NUR 274/NURS 274 EXAM 3 (CARDIAC)
[QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED
| DETAILED RATIONALES – PASS
GUARANTEED A+ GRADED | INSTANT
DOWNLOAD
Medgar Evers College — Comprehensive Cardiac Nursing Practice Review
Important note: This is an original, exam-style practice bank for studying cardiac
nursing. It is not an official Medgar Evers College examination, and the questions
have not been verified against a confidential exam or current course-specific test
blueprint. Use your instructor’s syllabus and assigned materials to confirm the precise
examinable topics.
Introduction
NUR 274/NURS 274 Exam 3 (Cardiac) preparation focuses on the nursing knowledge
and clinical judgment needed to assess cardiovascular function, recognize life-
threatening complications, prioritize interventions, administer cardiac medications
safely, and evaluate patient responses to treatment. This practice review is designed
for nursing students preparing for a cardiac-focused examination at Medgar Evers
College or reviewing equivalent medical-surgical nursing content.
Cardiac nursing requires more than memorizing diagnoses and medications. Students
must interpret clinical findings, recognize changes in electrocardiograms (ECGs),
distinguish stable from unstable patients, understand cardiac biomarkers, and identify
when immediate intervention is necessary. They must also apply principles of fluid
balance, oxygenation, hemodynamic monitoring, patient education, and discharge
planning.
The question bank uses four-option multiple-choice questions built around clinical
scenarios and application-level reasoning. Each question has one best answer and a
detailed rationale explaining why the correct option is appropriate and why the
alternatives are less appropriate. The review progresses through coronary artery
disease, acute coronary syndromes, heart failure, dysrhythmias, cardiac medications,
valvular disorders, vascular complications, and postoperative care. Practicing with
these questions can strengthen clinical reasoning, reveal knowledge gaps, and help
you develop a structured approach to difficult examination questions. No practice
bank can guarantee a particular grade, but deliberate review of the rationales and
remediation of weak areas can improve preparation.
,Core domains tested
The following are representative cardiac nursing domains, not a confirmed official
course blueprint.
1.
Cardiovascular assessment: Heart sounds, peripheral perfusion, vital signs,
chest pain assessment, and focused cardiovascular history.
2.
3.
Coronary artery disease: Atherosclerosis, angina, myocardial oxygen demand,
and risk-factor modification.
4.
5.
Acute coronary syndromes: STEMI, NSTEMI, unstable angina, cardiac
biomarkers, and reperfusion priorities.
6.
7.
Electrocardiography: ECG interpretation, ischemic changes, conduction
abnormalities, and rhythm recognition.
8.
9.
Cardiac dysrhythmias: Atrial fibrillation, supraventricular tachycardia,
ventricular tachycardia, ventricular fibrillation, and heart block.
10.
11.
Heart failure: Left- and right-sided failure, pulmonary congestion, fluid
management, and treatment evaluation.
12.
13.
Cardiac medications: Antiplatelets, anticoagulants, nitrates, beta-blockers,
ACE inhibitors, diuretics, and antiarrhythmics.
14.
15.
, Hemodynamic instability: Shock, hypotension, impaired cardiac output, and
emergency prioritization.
16.
17.
Valvular and inflammatory disorders: Valve disease, endocarditis, pericarditis,
and cardiac tamponade.
18.
19.
Hypertension and vascular disease: Hypertensive emergencies, peripheral
arterial disease, and thromboembolic complications.
20.
21.
Cardiac procedures: PCI, cardiac catheterization, pacemakers, CABG, and
postoperative monitoring.
22.
23.
Laboratory and diagnostic interpretation: Troponin, electrolytes, renal function,
echocardiography, and relevant hemodynamic measurements.
24.
25.
Patient safety and education: Medication precautions, symptom recognition,
lifestyle modification, and discharge teaching.
26.
QUESTIONS 1–100
Section 1: Coronary Artery Disease and Acute
Coronary Syndromes
Q1: A 62-year-old patient arrives in the emergency department reporting crushing
substernal chest pain radiating to the left arm for 35 minutes. The ECG shows ST-
segment elevation in leads II, III, and aVF. Blood pressure is 86/54 mmHg, and the
patient has jugular venous distention with clear lung sounds. Which intervention
should the nurse anticipate as a priority?
, A) Administer sublingual nitroglycerin immediately B) Recognize possible right
ventricular infarction, obtain urgent cardiac team evaluation, and anticipate cautious
fluid administration if indicated C) Administer an IV loop diuretic to reduce preload
D) Place the patient in a high-Fowler position and restrict fluids
Rationale: Inferior STEMI with hypotension, jugular venous distention, and clear
lungs suggests right ventricular involvement, which can impair preload-dependent
cardiac output. Urgent reperfusion and hemodynamic support are priorities; cautious
isotonic fluid administration may be appropriate after clinical assessment. Option A is
incorrect because nitrates can worsen hypotension in right ventricular infarction.
