NR 545 EXAM REVIEW QUESTIONS AND
ANSWERS
Chest Pain AKA Angina Patho - Answer-Patho: Chest pain associated with decreased
blood flow or ischemia to the myocardial tissue.
Chest pain PA - Answer-Physical Assessment: chest heaviness
Pressure
Squeezing
Fullness
Pain radiates to left shoulder, arm, or jaw.
Elevation of blood pressure during attack
Chest pain Pharm - Answer-Pharm: Nitroglycerin- relaxes and widens blood vessels
Dosing: 0.3-0.6mg every 5 minutes for max of 3 doses
Long-term treatment to consider: ACE Inhibitors & Beta-Blockers
Chest pain risks - Answer-Risks and complications: Acute Coronary Syndrome
Myocardial Infarction - Answer-blood flow to the heart is minimized.
Buildup of cholesterol
MI Patho - Answer-imbalance between myocardial oxygen supply and demand
Prolonged for greater than 30 minutes can lead to cardiac tissue death.
MI PA - Answer-Pain at rest
Not relieved with nitro
Lightheaded
Impending doom
Nausea
Diaphoresis
Wheezing
MI Dx - Answer-Troponins elevated, often stay elevated for one week after infarction.
EKG- ST elevation or new left bundle branch block
Atherosclerosis - Answer-when blood vessels that carry oxygen to organs and tissues is
restricted.
Hardening of vessels from buildup of fats, cholesterol in the artery walls
Happens gradually.
Formed plaque can break off and burst, triggering a blood clot.
Atherosclerosis patho - Answer-inflammatory process that begins with damage to the
endothelium often result of HTN, smoking, high cholesterol, or other risk factors.
, Fatty streak to fibrous plaque and then complicated lesion
Atherosclerosis PA - Answer-modifiable risk factors
Fluid retention
Fatigue
Neck vein distension
Edema
Calf pain
Atherosclerosis Dx - Answer-Dx: Stress tests
Chest Xray
EKG
Ankle-Brachial Index to assess blood pressure in the extremities.
Atherosclerosis Pharm - Answer-Pharm: Antiplatelets (Aspirin)
Statins- reduce inflammation.
ACE Inhibitor- relax blood pressure and reduce work and pressure on heart.
Can be treated with lifestyle management.
Heart Failure - Answer-complex clinical syndrome that results from structural or
functional impairment of ventricular or ejection of blood, which in turn leads to the
cardinal clinical symptoms of dyspnea and fatigue, edema, and rales.
Heart Failure PA - Answer-Pre-existing conditions such as diabetes, liver failure, renal
disease, anemia.
Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea (PND), nocturnal
angina, Cheyne-Stokes respirations (ask families or caretaker)
Fatigue, lethargy, decreased functional capacity Patient takes medications as directed,
observing, and adhering to dietary requirements.
Alcohol or tobacco use
History of rheumatic heart disease or Chaga's disease
Discomfort when laying down.
Hypertension
Tachycardia
HF Dx - Answer-CBC, electrolytes, BUN, serum creatinine, hepatic enzymes, and a
urinalysis to screen for diabetes mellitus
Fasting lipid panel and TSH
B-type natriuretic peptide (BNP) and N-Terminal pro-BNP (NT-proBNP) are released
from a failing heart and a sensitive marker for the presence of HF
Newer markers, soluble ST-2, and galectin-3 are used to determine the prognosis of HF
patients
Chest Xray to show the size and shape of the heart, as well as pulmonary vasculature
Electrocardiogram 12-lead; assess for cardiac rhythm, and if LV hypertrophy is present,
prior MI, QRS width. A normal ECG can exclude any LV systolic dysfunction.
ANSWERS
Chest Pain AKA Angina Patho - Answer-Patho: Chest pain associated with decreased
blood flow or ischemia to the myocardial tissue.
Chest pain PA - Answer-Physical Assessment: chest heaviness
Pressure
Squeezing
Fullness
Pain radiates to left shoulder, arm, or jaw.
Elevation of blood pressure during attack
Chest pain Pharm - Answer-Pharm: Nitroglycerin- relaxes and widens blood vessels
Dosing: 0.3-0.6mg every 5 minutes for max of 3 doses
Long-term treatment to consider: ACE Inhibitors & Beta-Blockers
Chest pain risks - Answer-Risks and complications: Acute Coronary Syndrome
Myocardial Infarction - Answer-blood flow to the heart is minimized.
Buildup of cholesterol
MI Patho - Answer-imbalance between myocardial oxygen supply and demand
Prolonged for greater than 30 minutes can lead to cardiac tissue death.
MI PA - Answer-Pain at rest
Not relieved with nitro
Lightheaded
Impending doom
Nausea
Diaphoresis
Wheezing
MI Dx - Answer-Troponins elevated, often stay elevated for one week after infarction.
EKG- ST elevation or new left bundle branch block
Atherosclerosis - Answer-when blood vessels that carry oxygen to organs and tissues is
restricted.
Hardening of vessels from buildup of fats, cholesterol in the artery walls
Happens gradually.
Formed plaque can break off and burst, triggering a blood clot.
Atherosclerosis patho - Answer-inflammatory process that begins with damage to the
endothelium often result of HTN, smoking, high cholesterol, or other risk factors.
, Fatty streak to fibrous plaque and then complicated lesion
Atherosclerosis PA - Answer-modifiable risk factors
Fluid retention
Fatigue
Neck vein distension
Edema
Calf pain
Atherosclerosis Dx - Answer-Dx: Stress tests
Chest Xray
EKG
Ankle-Brachial Index to assess blood pressure in the extremities.
Atherosclerosis Pharm - Answer-Pharm: Antiplatelets (Aspirin)
Statins- reduce inflammation.
ACE Inhibitor- relax blood pressure and reduce work and pressure on heart.
Can be treated with lifestyle management.
Heart Failure - Answer-complex clinical syndrome that results from structural or
functional impairment of ventricular or ejection of blood, which in turn leads to the
cardinal clinical symptoms of dyspnea and fatigue, edema, and rales.
Heart Failure PA - Answer-Pre-existing conditions such as diabetes, liver failure, renal
disease, anemia.
Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea (PND), nocturnal
angina, Cheyne-Stokes respirations (ask families or caretaker)
Fatigue, lethargy, decreased functional capacity Patient takes medications as directed,
observing, and adhering to dietary requirements.
Alcohol or tobacco use
History of rheumatic heart disease or Chaga's disease
Discomfort when laying down.
Hypertension
Tachycardia
HF Dx - Answer-CBC, electrolytes, BUN, serum creatinine, hepatic enzymes, and a
urinalysis to screen for diabetes mellitus
Fasting lipid panel and TSH
B-type natriuretic peptide (BNP) and N-Terminal pro-BNP (NT-proBNP) are released
from a failing heart and a sensitive marker for the presence of HF
Newer markers, soluble ST-2, and galectin-3 are used to determine the prognosis of HF
patients
Chest Xray to show the size and shape of the heart, as well as pulmonary vasculature
Electrocardiogram 12-lead; assess for cardiac rhythm, and if LV hypertrophy is present,
prior MI, QRS width. A normal ECG can exclude any LV systolic dysfunction.
