NU621 Advanced Pathophysiology

Unit 2 Exam 1

1 What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood?

Chordae tendineae relax, which allows the valves to close.

Increased pressure in the ventricles pushes the valves to close.

Trabeculaecarneae contract, which pulls the valves closed.

Reduced pressure in the atria creates a negative pressure that pulls the valves closed.

2What is an expected change in the cardiovascular system that occurs with aging?

Arterial stiffening

Decreased left ventricular wall tension

Decreased aortic wall thickness


3A patient in the Emergency department is suspected of having a myocardial infarction (MI). The initial cardiac troponin 1 level was negative. What action by the healthcare professional is best?

Prepare the patient for thrombolytic therapy.

Dismiss the patient because the lab was negative.

Schedule repeat lab within a few hours.

Give the patient oxygen and pain medication.

4A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsusparadoxus. A student asks for an explanation of how this occurs. What description by the professional is best?

Diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles

Blood ejected from the right atrium and reduction of blood volume in the right ventricle

Blood ejected from the left atrium and reduction of blood volume in the left ventricle

Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers

5In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?

Increases preload and decreases afterload

Increases preload and increases afterload

Decreases preload and increases afterload

Decreases preload and decreases afterload

6Events in the development of atherosclerotic plaque include all the following except:

accumulation of LDL (low-density lipoprotein) cholesterol.

smooth muscle proliferation.


decreased elasticity.

7The complications of uncontrolled hypertension include all of the following except:

cerebrovascular accidents.

renal injury.

cardiac hypertrophy.

All of the above are complications.

8Identify the correct sequence of the portions of the pulmonary circulation.

(1) pulmonary veins

(2) pulmonary arteries

(3) lungs

(4) right ventricle

(5) left atrium

1, 5, 3, 2, 4


4, 2, 3, 1, 5

4, 1, 3, 2, 5

5, 2, 3, 1, 4

9Primary hypertension:

is essentially idiopathic.

can be caused by renal disease.

can be caused by hormone imbalance.

results from arterial coarctation.

10Which is a possible cause of varicose veins?

gravitational forces on blood

Selected Answer – Incorrect

long periods of standing

trauma to the saphenous veins

11A 76-year-old man came to the emergency room after experiencing chest pain while shoveling snow. Laboratory tests revealed essentially normal blood levels of SGOT, CPK, and LDH enzymes. The chest pain was relieved following rest and nitroglycerin therapy. The most probable diagnosis is:

myocardial infarct.


angina pectoris.

hepatic cirrhosis.

12Which factor might increase resistance to the flow of blood through the blood vessels?

an increased inner radius of diameter of blood vessels

decreased numbers of capillaries

decreased blood viscosity

decreased numbers of red blood cells

13Blood pressure is measured as the:

pressure exerted on the ventricular walls during systole.

pressure exerted by the blood on the wall of any blood vessel.

pressure exerted on arteries by the blood.

product of the stroke volume times heart rate.


14Complications of an infarcted myocardium likely could include:


heart failure.


urinary retention.

15In pericardial effusion:

there is associated rheumatoid arthritis.

tamponade compresses the right heart before affecting other structures.

arterial blood pressure during expiration exceeds that during inspiration.

16Chamber volume increase is observed in what type of cardiomyopathy?




17Which statement is true regarding rheumatic heart disease?

It is caused by staphylococcal infections.

It is caused by hypersensitivity/immunity to streptococci.

It damages the tricuspid valve most often.

It usually damages the pulmonic valve.

18Transmural myocardial infarction:

displays non-STEMI.

occurs when infarction is limited to part of the heart wall.

is categorized as STEMI.

displays I-wave inversion.

19Bacterial infective endocarditis differs from rheumatic heart disease because of which of the following? (More than one answer may be correct.)

Bacterial endocarditis is an infection of the heart, endocardium, and valves.

It always follows a myocardial infarction.

It may occur following colonoscopy procedures.

It commonly involves the vena cava valve.

20Individuals with only left heart failure would exhibit which of the following? (More than one answer may be correct.)



facial swelling

pulmonary fibrosis

21In congestive heart failure, the pump or myocardium itself fails because of which of the following?

loss of contractile force of the heart


cardiac perfusion

intermittent claudication from occlusive vascular disease

22Shock is a complex pathophysiologic process involving all of the following except:

decreased blood perfusion to kidneys.



anaerobic glycolysis.

23Which statement is incorrect concerning hypertension?

Malignant hypertension is characterized by a diastolic pressure higher than140 mm Hg.

More than 90% of cases are of the essential or primary type.

Headache is the most reliable symptom.