Nsg 530 Exam 2 Review | Questions And Answers | 2026/2027 Update | With Complete Solutions - Wilkes.

NSG 530 EXAM 2 REVIEW |
QUESTIONS AND ANSWERS |
2026/2027 UPDATE | WITH
COMPLETE SOLUTIONS - WILKES.




SECTION 1: CARDIOVASCULAR SYSTEM
PATHOPHYSIOLOGY

Question 1
What is the most common cause of heart failure in the United States?

A) Valvular heart disease
B) Coronary artery disease
C) Hypertension
D) Myocarditis

Rationale: Coronary artery disease (CAD) is the most common cause of heart failure in
the United States. Hypertension is the second leading cause. Both lead to myocardial
ischemia and dysfunction.




Question 2

,A patient with heart failure with reduced ejection fraction (HFrEF) has an ejection
fraction of:

A) > 50%
B) < 40%
C) 40-50%
D) > 60%

Rationale: HFrEF is defined as an ejection fraction (EF) of < 40%. Heart failure with
preserved ejection fraction (HFpEF) has an EF > 50%. HF with mid-range EF is 40-50%.




Question 3
A patient with heart failure presents with weight gain, peripheral edema, and
jugular venous distension. This is most consistent with:

A) Systolic heart failure with fluid overload
B) Diastolic heart failure
C) Acute decompensated heart failure
D) Right-sided heart failure only

Rationale: Weight gain, peripheral edema, and jugular venous distension indicate fluid
overload, which is common in systolic heart failure (HFrEF). Right-sided heart failure can
occur as a complication of left-sided failure.




Question 4
What is the first-line medication for a patient with heart failure with reduced
ejection fraction (HFrEF)?

A) ACE inhibitors or ARBs
B) Calcium channel blockers
C) Thiazide diuretics only
D) NSAIDs

,Rationale: ACE inhibitors or ARBs are first-line treatment for HFrEF. They reduce
afterload and preload, improve symptoms, and reduce mortality. Beta-blockers (e.g.,
carvedilol, metoprolol succinate) are also recommended.




Question 5
A patient with chronic heart failure develops a cough, worsening dyspnea, and
frothy pink sputum. What is the most likely diagnosis?

A) Acute pulmonary edema
B) Pneumonia
C) Pulmonary embolism
D) COPD exacerbation

Rationale: Frothy pink sputum is a classic sign of acute pulmonary edema. This is a
medical emergency caused by acute decompensated heart failure, requiring oxygen,
diuretics, and vasodilators.




Question 6
What is the classic chest X-ray finding in heart failure?

A) Pulmonary edema (Kerley B lines, pleural effusion)
B) Upper lobe cavitary lesions
C) Consolidation with air bronchograms
D) Hilar adenopathy

Rationale: Heart failure with fluid overload causes pulmonary edema, which shows on
chest X-ray as Kerley B lines (septal lines), pleural effusion, and bat wing opacities.




Question 7

, A 55-year-old patient presents with chest pain described as pressure radiating to
the left arm, accompanied by diaphoresis and nausea. The EKG shows ST-segment
elevation in leads V1-V4. What is the most likely diagnosis?

A) Unstable angina
B) ST-segment elevation myocardial infarction (STEMI)
C) Non-ST elevation myocardial infarction (NSTEMI)
D) Pericarditis

Rationale: STEMI is characterized by ST-segment elevation in contiguous leads (V1-V4
indicates anterior wall MI). Immediate reperfusion therapy (PCI or thrombolytics) is
indicated.




Question 8
What is the first-line treatment for STEMI?

A) Emergency percutaneous coronary intervention (PCI)
B) Thrombolytic therapy
C) Oral anticoagulants
D) Beta-blockers only

Rationale: Emergency PCI is the preferred treatment for STEMI when available.
Thrombolytics are used if PCI cannot be performed within 90-120 minutes. "Door-to-
balloon" time should be < 90 minutes.




Question 9
Which cardiac biomarker is most specific for myocardial infarction?

A) Creatine kinase MB (CK-MB)
B) Myoglobin
C) Troponin I or T
D) LDH