinical findings?
A. Left-sided heart failure
B. Acute Myocardial Infarction
C. Right-sided heart failure
D. Pulmonary Stenosis
Correct Answer: C
Rationale: Right-sided heart failure leads to systemic venous congestion because the right
ventricle is unable to pump blood effectively into the pulmonary circulation. This causes
blood to back up into the superior and inferior vena cavae, resulting in JVD, liver
enlargement, and dependent edema. In contrast, left-sided heart failure primarily results in
pulmonary congestion and respiratory symptoms.
2. Which of the following compensatory mechanisms is activated in response to a decrease in
cardiac output to maintain blood pressure?
A. Parasympathetic nervous system activation
B. Release of Atrial Natriuretic Peptide (ANP)
,C. Decreased peripheral vascular resistance
D. Activation of the Renin-Angiotensin-Aldosterone System (RAAS)
Correct Answer: D
Rationale: When cardiac output falls, the kidneys detect decreased perfusion and release
renin, which initiates the RAAS cascade. This leads to vasoconstriction via Angiotensin II
and water/sodium retention via Aldosterone to increase blood volume and pressure. These
mechanisms are vital for short-term survival but can be detrimental in chronic heart failure
states.
3. A patient with Chronic Obstructive Pulmonary Disease (COPD) is characterized by which
underlying pathophysiology?
A. Reversible airway bronchoconstriction
B. Excessive fluid accumulation in the alveoli
C. Acute inflammation of the pleural lining
D. Persistent airflow limitation and alveolar destruction
Correct Answer: D
Rationale: COPD involves chronic bronchitis and emphysema which result in permanent
damage to the airways and lung parenchyma. Emphysema specifically involves the
destruction of alveolar walls, leading to decreased surface area for gas exchange. Unlike
asthma, the airflow obstruction in COPD is typically progressive and not fully reversible.
, 4. What is the primary cause of the ‘Pink Puffer’ appearance in patients with emphysema?
A. Maintenance of oxygen levels through hyperventilation
B. Excessive mucus production and cyanosis
C. Hypoventilation and carbon dioxide retention
D. Fluid overload and systemic edema
Correct Answer: A
Rationale: Patients with emphysema are often called ‘pink puffers’ because they
hyperventilate to maintain relatively normal blood oxygen levels, giving them a flushed
appearance. This increased work of breathing uses a significant amount of energy, often
leading to a thin, cachectic physical build. This is distinguished from ‘blue bloaters’ (chronic
bronchitis) who suffer from cyanosis and fluid retention.
5. Which electrolyte imbalance is a patient most at risk for when developing acute kidney
injury (AKI) in the oliguric phase?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Correct Answer: D
