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NR 545 EXAM 2 - 2026 QUESTIONS LATEST 2026 – 2027
VERSION SOLVED QUESTIONS & ANSWERS
NR 545 EXAM 2 - 250 Questions with Rationales
QUESTIONS 1-250
SECTION 1: CARDIOVASCULAR DISORDERS - ANGINA & MYOCARDIAL INFARCTION
(Questions 1-40)
1. A patient describes chest pain as "a heavy weight on my chest" that occurs with
exertion and is relieved by rest. What is the most likely diagnosis?
A) Myocardial infarction
B) Stable angina
C) Pericarditis
D) Pulmonary embolism
Answer: B
Rationale: Angina pectoris is chest pain usually precipitated by stress or exertion and
relieved rapidly with rest or nitrates. Patients often describe the pain as squeezing or like
a heavy weight being placed on the chest .
2. Chest pain associated with angina is caused by which pathophysiologic
mechanism?
A) Inflammation of the pericardial sac
B) Decreased blood flow or ischemia to the myocardial tissue
C) Infection of the cardiac valves
D) Rupture of the aortic wall
Answer: B
Rationale: Angina is caused by myocardial ischemia from reduced coronary blood flow,
typically due to atherosclerotic heart disease with narrowing of the coronary arteries.
Option A describes pericarditis, C is endocarditis, and D is aortic dissection .
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3. Which physical assessment finding is characteristic of angina?
A) Chest heaviness, pressure, squeezing, fullness with pain radiating to left
shoulder/arm/jaw, elevated BP during attack
B) Sharp pleuritic pain worsened by inspiration
C) Pain relieved by leaning forward
D) Burning epigastric pain with no radiation
Answer: A
Rationale: Angina presents with retrosternal pressure and radiation to the left arm or
jaw. Blood pressure may be elevated during the attack due to sympathetic activation.
Option B is pleurisy/pericarditis, C is pericarditis, and D is GERD .
4. What is the first-line pharmacologic treatment for acute angina?
A) Aspirin 81 mg daily
B) Nitroglycerin 0.3-0.6 mg sublingual every 5 minutes for a maximum of 3 doses
C) Metoprolol 25 mg twice daily
D) Lisinopril 10 mg daily
Answer: B
Rationale: Nitroglycerin is the first-line treatment for acute angina. It relaxes and
widens blood vessels, decreasing preload and cardiac workload. Aspirin, metoprolol,
and lisinopril are used for long-term management, not acute symptom relief .
5. A patient with chest pain that is not relieved after 3 doses of nitroglycerin should
be evaluated for which condition?
A) Stable angina
B) Unstable angina or myocardial infarction
C) Costochondritis
D) Gastroesophageal reflux disease
Answer: B
Rationale: Chest pain that does not respond to nitroglycerin may indicate unstable
angina or myocardial infarction. This requires immediate evaluation and treatment .
6. What are the risks and complications of angina?
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A) Myocardial infarction and Acute Coronary Syndrome
B) Pericarditis and endocarditis
C) Pulmonary embolism and pneumonia
D) Stroke and renal failure
Answer: A
Rationale: Angina is a manifestation of coronary artery disease and can progress to
Acute Coronary Syndrome, which includes unstable angina and myocardial infarction.
These are the primary complications of untreated or worsening angina .
7. What is a myocardial infarction (MI)?
A) Inflammation of the heart muscle
B) Complete cessation of cardiac activity
C) Blood flow to the heart is minimized with buildup of cholesterol, leading to ischemia
and tissue death
D) Infection of the cardiac valves
Answer: C
Rationale: MI occurs when coronary blood flow is significantly reduced or blocked,
typically due to atherosclerosis, leading to myocardial ischemia and tissue death.
Option A is myocarditis, B is cardiac arrest, and D is endocarditis .
8. The pathophysiology of myocardial infarction involves:
A) Imbalance between myocardial oxygen supply and demand lasting greater than 30
minutes
B) Inflammation of the pericardium
C) Viral infection of the heart muscle
D) Structural abnormality of cardiac valves
Answer: A
Rationale: MI is caused by an imbalance between myocardial oxygen supply and
demand. When prolonged for greater than 30 minutes, it leads to cardiac tissue death.
This is the fundamental pathophysiologic mechanism .
9. Which symptom is characteristic of myocardial infarction rather than stable
angina?
A) Pain relieved by rest
B) Pain at rest not relieved by nitroglycerin
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C) Pain that occurs only with exercise
D) Pain relieved by antacids
Answer: B
Rationale: Myocardial infarction presents with pain at rest that is not relieved by
nitroglycerin. Associated symptoms may include lightheadedness, impending doom,
nausea, diaphoresis, and wheezing. Stable angina is relieved by rest and nitrates .
10. Which laboratory finding is most specific for myocardial infarction?
A) Elevated white blood cell count
B) Elevated troponins
C) Elevated B-type natriuretic peptide
D) Decreased hemoglobin
Answer: B
Rationale: Troponins are elevated in myocardial infarction and often stay elevated for
one week after infarction. This is the most specific laboratory marker for myocardial
injury .
11. Which EKG finding is most consistent with acute myocardial injury?
A) ST-segment depression
B) T-wave inversion
C) ST-segment elevation
D) Prolonged QT interval
Answer: C
Rationale: ST-segment elevation or new left bundle branch block is the EKG finding
most consistent with acute myocardial injury (STEMI), indicating transmural ischemia .
12. Which medication reduces inflammation and is used in the treatment of
atherosclerosis?
A) Aspirin
B) Statins
C) ACE inhibitors
D) Beta-blockers
Answer: B
Rationale: Statins reduce inflammation and lower cholesterol in the treatment of
atherosclerosis. They are a cornerstone of cardiovascular risk reduction .
