NUR 355 Exam 5 Actual Exam 2026/2027 –
V1 & V2 Questions and Answers – Complete
Solution with Detailed Rationales – Pass
Guaranteed – A+ Graded
Cardiovascular Complex Conditions
Q1: As you are getting report on your ICU patient, the night nurse mentions the patient's
central venous pressure (CVP) from last shift was 2 mmHg. What does this value
typically indicate about the patient's volume status?
A. The patient is likely volume overloaded.
B. The patient is likely severely hypovolemic.
C. The patient is in right-sided heart failure.
D. The patient has normal fluid balance.
Correct Answer: B
Rationale: A normal CVP ranges from 2 to 8 mmHg, but a value at the extreme low end
of 2 mmHg in an acutely ill patient usually signals hypovolemia, meaning the venous
return to the heart is too low. Volume overload and right-sided heart failure (A, C) would
push the CVP up. Normal fluid balance (D) doesn't automatically explain a bottomed-out
CVP in the ICU.
Q2: You are reviewing morning labs for a patient admitted with chest pain. Their serum
lactate level is 1.2 mmol/L. How should you interpret this result in the context of their
cardiovascular status?
A. It indicates severe tissue hypoperfusion and impending shock.
B. It is a normal finding and suggests adequate tissue oxygenation.
C. It means the patient has developed a severe aerobic infection.
D. It shows the patient is having an acute myocardial infarction.
Correct Answer: B
Rationale: Normal serum lactate is generally less than 2.0 mmol/L. A level of 1.2
mmol/L means the patient's tissues are being adequately perfused and oxygenated
without relying on anaerobic metabolism. Levels above 2.0 mmHg (A) suggest
hypoperfusion. Lactate isn't specific to infections (C) or myocardial infarctions (D) on its
own.
,Q3: When calculating a patient's Mean Arterial Pressure (MAP), which of the following
ranges is considered the minimum target to ensure adequate perfusion to vital organs
like the brain and kidneys?
A. Greater than 50 mmHg
B. Greater than 60 mmHg
C. Greater than 90 mmHg
D. Greater than 110 mmHg
Correct Answer: B
Rationale: A MAP of at least 65 mmHg is the standard target in most critical care
settings to sustain autoregulation of the brain and kidneys. Below 60 mmHg (A), these
organs become ischemic. Goals of 90 or 110 mmHg (C, D) are unnecessarily high for a
baseline perfusion target and would require aggressive, risky interventions.
Q4: You walk into your patient's room and notice they are sitting straight up, gasping for
breath, and you hear coarse crackles throughout their lung fields bilaterally. Their legs
are profoundly edematous. Which medication class do you anticipate the provider will
order first to resolve this acute exacerbation?
A. Beta-blocker
B. Loop diuretic
C. Calcium channel blocker
D. Antiplatelet agent
Correct Answer: B
Rationale: This patient is experiencing acute decompensated heart failure with
pulmonary edema. Loop diuretics (like furosemide) are the first-line treatment to rapidly
pull the fluid off the lungs and reduce preload. Beta-blockers and calcium channel
blockers (A, C) will slow the heart rate too much or decrease contractility when a patient
is actively failing. Antiplatelets (D) won't fix acute fluid overload.
Q5: A patient arrives to the ED with cool, clammy skin, a blood pressure of 78/50, and a
heart rate of 125. Their cardiac monitor shows ST elevations in V1-V4. You recognize
they are in cardiogenic shock. Which hemodynamic parameter is most likely elevated in
this specific type of shock?
A. Systemic Vascular Resistance (SVR)
B. Pulmonary Capillary Wedge Pressure (PCWP)
C. Cardiac Output (CO)
D. Central Venous Oxygen Saturation (ScvO2)
Correct Answer: B
Rationale: Cardiogenic shock means the pump is failing. Blood backs up into the lungs,
which directly elevates the Pulmonary Capillary Wedge Pressure (PCWP). SVR (A) is
also elevated as the body clamps down, but PCWP is the direct reflection of the
, left-sided backup. Cardiac output (C) and ScvO2 (D) drop because blood isn't moving
forward.
