NR 341
EXAM 1
Test Covering Weeks 1 through 3
Verified Questions & Answers With Rationales
(Complex Adult Health)
Chamberlain
,1. A nurse is preparing to administer diltiazem to a patient with atrial fibrillation.
Which of the following best describes the primary action of this medication?
A. Increases myocardial contractility and heart rate
B. Relaxes blood vessels and decreases heart rate
C. Stimulates beta-adrenergic receptors to lower blood pressure
D. Constricts coronary arteries to improve perfusion
Correct Answer: B. Relaxes blood vessels and decreases heart rate
Rationales:
A. Incorrect — diltiazem is not an inotrope; it decreases contractility and slows conduction.
B. Correct — calcium channel blockers like diltiazem relax vascular smooth muscle and
reduce heart rate.
C. Incorrect — this describes beta-blockers, not calcium channel blockers.
D. Incorrect — vasoconstriction would worsen angina, opposite of diltiazem's action.
Test-Taking Tip: If you see "calcium channel blocker," think relaxation of vessels and
slowing the heart.
2. The provider prescribes metoprolol for a patient experiencing supraventricular
tachycardia (SVT). What type of medication is metoprolol?
A. Calcium channel blocker
B. Nitrate
C. Beta blocker
D. ACE inhibitor
Correct Answer: C. Beta blocker
Rationales:
A. Incorrect — diltiazem/verapamil are calcium channel blockers.
B. Incorrect — nitrates (like nitroglycerin) dilate veins and arteries.
C. Correct — metoprolol is a beta-1 selective blocker that slows AV node conduction, useful
in SVT.
D. Incorrect — ACE inhibitors lower BP but are not used acutely for SVT.
Test-Taking Tip: Beta blockers = "-lol" medications that slow the heart.
3. A nurse is caring for a patient with chest pain. Which lab diagnostic markers
should be assessed for possible myocardial infarction (MI)? (Select all that apply.)
,A. Troponin I (cTnI)
B. Troponin T (cTnT)
C. Creatine kinase-MB (CK-MB)
D. Myoglobin
E. B-type natriuretic peptide (BNP)
Correct Answers: A, B, C, D
Rationales:
A. Correct — Troponin I is highly specific for cardiac muscle injury.
B. Correct — Troponin T is also specific for myocardial injury.
C. Correct — CK-MB rises in myocardial damage.
D. Correct — Myoglobin rises early but is not cardiac-specific; still used in panels.
E. Incorrect — BNP is used in diagnosing heart failure, not MI.
Test-Taking Tip: "Troponins first, CK-MB second, myoglobin earliest" — remember timing.
4. A patient with acute chest pain is prescribed aspirin in the emergency department.
What is the primary purpose of administering aspirin in this situation?
A. To relieve pain by acting as an analgesic
B. To dilate coronary arteries and improve blood flow
C. To prevent platelet aggregation and thin the blood
D. To dissolve an existing clot in the coronary artery
Correct Answer: C. To prevent platelet aggregation and thin the blood
Rationales:
A. Incorrect — although aspirin has analgesic properties, it's given for antiplatelet effect.
B. Incorrect — nitrates dilate coronary arteries, not aspirin.
C. Correct — aspirin inhibits platelet aggregation, reducing clot propagation.
D. Incorrect — fibrinolytics (e.g., TPA) dissolve existing clots.
Test-Taking Tip: "Chest pain + aspirin" = stop platelets from aggregating.
5. The nurse is preparing to administer sublingual nitroglycerin to a patient with
angina. Which of the following is the correct administration guideline?
A. Administer every 5 minutes, up to 3 doses
B. Administer every 10 minutes, up to 5 doses
C. Administer every 30 minutes as needed
D. Administer continuously until chest pain subsides
, Correct Answer: A. Administer every 5 minutes, up to 3 doses
Rationales:
A. Correct — nitroglycerin can be given every 5 minutes, up to 3 doses within 15 minutes.
B. Incorrect — 10 minutes is too long; rapid relief is needed.
C. Incorrect — 30 minutes is not safe for acute angina.
D. Incorrect — uncontrolled repeated dosing risks hypotension and reflex tachycardia.
Test-Taking Tip: "Rule of 3's" — nitro every 5 minutes × 3 doses.
6. A nurse is caring for a patient with chest pain who has both nitroglycerin and IV
morphine ordered. Which action should the nurse take first?
A. Administer morphine IV to relieve pain
B. Administer nitroglycerin before morphine
C. Hold nitroglycerin if morphine is available
D. Give both medications at the same time
Correct Answer: B. Administer nitroglycerin before morphine
Rationales:
A. Incorrect — morphine is not the first-line intervention; nitro is given first for
vasodilation.
B. Correct — nitroglycerin is administered first to reduce myocardial oxygen demand,
followed by morphine if pain persists.
C. Incorrect — nitro should not be held unless contraindicated.
D. Incorrect — simultaneous administration increases risk without sequencing benefit.
Test-Taking Tip: Think "MONA" but actual order is Oxygen → Nitro → Morphine → Aspirin
(not always spelled out in acronym).
7. Which medications can be administered through an endotracheal tube (ETT) if IV
access is unavailable? (Select all that apply.)
