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NURS 610A EXAM 2 —MARYVILLE UNIVERSITY GRADUATE
NURSING PROGRAM 2026/2027 COMPLETE (100)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
NURS
Prepare for the NURS 610A Exam 2 with a focused study resource designed to
reinforce key concepts in advanced nursing practice and clinical care. It provides
targeted review of important topics, high-acuity cardiac devices, procedural sedation,
acute lung injury, wound healing, hematologic disorders, stem cell transplantation,
legal and ethical concepts in nursing. Use the material to strengthen clinical
reasoning, improve knowledge retention, and identify areas that may require
additional review before the exam. This resource is best suited for NURS 610A nursing
students and advanced nursing learners preparing for Exam 2.
MULTIPLE CHOICE.
SECTION 1: HIGH-ACUITY CARDIAC DEVICES (Questions 1–10)
Question 1:
A patient with cardiogenic shock is being managed with an Impella device.
What is the primary mechanism of action of the Impella?
A) It provides counterpulsation to augment coronary perfusion
B) It acts as a left ventricular assist device that unloads the left ventricle
C) It provides right ventricular support
D) It functions as an oxygenator
Answer: B) It acts as a left ventricular assist device that unloads the left
ventricle
Rationale: The Impella is a percutaneous ventricular assist device (pVAD)
that is placed across the aortic valve. It actively pumps blood from the left
ventricle into the ascending aorta, thereby reducing left ventricular
workload and pressure, and increasing cardiac output. This mechanism
directly unloads the left ventricle, improving hemodynamics in
cardiogenic shock.
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Question 2:
Which of the following is an example of a high-acuity cardiac device that
provides counterpulsation to improve coronary perfusion?
A) LVAD
B) IABP (Intra-Aortic Balloon Pump)
C) ECMO
D) TAVR
Answer: B) IABP (Intra-Aortic Balloon Pump)
Rationale: The Intra-Aortic Balloon Pump (IABP) provides
counterpulsation—it inflates during diastole to increase coronary
perfusion and deflates during systole to decrease afterload. This
improves myocardial oxygen supply and reduces demand. LVAD (A)
provides continuous flow support, ECMO (C) provides both cardiac and
respiratory support, and TAVR (D) is a valve replacement procedure.
Question 3:
A patient with end-stage heart failure is being evaluated for a Ventricular
Assist Device (VAD). What is the primary purpose of a VAD?
A) To replace the native heart permanently
B) To provide mechanical circulatory support as a bridge to transplant or
destination therapy
C) To provide temporary support during cardiac arrest
D) To oxygenate blood in the absence of lung function
Answer: B) To provide mechanical circulatory support as a bridge to
transplant or destination therapy
Rationale: Ventricular Assist Devices (VADs) are mechanical pumps that
support cardiac function in patients with severe heart failure. They can
serve as a bridge to transplantation (providing support until a donor heart
is available), as destination therapy (long-term support for patients who
are not transplant candidates), or as a bridge to recovery.
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Question 4:
A patient has undergone Transcatheter Aortic Valve Replacement (TAVR).
Which of the following is the most appropriate post-procedure nursing
intervention?
A) Monitor for signs of aortic regurgitation and vascular complications
B) Maintain strict bed rest for 48 hours
C) Administer high-dose anticoagulation
D) Monitor for signs of left ventricular hypertrophy
Answer: A) Monitor for signs of aortic regurgitation and vascular
complications
Rationale: After TAVR, the nurse should monitor for aortic regurgitation
(paravalvular leaks), vascular complications at the access site (bleeding,
hematoma, pseudoaneurysm), and cardiac arrhythmias (heart block).
TAVR is a less invasive alternative to surgical aortic valve replacement for
patients with severe aortic stenosis.
Question 5:
Which high-acuity cardiac device is used to provide both cardiac and
respiratory support in critically ill patients?
