Examl 2:l NSGl 430/l NSG430l (NEWl 2025/l
2026l Update)l Adultl Healthl Nursingl IIl
Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
QUESTION
cardiomyopathy
Answer:
groupl ofl diseasesl thatl affectsl thel myocardium
1.l primaryl CMP:l idiopathic
2.l Secondary:l anotherl diseasel processl affectingl thel myocardium
TYPES
1.l Dilated:
-LVl andl LAl dilate,l impairedl systole,l bloodl stasisl inl LV
-thesel peoplel arel criticallyl ill
2.l Hypertrophy:
-asymmetricl LVl hypertrophyl withoutl dilation
-impairedl LVl fillingl bcl itl cantl relax->obstructedl LVl outflow
-mcl inl males,l suddenl cardiacl deathl inl athletes
3.l Restrictive:
-impairedl diastolel fillingl andl stretch
-exercisel intolerancel
MANIFESTATIONS
-exercisel intolerance,l fatigue
-dyspnea
-edema,l JVD,l abdominall bloating,l n/v,l anorexia
-S3l S4,l murmur,l palpitation,l dysrhythmiasl
-crackles,l cough
-weakl peripherall pulse
-pale
-stasis->thromboembolism
MEDICATIONS
-antidysrhythmic
-anticoagulantsl ifl needed
,-digoxin:l unlessl hypertrophic
-BB,l Cal channell blockers
-nitrates:l unlessl hypertrophicl
TREATMENT
-VAD
-implantablel cardioverter-defibrillatorl
-heartl transplant
-cardiacl rehab
-hospicel andl palliativel carel
-cardiacl resynchronizationl
-surgicall repair
QUESTION
typesl ofl shock
Answer:
CARDIOGENIC
issuel wl systolel orl diastole->decreasedl CO,l SV,l BP
1.l systolicl dysfunction
2.l diastolicl dysfunction
3.l dysrhythmias
4.l structurall abnormality
HYPOVOLEMIC
1.l absolute:
-externall lossl ofl totall bloodl volume
-lossl ofl otherl bodyl fluid:l extremel diuresis,l vomit,l sweating
2.l relative:
-internall bleeding
-fluidl shift
-massivel vasodilation
-pooll ofl bloodl orl fluid
DISTRIBUTIVE
1.l anaphylactic
2.l septic
3.l neurogenic
OBSTRUCTIVE
-impededl bloodl flow
QUESTION
cardiogenicl shock
,Answer:
inadequatel tissuel perfusionl andl impairedl cellularl metabolism,l thesel isl anl imbalancel
supplyl andl demandl ofl oxygenl andl nutrientsl
1.l systolicl dysfunction:l inabilityl ofl heartl tol pumpl bloodl forward
-causesl al decreasedl COl (lessl 4)l andl cardiacl indexl (lessl thanl 2.5)l (thisl isl thel
relationshipl betweenl totall bodyl surfacel areal andl CO)
-mostl commonl causel isl MI
2.l diastolicl dysfunction:l impairedl fillingl ofl thel ventricles
-causesl decreasedl SV
CAUSES
-MI
-cardiomyopathy
-severel HTN
-bluntl cardiacl trauma
-metabolicl disorders->cardiacl depression
-cardiacl tamponadel
MANIFESTATIONS
-tachycardia,l hypotension
>narrowl pulsel pressure
-increasedl myocardiall oxygenl consumption
-tachypnea,l pulmonaryl congestion
-agitation,l confusion,l anxiety
-cool,l clammy,l pale
-decreasel capl refilll time
-increasedl systemicl vascularl resistance
-increasel pulmonaryl arteryl wedgel pressure:l pressurel inl thel rightl atria,l bcl bloodl isl
backingl up
-increasedl pulmonaryl vascularl resistance
-increasedl strokel volumel variation
-decreasedl renall perfusionl andl UO
LABS
-earlyl isl respl alkalosisl bcl blowingl offl CO2->metabolicl acidosisl bcl anaerobicl
metabolisml
-troponinl andl Dl dimer
QUESTION
cardiogenicl shockl cont
Answer:
DIAGNOSTIC
, -lactate:l bcl ofl anaerobicl respiration
-ecg
-pulsel ox
-chestl xl ray
TREATMENT
-angioplastyl withl stenting
-emergencyl revascularizationl
-valvel replacement
-increasel COl wl fluidsl andl drugs
>nitratesl (vasodilate),l diureticsl (decreasel preload),l BBl (decreasel HRl andl contractility)
-increasel Hgbl withl transfusion
-increasel oxygenl withl supplementall oxygen
DRUGl THERAPY
1.l Vasopressor:l norepinephrinel
*ifl thisl infiltratesl itl canl bel veryl harmfull
-vasoconstrict
-tol keepl MAPl abovel 65
-monitorl endl stagel organs
-receivedl ifl therel wasl nol responsel tol fluidl replacementl
2.l Vasodilators:l nitroglycerin
*monitorl BPl andl HRl bcl reflexl tachycardial isl al thingl
-decreasel afterloadl
-keepsl MAPl abovel 65
3.l diuretics:l furosemidel
-decreasel preload
4.l BB
-decreasel HR
CIRCULATORYl DEVICES
-VAD
-intraaroticl balloonl pump
-decreasel SVRl andl decreasel leftl ventriclel workload
-or,l heartl transplant
QUESTION
reviewl ofl heartl andl impulses
Answer:
HEARTl CELLS
1.l automaticity:l abilityl ofl heartl tol initiatel anl impulse
2.l excitability:l abilityl ofl heartl celll tol bel stimulated
3.l conduction:l abilityl ofl heartl celll tol transmitl andl impulse
