NSG 233 Exam 2 - (Latest 2026/2027 Update) Cardiac, Neurological, & Critical
Care | Q&A | Grade A | 100% Correct (Verified Answers)
Subject: Medical-Surgical Nursing / Cardiac & Neurological Emergencies
Source: NSG 233 Exam 2 – Comprehensive Review
Format: Q&A Guide with Clinical Rationale
1: What is the diagnostic test for thoracic aortic aneurysm?
Correct Answer: CT (computed tomography).
1. CT angiography is gold standard.
2. Also chest X-ray may show widened mediastinum.
3. Echocardiography (TEE) for ascending aorta.
2: What are the signs and symptoms of cardiac tamponade?
Correct Answer: Muffled heart sounds, hypotension, dyspnea, tachycardia, pulsus paradoxus, JVD.
Crackles in lungs - make them hold their breath to determine if pericarditis or cardiac tamponade.
1. Beck's triad: hypotension, JVD, muffled heart sounds.
2. Pulsus paradoxus: >10 mmHg drop in systolic BP during inspiration.
3. Emergency pericardiocentesis needed.
3: What is a fixed pacemaker?
Correct Answer: Goes off all the time (asynchronous pacing). Fires at a fixed rate regardless of
intrinsic cardiac activity.
1. Risk of R-on-T phenomenon.
2. Compete with intrinsic rhythm.
3. Modern pacemakers are demand pacemakers.
4: What are the signs and symptoms of DIC (Disseminated Intravascular Coagulation)?
Correct Answer: Uncontrolled bleeding from all orifices, low BP, tachycardia, low temperature.
1. Simultaneous bleeding and clotting.
2. Petechiae, purpura, oozing from IV sites.
3. Microthrombi cause organ ischemia.
, 5: What is digoxin used for and what should you check before giving?
Correct Answer: Used for heart failure and chest pain and to slow contraction of heart for atrial
fibrillation. Check HR and pulse, BP. Check pulse before giving meds. Can put you in a heart block,
same with metoprolol - gotta push it slow and monitor HR.
1. Hold if apical pulse <60 bpm.
2. Monitor potassium levels (hypokalemia increases toxicity).
3. Signs of toxicity: nausea, vomiting, yellow-green halos.
6: What are early signs of increased ICP in traumatic brain injury (TBI)?
Correct Answer: Bradycardia with systolic high. Pulse pressure widened.
1. Cushing's triad: hypertension, bradycardia, irregular respirations.
2. Early: decreased LOC, headache, pupillary changes.
3. Widening pulse pressure (systolic rises, diastolic stays same).
7: What is propranolol education for patients?
Correct Answer: Move slowly for orthostatic hypotension. Don't stop abruptly (can get rebound chest
pain). If patient wants to stop taking it, ask them why.
1. Abrupt withdrawal can cause rebound hypertension, tachycardia, angina.
2. Take with food to reduce GI upset.
3. Monitor HR and BP before administration.
8: When do you cardiovert?
Correct Answer: With atrial fibrillation. Want the impulse and electrical charge cycle to start at the
QRS complex.
1. Synchronized cardioversion used for unstable SVT, AF, VT with pulse.
2. Shock delivered on R wave to avoid R-on-T.
3. Sedate patient if hemodynamically stable.
9: What is DIC and how do you fix it? What orders would you question and what labs do you need?
Correct Answer: Hemorrhaging and clotting at same time. Give heparin. Protamine antidote and
vitamin K - if you get this order, question it. Lab tests: PTT, platelets, and D-dimer.
1. Treat underlying cause (sepsis, trauma, cancer).
2. Transfuse platelets, cryoprecipitate, FFP.
3. Heparin for thrombotic symptoms.
10: How to differentiate VTach vs VFib on EKG?
Correct Answer: VTach - upside down U's all uniform. VFib - not uniform, chaotic waveform.