A) Impella
B) IABP
C) ECMO (Extracorporeal Membrane Oxygenation)
D) MitraClip
Answer: C) ECMO (Extracorporeal Membrane Oxygenation)
Rationale: ECMO provides both cardiac and respiratory support by
oxygenating blood outside the body and pumping it back to the patient. It
can be used in severe cardiac or respiratory failure when conventional
therapies have failed. Impella (A) and IABP (B) provide cardiac support
only, while MitraClip (D) is used for mitral valve repair.
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Question 6:
A patient with severe mitral regurgitation is being considered for a MitraClip
procedure. What is the primary mechanism of action of the MitraClip?
A) It replaces the mitral valve with a mechanical valve
B) It clips the mitral valve leaflets together to reduce regurgitation
C) It provides continuous flow support to the left ventricle
D) It delivers an electrical shock to the mitral valve
Answer: B) It clips the mitral valve leaflets together to reduce
regurgitation
Rationale: The MitraClip is a percutaneous device that clips the mitral
valve leaflets together, reducing mitral regurgitation by creating a double
orifice. It is used for patients with severe mitral regurgitation who are at
high risk for open heart surgery. It does not replace the valve, provide
ventricular support, or deliver electrical shocks.
Question 7:
Which of the following is a key nursing consideration when caring for a patient
with an LVAD (Left Ventricular Assist Device)?
A) Monitor for the presence of a palpable pulse
B) Auscultate for a continuous humming sound (the "LVAD hum")
C) Administer high-dose diuretics
D) Maintain the patient in a supine position at all times
Answer: B) Auscultate for a continuous humming sound (the "LVAD hum")
Rationale: The LVAD produces a continuous humming sound that should
be auscultated over the device. The presence of the hum indicates the
device is functioning properly. Patients with LVADs may have a
continuous flow and may not have a palpable pulse (A), so blood pressure
assessment requires a Doppler. Diuretics (C) may be needed but are not
the priority assessment; mobility (D) should be encouraged.
NURS 610A EXAM 2 —MARYVILLE UNIVERSITY GRADUATE
NURSING PROGRAM 2026/2027 COMPLETE (100)
CURRENT TESTING QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES.
NURS
Prepare for the NURS 610A Exam 2 with a focused study resource designed to
reinforce key concepts in advanced nursing practice and clinical care. It provides
targeted review of important topics, high-acuity cardiac devices, procedural sedation,
acute lung injury, wound healing, hematologic disorders, stem cell transplantation,
legal and ethical concepts in nursing. Use the material to strengthen clinical
reasoning, improve knowledge retention, and identify areas that may require
additional review before the exam. This resource is best suited for NURS 610A nursing
students and advanced nursing learners preparing for Exam 2.
MULTIPLE CHOICE.
SECTION 1: HIGH-ACUITY CARDIAC DEVICES (Questions 1–10)
Question 1:
A patient with cardiogenic shock is being managed with an Impella device.
What is the primary mechanism of action of the Impella?
A) It provides counterpulsation to augment coronary perfusion
B) It acts as a left ventricular assist device that unloads the left ventricle
C) It provides right ventricular support
D) It functions as an oxygenator
Answer: B) It acts as a left ventricular assist device that unloads the left
ventricle
Rationale: The Impella is a percutaneous ventricular assist device (pVAD)
that is placed across the aortic valve. It actively pumps blood from the left
ventricle into the ascending aorta, thereby reducing left ventricular
workload and pressure, and increasing cardiac output. This mechanism
directly unloads the left ventricle, improving hemodynamics in
cardiogenic shock.
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Question 2:
Which of the following is an example of a high-acuity cardiac device that
provides counterpulsation to improve coronary perfusion?
