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NSG 430 Adult Health Nursing II — Exam 2 Practice Questions
Complete (Verified Update!!!!2026–2027)
Exam 2 Blueprint Coverage:
• Topic 5: Management of Acute Cardiovascular Disorders
• Topic 6: Management of Acute Respiratory Disorders
• Topic 7: Management of Acute Renal & Urinary Disorders
• Topic 8: Management of Acute Hematologic Disorders
• Topic 9: Management of Shock States
SECTION 1: CARDIOVASCULAR DISORDERS (Questions)
Acute Coronary Syndrome & Myocardial Infarction
1. A patient with acute chest pain reports pressure radiating to
the left arm and jaw. Which condition should the nurse suspect
first?
A) Gastroesophageal reflux disease
B) Acute coronary syndrome
C) Peptic ulcer disease
D) Costochondritis
Correct Answer: B
Rationale: Substernal chest pressure radiating to the left arm
and jaw is the classic presentation of acute coronary syndrome
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(ACS). Gastroesophageal reflux typically causes burning
epigastric pain, peptic ulcer disease causes gnawing epigastric
pain relieved by food or antacids, and costochondritis causes
reproducible chest wall tenderness.
2. Which laboratory value is most specific for myocardial injury?
A) BNP
B) D-dimer
C) Cardiac troponin
D) Serum potassium
Correct Answer: C
Rationale: Cardiac troponin I and T are the most specific and
sensitive biomarkers for myocardial injury. They are released
when myocardial cells are damaged and are not found in other
tissues. BNP indicates heart failure, D-dimer indicates clot
formation, and potassium is an electrolyte.
3. A 68-year-old male is admitted with chest pain rated 8/10,
radiating to his left jaw and arm. His blood pressure is 92/58
mmHg, heart rate is 48 bpm, and he is diaphoretic. The nurse
recognizes these findings as indicative of an inferior wall
myocardial infarction and prepares for which priority
intervention?
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A) Atropine 0.5 mg IV push for symptomatic bradycardia
B) Nitroglycerin 0.4 mg sublingual for chest pain relief
C) Metoprolol 25 mg PO for rate control
D) Furosemide 40 mg IV for fluid overload
Correct Answer: A
Rationale: Inferior wall MIs often involve the right coronary
artery, which supplies the SA and AV nodes, causing
bradycardia and hypotension. Atropine is indicated for
symptomatic bradycardia. Nitroglycerin and metoprolol could
worsen hypotension in this scenario.
4. Which assessment finding is most concerning in a patient
with acute myocardial infarction?
A) Mild fatigue
B) New-onset ventricular dysrhythmia
C) Increased appetite
D) Mild headache
Correct Answer: B
Rationale: New-onset ventricular dysrhythmias (such as
ventricular tachycardia or fibrillation) are life-threatening
complications of MI and are the leading cause of sudden
cardiac death in the post-MI period. The other findings are not
immediately concerning.
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5. A patient is started on metoprolol after an MI. Which
assessment finding indicates that the medication is effective?
A) Decreased heart rate and blood pressure
B) Increased heart rate
C) Increased blood pressure
D) Decreased respiratory rate
Correct Answer: A
Rationale: Metoprolol is a beta-blocker that reduces heart rate,
contractility, and blood pressure, thereby decreasing
myocardial oxygen demand. A decreased heart rate and blood
pressure indicate therapeutic effectiveness. The nurse should
monitor for symptomatic bradycardia and hypotension.
6. A nurse is reviewing the ECG of a patient with an acute MI.
Which finding indicates a STEMI?
