ACE YOUR NUR MED-SURG 242 EXAM: COMPLETE STUDY GUIDE
WITH COMPREHENSIVE QUESTIONS AND ANSWERS LATEST
2026/2027
◉ angina pectoris. Answer: chest pain that results when the heart does
not get enough oxygen
◉ unstable angina. Answer: chest pain that occurs while a person is at
rest and not exerting themself, not relieved by nitro
◉ Stable angina. Answer: chest pain that occurs when a person is active
or under severe stress, *IS* relieved by nitro
◉ labs associated with acute MI. Answer: EKG: ST elevation
(sometimes)
CXR: decreased heart function
Echocardiography: shows wall motion and ejection fraction
Elevated troponin -> 1st will be negative, 2nd is usually elevated. Peaks
around 24 hrs post MI
Elevated CK-MB: NOT cardiac specific, shows muscle cell death.
Increases with other disease processes like rhabdomyolysis
Increased Myoglobin
CBC: increased WBC
,◉ manifestations of acute MI. Answer: -differs in everyone (pain is
subjective) men different vs women
-depends on the wall involved
*Anterior wall*: most fatal (has ST elevation)
*Inferior wall*: lesion on right coronary artery, persistent hiccups is a
telltale sign
*Posterior wall*: uncommon
Diaphoresis
Crushing, aching, burning chest pain/pressure
Dyspnea (low O2)
Dizziness (low BP)
Nausea/vomiting or malaise
Palpitations
Cool, dusky, pale skin
Feeling of impending doom
EKG: ST elevation WITH cardiac markers = STEMI
No ST elevation WITH cardiac markers= NSTEMI
◉ STEMI. Answer: ST elevated myocardial infarction
Flipped T waves (retrograde)- zone of ischemia also seen post MI
ST elevation- zone of injury
Q Waves- zone of infarction
,◉ NSTEMI/NONSTEMI. Answer: non ST elevated myocardial
infarction
NO ST elevation
Sometimes ST depression
Elevated troponins
T wave irregularities
Q wave irregularities
◉ What is door to balloon time?. Answer: Time of hospital presentation
to time occluded artery is opened should be ≤ 30 min.
◉ Treatment of MI and ACS. Answer: Morphine- decreases respirations
but also PRELOAD
O2
Aspirin and other antiplatelets/ Heparin: goal is to prevent blood clots
and restore blood flow
Cath lab- possibly put in stents or other procedures to open vessel
Nitroglycerin/ nitrates: vasodilators (arteries and veins)- decreases
preload and afterload to decrease workload of the heart while opening
coronary vessels to decrease O2 demand on the myocardium
*Can be given IV, sublingual, transdermal, paste, oral*
Beta Blockers: used early, and continued for at least a year. Patient
needs to be WEANED off these medications
, ACE inhibitors: prevent the conversion of angiotensin 1 to angiotensin 2
which is a potent vasoconstrictor.
Antiarrythmics
Thrombolytics: altepase
CCB
Stool softeners: prevents bearing down
Statins
◉ biggest risk for antiplatelet medications. Answer: Risk for GI
bleeding-> watch for S/S: fatigue, malaise, dark black tarry stools.
Pts usually take this for only ONE year following PCI
◉ Side effects of nitroglycerin. Answer: *HEADACHE*
Syncope
Hypotension
◉ patient teaching for nitro. Answer: take one tablet every 5 mins x3, do
not take anymore after 3rd tab. If chest pain is unrelieved then go to ER
immediately. Store nitro in a dark area away from light.
◉ precautions for beta blockers. Answer: -Asthma
-COPD
-respiratory issues
WITH COMPREHENSIVE QUESTIONS AND ANSWERS LATEST
2026/2027
◉ angina pectoris. Answer: chest pain that results when the heart does
not get enough oxygen
◉ unstable angina. Answer: chest pain that occurs while a person is at
rest and not exerting themself, not relieved by nitro
◉ Stable angina. Answer: chest pain that occurs when a person is active
or under severe stress, *IS* relieved by nitro
◉ labs associated with acute MI. Answer: EKG: ST elevation
(sometimes)
CXR: decreased heart function
Echocardiography: shows wall motion and ejection fraction
Elevated troponin -> 1st will be negative, 2nd is usually elevated. Peaks
around 24 hrs post MI
Elevated CK-MB: NOT cardiac specific, shows muscle cell death.
Increases with other disease processes like rhabdomyolysis
Increased Myoglobin
CBC: increased WBC
,◉ manifestations of acute MI. Answer: -differs in everyone (pain is
subjective) men different vs women
-depends on the wall involved
*Anterior wall*: most fatal (has ST elevation)
*Inferior wall*: lesion on right coronary artery, persistent hiccups is a
telltale sign
*Posterior wall*: uncommon
Diaphoresis
Crushing, aching, burning chest pain/pressure
Dyspnea (low O2)
Dizziness (low BP)
Nausea/vomiting or malaise
Palpitations
Cool, dusky, pale skin
Feeling of impending doom
EKG: ST elevation WITH cardiac markers = STEMI
No ST elevation WITH cardiac markers= NSTEMI
◉ STEMI. Answer: ST elevated myocardial infarction
Flipped T waves (retrograde)- zone of ischemia also seen post MI
ST elevation- zone of injury
Q Waves- zone of infarction
,◉ NSTEMI/NONSTEMI. Answer: non ST elevated myocardial
infarction
NO ST elevation
Sometimes ST depression
Elevated troponins
T wave irregularities
Q wave irregularities
◉ What is door to balloon time?. Answer: Time of hospital presentation
to time occluded artery is opened should be ≤ 30 min.
◉ Treatment of MI and ACS. Answer: Morphine- decreases respirations
but also PRELOAD
O2
Aspirin and other antiplatelets/ Heparin: goal is to prevent blood clots
and restore blood flow
Cath lab- possibly put in stents or other procedures to open vessel
Nitroglycerin/ nitrates: vasodilators (arteries and veins)- decreases
preload and afterload to decrease workload of the heart while opening
coronary vessels to decrease O2 demand on the myocardium
*Can be given IV, sublingual, transdermal, paste, oral*
Beta Blockers: used early, and continued for at least a year. Patient
needs to be WEANED off these medications
, ACE inhibitors: prevent the conversion of angiotensin 1 to angiotensin 2
which is a potent vasoconstrictor.
Antiarrythmics
Thrombolytics: altepase
CCB
Stool softeners: prevents bearing down
Statins
◉ biggest risk for antiplatelet medications. Answer: Risk for GI
bleeding-> watch for S/S: fatigue, malaise, dark black tarry stools.
Pts usually take this for only ONE year following PCI
◉ Side effects of nitroglycerin. Answer: *HEADACHE*
Syncope
Hypotension
◉ patient teaching for nitro. Answer: take one tablet every 5 mins x3, do
not take anymore after 3rd tab. If chest pain is unrelieved then go to ER
immediately. Store nitro in a dark area away from light.
◉ precautions for beta blockers. Answer: -Asthma
-COPD
-respiratory issues