1. VTach: wide QRS, regular, rate 150-250.
2. VFib: chaotic, no identifiable complexes.
3. Both are shockable rhythms (pulseless VT and VF).
Care | Q&A | Grade A | 100% Correct (Verified Answers)
Subject: Medical-Surgical Nursing / Cardiac & Neurological Emergencies
Source: NSG 233 Exam 2 – Comprehensive Review
Format: Q&A Guide with Clinical Rationale
1: What is the diagnostic test for thoracic aortic aneurysm?
Correct Answer: CT (computed tomography).
1. CT angiography is gold standard.
2. Also chest X-ray may show widened mediastinum.
3. Echocardiography (TEE) for ascending aorta.
2: What are the signs and symptoms of cardiac tamponade?
Correct Answer: Muffled heart sounds, hypotension, dyspnea, tachycardia, pulsus paradoxus, JVD.
Crackles in lungs - make them hold their breath to determine if pericarditis or cardiac tamponade.
1. Beck's triad: hypotension, JVD, muffled heart sounds.
2. Pulsus paradoxus: >10 mmHg drop in systolic BP during inspiration.
3. Emergency pericardiocentesis needed.
3: What is a fixed pacemaker?
Correct Answer: Goes off all the time (asynchronous pacing). Fires at a fixed rate regardless of
intrinsic cardiac activity.
1. Risk of R-on-T phenomenon.
2. Compete with intrinsic rhythm.
3. Modern pacemakers are demand pacemakers.
4: What are the signs and symptoms of DIC (Disseminated Intravascular Coagulation)?
Correct Answer: Uncontrolled bleeding from all orifices, low BP, tachycardia, low temperature.
1. Simultaneous bleeding and clotting.
2. Petechiae, purpura, oozing from IV sites.
3. Microthrombi cause organ ischemia.
, 5: What is digoxin used for and what should you check before giving?
Correct Answer: Used for heart failure and chest pain and to slow contraction of heart for atrial
fibrillation. Check HR and pulse, BP. Check pulse before giving meds. Can put you in a heart block,
same with metoprolol - gotta push it slow and monitor HR.
1. Hold if apical pulse <60 bpm.
2. Monitor potassium levels (hypokalemia increases toxicity).
3. Signs of toxicity: nausea, vomiting, yellow-green halos.
6: What are early signs of increased ICP in traumatic brain injury (TBI)?
Correct Answer: Bradycardia with systolic high. Pulse pressure widened.
1. Cushing's triad: hypertension, bradycardia, irregular respirations.
2. Early: decreased LOC, headache, pupillary changes.
3. Widening pulse pressure (systolic rises, diastolic stays same).
7: What is propranolol education for patients?
Correct Answer: Move slowly for orthostatic hypotension. Don't stop abruptly (can get rebound chest
pain). If patient wants to stop taking it, ask them why.
1. Abrupt withdrawal can cause rebound hypertension, tachycardia, angina.
2. Take with food to reduce GI upset.
3. Monitor HR and BP before administration.
8: When do you cardiovert?
Correct Answer: With atrial fibrillation. Want the impulse and electrical charge cycle to start at the
QRS complex.
1. Synchronized cardioversion used for unstable SVT, AF, VT with pulse.
2. Shock delivered on R wave to avoid R-on-T.
3. Sedate patient if hemodynamically stable.
9: What is DIC and how do you fix it? What orders would you question and what labs do you need?
Correct Answer: Hemorrhaging and clotting at same time. Give heparin. Protamine antidote and
vitamin K - if you get this order, question it. Lab tests: PTT, platelets, and D-dimer.
1. Treat underlying cause (sepsis, trauma, cancer).
2. Transfuse platelets, cryoprecipitate, FFP.
3. Heparin for thrombotic symptoms.
10: How to differentiate VTach vs VFib on EKG?
Correct Answer: VTach - upside down U's all uniform. VFib - not uniform, chaotic waveform.
1. VTach: wide QRS, regular, rate 150-250.
2. VFib: chaotic, no identifiable complexes.
3. Both are shockable rhythms (pulseless VT and VF).
