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WorksheetsNur 2211 – Exam 1 Worksheet Questions
Total questions: 25
Worksheet time: 13mins
A patient with long-standing hypertension is noted to have left ventricular hypertrophy on echocardiogram. Which physiologic change most directly led to this finding?
Increased preload from fluid retention
Decreased contractility over time
Increased afterload requiring the ventricle to pump against higher resistance
Increased stroke volume during systole
In CAD, myocardial ischemia occurs when oxygen ______ exceeds oxygen ______.
Demand; supply
Supply; demand
Saturation; gradient
Consumption; delivery
ACS differs from stable CAD primarily because ACS involves:
Progressive fixed plaque formation
Sudden plaque rupture with thrombus formation
Chronic narrowing of coronary vessels
Temporary coronary vasospasm without ischemia
A patient with primary hypertension and early renal insufficiency (elevated BUN and creatinine) is being started on antihypertensive therapy. Which medication class provides BP control and renal protection?
Beta blockers
Calcium channel blockers
ACE inhibitors
Direct vasodilators
A patient with systolic heart failure is prescribed a loop diuretic. What is the primary therapeutic effect of this medication in heart failure?
Improves myocardial contractility
Reduces preload by decreasing circulating volume
Decreases afterload through vasodilation
Enhances ventricular relaxation
A patient develops severe tachycardia following blood loss. Despite the elevated heart rate, cardiac output remains low. What best explains this finding?
Tachycardia increases oxygen demand
Increased heart rate shortens diastole, limiting ventricular filling
Stroke volume automatically decreases with blood loss
Afterload increases when heart rate exceeds 100 bpm
A patient reports chest discomfort that occurs while mowing the lawn and resolves within 5 – 10 minutes of resting. Which mechanism best explains these symptoms?
Fixed coronary artery narrowing limiting blood flow during exertion
Acute plaque rupture with thrombus formation
Complete coronary artery occlusion
Coronary artery vasospasm at rest
A 62 -year-old patient with CAD reports chest pain while walking upstairs. The pain resolves after taking sublingual nitroglycerin. What is the primary therapeutic effect of nitroglycerin in this patient?
Decreases platelet aggregation at the site of plaque rupture
Increases myocardial contractility
Reduces preload and myocardial oxygen demand
Prevents thrombus formation in coronary arteries
A patient presents with a blood pressure of 186/122 mm Hg, blurred vision, confusion, and shortness of breath. How should the nurse interpret this presentation?
Hypertensive urgency
Chronic uncontrolled hypertension
Hypertensive emergency
White coat hypertension
A patient admitted with acute decompensated heart failure is tachypneic (RR 32 ), hypoxic, and using accessory muscles. Which nursing intervention is the priority?
Obtain daily weight
Restrict sodium intake
Administer beta blockers
Position the patient in high Fowler’s and administer oxygen
A decrease in ______ reduces ventricular stretch at the end of diastole, leading to a decrease in stroke volume.
Preload
Afterload
Contractility
Heart rate
Which characteristic makes a complicated atherosclerotic lesion the most dangerous?
Gradual narrowing of the arterial lumen
Increased vessel elasticity
Plaque instability leading to thrombus formation
Complete endothelial healing
A patient with chronic stable angina presents to the ED with chest pain at rest that is unrelieved by nitroglycerin. ECG shows ST-segment depression, and troponin levels are elevated. How should the nurse interpret these findings?
Stable angina
Unstable angina
NSTEMI
STEMI
A patient with hypertensive emergency is started on IV antihypertensive therapy. What is the priority goal of treatment during the initial phase?
Gradually reduce MAP to prevent organ ischemia
Reduce blood pressure below 120/80 mm Hg
Normalize blood pressure rapidly
Eliminate symptoms immediately
A patient with suspected heart failure has a BNP level of 828 pg/mL and an EF of 25% . How should the nurse interpret these findings?
Findings suggest acute decompensated heart failure
Findings are consistent with compensated heart failure
Findings indicate isolated right-sided heart failure
Findings rule out cardiac involvement
If a patient’s heart rate is 90 beats/min and their stroke volume is 60 mL/beat, their cardiac output is mL.
3600 mL
5400 mL
6000 mL
7200 mL
Which finding best supports a diagnosis of chronic stable angina rather than ACS?
Chest pain occurring at rest
ST-segment elevation on ECG
Troponin elevation
Chest pain relieved with rest or nitroglycerin
A patient undergoes PCI with stent placement following a STEMI. Which discharge teaching statement indicates the greatest need for further education?
“I’ll take my statin every night as prescribed.”
“I should report any new chest pain immediately.”
“The stent fixed my heart disease, so lifestyle changes aren’t necessary.”
“I will continue my antiplatelet medications as directed.”
A patient newly prescribed hydrochlorothiazide asks how the medication lowers blood pressure. Which explanation is most accurate?
It relaxes arterial smooth muscle to lower resistance.
It prevents aldosterone from causing fluid retention.
It blocks sympathetic stimulation of the heart.
It increases sodium and water excretion, reducing circulating volume.
A patient with chronic heart failure is prescribed a beta blocker. Which assessment finding would require the nurse to question administration of this medication?
Heart rate of 58 beats per minute
Blood pressure of 142/88 mm Hg
Mild bilateral lower extremity edema
History of myocardial infarction
A patient receives aggressive IV fluids for dehydration. Shortly after, the nurse notes an increase in stroke volume. Which mechanism best explains this change?
Reduced afterload improves ventricular ejection
Increased preload enhances ventricular contraction
Increased contractility occurs in response to volume expansion
Decreased heart rate allows longer ventricular filling
A 59-year-old patient with known coronary artery disease reports chest tightness while shoveling snow. The pain resolves after resting and taking sublingual nitroglycerin. Vital signs are stable. ECG shows no ST-segment elevation, and troponin levels are within normal limits. Which long-term medication regimen is most appropriate to reduce this patient’s risk of progression to acute coronary syndrome?
Sublingual nitroglycerin as needed only
Enoxaparin and clopidogrel indefinitely
Morphine and oxygen therapy during exertion
Aspirin, statin therapy, and a beta blocker
A patient presents with severe chest pain, diaphoresis, and nausea. The provider suspects ACS. Which nursing action is most appropriate to perform first?
Obtain baseline cardiac biomarkers
Administer high-dose statin therapy
Initiate oxygen therapy and obtain a 12-lead ECG
Prepare the patient for cardiac catheterization
A 64-year-old patient with long-standing primary hypertension presents with a blood pressure of 178/102 mm Hg. Laboratory results show elevated BUN and creatinine, and ECG reveals left ventricular hypertrophy. The provider plans to start antihypertensive therapy. Which outcome best indicates successful long-term blood pressure management in this patient?
Rapid reduction of blood pressure to 120/80 mm Hg within 24 hours
Resolution of symptoms such as dizziness and palpitations
Slowing of progression of target organ damage over time
Immediate normalization of renal laboratory values
Which patient statement indicates effective understanding of self-management for chronic heart failure?
“I’ll call my provider if I gain more than 2–3 pounds in a day.”
“I will weigh myself once a week after dinner.”
“I should drink more fluids if I feel short of breath.”
“Once my symptoms improve, I can stop my medications.”