Option C is incorrect because diuresis may further reduce preload. Option D is
incorrect because fluid restriction and upright positioning alone do not address the
hemodynamic problem and may worsen hypotension.
Q2: A patient with suspected acute myocardial infarction has a prescription for aspirin.
The patient reports no allergy or active bleeding. Which nursing action is most
appropriate?
A) Delay aspirin until the troponin result confirms infarction B) Administer aspirin
only after the patient develops recurrent pain C) Administer the prescribed loading
dose of chewable aspirin promptly D) Substitute an oral anticoagulant for aspirin
Rationale: Early aspirin inhibits platelet aggregation and reduces adverse outcomes in
acute coronary syndromes when no contraindication exists. Chewing the prescribed
loading dose promotes rapid absorption. Option A is incorrect because treatment
should not be unnecessarily delayed for biomarkers when ACS is suspected and
aspirin is appropriate. Option B is incorrect because administration is not dependent
on recurrent pain. Option D is incorrect because anticoagulants and antiplatelet agents
have different mechanisms and are not automatically interchangeable.
Q3: A patient reports chest pressure when climbing stairs that resolves within four
minutes of resting. The episodes have occurred in the same pattern for several months.
Which interpretation is most appropriate?
A) Acute pericarditis B) Unstable angina requiring an automatic diagnosis of
infarction C) Stable angina caused by transient myocardial oxygen supply-demand
imbalance D) Pulmonary embolism until proven otherwise
Rationale: Predictable exertional chest discomfort that resolves with rest is
characteristic of stable angina. The underlying coronary disease limits the ability to
increase blood flow when myocardial oxygen demand rises. Option A is less likely
because pericarditis typically causes pleuritic or positional pain. Option B is incorrect
because stable angina does not establish infarction, and unstable angina involves new,
worsening, or rest symptoms. Option D is not the best fit for this recurrent predictable
pattern, although new symptoms still require assessment.
Q4: A patient with chest pain has an initial high-sensitivity troponin result within the
reference range 45 minutes after symptom onset. The ECG is nondiagnostic. What
should the nurse anticipate?
[QUESTION 1-200] AND ANSWERS
UPDATED 2026/2027 | 100% VERIFIED
| DETAILED RATIONALES – PASS
GUARANTEED A+ GRADED | INSTANT
DOWNLOAD
Medgar Evers College — Comprehensive Cardiac Nursing Practice Review
Important note: This is an original, exam-style practice bank for studying cardiac
nursing. It is not an official Medgar Evers College examination, and the questions
have not been verified against a confidential exam or current course-specific test
blueprint. Use your instructor’s syllabus and assigned materials to confirm the precise
examinable topics.
Introduction
NUR 274/NURS 274 Exam 3 (Cardiac) preparation focuses on the nursing knowledge
and clinical judgment needed to assess cardiovascular function, recognize life-
threatening complications, prioritize interventions, administer cardiac medications
safely, and evaluate patient responses to treatment. This practice review is designed
for nursing students preparing for a cardiac-focused examination at Medgar Evers
College or reviewing equivalent medical-surgical nursing content.
Cardiac nursing requires more than memorizing diagnoses and medications. Students
must interpret clinical findings, recognize changes in electrocardiograms (ECGs),
distinguish stable from unstable patients, understand cardiac biomarkers, and identify
when immediate intervention is necessary. They must also apply principles of fluid
balance, oxygenation, hemodynamic monitoring, patient education, and discharge
planning.
The question bank uses four-option multiple-choice questions built around clinical
scenarios and application-level reasoning. Each question has one best answer and a
detailed rationale explaining why the correct option is appropriate and why the
alternatives are less appropriate. The review progresses through coronary artery
disease, acute coronary syndromes, heart failure, dysrhythmias, cardiac medications,
valvular disorders, vascular complications, and postoperative care. Practicing with
these questions can strengthen clinical reasoning, reveal knowledge gaps, and help
you develop a structured approach to difficult examination questions. No practice
bank can guarantee a particular grade, but deliberate review of the rationales and
remediation of weak areas can improve preparation.
,Core domains tested
The following are representative cardiac nursing domains, not a confirmed official
course blueprint.
1.
Cardiovascular assessment: Heart sounds, peripheral perfusion, vital signs,
chest pain assessment, and focused cardiovascular history.
2.
3.
Coronary artery disease: Atherosclerosis, angina, myocardial oxygen demand,
and risk-factor modification.
4.
