,NURS 3661 Exam 3 | Nursing of Adults (2026) Q&A
| University of Texas at Arlington
1. A patient has chronic stable angina. Which pain description is expected?
A) Burning epigastric pain
B) Substernal pressure precipitated by exertion, relieved by rest and nitroglycerin
C) Sharp stabbing pain worse with breathing
D) Pain lasting >30 minutes unrelieved by rest
Correct Answer: Substernal pressure precipitated by exertion, relieved by rest and
nitroglycerin
Rationale: Stable angina is characterized by substernal pressure or heaviness
precipitated by exertion or stress and relieved by rest or nitroglycerin within 15 minutes.
Burning epigastric pain suggests GI disorders, sharp pleuritic pain suggests pleurisy, and
prolonged unrelieved pain suggests unstable angina or myocardial infarction.
2. Which ECG change indicates myocardial ischemia during angina?
A) Prolonged PR interval
B) Q wave development
C) ST depression and T wave inversion
D) ST elevation
Correct Answer: ST depression and T wave inversion
Rationale: Myocardial ischemia produces ST depression and T wave inversion on ECG. ST
elevation indicates injury or infarction, Q waves indicate necrosis, and a prolonged PR
interval suggests a conduction delay rather than ischemia.
,3. A patient with an acute myocardial infarction is prescribed morphine sulfate. What is the
primary rationale for this medication?
A) To reverse cardiac dysrhythmias
B) To reduce myocardial oxygen demand and relieve pain
C) To increase heart rate and contractility
D) To prevent clot formation
Correct Answer: To reduce myocardial oxygen demand and relieve pain
Rationale: Morphine relieves pain and reduces sympathetic nervous system activity,
which decreases heart rate, contractility, and myocardial oxygen demand in acute MI. It
does not reverse dysrhythmias, increase contractility, or prevent clot formation, which
require other interventions.
4. Which laboratory biomarker is most specific for myocardial infarction?
A) Myoglobin
B) Troponin I
C) Creatine kinase–MB
D) Lactate dehydrogenase
Correct Answer: Troponin I
Rationale: Troponin I and T are highly specific to cardiac muscle and rise within hours of
myocardial injury, remaining elevated for days. Myoglobin rises early but is nonspecific, CK-
MB is less specific than troponin, and lactate dehydrogenase is not a primary cardiac
biomarker.
, 5. What is the priority nursing intervention for a patient with a new onset of atrial
fibrillation and a rapid ventricular response?
A) Administering a scheduled dose of digoxin
B) Assessing for hemodynamic instability and preparing for rate control
C) Encouraging the patient to ambulate
D) Applying sequential compression devices
Correct Answer: Assessing for hemodynamic instability and preparing for rate control
Rationale: New-onset atrial fibrillation with rapid ventricular response can compromise
cardiac output, so the priority is assessing hemodynamic stability and preparing for rate
control or cardioversion as indicated. Administering digoxin without assessment,
ambulation, and compression devices do not address the acute rhythm disturbance.
6. Which medication is used to reverse the effects of heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: Protamine sulfate
Rationale: Protamine sulfate binds heparin and neutralizes its anticoagulant effect.
Vitamin K reverses warfarin, naloxone reverses opioids, and flumazenil reverses
benzodiazepines.
7. A patient with heart failure has a B-type natriuretic peptide level of 900 pg/mL. What is
the most likely interpretation?
| University of Texas at Arlington
1. A patient has chronic stable angina. Which pain description is expected?
A) Burning epigastric pain
B) Substernal pressure precipitated by exertion, relieved by rest and nitroglycerin
C) Sharp stabbing pain worse with breathing
D) Pain lasting >30 minutes unrelieved by rest
Correct Answer: Substernal pressure precipitated by exertion, relieved by rest and
nitroglycerin
Rationale: Stable angina is characterized by substernal pressure or heaviness
precipitated by exertion or stress and relieved by rest or nitroglycerin within 15 minutes.
Burning epigastric pain suggests GI disorders, sharp pleuritic pain suggests pleurisy, and
prolonged unrelieved pain suggests unstable angina or myocardial infarction.
2. Which ECG change indicates myocardial ischemia during angina?
A) Prolonged PR interval
B) Q wave development
C) ST depression and T wave inversion
D) ST elevation
Correct Answer: ST depression and T wave inversion
Rationale: Myocardial ischemia produces ST depression and T wave inversion on ECG. ST
elevation indicates injury or infarction, Q waves indicate necrosis, and a prolonged PR
interval suggests a conduction delay rather than ischemia.
,3. A patient with an acute myocardial infarction is prescribed morphine sulfate. What is the
primary rationale for this medication?
A) To reverse cardiac dysrhythmias
B) To reduce myocardial oxygen demand and relieve pain
C) To increase heart rate and contractility
D) To prevent clot formation
Correct Answer: To reduce myocardial oxygen demand and relieve pain
Rationale: Morphine relieves pain and reduces sympathetic nervous system activity,
which decreases heart rate, contractility, and myocardial oxygen demand in acute MI. It
does not reverse dysrhythmias, increase contractility, or prevent clot formation, which
require other interventions.
4. Which laboratory biomarker is most specific for myocardial infarction?
A) Myoglobin
B) Troponin I
C) Creatine kinase–MB
D) Lactate dehydrogenase
Correct Answer: Troponin I
Rationale: Troponin I and T are highly specific to cardiac muscle and rise within hours of
myocardial injury, remaining elevated for days. Myoglobin rises early but is nonspecific, CK-
MB is less specific than troponin, and lactate dehydrogenase is not a primary cardiac
biomarker.
, 5. What is the priority nursing intervention for a patient with a new onset of atrial
fibrillation and a rapid ventricular response?
A) Administering a scheduled dose of digoxin
B) Assessing for hemodynamic instability and preparing for rate control
C) Encouraging the patient to ambulate
D) Applying sequential compression devices
Correct Answer: Assessing for hemodynamic instability and preparing for rate control
Rationale: New-onset atrial fibrillation with rapid ventricular response can compromise
cardiac output, so the priority is assessing hemodynamic stability and preparing for rate
control or cardioversion as indicated. Administering digoxin without assessment,
ambulation, and compression devices do not address the acute rhythm disturbance.
6. Which medication is used to reverse the effects of heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: Protamine sulfate
Rationale: Protamine sulfate binds heparin and neutralizes its anticoagulant effect.
Vitamin K reverses warfarin, naloxone reverses opioids, and flumazenil reverses
benzodiazepines.
7. A patient with heart failure has a B-type natriuretic peptide level of 900 pg/mL. What is
the most likely interpretation?
