West Coast University NURS 120 Week 6 Quiz (pdf) |
2026/2027 | Cardiovascular & Perfusion Q&A | Medical-
Surgical Nursing
1. The sinoatrial (SA) node initiates the cardiac cycle through a process known as the SA kick.
Which physiological event directly triggers this impulse generation?
A) Rapid filling of the left ventricle during diastole
B) 80% to 90% filling of the right atrium with blood
C) Closure of the semilunar valves during isovolumetric contraction
D) Depolarization of the atrioventricular node
Correct Answer: 80% to 90% filling of the right atrium with blood
Rationale: The SA node fires when the right atrium reaches approximately 80% to 90% filling, which
triggers atrial depolarization and the beginning of the cardiac cycle. Conditions that reduce atrial
volume, such as hemorrhage, can impair this mechanism. The other options describe events that
occur after SA node firing or relate to ventricular function.
2. A nurse is reviewing modifiable risk factors for atherosclerosis with a community group.
Which factor should the nurse emphasize as having the greatest potential for reduction
through lifestyle change?
A) Family history of coronary artery disease
B) Age over 65 years
C) Cigarette smoking
D) Male biological sex
Correct Answer: Cigarette smoking
Rationale: Cigarette smoking is a major modifiable risk factor for atherosclerosis and cardiovascular
disease. Family history, advanced age, and male sex are non-modifiable factors that cannot be
altered through lifestyle changes. Smoking cessation significantly reduces cardiovascular risk within
months of quitting.
3. Which electrocardiographic finding is most characteristic of a ST-elevation myocardial
infarction (STEMI) and requires immediate reperfusion therapy?
A) ST depression in contiguous leads
B) T wave inversion in a single lead
C) ST elevation in two or more contiguous leads
D) Prolonged QT interval across all leads
Correct Answer: ST elevation in two or more contiguous leads
,Rationale: STEMI is diagnosed when ST elevation is present in two or more contiguous leads on a 12-
lead ECG, indicating complete coronary artery occlusion. This finding mandates emergent
reperfusion, ideally within 90 minutes of first medical contact. ST depression and T wave inversion are
more consistent with ischemia or non-STEMI patterns.
4. A patient with chronic stable angina reports chest discomfort that occurs predictably with
exertion and resolves within 5 minutes of rest. Which pathophysiological mechanism best
explains this pattern?
A) Complete rupture of an atherosclerotic plaque
B) Transient imbalance between myocardial oxygen supply and demand
C) Acute coronary artery vasospasm at rest
D) Embolic occlusion of a coronary artery
Correct Answer: Transient imbalance between myocardial oxygen supply and demand
Rationale: Chronic stable angina results from a reversible mismatch between myocardial oxygen
supply and demand, typically triggered by physical exertion or emotional stress. The discomfort
resolves when oxygen demand decreases with rest. Plaque rupture and embolic occlusion cause acute
coronary syndromes, not predictable exertional angina.
5. A patient is scheduled for a cardiac catheterization. Which pre-procedure assessment finding
should the nurse report to the provider immediately?
A) Allergy to shellfish
B) Serum creatinine of 1.0 mg/dL
C) International normalized ratio (INR) of 3.5
D) Blood pressure of 138/82 mm Hg
Correct Answer: International normalized ratio (INR) of 3.5
Rationale: An INR of 3.5 indicates the patient is at significant risk for bleeding, which is a critical
concern before an invasive procedure. The provider may need to adjust anticoagulation therapy or
postpone the catheterization. Shellfish allergy is relevant due to contrast media but does not require
immediate provider notification. A creatinine of 1.0 is within normal limits.
6. Which assessment finding in a patient with peripheral arterial disease (PAD) would the nurse
most likely identify?
A) Dependent rubor and thick, opaque toenails
B) Pitting edema of the lower extremities
C) Warm, erythematous skin over the affected limb
D) Bounding pedal pulses
Correct Answer: Dependent rubor and thick, opaque toenails
, Rationale: Peripheral arterial disease reduces blood flow to the extremities, causing dependent rubor,
thickened toenails, hair loss, and cool, pale skin. Edema, warmth, and bounding pulses are more
consistent with venous insufficiency. PAD typically presents with diminished or absent pulses.
7. A nurse is teaching a patient about lifestyle modifications to manage hypertension. Which
dietary pattern should the nurse recommend as having the strongest evidence for blood
pressure reduction?
A) High-protein, low-carbohydrate diet
B) DASH eating plan
C) Intermittent fasting regimen
D) Ketogenic diet
Correct Answer: DASH eating plan
Rationale: The Dietary Approaches to Stop Hypertension (DASH) plan emphasizes fruits, vegetables,
whole grains, and low-fat dairy while reducing sodium and saturated fat. It has the strongest
evidence for lowering blood pressure. High-protein, ketogenic, and intermittent fasting diets lack
comparable evidence for hypertension management.
8. A patient presents with sudden onset of severe chest pain that radiates to the back, along
with a blood pressure difference of 20 mm Hg between the right and left arms. Which
condition should the nurse suspect?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Correct Answer: Aortic dissection
Rationale: Sudden severe chest pain radiating to the back combined with a significant blood pressure
differential between arms is classic for aortic dissection. This is a life-threatening emergency requiring
immediate intervention. MI typically presents with pressure-like pain, and pulmonary embolism
causes dyspnea and pleuritic pain.
9. Which laboratory value is most important for the nurse to monitor in a patient receiving
unfractionated heparin therapy?
A) Serum potassium
B) Activated partial thromboplastin time (aPTT)
C) Prothrombin time (PT)
D) Serum creatinine
Correct Answer: Activated partial thromboplastin time (aPTT)
2026/2027 | Cardiovascular & Perfusion Q&A | Medical-
Surgical Nursing
1. The sinoatrial (SA) node initiates the cardiac cycle through a process known as the SA kick.
Which physiological event directly triggers this impulse generation?
