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NURS 642 Exam 2 – Advanced Nursing Concepts | Verified Questions & Answers Latest Update 2026

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NURS 642 Exam 2 – Advanced Nursing Concepts | Verified Questions & Answers Latest Update 2026

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NURS 642 Advanced Nursing Concepts
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NURS 642 Exam 2 – Advanced Nursing
Concepts | Verified Questions & Answers
Latest Update 2026


Cardiomyopathy - correct answer-Heart muscle structurally/functionally abnormal without
CAD, HTN, or congenital heart disease.


Restrictive Cardiomyopathy - correct answer-Muscle unable to dilate. Impaired filling.
Decreased CO from diastole = Diastolic HF. Presentation: exertional intolerance and fluid
restriction
CXR - pulm congestion, normal heart size.
*Echo - moderate EF (25-50%). normal to Thick ventricle walls. Valvular: Endocardial
involvement involvement
Biopsy to find cause. Most common is Amyloidosis. Arrthymias: Ventricular tachy are
uncommon except in sacrodosis blocks. Mainly Atrial fib


Amyloidosis - correct answer-Protein deposited into heart muscle.
PE: : thickened tongue, peri-orbital purpura, hepatomegaly


Dilated Cardiomyopathy - correct answer-Muscle is over dilated (LV or LV&RV). Impaired
contraction. Presenting symptoms: exertional intolerance
Decreased CO from systole = Systolic HF.
Pansystolic (MR) murmur @ apex.
Labs - elevated BNP.
EKG - will be abnormal, nonspecific.
CXR - Cardiomegaly.

,*Echo - Thin (dilated) ventricle walls (>60mm). Decreased EF < 30%. Valvular: Annular
dilatation-Mitral regurgitation is seen first then tricuspid
Cause: idiopathic, genetic, pregnancy, myocarditis. Arrhythmias: ventricular tachy or
connection blocks


Hypertrophic Cardiomyopathy - correct answer-Muscle cell protein *genetic abnormality.
Impaired filling (small ventricles due to hypertrophy).
Muscle does not contract properly.
Decreased CO from diastole = Diastolic HF.
S/SX: asymptomatic; syncope, palpitations, DOE, sudden death! SYSTOLIC EJECTION MURMUR /
S4.
CXR - normal. EKG - normal.
*Echo - Thick ventricle walls & septum is thickest! EF Normal >60% Valvular: related to valve
septum.
Genetic testing or Biopsy for confirmation.
TX: temporary = BB, CCB, diuretics. Later, EP interventions - ablation, PPM, AICD.
Avoid: sudden position changes, bearing down, lifting weights, sudden activity.


Tako-Tsubo Cardiomyopathy or "broken heart syndrome" - correct answer-Stressful event,
postmenopausal
Presents similar to ACS: ST elevation & troponin elevated.
Echo - LV ballooning at apex.
TX: BB, ASA, and ACE-I until LV function normalizes (weeks to months).


Arrhythmogenic RV Cardiomyopathy (ARVC) - correct answer-Muscle replaced by fibrous fatty
tissue. RV=1st.
Genetic.
S/SX: syncope, presyncope, sustained palpitations, sudden cardiac death (youth, athletes).
EKG: LBBB, arrhythmias.

, Echo w/ unique RV findings.


AHA Indications for Cardiac Monitoring - correct answer-AHA Class 1: Cardiac monitoring
indicated due to risk for life threatening arrhythmia.
§ EX: Cardiac arrest, unstable ACS, acute HF, Long QT, Complicated PCI.


AHA Class 2: Cardiac monitoring may be indicated but not essential.
§ EX: Nonurgent PCI, chest pain syndrome, chronic arrhythmias.


AHA Class 3: Cardiac monitoring may be indicated but not expected to save lives.
§ EX: Permanent Afib rate controlled, OB patients without heart disease.


Pulmonary valve Stenosis - correct answer-valve does not open all the way.
(Fibrosis/calcification).
Genetic.
S/SX: *Crescendo-decrescendo murmur, edema, JVD, SOB, fatigue.
DX: ECHO.
TX: Balloon valvuloplasty.


Endocarditis - correct answer-Infection of the endocardium. Innermost layer of the heart.
High risk: IV drug use.
S/SX: *Fever, *new heart murmur, septic emboli, splinter hemorrhages in the nails, Roth spots
in the eyes, and glomerulonephritis.
**FUO + new murmur = assess for endocarditis.
DX: *Multiple positive blood cultures, ECHO, TEE
TX: underlying pathogen (culture) - Usually staph aureus.
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