1
, NUR 6130 Exam 3 | (2026) Nursing Exam
Questions | Practice III (PDF)
. A 72-year-old male with a history of hypertension
presents with acute onset of tearing chest pain radiating
to the back. Blood pressure is 100/60 mm Hg in the right
arm and 140/90 mm Hg in the left arm. What is the most
appropriate next step?
A. Administer IV metoprolol
B. Obtain a stat chest x-ray
C. Order a computed tomography angiography (CTA) of
the chest
D. Give sublingual nitroglycerin
Answer: C
Rationale: Blood pressure differential and tearing pain
suggest aortic dissection. CTA is the definitive diagnostic
test. Beta-blockers are used after diagnosis to reduce
shear force, not before imaging.
2
,2. A patient with heart failure with preserved ejection
fraction (HFpEF) presents with worsening dyspnea and leg
swelling. Which medication has been shown to reduce
hospitalizations in HFpEF?
A. Digoxin
B. Spironolactone
C. Sacubitril/valsartan
D. Metoprolol succinate
Answer: B
Rationale: TOPCAT trial showed spironolactone reduces
hospitalizations in HFpEF. Sacubitril/valsartan is not FDA-
approved for HFpEF as of 2026.
3. A patient on amlodipine develops new-onset gingival
hyperplasia and ankle edema. What is the best
management?
A. Add hydrochlorothiazide
B. Switch to lisinopril
3
, C. Increase amlodipine dose
D. Add furosemide
Answer: B
Rationale: Gingival hyperplasia and edema are dose-
dependent side effects of dihydropyridine CCBs.
Switching to another class (ACE inhibitor) resolves both.
4. An ECG shows a regular, narrow-complex tachycardia
at 180 bpm with no visible P waves. The patient is
hemodynamically stable. What is the first-line treatment?
A. IV adenosine
B. Synchronized cardioversion
C. IV amiodarone
D. Vagal maneuvers
Answer: D
Rationale: AV nodal reentrant tachycardia (AVNRT) is
most likely. Vagal maneuvers (e.g., Valsalva) are first-line
in stable patients. Adenosine is next if vagal maneuvers
fail.
4
, NUR 6130 Exam 3 | (2026) Nursing Exam
Questions | Practice III (PDF)
. A 72-year-old male with a history of hypertension
presents with acute onset of tearing chest pain radiating
to the back. Blood pressure is 100/60 mm Hg in the right
arm and 140/90 mm Hg in the left arm. What is the most
appropriate next step?
A. Administer IV metoprolol
B. Obtain a stat chest x-ray
C. Order a computed tomography angiography (CTA) of
the chest
D. Give sublingual nitroglycerin
Answer: C
Rationale: Blood pressure differential and tearing pain
suggest aortic dissection. CTA is the definitive diagnostic
test. Beta-blockers are used after diagnosis to reduce
shear force, not before imaging.
2
,2. A patient with heart failure with preserved ejection
fraction (HFpEF) presents with worsening dyspnea and leg
swelling. Which medication has been shown to reduce
hospitalizations in HFpEF?
A. Digoxin
B. Spironolactone
C. Sacubitril/valsartan
D. Metoprolol succinate
Answer: B
Rationale: TOPCAT trial showed spironolactone reduces
hospitalizations in HFpEF. Sacubitril/valsartan is not FDA-
approved for HFpEF as of 2026.
3. A patient on amlodipine develops new-onset gingival
hyperplasia and ankle edema. What is the best
management?
A. Add hydrochlorothiazide
B. Switch to lisinopril
3
, C. Increase amlodipine dose
D. Add furosemide
Answer: B
Rationale: Gingival hyperplasia and edema are dose-
dependent side effects of dihydropyridine CCBs.
Switching to another class (ACE inhibitor) resolves both.
4. An ECG shows a regular, narrow-complex tachycardia
at 180 bpm with no visible P waves. The patient is
hemodynamically stable. What is the first-line treatment?
A. IV adenosine
B. Synchronized cardioversion
C. IV amiodarone
D. Vagal maneuvers
Answer: D
Rationale: AV nodal reentrant tachycardia (AVNRT) is
most likely. Vagal maneuvers (e.g., Valsalva) are first-line
in stable patients. Adenosine is next if vagal maneuvers
fail.
4