A) ST-segment elevation in contiguous leads
B) ST-segment depression
C) T-wave inversion
D) Normal sinus rhythm
Correct Answer: A
Rationale: ST-segment elevation in contiguous leads is the
hallmark of STEMI, indicating transmural myocardial injury. ST
depression and T-wave inversion are seen in NSTEMI or
NSG 430 Adult Health Nursing II — Exam 2 Practice Questions
Complete (Verified Update!!!!2026–2027)
Exam 2 Blueprint Coverage:
• Topic 5: Management of Acute Cardiovascular Disorders
• Topic 6: Management of Acute Respiratory Disorders
• Topic 7: Management of Acute Renal & Urinary Disorders
• Topic 8: Management of Acute Hematologic Disorders
• Topic 9: Management of Shock States
SECTION 1: CARDIOVASCULAR DISORDERS (Questions)
Acute Coronary Syndrome & Myocardial Infarction
1. A patient with acute chest pain reports pressure radiating to
the left arm and jaw. Which condition should the nurse suspect
first?
A) Gastroesophageal reflux disease
B) Acute coronary syndrome
C) Peptic ulcer disease
D) Costochondritis
Correct Answer: B
Rationale: Substernal chest pressure radiating to the left arm
and jaw is the classic presentation of acute coronary syndrome
, Page |2
(ACS). Gastroesophageal reflux typically causes burning
epigastric pain, peptic ulcer disease causes gnawing epigastric
pain relieved by food or antacids, and costochondritis causes
reproducible chest wall tenderness.
2. Which laboratory value is most specific for myocardial injury?
A) BNP
B) D-dimer
C) Cardiac troponin
D) Serum potassium
Correct Answer: C
Rationale: Cardiac troponin I and T are the most specific and
sensitive biomarkers for myocardial injury. They are released
when myocardial cells are damaged and are not found in other
tissues. BNP indicates heart failure, D-dimer indicates clot
formation, and potassium is an electrolyte.
3. A 68-year-old male is admitted with chest pain rated 8/10,
radiating to his left jaw and arm. His blood pressure is 92/58
mmHg, heart rate is 48 bpm, and he is diaphoretic. The nurse
recognizes these findings as indicative of an inferior wall
myocardial infarction and prepares for which priority
intervention?
, Page |3
A) Atropine 0.5 mg IV push for symptomatic bradycardia
B) Nitroglycerin 0.4 mg sublingual for chest pain relief
C) Metoprolol 25 mg PO for rate control
D) Furosemide 40 mg IV for fluid overload
Correct Answer: A
Rationale: Inferior wall MIs often involve the right coronary
artery, which supplies the SA and AV nodes, causing
bradycardia and hypotension. Atropine is indicated for
symptomatic bradycardia. Nitroglycerin and metoprolol could
worsen hypotension in this scenario.
4. Which assessment finding is most concerning in a patient
with acute myocardial infarction?
A) Mild fatigue
B) New-onset ventricular dysrhythmia
C) Increased appetite
D) Mild headache
Correct Answer: B
Rationale: New-onset ventricular dysrhythmias (such as
ventricular tachycardia or fibrillation) are life-threatening
complications of MI and are the leading cause of sudden
cardiac death in the post-MI period. The other findings are not
immediately concerning.
, Page |4
5. A patient is started on metoprolol after an MI. Which
assessment finding indicates that the medication is effective?
A) Decreased heart rate and blood pressure
B) Increased heart rate
C) Increased blood pressure
D) Decreased respiratory rate
Correct Answer: A
Rationale: Metoprolol is a beta-blocker that reduces heart rate,
contractility, and blood pressure, thereby decreasing
myocardial oxygen demand. A decreased heart rate and blood
pressure indicate therapeutic effectiveness. The nurse should
monitor for symptomatic bradycardia and hypotension.
6. A nurse is reviewing the ECG of a patient with an acute MI.
Which finding indicates a STEMI?
A) ST-segment elevation in contiguous leads
B) ST-segment depression
C) T-wave inversion
D) Normal sinus rhythm
Correct Answer: A
Rationale: ST-segment elevation in contiguous leads is the
hallmark of STEMI, indicating transmural myocardial injury. ST
depression and T-wave inversion are seen in NSTEMI or
