NR 545 ACTUAL EXAMINATION ONE 2026
QUESTIONS WITH ANSWERS GRADED A+
⩥ What is the Patho of Angina? Answer: Angina is chest pain that is
associated with decreased blood flow or ischemia to the myocardial
tissue. The decreased blood flow may be the result of atherosclerosis or
coronary artery spasm. Neural pain receptors are stimulated by
accelerated cellular metabolism, chemical changes, and imbalances
⩥ What are signs and symptoms of Angina? Answer: - chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder
and arm while others report pain in the jaw.
Generally, the attack length can range anywhere between three minutes
to twenty minutes. Attacks reported at greater than thirty minutes are
concerning and could indicate the development of acute coronary
syndrome.
⩥ What lab test are needed for angina? Answer: - Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for
anemia which might be contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome.
,⩥ What are pharmacological remedies for Angina? Answer:
Nitroglycerin (Drug of choice):
Nitroglycerin relaxes and widens the blood vessel promoting easier
blood flow to the heart muscle. Dosing of nitroglycerin is 0.3-0.6 mg by
translingual spray or sublingual tablet every five minutes, as indicated
with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors
⩥ What is a myocardial infarction? Answer: (Heart Attack)
A myocardial infarction (MI) occurs when blood flow to the heart is
minimized. The blockage is most often caused by a buildup of
cholesterol, which forms a plaque in the arteries that circulate
oxygenated blood flow to the myocardium. When the plaque breaks
away it can form a clot, interrupting or completely blocking blood flow
and destroying a part of the heart muscle. Unlike with an episode of
angina, those experiencing a myocardial
infarction often report symptoms of pain at rest.
⩥ What is the patho of a Myocardial Infarction? Answer: During a
myocardial infarction there is an imbalance between myocardial oxygen
supply and demand. Prolonged ischemia (>30 minutes) from the lack of
circulating blood flow to the myocardium results in cellular death,
further impacting the heart's ability to function. Depending on the extent
,of the cell death, the heart might have decreased contractility resulting in
wall function abnormalities further placing the patient at risk for
decompensation.
⩥ What are the symptoms of a Myocardial Infraction? Answer: - Sharp
radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing
⩥ What lab test are needed for a Myocardial Infraction? Answer: -
Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left
bundle
branch block.
⩥ How do you manage a Myocardial Infraction? Answer: Patients
presenting with acute myocardial infarction will need reperfusion
, therapy or fibrinolytic therapy. To decrease mortality rates, reperfusion
through PCI needs to be completed within 90 minutes of presentation to
the emergency room.
⩥ What is Atherosclerosis? Answer: a disease of the arteries
characterized by the deposition of plaques of fatty material on their inner
walls.
⩥ What is the path of Atherosclerosis? Answer: Atherosclerosis is an
inflammatory process that begins with damage to the endothelium often
the result of hypertension, smoking, high cholesterol or other risk
factors. The endothelium develops a fatty streak which further develops
into a fibrous plaque and then complicated lesion.
⩥ Physical assessment of Atherosclerosis? Answer: Family medical
history and personal medical history should be reviewed for risk factors,
including level of physical activity, tobacco, use, and dietary habits. A
review of symptoms including recent and increasing fatigue, as well as
fluid retention should be completed. A medication history should be
obtained to determine risk factors including high cholesterol,
hypertension, or diabetes.
While a full physical assessment should be performed, particular
attention to pulse deficits, neck vein distention, edema, and calf pain can
further contribute to the diagnosis.
QUESTIONS WITH ANSWERS GRADED A+
⩥ What is the Patho of Angina? Answer: Angina is chest pain that is
associated with decreased blood flow or ischemia to the myocardial
tissue. The decreased blood flow may be the result of atherosclerosis or
coronary artery spasm. Neural pain receptors are stimulated by
accelerated cellular metabolism, chemical changes, and imbalances
⩥ What are signs and symptoms of Angina? Answer: - chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder
and arm while others report pain in the jaw.
Generally, the attack length can range anywhere between three minutes
to twenty minutes. Attacks reported at greater than thirty minutes are
concerning and could indicate the development of acute coronary
syndrome.
⩥ What lab test are needed for angina? Answer: - Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for
anemia which might be contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome.
,⩥ What are pharmacological remedies for Angina? Answer:
Nitroglycerin (Drug of choice):
Nitroglycerin relaxes and widens the blood vessel promoting easier
blood flow to the heart muscle. Dosing of nitroglycerin is 0.3-0.6 mg by
translingual spray or sublingual tablet every five minutes, as indicated
with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors
⩥ What is a myocardial infarction? Answer: (Heart Attack)
A myocardial infarction (MI) occurs when blood flow to the heart is
minimized. The blockage is most often caused by a buildup of
cholesterol, which forms a plaque in the arteries that circulate
oxygenated blood flow to the myocardium. When the plaque breaks
away it can form a clot, interrupting or completely blocking blood flow
and destroying a part of the heart muscle. Unlike with an episode of
angina, those experiencing a myocardial
infarction often report symptoms of pain at rest.
⩥ What is the patho of a Myocardial Infarction? Answer: During a
myocardial infarction there is an imbalance between myocardial oxygen
supply and demand. Prolonged ischemia (>30 minutes) from the lack of
circulating blood flow to the myocardium results in cellular death,
further impacting the heart's ability to function. Depending on the extent
,of the cell death, the heart might have decreased contractility resulting in
wall function abnormalities further placing the patient at risk for
decompensation.
⩥ What are the symptoms of a Myocardial Infraction? Answer: - Sharp
radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing
⩥ What lab test are needed for a Myocardial Infraction? Answer: -
Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left
bundle
branch block.
⩥ How do you manage a Myocardial Infraction? Answer: Patients
presenting with acute myocardial infarction will need reperfusion
, therapy or fibrinolytic therapy. To decrease mortality rates, reperfusion
through PCI needs to be completed within 90 minutes of presentation to
the emergency room.
⩥ What is Atherosclerosis? Answer: a disease of the arteries
characterized by the deposition of plaques of fatty material on their inner
walls.
⩥ What is the path of Atherosclerosis? Answer: Atherosclerosis is an
inflammatory process that begins with damage to the endothelium often
the result of hypertension, smoking, high cholesterol or other risk
factors. The endothelium develops a fatty streak which further develops
into a fibrous plaque and then complicated lesion.
⩥ Physical assessment of Atherosclerosis? Answer: Family medical
history and personal medical history should be reviewed for risk factors,
including level of physical activity, tobacco, use, and dietary habits. A
review of symptoms including recent and increasing fatigue, as well as
fluid retention should be completed. A medication history should be
obtained to determine risk factors including high cholesterol,
hypertension, or diabetes.
While a full physical assessment should be performed, particular
attention to pulse deficits, neck vein distention, edema, and calf pain can
further contribute to the diagnosis.
