NURS 5432 EXAM QUESTIONS AND 100% VERIFIED
ANSWERS (NEWEST VERSION)
1. Q: What is the primary pathophysiological mechanism behind heart failure
with preserved ejection fraction (HFpEF)? A: Diastolic dysfunction due to
impaired ventricular relaxation and filling, often associated with hypertension,
diabetes, and aging.
2. Q: Which medication class is contraindicated in patients with decompensated
heart failure due to risk of negative inotropic effects? A: Calcium channel
blockers (particularly verapamil and diltiazem).
3. Q: What is the normal ejection fraction range for the left ventricle? A: 55-
70% (or 50-70% depending on guidelines).
4. Q: Describe the Frank-Starling mechanism. A: The heart's ability to increase
stroke volume in response to increased venous return by stretching cardiac
muscle fibers to optimize contractility.
5. Q: What laboratory value is most specific for diagnosing acute myocardial
infarction? A: Troponin I or T levels.
6. Q: Which type of shock is characterized by high cardiac output and low
systemic vascular resistance? A: Distributive shock (septic, anaphylactic, or
neurogenic).
7. Q: What is the mechanism of action of ACE inhibitors in heart failure
management? A: Block conversion of angiotensin I to angiotensin II, reducing
afterload and preload while preventing ventricular remodeling.
8. Q: Define cardiac tamponade and its classic triad of symptoms. A:
Compression of the heart by pericardial fluid; Beck's triad: elevated JVP,
hypotension, and muffled heart sounds.
9. Q: What ECG changes are characteristic of hyperkalemia? A: Peaked T
waves, prolonged PR interval, widened QRS complex, and potential sine wave
pattern.
, 10. Q: Which valve abnormality creates a harsh systolic murmur that radiates to
the carotid arteries? A: Aortic stenosis.
11. Q: What is the primary difference between STEMI and NSTEMI? A:
STEMI shows ST elevation on ECG indicating complete coronary occlusion;
NSTEMI shows ST depression/T wave changes indicating partial occlusion.
12. Q: Which medication should be avoided in patients with severe aortic
stenosis? A: Vasodilators (including nitroglycerin) due to risk of severe
hypotension.
13. Q: What is the target blood pressure for most hypertensive patients
according to current guidelines? A: Less than 130/80 mmHg.
14. Q: Describe the pathophysiology of atherosclerosis. A: Endothelial injury
leads to lipid accumulation, inflammatory response, plaque formation, and
potential rupture causing thrombosis.
15. Q: What is the most common cause of sudden cardiac death in young
athletes? A: Hypertrophic cardiomyopathy.
16. Q: Which electrolyte imbalance can cause prolonged QT interval and
torsades de pointes? A: Hypomagnesemia, hypokalemia, or hypocalcemia.
17. Q: What is the first-line treatment for atrial fibrillation with rapid
ventricular response? A: Rate control with beta-blockers or calcium channel
blockers, plus anticoagulation assessment.
18. Q: Define preload and afterload. A: Preload: ventricular filling
pressure/volume; Afterload: resistance the ventricle must overcome to eject
blood.
19. Q: What is the pathophysiology of cardiogenic shock? A: Severe
impairment of cardiac pump function leading to inadequate tissue perfusion
despite adequate intravascular volume.
20. Q: Which diagnostic test is gold standard for evaluating coronary artery
disease? A: Cardiac catheterization with coronary angiography.
21. Q: What medication combination is recommended for secondary prevention
after MI? A: Dual antiplatelet therapy (aspirin + P2Y12 inhibitor), beta-blocker,
ACE inhibitor/ARB, and statin.
ANSWERS (NEWEST VERSION)
1. Q: What is the primary pathophysiological mechanism behind heart failure
with preserved ejection fraction (HFpEF)? A: Diastolic dysfunction due to
impaired ventricular relaxation and filling, often associated with hypertension,
diabetes, and aging.
2. Q: Which medication class is contraindicated in patients with decompensated
heart failure due to risk of negative inotropic effects? A: Calcium channel
blockers (particularly verapamil and diltiazem).
3. Q: What is the normal ejection fraction range for the left ventricle? A: 55-
70% (or 50-70% depending on guidelines).
4. Q: Describe the Frank-Starling mechanism. A: The heart's ability to increase
stroke volume in response to increased venous return by stretching cardiac
muscle fibers to optimize contractility.
5. Q: What laboratory value is most specific for diagnosing acute myocardial
infarction? A: Troponin I or T levels.
6. Q: Which type of shock is characterized by high cardiac output and low
systemic vascular resistance? A: Distributive shock (septic, anaphylactic, or
neurogenic).
7. Q: What is the mechanism of action of ACE inhibitors in heart failure
management? A: Block conversion of angiotensin I to angiotensin II, reducing
afterload and preload while preventing ventricular remodeling.
8. Q: Define cardiac tamponade and its classic triad of symptoms. A:
Compression of the heart by pericardial fluid; Beck's triad: elevated JVP,
hypotension, and muffled heart sounds.
9. Q: What ECG changes are characteristic of hyperkalemia? A: Peaked T
waves, prolonged PR interval, widened QRS complex, and potential sine wave
pattern.
, 10. Q: Which valve abnormality creates a harsh systolic murmur that radiates to
the carotid arteries? A: Aortic stenosis.
11. Q: What is the primary difference between STEMI and NSTEMI? A:
STEMI shows ST elevation on ECG indicating complete coronary occlusion;
NSTEMI shows ST depression/T wave changes indicating partial occlusion.
12. Q: Which medication should be avoided in patients with severe aortic
stenosis? A: Vasodilators (including nitroglycerin) due to risk of severe
hypotension.
13. Q: What is the target blood pressure for most hypertensive patients
according to current guidelines? A: Less than 130/80 mmHg.
14. Q: Describe the pathophysiology of atherosclerosis. A: Endothelial injury
leads to lipid accumulation, inflammatory response, plaque formation, and
potential rupture causing thrombosis.
15. Q: What is the most common cause of sudden cardiac death in young
athletes? A: Hypertrophic cardiomyopathy.
16. Q: Which electrolyte imbalance can cause prolonged QT interval and
torsades de pointes? A: Hypomagnesemia, hypokalemia, or hypocalcemia.
17. Q: What is the first-line treatment for atrial fibrillation with rapid
ventricular response? A: Rate control with beta-blockers or calcium channel
blockers, plus anticoagulation assessment.
18. Q: Define preload and afterload. A: Preload: ventricular filling
pressure/volume; Afterload: resistance the ventricle must overcome to eject
blood.
19. Q: What is the pathophysiology of cardiogenic shock? A: Severe
impairment of cardiac pump function leading to inadequate tissue perfusion
despite adequate intravascular volume.
20. Q: Which diagnostic test is gold standard for evaluating coronary artery
disease? A: Cardiac catheterization with coronary angiography.
21. Q: What medication combination is recommended for secondary prevention
after MI? A: Dual antiplatelet therapy (aspirin + P2Y12 inhibitor), beta-blocker,
ACE inhibitor/ARB, and statin.