A. Naloxone (Narcan)
B. Atropine
C. Vasopressin
D. Epinephrine
E. Lidocaine
Correct Answers: A, B, C, D, E
EXAM 1
Test Covering Weeks 1 through 3
Verified Questions & Answers With Rationales
(Complex Adult Health)
Chamberlain
,1. A nurse is preparing to administer diltiazem to a patient with atrial fibrillation.
Which of the following best describes the primary action of this medication?
A. Increases myocardial contractility and heart rate
B. Relaxes blood vessels and decreases heart rate
C. Stimulates beta-adrenergic receptors to lower blood pressure
D. Constricts coronary arteries to improve perfusion
Correct Answer: B. Relaxes blood vessels and decreases heart rate
Rationales:
A. Incorrect — diltiazem is not an inotrope; it decreases contractility and slows conduction.
B. Correct — calcium channel blockers like diltiazem relax vascular smooth muscle and
reduce heart rate.
C. Incorrect — this describes beta-blockers, not calcium channel blockers.
D. Incorrect — vasoconstriction would worsen angina, opposite of diltiazem's action.
Test-Taking Tip: If you see "calcium channel blocker," think relaxation of vessels and
slowing the heart.
2. The provider prescribes metoprolol for a patient experiencing supraventricular
tachycardia (SVT). What type of medication is metoprolol?
A. Calcium channel blocker
B. Nitrate
C. Beta blocker
D. ACE inhibitor
Correct Answer: C. Beta blocker
Rationales:
A. Incorrect — diltiazem/verapamil are calcium channel blockers.
B. Incorrect — nitrates (like nitroglycerin) dilate veins and arteries.
C. Correct — metoprolol is a beta-1 selective blocker that slows AV node conduction, useful
in SVT.
D. Incorrect — ACE inhibitors lower BP but are not used acutely for SVT.
Test-Taking Tip: Beta blockers = "-lol" medications that slow the heart.
3. A nurse is caring for a patient with chest pain. Which lab diagnostic markers
should be assessed for possible myocardial infarction (MI)? (Select all that apply.)
,A. Troponin I (cTnI)
B. Troponin T (cTnT)
C. Creatine kinase-MB (CK-MB)
D. Myoglobin
E. B-type natriuretic peptide (BNP)
Correct Answers: A, B, C, D
Rationales:
A. Correct — Troponin I is highly specific for cardiac muscle injury.
B. Correct — Troponin T is also specific for myocardial injury.
C. Correct — CK-MB rises in myocardial damage.
D. Correct — Myoglobin rises early but is not cardiac-specific; still used in panels.
E. Incorrect — BNP is used in diagnosing heart failure, not MI.
Test-Taking Tip: "Troponins first, CK-MB second, myoglobin earliest" — remember timing.
4. A patient with acute chest pain is prescribed aspirin in the emergency department.
What is the primary purpose of administering aspirin in this situation?
A. To relieve pain by acting as an analgesic
B. To dilate coronary arteries and improve blood flow
C. To prevent platelet aggregation and thin the blood
D. To dissolve an existing clot in the coronary artery
Correct Answer: C. To prevent platelet aggregation and thin the blood
Rationales:
A. Incorrect — although aspirin has analgesic properties, it's given for antiplatelet effect.
B. Incorrect — nitrates dilate coronary arteries, not aspirin.
C. Correct — aspirin inhibits platelet aggregation, reducing clot propagation.
D. Incorrect — fibrinolytics (e.g., TPA) dissolve existing clots.
Test-Taking Tip: "Chest pain + aspirin" = stop platelets from aggregating.
5. The nurse is preparing to administer sublingual nitroglycerin to a patient with
angina. Which of the following is the correct administration guideline?
A. Administer every 5 minutes, up to 3 doses
B. Administer every 10 minutes, up to 5 doses
C. Administer every 30 minutes as needed
D. Administer continuously until chest pain subsides
, Correct Answer: A. Administer every 5 minutes, up to 3 doses
Rationales:
A. Correct — nitroglycerin can be given every 5 minutes, up to 3 doses within 15 minutes.
B. Incorrect — 10 minutes is too long; rapid relief is needed.
C. Incorrect — 30 minutes is not safe for acute angina.
D. Incorrect — uncontrolled repeated dosing risks hypotension and reflex tachycardia.
Test-Taking Tip: "Rule of 3's" — nitro every 5 minutes × 3 doses.
6. A nurse is caring for a patient with chest pain who has both nitroglycerin and IV
morphine ordered. Which action should the nurse take first?
A. Administer morphine IV to relieve pain
B. Administer nitroglycerin before morphine
C. Hold nitroglycerin if morphine is available
D. Give both medications at the same time
Correct Answer: B. Administer nitroglycerin before morphine
Rationales:
A. Incorrect — morphine is not the first-line intervention; nitro is given first for
vasodilation.
B. Correct — nitroglycerin is administered first to reduce myocardial oxygen demand,
followed by morphine if pain persists.
C. Incorrect — nitro should not be held unless contraindicated.
D. Incorrect — simultaneous administration increases risk without sequencing benefit.
Test-Taking Tip: Think "MONA" but actual order is Oxygen → Nitro → Morphine → Aspirin
(not always spelled out in acronym).
7. Which medications can be administered through an endotracheal tube (ETT) if IV
access is unavailable? (Select all that apply.)
A. Naloxone (Narcan)
B. Atropine
C. Vasopressin
D. Epinephrine
E. Lidocaine
Correct Answers: A, B, C, D, E
