,NU 155 EXAM 3 Medical-Surgical Nursing I Questions And Answers
2026/2027 Galen College
Q1. Which factor is a modifiable risk factor for coronary artery
disease?
A) Family history
B) Age
C) Cigarette smoking
D) Sex assigned at birth
Correct Answer: C) Cigarette smoking
Rationale: Cigarette smoking can be modified and substantially increases
cardiovascular risk by promoting endothelial injury, atherosclerosis,
thrombosis, and reduced oxygen delivery.
Q2. Which finding is most consistent with left-sided heart failure?
A) Pulmonary crackles and dyspnea
B) Ascites only
C) Peripheral cyanosis without respiratory symptoms
D) Enlarged liver without pulmonary findings
Correct Answer: A) Pulmonary crackles and dyspnea
Rationale: Left ventricular dysfunction causes blood to back up into the
pulmonary circulation, producing pulmonary congestion, crackles, dyspnea,
and potentially pulmonary edema.
Q3. A patient reports chest pressure that occurs predictably during
strenuous activity and resolves with rest. Which condition is most
likely?
A) Unstable angina
B) Stable angina
C) Pericarditis
D) Pulmonary embolism
Correct Answer: B) Stable angina
Rationale: Stable angina results from a predictable mismatch between
myocardial oxygen demand and coronary blood supply and typically
improves when activity stops or prescribed nitroglycerin is used.
Q4. Which laboratory marker is most specific for myocardial injury?
, A) BNP
B) Hemoglobin
C) Potassium
D) Cardiac troponin
Correct Answer: D) Cardiac troponin
Rationale: Cardiac troponins are highly specific markers of myocardial cell
injury and are central to the evaluation of suspected acute coronary
syndrome.
Q5. Which statement about BNP is correct?
A) It primarily measures myocardial cell death.
B) It increases with ventricular stretch and can support evaluation of heart
failure.
C) It directly measures coronary artery blockage.
D) It measures blood oxygen saturation.
Correct Answer: B) It increases with ventricular stretch and can support
evaluation of heart failure.
Rationale: B-type natriuretic peptide is released when the ventricles are
stretched by increased volume or pressure and can support assessment of
heart failure.
Q6. Which finding is most concerning for acute coronary syndrome?
A) New chest pressure occurring at rest
B) Mild fatigue after exercise
C) Stable chronic ankle edema
D) Brief discomfort that always resolves immediately with rest
Correct Answer: A) New chest pressure occurring at rest
Rationale: New, worsening, prolonged, or rest-related chest discomfort may
represent unstable ischemia or myocardial infarction and requires urgent
evaluation.
Q7. Which intervention should the nurse prioritize for a patient with
suspected acute myocardial infarction?
A) Encourage ambulation
B) Provide a large meal
C) Obtain rapid cardiac assessment and follow the acute-coronary-syndrome
2026/2027 Galen College
Q1. Which factor is a modifiable risk factor for coronary artery
disease?
A) Family history
B) Age
C) Cigarette smoking
D) Sex assigned at birth
Correct Answer: C) Cigarette smoking
Rationale: Cigarette smoking can be modified and substantially increases
cardiovascular risk by promoting endothelial injury, atherosclerosis,
thrombosis, and reduced oxygen delivery.
Q2. Which finding is most consistent with left-sided heart failure?
A) Pulmonary crackles and dyspnea
B) Ascites only
C) Peripheral cyanosis without respiratory symptoms
D) Enlarged liver without pulmonary findings
Correct Answer: A) Pulmonary crackles and dyspnea
Rationale: Left ventricular dysfunction causes blood to back up into the
pulmonary circulation, producing pulmonary congestion, crackles, dyspnea,
and potentially pulmonary edema.
Q3. A patient reports chest pressure that occurs predictably during
strenuous activity and resolves with rest. Which condition is most
likely?
A) Unstable angina
B) Stable angina
C) Pericarditis
D) Pulmonary embolism
Correct Answer: B) Stable angina
Rationale: Stable angina results from a predictable mismatch between
myocardial oxygen demand and coronary blood supply and typically
improves when activity stops or prescribed nitroglycerin is used.
Q4. Which laboratory marker is most specific for myocardial injury?
, A) BNP
B) Hemoglobin
C) Potassium
D) Cardiac troponin
Correct Answer: D) Cardiac troponin
Rationale: Cardiac troponins are highly specific markers of myocardial cell
injury and are central to the evaluation of suspected acute coronary
syndrome.
Q5. Which statement about BNP is correct?
A) It primarily measures myocardial cell death.
B) It increases with ventricular stretch and can support evaluation of heart
failure.
C) It directly measures coronary artery blockage.
D) It measures blood oxygen saturation.
Correct Answer: B) It increases with ventricular stretch and can support
evaluation of heart failure.
Rationale: B-type natriuretic peptide is released when the ventricles are
stretched by increased volume or pressure and can support assessment of
heart failure.
Q6. Which finding is most concerning for acute coronary syndrome?
A) New chest pressure occurring at rest
B) Mild fatigue after exercise
C) Stable chronic ankle edema
D) Brief discomfort that always resolves immediately with rest
Correct Answer: A) New chest pressure occurring at rest
Rationale: New, worsening, prolonged, or rest-related chest discomfort may
represent unstable ischemia or myocardial infarction and requires urgent
evaluation.
Q7. Which intervention should the nurse prioritize for a patient with
suspected acute myocardial infarction?
A) Encourage ambulation
B) Provide a large meal
C) Obtain rapid cardiac assessment and follow the acute-coronary-syndrome