Q6: You are caring for a patient with a confirmed STEMI. They have a history of severe
erectile dysfunction and just took a dose of sildenafil (Viagra) two hours ago. Their
blood pressure is 150/90, and they are having crushing chest pain. Which medication is
strictly contraindicated?
A. Heparin
B. Nitroglycerin
C. Morphine
D. Aspirin
Correct Answer: B
Rationale: Nitroglycerin is strictly contraindicated in patients who have taken
phosphodiesterase-5 inhibitors (like sildenafil) within the last 24 to 48 hours because the
combination can cause a profound, life-threatening drop in blood pressure. Heparin,
morphine, and aspirin (A, C, D) do not have this dangerous interaction.
Q7: A patient is admitted with a hypertensive crisis and is complaining of a severe,
throbbing headache and blurred vision. The provider orders a continuous IV infusion of
nicardipine. What is your primary nursing priority during this titration?
A. Keeping the room dark and quiet to reduce the headache
B. Lowering the blood pressure to normal limits (120/80) within the first hour
C. Monitoring the blood pressure every 5 to 15 minutes to prevent a sudden, precipitous
drop
D. Encouraging the patient to ambulate to improve circulation
Correct Answer: C
Rationale: The biggest danger in hypertensive crisis treatment is lowering the blood
pressure too fast, which can cause ischemia to the brain, kidneys, or heart. You must
monitor continuously (every 5-15 mins) and titrate slowly. Lowering to 120/80 in an hour
(B) is dangerous; the goal is usually a 25% reduction in the first hour. Dark rooms (A)
are nice but not the priority over safety. Ambulation (D) is unsafe.
Q8: Your patient goes into sudden cardiac arrest, and the defibrillator shows a wide,
regular, chaotic rhythm without a pulse. You shock the patient and immediately resume
CPR. Which medication do you prepare to give next?
A. Atropine
B. Amiodarone
C. Adenosine
D. Diltiazem
Correct Answer: B
V1 & V2 Questions and Answers – Complete
Solution with Detailed Rationales – Pass
Guaranteed – A+ Graded
Cardiovascular Complex Conditions
Q1: As you are getting report on your ICU patient, the night nurse mentions the patient's
central venous pressure (CVP) from last shift was 2 mmHg. What does this value
typically indicate about the patient's volume status?
A. The patient is likely volume overloaded.
B. The patient is likely severely hypovolemic.
C. The patient is in right-sided heart failure.
D. The patient has normal fluid balance.
Correct Answer: B
Rationale: A normal CVP ranges from 2 to 8 mmHg, but a value at the extreme low end
of 2 mmHg in an acutely ill patient usually signals hypovolemia, meaning the venous
return to the heart is too low. Volume overload and right-sided heart failure (A, C) would
push the CVP up. Normal fluid balance (D) doesn't automatically explain a bottomed-out
CVP in the ICU.
Q2: You are reviewing morning labs for a patient admitted with chest pain. Their serum
lactate level is 1.2 mmol/L. How should you interpret this result in the context of their
cardiovascular status?
A. It indicates severe tissue hypoperfusion and impending shock.
B. It is a normal finding and suggests adequate tissue oxygenation.
C. It means the patient has developed a severe aerobic infection.
D. It shows the patient is having an acute myocardial infarction.
Correct Answer: B
Rationale: Normal serum lactate is generally less than 2.0 mmol/L. A level of 1.2
mmol/L means the patient's tissues are being adequately perfused and oxygenated
without relying on anaerobic metabolism. Levels above 2.0 mmHg (A) suggest
hypoperfusion. Lactate isn't specific to infections (C) or myocardial infarctions (D) on its
own.
,Q3: When calculating a patient's Mean Arterial Pressure (MAP), which of the following
ranges is considered the minimum target to ensure adequate perfusion to vital organs
like the brain and kidneys?