2026l Update)l Adultl Healthl Nursingl IIl
Completel Guide|l Questionsl &l Answers|l
Gradel A|l 100%l Correctl (Verifiedl
Solutions)-l GCU
QUESTION
cardiomyopathy
Answer:
groupl ofl diseasesl thatl affectsl thel myocardium
1.l primaryl CMP:l idiopathic
2.l Secondary:l anotherl diseasel processl affectingl thel myocardium
TYPES
1.l Dilated:
-LVl andl LAl dilate,l impairedl systole,l bloodl stasisl inl LV
-thesel peoplel arel criticallyl ill
2.l Hypertrophy:
-asymmetricl LVl hypertrophyl withoutl dilation
-impairedl LVl fillingl bcl itl cantl relax->obstructedl LVl outflow
-mcl inl males,l suddenl cardiacl deathl inl athletes
3.l Restrictive:
-impairedl diastolel fillingl andl stretch
-exercisel intolerancel
MANIFESTATIONS
-exercisel intolerance,l fatigue
-dyspnea
-edema,l JVD,l abdominall bloating,l n/v,l anorexia
-S3l S4,l murmur,l palpitation,l dysrhythmiasl
-crackles,l cough
-weakl peripherall pulse
-pale
-stasis->thromboembolism
MEDICATIONS
-antidysrhythmic
-anticoagulantsl ifl needed
,-digoxin:l unlessl hypertrophic
-BB,l Cal channell blockers
-nitrates:l unlessl hypertrophicl
TREATMENT
-VAD
-implantablel cardioverter-defibrillatorl
-heartl transplant
-cardiacl rehab
-hospicel andl palliativel carel
-cardiacl resynchronizationl
-surgicall repair
QUESTION
typesl ofl shock
Answer:
CARDIOGENIC
issuel wl systolel orl diastole->decreasedl CO,l SV,l BP
1.l systolicl dysfunction
2.l diastolicl dysfunction
3.l dysrhythmias
4.l structurall abnormality
HYPOVOLEMIC
1.l absolute:
-externall lossl ofl totall bloodl volume
-lossl ofl otherl bodyl fluid:l extremel diuresis,l vomit,l sweating
2.l relative:
-internall bleeding
-fluidl shift
-massivel vasodilation
-pooll ofl bloodl orl fluid
DISTRIBUTIVE
1.l anaphylactic
2.l septic
3.l neurogenic
OBSTRUCTIVE
-impededl bloodl flow
QUESTION
cardiogenicl shock
,Answer:
inadequatel tissuel perfusionl andl impairedl cellularl metabolism,l thesel isl anl imbalancel
supplyl andl demandl ofl oxygenl andl nutrientsl
1.l systolicl dysfunction:l inabilityl ofl heartl tol pumpl bloodl forward
-causesl al decreasedl COl (lessl 4)l andl cardiacl indexl (lessl thanl 2.5)l (thisl isl thel
relationshipl betweenl totall bodyl surfacel areal andl CO)
-mostl commonl causel isl MI
2.l diastolicl dysfunction:l impairedl fillingl ofl thel ventricles
-causesl decreasedl SV
CAUSES
-MI
-cardiomyopathy
-severel HTN
-bluntl cardiacl trauma
-metabolicl disorders->cardiacl depression
-cardiacl tamponadel
MANIFESTATIONS
-tachycardia,l hypotension
>narrowl pulsel pressure
-increasedl myocardiall oxygenl consumption
-tachypnea,l pulmonaryl congestion
-agitation,l confusion,l anxiety
-cool,l clammy,l pale
-decreasel capl refilll time
-increasedl systemicl vascularl resistance
-increasel pulmonaryl arteryl wedgel pressure:l pressurel inl thel rightl atria,l bcl bloodl isl
backingl up
-increasedl pulmonaryl vascularl resistance
-increasedl strokel volumel variation
-decreasedl renall perfusionl andl UO
LABS
-earlyl isl respl alkalosisl bcl blowingl offl CO2->metabolicl acidosisl bcl anaerobicl
metabolisml
-troponinl andl Dl dimer
QUESTION
cardiogenicl shockl cont
Answer:
DIAGNOSTIC
, -lactate:l bcl ofl anaerobicl respiration
-ecg
-pulsel ox
-chestl xl ray
TREATMENT
-angioplastyl withl stenting
-emergencyl revascularizationl
-valvel replacement
-increasel COl wl fluidsl andl drugs
>nitratesl (vasodilate),l diureticsl (decreasel preload),l BBl (decreasel HRl andl contractility)
-increasel Hgbl withl transfusion
-increasel oxygenl withl supplementall oxygen
DRUGl THERAPY
1.l Vasopressor:l norepinephrinel
*ifl thisl infiltratesl itl canl bel veryl harmfull
-vasoconstrict
-tol keepl MAPl abovel 65
-monitorl endl stagel organs
-receivedl ifl therel wasl nol responsel tol fluidl replacementl
2.l Vasodilators:l nitroglycerin
*monitorl BPl andl HRl bcl reflexl tachycardial isl al thingl
-decreasel afterloadl
-keepsl MAPl abovel 65
3.l diuretics:l furosemidel
-decreasel preload
4.l BB
-decreasel HR
CIRCULATORYl DEVICES
-VAD
-intraaroticl balloonl pump
-decreasel SVRl andl decreasel leftl ventriclel workload
-or,l heartl transplant
QUESTION
reviewl ofl heartl andl impulses
Answer:
HEARTl CELLS
1.l automaticity:l abilityl ofl heartl tol initiatel anl impulse
2.l excitability:l abilityl ofl heartl celll tol bel stimulated
3.l conduction:l abilityl ofl heartl celll tol transmitl andl impulse
