NR 545 EXAM 1 LATEST 2026 LATEST SPRING
SUMMER EXAM 100% GUARANTEED PASS
(FULL LENGTH EXAM WITH ANSWERS AND
DETAILED RATIONALES)
1. A patient presents with substernal chest pressure radiating to the left arm, lasting 5 minutes, relieved by rest. What
is this?
A) Unstable angina
B) Myocardial infarction
C) Stable angina
D) Pericarditis
Answer: C
Stable angina occurs with exertion and resolves with rest or nitroglycerin.
2. Which lab value is the most sensitive and specific for acute myocardial infarction?
A) CK-MB
B) Myoglobin
C) Troponin I
D) LDH
Answer: C
Troponin rises within hours and remains elevated for days; gold standard for MI.
3. A patient with heart failure reports waking up at night gasping for air, relieved by sitting up. This is called:
A) Orthopnea
B) Paroxysmal nocturnal dyspnea
C) Dyspnea on exertion
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,D) Kussmaul breathing
Answer: B
PND occurs due to fluid redistribution to the lungs when supine, common in left heart failure.
4. What is the primary pathophysiological mechanism of coronary artery disease?
A) Vasospasm of coronary arteries
B) Atherosclerotic plaque formation
C) Inflammatory destruction of valves
D) Thromboembolism from the left atrium
Answer: B
Atherosclerosis narrows coronary arteries, reducing oxygen delivery to the myocardium.
5. A patient with an ischemic stroke arrives 2 hours after symptom onset. Which treatment is first-line if no
contraindications?
A) Aspirin 325 mg
B) Warfarin
C) tPA (alteplase)
D) Clopidogrel
Answer: C
tPA dissolves the clot and must be given within 3–4.5 hours of symptom onset.
6. Which EKG finding is most consistent with acute myocardial injury (infarction)?
A) ST-segment depression
B) T-wave inversion
C) ST-segment elevation
D) Prolonged QT interval
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,Answer: C
ST elevation indicates transmural ischemia and requires emergent reperfusion.
7. A patient with chronic heart failure has a BNP level of 1,200 pg/mL. This indicates:
A) Well-compensated HF
B) Severe fluid overload
C) Dehydration
D) Pulmonary embolism
Answer: B
BNP >500 pg/mL suggests decompensated heart failure with volume overload.
8. Which medication class is first-line for stable angina?
A) Beta-blockers
B) Calcium channel blockers
C) Nitrates
D) ACE inhibitors
Answer: C
Nitrates (e.g., nitroglycerin) vasodilate coronary arteries and reduce preload.
9. A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 4. What is recommended?
A) Aspirin only
B) No anticoagulation
C) Oral anticoagulation (warfarin/DOAC)
D) Dual antiplatelet therapy
Answer: C
High CHA₂DS₂-VASc indicates elevated stroke risk; anticoagulation is indicated.
3|Page SUCCESS!!!
, 10. What is the most common cause of valvular aortic stenosis in elderly adults?
A) Rheumatic fever
B) Bicuspid aortic valve
C) Calcific degeneration
D) Infective endocarditis
Answer: C
Age-related calcific trileaflet valve degeneration is most common in elderly.
11. A patient with right-sided heart failure is expected to have:
A) Crackles in lungs
B) Jugular venous distention
C) Paroxysmal nocturnal dyspnea
D) Orthostatic hypotension
Answer: B
Right HF causes systemic congestion: JVD, peripheral edema, hepatomegaly.
12. Which medication is first-line for chronic heart failure with reduced ejection fraction (HFrEF)?
A) Digoxin
B) Hydralazine
C) Metoprolol succinate
D) Furosemide
Answer: C
Beta-blockers (carvedilol, metoprolol succinate) reduce mortality in HFrEF.
4|Page SUCCESS!!!
SUMMER EXAM 100% GUARANTEED PASS
(FULL LENGTH EXAM WITH ANSWERS AND
DETAILED RATIONALES)
1. A patient presents with substernal chest pressure radiating to the left arm, lasting 5 minutes, relieved by rest. What
is this?
A) Unstable angina
B) Myocardial infarction
C) Stable angina
D) Pericarditis
Answer: C
Stable angina occurs with exertion and resolves with rest or nitroglycerin.
2. Which lab value is the most sensitive and specific for acute myocardial infarction?
A) CK-MB
B) Myoglobin
C) Troponin I
D) LDH
Answer: C
Troponin rises within hours and remains elevated for days; gold standard for MI.
3. A patient with heart failure reports waking up at night gasping for air, relieved by sitting up. This is called:
A) Orthopnea
B) Paroxysmal nocturnal dyspnea
C) Dyspnea on exertion
1|Page SUCCESS!!!
,D) Kussmaul breathing
Answer: B
PND occurs due to fluid redistribution to the lungs when supine, common in left heart failure.
4. What is the primary pathophysiological mechanism of coronary artery disease?
A) Vasospasm of coronary arteries
B) Atherosclerotic plaque formation
C) Inflammatory destruction of valves
D) Thromboembolism from the left atrium
Answer: B
Atherosclerosis narrows coronary arteries, reducing oxygen delivery to the myocardium.
5. A patient with an ischemic stroke arrives 2 hours after symptom onset. Which treatment is first-line if no
contraindications?
A) Aspirin 325 mg
B) Warfarin
C) tPA (alteplase)
D) Clopidogrel
Answer: C
tPA dissolves the clot and must be given within 3–4.5 hours of symptom onset.
6. Which EKG finding is most consistent with acute myocardial injury (infarction)?
A) ST-segment depression
B) T-wave inversion
C) ST-segment elevation
D) Prolonged QT interval
2|Page SUCCESS!!!
,Answer: C
ST elevation indicates transmural ischemia and requires emergent reperfusion.
7. A patient with chronic heart failure has a BNP level of 1,200 pg/mL. This indicates:
A) Well-compensated HF
B) Severe fluid overload
C) Dehydration
D) Pulmonary embolism
Answer: B
BNP >500 pg/mL suggests decompensated heart failure with volume overload.
8. Which medication class is first-line for stable angina?
A) Beta-blockers
B) Calcium channel blockers
C) Nitrates
D) ACE inhibitors
Answer: C
Nitrates (e.g., nitroglycerin) vasodilate coronary arteries and reduce preload.
9. A patient with atrial fibrillation has a CHA₂DS₂-VASc score of 4. What is recommended?
A) Aspirin only
B) No anticoagulation
C) Oral anticoagulation (warfarin/DOAC)
D) Dual antiplatelet therapy
Answer: C
High CHA₂DS₂-VASc indicates elevated stroke risk; anticoagulation is indicated.
3|Page SUCCESS!!!
, 10. What is the most common cause of valvular aortic stenosis in elderly adults?
A) Rheumatic fever
B) Bicuspid aortic valve
C) Calcific degeneration
D) Infective endocarditis
Answer: C
Age-related calcific trileaflet valve degeneration is most common in elderly.
11. A patient with right-sided heart failure is expected to have:
A) Crackles in lungs
B) Jugular venous distention
C) Paroxysmal nocturnal dyspnea
D) Orthostatic hypotension
Answer: B
Right HF causes systemic congestion: JVD, peripheral edema, hepatomegaly.
12. Which medication is first-line for chronic heart failure with reduced ejection fraction (HFrEF)?
A) Digoxin
B) Hydralazine
C) Metoprolol succinate
D) Furosemide
Answer: C
Beta-blockers (carvedilol, metoprolol succinate) reduce mortality in HFrEF.
4|Page SUCCESS!!!
