NRSG 3420 Exam 2 2026/2027 – 45+ Questions & Answers | Cardiovascular, Dysrhythmias, CAD, Heart Failure, COPD, Asthma & Respiratory Care

The NRSG 3420 Exam 2 2026/2027 study guide is a 91-page nursing exam-preparation resource containing 45+ multiple-choice and select-all-that-apply questions with correct answers, detailed rationales, and textbook references. Its two major areas are cardiovascular nursing and respiratory nursing, with extensive coverage of cardiovascular assessment, coronary artery disease, myocardial infarction, dysrhythmias, heart failure, valvular disorders, cardiac procedures, pulmonary assessment, oxygen therapy, COPD, asthma, ARDS, atelectasis, pneumothorax, chest drainage, and respiratory emergencies. The uploaded document identifies the course code as NRSG 3420, but it does not identify a university, so no institution has been inferred. The cardiovascular assessment and coronary artery disease material examines myocardial perfusion, cardiac output, cholesterol management, coronary risk factors, and hemodynamic monitoring. Students review why increased heart rate can contribute to myocardial ischemia in clients with CAD, the desired relationship of low LDL and high HDL values, modifiable cardiovascular risk factors such as hyperlipidemia, diabetes and hypertension, and the interpretation of central venous pressure. The questions also test diagnostic methods for estimating ejection fraction, including echocardiography, cardiac catheterization, and magnetic resonance imaging. A major portion addresses angina, myocardial infarction, and cardiovascular pharmacology. The document identifies throbbing headache and dizziness as potential adverse effects associated with nitroglycerin therapy and emphasizes the importance of rapid intervention in myocardial infarction to limit myocardial tissue necrosis. Medication-related scenarios also cover warfarin monitoring following valve replacement, loop diuretics in heart failure, digoxin toxicity, atropine for symptomatic bradycardia, epinephrine following unsuccessful defibrillation for ventricular fibrillation, and cyclosporine following heart transplantation. The guide provides detailed review of cardiac electrophysiology and dysrhythmias. Students are tested on the heart's normal conduction sequence from the SA node through atrial stimulation, AV node, bundle of His, bundle branches, and Purkinje fibers. Additional concepts include ventricular depolarization and the QRS complex, positive chronotropy, asystole, ventricular fibrillation, catheter ablation, cardiac arrest, pacemaker coding such as VVI, and the priority of maintaining adequate cardiac output in clients experiencing dysrhythmias. The material also examines structural heart disease, heart failure, and advanced cardiac procedures. Questions cover valvuloplasty, mechanical valve replacement, antibiotic prophylaxis before certain dental procedures, heart transplantation, pulmonary edema, pulsus paradoxus, cardiopulmonary bypass, cardiac catheterization, pulmonary artery pressure monitoring, and central venous pressure monitoring. Discharge teaching includes daily weight monitoring for fluid balance in heart failure and precautions for clients with permanent pacemakers. Peripheral vascular nursing is integrated into the cardiovascular section through venous return, deep vein thrombosis and venous thromboembolism prevention. One postoperative scenario highlights early ambulation and leg exercises for a client taking oral contraceptives, while cardiac rehabilitation content explains how contraction of leg muscles helps move venous blood back toward the heart. Post-cardiac-catheterization assessment reinforces monitoring blood pressure and pulse, checking the pressure dressing for bleeding, and evaluating peripheral circulation. The second major portion focuses on respiratory assessment and oxygenation. Students review pulmonary diffusion and perfusion, sputum assessment, voice sounds, pulmonary function testing, and oxygen-delivery devices. The document identifies egophony as the E-to-A voice-sound change associated with lung consolidation and discusses proper collection and timely laboratory submission of sputum specimens. Pulmonary function testing is addressed through spirometry, including interpretation of an FEV1/FVC ratio below 70% as evidence of obstructive lung disease within the source material. The guide contains substantial coverage of COPD and asthma management. Topics include precise oxygen delivery using a Venturi mask, oxygen toxicity, inhaled beta-adrenergic agonists for acute asthma-related airflow obstruction, corticosteroid therapy, status asthmaticus, pulmonary function tests, and chronic respiratory disease management. Smoking-related questions address lung-cancer risk and the harmful effects of tobacco smoke on the respiratory tract's ciliary cleansing mechanism. Acute pulmonary conditions are another major exam area. Students encounter scenarios involving ARDS, pulmonary embolism, pneumonia, atelectasis, pleurisy, pneumothorax, thoracic trauma, subcutaneous emphysema, and chest drainage systems. The questions reinforce recognition of respiratory deterioration, use of BNP in differentiating ARDS from cardiogenic pulmonary edema, incentive spirometry as a first-line measure for minimizing atelectasis, and chest drainage following thoracotomy or pneumothorax. Later questions extend respiratory nursing into airway management and critical care, including endotracheal suctioning, thoracotomy teaching, chest trauma, tracheostomy considerations, smoke inhalation, respiratory infection, and interpretation of abnormal sputum. The source emphasizes clinically focused nursing assessment and prioritization rather than simple memorization, making the document especially useful for practicing scenario-based medical-surgical nursing questions. Academic Reference The questions and rationales repeatedly cite Hinkle, J. L., & Cheever, K. H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th edition, Wolters Kluwer, 2018. Referenced material spans chapters on respiratory assessment and care, chronic pulmonary disease, cardiovascular assessment, dysrhythmias, coronary vascular disorders, structural and inflammatory cardiac disorders, complications of heart disease, and peripheral vascular disorders. Examples in the document include Chapter 26 for dysrhythmias and conduction problems and Chapter 29 for complications of heart disease. Relevant Students This document is relevant to NRSG 3420 students, BSN students, ADN students, registered nursing students, medical-surgical nursing students, adult health nursing students, cardiovascular nursing students, respiratory nursing students, clinical nursing students, and nursing students preparing for exams covering cardiac and pulmonary disorders. It may also support NCLEX-style review because many questions use clinical scenarios, prioritization, patient education, pharmacology, assessment findings, and select-all-that-apply formats. 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