NSG 223 JUNETTA COOPER VSIM |
POST-SIMULATION CLINICAL JUDGMENT
WORKSHEET, ANGINA & NITROGLYCERIN
MANAGEMENT | 2026/2027 – 100
PRACTICE QUESTIONS WITH ANSWERS
AND DETAILED RATIONALES
This is an original exam-style practice bank, not an official Herzing University
examination or a guaranteed answer key.
INTRODUCTION
The NSG 223 Junetta Cooper vSim focuses on clinical judgment and safe
pharmacologic management of a patient experiencing angina pectoris. The official
vSim scenario identifies Junetta Cooper as the case involving nitroglycerin
administration for the treatment of angina pectoris. (Wolters Kluwer) The
scenario is designed to develop nursing students’ ability to recognize clinically
significant cues, assess chest pain, prioritize interventions, administer medications
safely, evaluate treatment effectiveness, communicate changes, and reflect on clinical
decisions.
This practice bank is intended for nursing students preparing for NSG 223 coursework,
the Junetta Cooper simulation, post-simulation clinical judgment activities, and
related cardiovascular/pharmacology assessments. Questions emphasize application
rather than simple recall. They integrate assessment findings, angina versus
myocardial infarction, nitroglycerin safety, blood-pressure considerations, medication
administration, reassessment, documentation, clinical judgment, patient education,
SBAR communication, and prioritization.
The questions are deliberately challenging and scenario-based so that students must
determine what matters most, what should happen first, and how the nurse
should evaluate the response to treatment.
The scenario has also been described in available NSG 223 materials as involving a
patient with chronic stable/exertional angina who experiences recurrent chest
discomfort and receives sublingual nitroglycerin. (Studocu)
CORE DOMAINS TESTED
1.
1
,Recognizing Cues — Identify clinically significant cardiovascular and
medication-related findings.
2.
3.
Analyzing Cues — Distinguish expected angina findings from findings
suggesting acute coronary syndrome.
4.
5.
Prioritization — Determine which assessment or intervention takes priority.
6.
7.
Angina Pathophysiology — Apply the relationship between myocardial
oxygen supply and demand.
8.
9.
Nitroglycerin Pharmacology — Apply mechanism, administration,
precautions, adverse effects, and therapeutic response.
10.
11.
Medication Safety — Evaluate contraindications, medication interactions,
allergies, blood pressure, and administration technique.
12.
13.
Clinical Judgment — Generate, implement, and evaluate appropriate nursing
solutions.
14.
15.
Patient Education — Teach safe use of nitroglycerin and recognition of
emergency symptoms.
16.
17.
Evaluation/Reassessment — Determine whether an intervention achieved the
intended outcome.
2
, 18.
19.
Documentation and SBAR — Communicate clinically relevant findings
accurately and concisely.
20.
21.
Cardiovascular Assessment — Interpret vital signs, pain characteristics,
rhythm, oxygenation, and hemodynamic changes.
22.
23.
Cardiac Catheterization Preparation — Apply nursing priorities when the
patient is awaiting diagnostic evaluation.
24.
25.
Safety and Delegation — Determine which actions require RN judgment and
which can appropriately be delegated.
26.
27.
Post-Simulation Clinical Reflection — Connect observations, interventions,
outcomes, and future practice.
28.
QUESTIONS 1-100
Q1:
Junetta Cooper reports new central chest tightness that she describes as heavy and
burning and rates 7/10. What should the nurse do first?
A) Ask the patient to ambulate to determine whether the pain worsens
B) Perform an immediate focused cardiovascular assessment, including vital
signs and pain characteristics
C) Document the pain and reassess in 30 minutes
D) Encourage the patient to drink water
3
, Rationale: B is correct because acute chest discomfort requires immediate assessment
of hemodynamic status and characteristics of the pain before and during intervention.
A is unsafe because activity may increase myocardial oxygen demand. C delays
assessment of potentially serious ischemia. D does not address the priority
cardiovascular problem.
Q2:
Which finding most strongly supports myocardial ischemia in Junetta?
A) Temperature of 98.6°F
B) Oxygen saturation of 96%
C) Central chest pressure described as tightness and burning
D) Respiratory rate of 16/min
Rationale: C is correct because pressure, tightness, heaviness, or burning in the
central chest is characteristic of myocardial ischemia. A, B, and D are not
independently indicative of acute ischemia.
Q3:
The nurse is assessing Junetta's chest pain. Which question provides the most
clinically useful additional information?
A) "Did you sleep well last night?"
B) "Have you ever been hospitalized before?"
C) "What were you doing when the pain began, and does anything relieve it?"
D) "Do you usually drink coffee?"
Rationale: C is correct because precipitating and relieving factors help differentiate
exertional stable angina from other causes of chest pain. A, B, and D may provide
background information but are less immediately useful for characterizing ischemic
pain.
Q4:
Junetta's chest pain occurs with exertion and improves after rest. Which interpretation
is most appropriate?
A) Acute pericarditis
B) Chronic stable angina
C) Acute pulmonary edema
D) Pleuritic chest pain
Rationale: B is correct because stable angina classically occurs predictably with
increased myocardial oxygen demand and improves with rest or treatment.
Pericarditis often produces positional or pleuritic pain. Pulmonary edema produces
significant respiratory findings. Pleuritic pain is generally worsened by inspiration.