A) LVAD
B) IABP (Intra-Aortic Balloon Pump)
C) ECMO
D) TAVR
Answer: B) IABP (Intra-Aortic Balloon Pump)
Rationale: The Intra-Aortic Balloon Pump (IABP) provides
counterpulsation—it inflates during diastole to increase coronary
perfusion and deflates during systole to decrease afterload. This
improves myocardial oxygen supply and reduces demand. LVAD (A)
provides continuous flow support, ECMO (C) provides both cardiac and
respiratory support, and TAVR (D) is a valve replacement procedure.
Question 3:
A patient with end-stage heart failure is being evaluated for a Ventricular
Assist Device (VAD). What is the primary purpose of a VAD?
A) To replace the native heart permanently
B) To provide mechanical circulatory support as a bridge to transplant or
destination therapy
C) To provide temporary support during cardiac arrest
D) To oxygenate blood in the absence of lung function
Answer: B) To provide mechanical circulatory support as a bridge to
transplant or destination therapy
Rationale: Ventricular Assist Devices (VADs) are mechanical pumps that
support cardiac function in patients with severe heart failure. They can
serve as a bridge to transplantation (providing support until a donor heart
is available), as destination therapy (long-term support for patients who
are not transplant candidates), or as a bridge to recovery.
, Page 3 of 47
Question 4:
A patient has undergone Transcatheter Aortic Valve Replacement (TAVR).
Which of the following is the most appropriate post-procedure nursing
intervention?
A) Monitor for signs of aortic regurgitation and vascular complications
B) Maintain strict bed rest for 48 hours
C) Administer high-dose anticoagulation
D) Monitor for signs of left ventricular hypertrophy
Answer: A) Monitor for signs of aortic regurgitation and vascular
complications
Rationale: After TAVR, the nurse should monitor for aortic regurgitation
(paravalvular leaks), vascular complications at the access site (bleeding,
hematoma, pseudoaneurysm), and cardiac arrhythmias (heart block).
TAVR is a less invasive alternative to surgical aortic valve replacement for
patients with severe aortic stenosis.
Question 5:
Which high-acuity cardiac device is used to provide both cardiac and
respiratory support in critically ill patients?
A) Impella
B) IABP
C) ECMO (Extracorporeal Membrane Oxygenation)
D) MitraClip
Answer: C) ECMO (Extracorporeal Membrane Oxygenation)
Rationale: ECMO provides both cardiac and respiratory support by
oxygenating blood outside the body and pumping it back to the patient. It
can be used in severe cardiac or respiratory failure when conventional
therapies have failed. Impella (A) and IABP (B) provide cardiac support
only, while MitraClip (D) is used for mitral valve repair.
, Page 4 of 47
Question 6:
A patient with severe mitral regurgitation is being considered for a MitraClip
procedure. What is the primary mechanism of action of the MitraClip?
A) It replaces the mitral valve with a mechanical valve
B) It clips the mitral valve leaflets together to reduce regurgitation
C) It provides continuous flow support to the left ventricle
D) It delivers an electrical shock to the mitral valve
Answer: B) It clips the mitral valve leaflets together to reduce
regurgitation
Rationale: The MitraClip is a percutaneous device that clips the mitral
valve leaflets together, reducing mitral regurgitation by creating a double
orifice. It is used for patients with severe mitral regurgitation who are at
high risk for open heart surgery. It does not replace the valve, provide
ventricular support, or deliver electrical shocks.
Question 7:
Which of the following is a key nursing consideration when caring for a patient
with an LVAD (Left Ventricular Assist Device)?
A) Monitor for the presence of a palpable pulse
B) Auscultate for a continuous humming sound (the "LVAD hum")
C) Administer high-dose diuretics
D) Maintain the patient in a supine position at all times
Answer: B) Auscultate for a continuous humming sound (the "LVAD hum")
Rationale: The LVAD produces a continuous humming sound that should
be auscultated over the device. The presence of the hum indicates the
device is functioning properly. Patients with LVADs may have a
continuous flow and may not have a palpable pulse (A), so blood pressure
assessment requires a Doppler. Diuretics (C) may be needed but are not
the priority assessment; mobility (D) should be encouraged.