NR 545 EXAM 2 - 2026 QUESTIONS LATEST 2026 – 2027
VERSION SOLVED QUESTIONS & ANSWERS
NR 545 EXAM 2 - 250 Questions with Rationales
QUESTIONS 1-250
SECTION 1: CARDIOVASCULAR DISORDERS - ANGINA & MYOCARDIAL INFARCTION
(Questions 1-40)
1. A patient describes chest pain as "a heavy weight on my chest" that occurs with
exertion and is relieved by rest. What is the most likely diagnosis?
A) Myocardial infarction
B) Stable angina
C) Pericarditis
D) Pulmonary embolism
Answer: B
Rationale: Angina pectoris is chest pain usually precipitated by stress or exertion and
relieved rapidly with rest or nitrates. Patients often describe the pain as squeezing or like
a heavy weight being placed on the chest .
2. Chest pain associated with angina is caused by which pathophysiologic
mechanism?
A) Inflammation of the pericardial sac
B) Decreased blood flow or ischemia to the myocardial tissue
C) Infection of the cardiac valves
D) Rupture of the aortic wall
Answer: B
Rationale: Angina is caused by myocardial ischemia from reduced coronary blood flow,
typically due to atherosclerotic heart disease with narrowing of the coronary arteries.
Option A describes pericarditis, C is endocarditis, and D is aortic dissection .
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3. Which physical assessment finding is characteristic of angina?
A) Chest heaviness, pressure, squeezing, fullness with pain radiating to left
shoulder/arm/jaw, elevated BP during attack
B) Sharp pleuritic pain worsened by inspiration
C) Pain relieved by leaning forward
D) Burning epigastric pain with no radiation
Answer: A
Rationale: Angina presents with retrosternal pressure and radiation to the left arm or
jaw. Blood pressure may be elevated during the attack due to sympathetic activation.
Option B is pleurisy/pericarditis, C is pericarditis, and D is GERD .
4. What is the first-line pharmacologic treatment for acute angina?
A) Aspirin 81 mg daily
B) Nitroglycerin 0.3-0.6 mg sublingual every 5 minutes for a maximum of 3 doses
C) Metoprolol 25 mg twice daily
D) Lisinopril 10 mg daily
Answer: B
Rationale: Nitroglycerin is the first-line treatment for acute angina. It relaxes and
widens blood vessels, decreasing preload and cardiac workload. Aspirin, metoprolol,
and lisinopril are used for long-term management, not acute symptom relief .
5. A patient with chest pain that is not relieved after 3 doses of nitroglycerin should
be evaluated for which condition?
A) Stable angina
B) Unstable angina or myocardial infarction
C) Costochondritis
D) Gastroesophageal reflux disease
Answer: B
Rationale: Chest pain that does not respond to nitroglycerin may indicate unstable
angina or myocardial infarction. This requires immediate evaluation and treatment .
6. What are the risks and complications of angina?
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A) Myocardial infarction and Acute Coronary Syndrome
B) Pericarditis and endocarditis
C) Pulmonary embolism and pneumonia
D) Stroke and renal failure
Answer: A
Rationale: Angina is a manifestation of coronary artery disease and can progress to
Acute Coronary Syndrome, which includes unstable angina and myocardial infarction.
These are the primary complications of untreated or worsening angina .
7. What is a myocardial infarction (MI)?
A) Inflammation of the heart muscle
B) Complete cessation of cardiac activity
C) Blood flow to the heart is minimized with buildup of cholesterol, leading to ischemia
and tissue death
D) Infection of the cardiac valves
Answer: C
Rationale: MI occurs when coronary blood flow is significantly reduced or blocked,
typically due to atherosclerosis, leading to myocardial ischemia and tissue death.
Option A is myocarditis, B is cardiac arrest, and D is endocarditis .
8. The pathophysiology of myocardial infarction involves:
A) Imbalance between myocardial oxygen supply and demand lasting greater than 30
minutes
B) Inflammation of the pericardium
C) Viral infection of the heart muscle
D) Structural abnormality of cardiac valves
Answer: A
Rationale: MI is caused by an imbalance between myocardial oxygen supply and
demand. When prolonged for greater than 30 minutes, it leads to cardiac tissue death.
This is the fundamental pathophysiologic mechanism .
9. Which symptom is characteristic of myocardial infarction rather than stable
angina?
A) Pain relieved by rest
B) Pain at rest not relieved by nitroglycerin
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C) Pain that occurs only with exercise
D) Pain relieved by antacids
Answer: B
Rationale: Myocardial infarction presents with pain at rest that is not relieved by
nitroglycerin. Associated symptoms may include lightheadedness, impending doom,
nausea, diaphoresis, and wheezing. Stable angina is relieved by rest and nitrates .
10. Which laboratory finding is most specific for myocardial infarction?
A) Elevated white blood cell count
B) Elevated troponins
C) Elevated B-type natriuretic peptide
D) Decreased hemoglobin
Answer: B
Rationale: Troponins are elevated in myocardial infarction and often stay elevated for
one week after infarction. This is the most specific laboratory marker for myocardial
injury .
11. Which EKG finding is most consistent with acute myocardial injury?
A) ST-segment depression
B) T-wave inversion
C) ST-segment elevation
D) Prolonged QT interval
Answer: C
Rationale: ST-segment elevation or new left bundle branch block is the EKG finding
most consistent with acute myocardial injury (STEMI), indicating transmural ischemia .
12. Which medication reduces inflammation and is used in the treatment of
atherosclerosis?
A) Aspirin
B) Statins
C) ACE inhibitors
D) Beta-blockers
Answer: B
Rationale: Statins reduce inflammation and lower cholesterol in the treatment of
atherosclerosis. They are a cornerstone of cardiovascular risk reduction .