4
POST-SIMULATION CLINICAL JUDGMENT
WORKSHEET, ANGINA & NITROGLYCERIN
MANAGEMENT | 2026/2027 – 100
PRACTICE QUESTIONS WITH ANSWERS
AND DETAILED RATIONALES
This is an original exam-style practice bank, not an official Herzing University
examination or a guaranteed answer key.
INTRODUCTION
The NSG 223 Junetta Cooper vSim focuses on clinical judgment and safe
pharmacologic management of a patient experiencing angina pectoris. The official
vSim scenario identifies Junetta Cooper as the case involving nitroglycerin
administration for the treatment of angina pectoris. (Wolters Kluwer) The
scenario is designed to develop nursing students’ ability to recognize clinically
significant cues, assess chest pain, prioritize interventions, administer medications
safely, evaluate treatment effectiveness, communicate changes, and reflect on clinical
decisions.
This practice bank is intended for nursing students preparing for NSG 223 coursework,
the Junetta Cooper simulation, post-simulation clinical judgment activities, and
related cardiovascular/pharmacology assessments. Questions emphasize application
rather than simple recall. They integrate assessment findings, angina versus
myocardial infarction, nitroglycerin safety, blood-pressure considerations, medication
administration, reassessment, documentation, clinical judgment, patient education,
SBAR communication, and prioritization.
The questions are deliberately challenging and scenario-based so that students must
determine what matters most, what should happen first, and how the nurse
should evaluate the response to treatment.
The scenario has also been described in available NSG 223 materials as involving a
patient with chronic stable/exertional angina who experiences recurrent chest
discomfort and receives sublingual nitroglycerin. (Studocu)
CORE DOMAINS TESTED
1.
1
,Recognizing Cues — Identify clinically significant cardiovascular and
medication-related findings.
2.
3.
Analyzing Cues — Distinguish expected angina findings from findings
suggesting acute coronary syndrome.
4.
5.
Prioritization — Determine which assessment or intervention takes priority.
6.
7.
Angina Pathophysiology — Apply the relationship between myocardial
oxygen supply and demand.
8.
9.
Nitroglycerin Pharmacology — Apply mechanism, administration,
precautions, adverse effects, and therapeutic response.
10.
11.
Medication Safety — Evaluate contraindications, medication interactions,
allergies, blood pressure, and administration technique.
12.
13.
Clinical Judgment — Generate, implement, and evaluate appropriate nursing
solutions.
14.
15.
Patient Education — Teach safe use of nitroglycerin and recognition of
emergency symptoms.
16.
17.
Evaluation/Reassessment — Determine whether an intervention achieved the
intended outcome.
2
, 18.
19.
Documentation and SBAR — Communicate clinically relevant findings
accurately and concisely.
20.
21.
Cardiovascular Assessment — Interpret vital signs, pain characteristics,
rhythm, oxygenation, and hemodynamic changes.
22.
23.
Cardiac Catheterization Preparation — Apply nursing priorities when the
patient is awaiting diagnostic evaluation.
24.
25.
Safety and Delegation — Determine which actions require RN judgment and
which can appropriately be delegated.
26.
27.
Post-Simulation Clinical Reflection — Connect observations, interventions,
outcomes, and future practice.
28.
QUESTIONS 1-100
Q1:
Junetta Cooper reports new central chest tightness that she describes as heavy and
burning and rates 7/10. What should the nurse do first?
A) Ask the patient to ambulate to determine whether the pain worsens
B) Perform an immediate focused cardiovascular assessment, including vital
signs and pain characteristics
C) Document the pain and reassess in 30 minutes
D) Encourage the patient to drink water
3
, Rationale: B is correct because acute chest discomfort requires immediate assessment
of hemodynamic status and characteristics of the pain before and during intervention.
A is unsafe because activity may increase myocardial oxygen demand. C delays
assessment of potentially serious ischemia. D does not address the priority
cardiovascular problem.
Q2:
Which finding most strongly supports myocardial ischemia in Junetta?
A) Temperature of 98.6°F
B) Oxygen saturation of 96%
C) Central chest pressure described as tightness and burning
D) Respiratory rate of 16/min
Rationale: C is correct because pressure, tightness, heaviness, or burning in the
central chest is characteristic of myocardial ischemia. A, B, and D are not
independently indicative of acute ischemia.
Q3:
The nurse is assessing Junetta's chest pain. Which question provides the most
clinically useful additional information?
A) "Did you sleep well last night?"
B) "Have you ever been hospitalized before?"
C) "What were you doing when the pain began, and does anything relieve it?"
D) "Do you usually drink coffee?"
Rationale: C is correct because precipitating and relieving factors help differentiate
exertional stable angina from other causes of chest pain. A, B, and D may provide
background information but are less immediately useful for characterizing ischemic
pain.
Q4:
Junetta's chest pain occurs with exertion and improves after rest. Which interpretation
is most appropriate?
A) Acute pericarditis
B) Chronic stable angina
C) Acute pulmonary edema
D) Pleuritic chest pain
Rationale: B is correct because stable angina classically occurs predictably with
increased myocardial oxygen demand and improves with rest or treatment.
Pericarditis often produces positional or pleuritic pain. Pulmonary edema produces
significant respiratory findings. Pleuritic pain is generally worsened by inspiration.
4