A. Greater than 50 mmHg
B. Greater than 60 mmHg
C. Greater than 90 mmHg
D. Greater than 110 mmHg
Correct Answer: B
Rationale: A MAP of at least 65 mmHg is the standard target in most critical care
settings to sustain autoregulation of the brain and kidneys. Below 60 mmHg (A), these
organs become ischemic. Goals of 90 or 110 mmHg (C, D) are unnecessarily high for a
baseline perfusion target and would require aggressive, risky interventions.
Q4: You walk into your patient's room and notice they are sitting straight up, gasping for
breath, and you hear coarse crackles throughout their lung fields bilaterally. Their legs
are profoundly edematous. Which medication class do you anticipate the provider will
order first to resolve this acute exacerbation?
A. Beta-blocker
B. Loop diuretic
C. Calcium channel blocker
D. Antiplatelet agent
Correct Answer: B
Rationale: This patient is experiencing acute decompensated heart failure with
pulmonary edema. Loop diuretics (like furosemide) are the first-line treatment to rapidly
pull the fluid off the lungs and reduce preload. Beta-blockers and calcium channel
blockers (A, C) will slow the heart rate too much or decrease contractility when a patient
is actively failing. Antiplatelets (D) won't fix acute fluid overload.
Q5: A patient arrives to the ED with cool, clammy skin, a blood pressure of 78/50, and a
heart rate of 125. Their cardiac monitor shows ST elevations in V1-V4. You recognize
they are in cardiogenic shock. Which hemodynamic parameter is most likely elevated in
this specific type of shock?
A. Systemic Vascular Resistance (SVR)
B. Pulmonary Capillary Wedge Pressure (PCWP)
C. Cardiac Output (CO)
D. Central Venous Oxygen Saturation (ScvO2)
Correct Answer: B
Rationale: Cardiogenic shock means the pump is failing. Blood backs up into the lungs,
which directly elevates the Pulmonary Capillary Wedge Pressure (PCWP). SVR (A) is
also elevated as the body clamps down, but PCWP is the direct reflection of the
, left-sided backup. Cardiac output (C) and ScvO2 (D) drop because blood isn't moving
forward.
Q6: You are caring for a patient with a confirmed STEMI. They have a history of severe
erectile dysfunction and just took a dose of sildenafil (Viagra) two hours ago. Their
blood pressure is 150/90, and they are having crushing chest pain. Which medication is
strictly contraindicated?
A. Heparin
B. Nitroglycerin
C. Morphine
D. Aspirin
Correct Answer: B
Rationale: Nitroglycerin is strictly contraindicated in patients who have taken
phosphodiesterase-5 inhibitors (like sildenafil) within the last 24 to 48 hours because the
combination can cause a profound, life-threatening drop in blood pressure. Heparin,
morphine, and aspirin (A, C, D) do not have this dangerous interaction.
Q7: A patient is admitted with a hypertensive crisis and is complaining of a severe,
throbbing headache and blurred vision. The provider orders a continuous IV infusion of
nicardipine. What is your primary nursing priority during this titration?
A. Keeping the room dark and quiet to reduce the headache
B. Lowering the blood pressure to normal limits (120/80) within the first hour
C. Monitoring the blood pressure every 5 to 15 minutes to prevent a sudden, precipitous
drop
D. Encouraging the patient to ambulate to improve circulation
Correct Answer: C
Rationale: The biggest danger in hypertensive crisis treatment is lowering the blood
pressure too fast, which can cause ischemia to the brain, kidneys, or heart. You must
monitor continuously (every 5-15 mins) and titrate slowly. Lowering to 120/80 in an hour
(B) is dangerous; the goal is usually a 25% reduction in the first hour. Dark rooms (A)
are nice but not the priority over safety. Ambulation (D) is unsafe.
Q8: Your patient goes into sudden cardiac arrest, and the defibrillator shows a wide,
regular, chaotic rhythm without a pulse. You shock the patient and immediately resume
CPR. Which medication do you prepare to give next?
A. Atropine
B. Amiodarone
C. Adenosine
D. Diltiazem
Correct Answer: B