5.
Acute coronary syndromes: STEMI, NSTEMI, unstable angina, cardiac
biomarkers, and reperfusion priorities.
6.
7.
Electrocardiography: ECG interpretation, ischemic changes, conduction
abnormalities, and rhythm recognition.
8.
9.
Cardiac dysrhythmias: Atrial fibrillation, supraventricular tachycardia,
ventricular tachycardia, ventricular fibrillation, and heart block.
10.
11.
Heart failure: Left- and right-sided failure, pulmonary congestion, fluid
management, and treatment evaluation.
12.
13.
Cardiac medications: Antiplatelets, anticoagulants, nitrates, beta-blockers,
ACE inhibitors, diuretics, and antiarrhythmics.
14.
15.
, Hemodynamic instability: Shock, hypotension, impaired cardiac output, and
emergency prioritization.
16.
17.
Valvular and inflammatory disorders: Valve disease, endocarditis, pericarditis,
and cardiac tamponade.
18.
19.
Hypertension and vascular disease: Hypertensive emergencies, peripheral
arterial disease, and thromboembolic complications.
20.
21.
Cardiac procedures: PCI, cardiac catheterization, pacemakers, CABG, and
postoperative monitoring.
22.
23.
Laboratory and diagnostic interpretation: Troponin, electrolytes, renal function,
echocardiography, and relevant hemodynamic measurements.
24.
25.
Patient safety and education: Medication precautions, symptom recognition,
lifestyle modification, and discharge teaching.
26.
QUESTIONS 1–100
Section 1: Coronary Artery Disease and Acute
Coronary Syndromes
Q1: A 62-year-old patient arrives in the emergency department reporting crushing
substernal chest pain radiating to the left arm for 35 minutes. The ECG shows ST-
segment elevation in leads II, III, and aVF. Blood pressure is 86/54 mmHg, and the
patient has jugular venous distention with clear lung sounds. Which intervention
should the nurse anticipate as a priority?
, A) Administer sublingual nitroglycerin immediately B) Recognize possible right
ventricular infarction, obtain urgent cardiac team evaluation, and anticipate cautious
fluid administration if indicated C) Administer an IV loop diuretic to reduce preload
D) Place the patient in a high-Fowler position and restrict fluids
Rationale: Inferior STEMI with hypotension, jugular venous distention, and clear
lungs suggests right ventricular involvement, which can impair preload-dependent
cardiac output. Urgent reperfusion and hemodynamic support are priorities; cautious
isotonic fluid administration may be appropriate after clinical assessment. Option A is
incorrect because nitrates can worsen hypotension in right ventricular infarction.
Option C is incorrect because diuresis may further reduce preload. Option D is
incorrect because fluid restriction and upright positioning alone do not address the
hemodynamic problem and may worsen hypotension.
Q2: A patient with suspected acute myocardial infarction has a prescription for aspirin.
The patient reports no allergy or active bleeding. Which nursing action is most
appropriate?
A) Delay aspirin until the troponin result confirms infarction B) Administer aspirin
only after the patient develops recurrent pain C) Administer the prescribed loading
dose of chewable aspirin promptly D) Substitute an oral anticoagulant for aspirin
Rationale: Early aspirin inhibits platelet aggregation and reduces adverse outcomes in
acute coronary syndromes when no contraindication exists. Chewing the prescribed
loading dose promotes rapid absorption. Option A is incorrect because treatment
should not be unnecessarily delayed for biomarkers when ACS is suspected and
aspirin is appropriate. Option B is incorrect because administration is not dependent
on recurrent pain. Option D is incorrect because anticoagulants and antiplatelet agents
have different mechanisms and are not automatically interchangeable.
Q3: A patient reports chest pressure when climbing stairs that resolves within four
minutes of resting. The episodes have occurred in the same pattern for several months.
Which interpretation is most appropriate?
A) Acute pericarditis B) Unstable angina requiring an automatic diagnosis of
infarction C) Stable angina caused by transient myocardial oxygen supply-demand
imbalance D) Pulmonary embolism until proven otherwise
Rationale: Predictable exertional chest discomfort that resolves with rest is
characteristic of stable angina. The underlying coronary disease limits the ability to
increase blood flow when myocardial oxygen demand rises. Option A is less likely
because pericarditis typically causes pleuritic or positional pain. Option B is incorrect
because stable angina does not establish infarction, and unstable angina involves new,
worsening, or rest symptoms. Option D is not the best fit for this recurrent predictable
pattern, although new symptoms still require assessment.
Q4: A patient with chest pain has an initial high-sensitivity troponin result within the
reference range 45 minutes after symptom onset. The ECG is nondiagnostic. What
should the nurse anticipate?