A) Rapid filling of the left ventricle during diastole
B) 80% to 90% filling of the right atrium with blood
C) Closure of the semilunar valves during isovolumetric contraction
D) Depolarization of the atrioventricular node
Correct Answer: 80% to 90% filling of the right atrium with blood
Rationale: The SA node fires when the right atrium reaches approximately 80% to 90% filling, which
triggers atrial depolarization and the beginning of the cardiac cycle. Conditions that reduce atrial
volume, such as hemorrhage, can impair this mechanism. The other options describe events that
occur after SA node firing or relate to ventricular function.
2. A nurse is reviewing modifiable risk factors for atherosclerosis with a community group.
Which factor should the nurse emphasize as having the greatest potential for reduction
through lifestyle change?
A) Family history of coronary artery disease
B) Age over 65 years
C) Cigarette smoking
D) Male biological sex
Correct Answer: Cigarette smoking
Rationale: Cigarette smoking is a major modifiable risk factor for atherosclerosis and cardiovascular
disease. Family history, advanced age, and male sex are non-modifiable factors that cannot be
altered through lifestyle changes. Smoking cessation significantly reduces cardiovascular risk within
months of quitting.
3. Which electrocardiographic finding is most characteristic of a ST-elevation myocardial
infarction (STEMI) and requires immediate reperfusion therapy?
A) ST depression in contiguous leads
B) T wave inversion in a single lead
C) ST elevation in two or more contiguous leads
D) Prolonged QT interval across all leads
Correct Answer: ST elevation in two or more contiguous leads
,Rationale: STEMI is diagnosed when ST elevation is present in two or more contiguous leads on a 12-
lead ECG, indicating complete coronary artery occlusion. This finding mandates emergent
reperfusion, ideally within 90 minutes of first medical contact. ST depression and T wave inversion are
more consistent with ischemia or non-STEMI patterns.
4. A patient with chronic stable angina reports chest discomfort that occurs predictably with
exertion and resolves within 5 minutes of rest. Which pathophysiological mechanism best
explains this pattern?
A) Complete rupture of an atherosclerotic plaque
B) Transient imbalance between myocardial oxygen supply and demand
C) Acute coronary artery vasospasm at rest
D) Embolic occlusion of a coronary artery
Correct Answer: Transient imbalance between myocardial oxygen supply and demand
Rationale: Chronic stable angina results from a reversible mismatch between myocardial oxygen
supply and demand, typically triggered by physical exertion or emotional stress. The discomfort
resolves when oxygen demand decreases with rest. Plaque rupture and embolic occlusion cause acute
coronary syndromes, not predictable exertional angina.
5. A patient is scheduled for a cardiac catheterization. Which pre-procedure assessment finding
should the nurse report to the provider immediately?
A) Allergy to shellfish
B) Serum creatinine of 1.0 mg/dL
C) International normalized ratio (INR) of 3.5
D) Blood pressure of 138/82 mm Hg
Correct Answer: International normalized ratio (INR) of 3.5
Rationale: An INR of 3.5 indicates the patient is at significant risk for bleeding, which is a critical
concern before an invasive procedure. The provider may need to adjust anticoagulation therapy or
postpone the catheterization. Shellfish allergy is relevant due to contrast media but does not require
immediate provider notification. A creatinine of 1.0 is within normal limits.
6. Which assessment finding in a patient with peripheral arterial disease (PAD) would the nurse
most likely identify?
A) Dependent rubor and thick, opaque toenails
B) Pitting edema of the lower extremities
C) Warm, erythematous skin over the affected limb
D) Bounding pedal pulses
Correct Answer: Dependent rubor and thick, opaque toenails
, Rationale: Peripheral arterial disease reduces blood flow to the extremities, causing dependent rubor,
thickened toenails, hair loss, and cool, pale skin. Edema, warmth, and bounding pulses are more
consistent with venous insufficiency. PAD typically presents with diminished or absent pulses.
7. A nurse is teaching a patient about lifestyle modifications to manage hypertension. Which
dietary pattern should the nurse recommend as having the strongest evidence for blood
pressure reduction?
A) High-protein, low-carbohydrate diet
B) DASH eating plan
C) Intermittent fasting regimen
D) Ketogenic diet
Correct Answer: DASH eating plan
Rationale: The Dietary Approaches to Stop Hypertension (DASH) plan emphasizes fruits, vegetables,
whole grains, and low-fat dairy while reducing sodium and saturated fat. It has the strongest
evidence for lowering blood pressure. High-protein, ketogenic, and intermittent fasting diets lack
comparable evidence for hypertension management.
8. A patient presents with sudden onset of severe chest pain that radiates to the back, along
with a blood pressure difference of 20 mm Hg between the right and left arms. Which
condition should the nurse suspect?
A) Acute myocardial infarction
B) Pulmonary embolism
C) Aortic dissection
D) Pericarditis
Correct Answer: Aortic dissection
Rationale: Sudden severe chest pain radiating to the back combined with a significant blood pressure
differential between arms is classic for aortic dissection. This is a life-threatening emergency requiring
immediate intervention. MI typically presents with pressure-like pain, and pulmonary embolism
causes dyspnea and pleuritic pain.
9. Which laboratory value is most important for the nurse to monitor in a patient receiving
unfractionated heparin therapy?
A) Serum potassium
B) Activated partial thromboplastin time (aPTT)
C) Prothrombin time (PT)
D) Serum creatinine
Correct Answer: Activated partial thromboplastin time (aPTT)
