NSG 223 JUNETTA COOPER VSIM
PHARMACOLOGY SCENARIO 1 | COMPLETE
DOCUMENTATION ASSIGNMENT, ANGINA &
NITROGLYCERIN MANAGEMENT |
2026/2027 – HERZING UNIVERSITY —
PRACTICE QUESTION BANK
INTRODUCTION
The NSG 223 Junetta Cooper vSim Pharmacology Scenario 1 practice bank
focuses on the clinical reasoning and medication-safety skills needed when caring for
a patient experiencing angina and receiving nitroglycerin therapy. It is intended for
nursing students preparing for simulation activities, pharmacology assessments,
clinical-judgment exercises, documentation assignments, and SBAR-style clinical
communication. The scenario requires more than memorizing medication facts:
students must recognize clinically significant cues, assess chest discomfort, determine
whether nitroglycerin is appropriate, administer the medication safely, monitor for
adverse effects, evaluate therapeutic response, and communicate changes in condition.
The questions below emphasize application-level reasoning and realistic nursing
decisions. They cover angina pathophysiology, nitroglycerin pharmacology,
contraindication and safety considerations, blood-pressure monitoring, adverse effects,
patient education, documentation, prioritization, clinical judgment, and escalation of
care. The items are original study questions, not reproduced university or vSim
examination questions. They are designed to complement the student's assigned vSim,
course materials, medication references, and instructor guidance.
CORE DOMAINS TESTED
1.
Angina and Myocardial Ischemia — Recognition of ischemic chest
discomfort and changes from baseline.
2.
3.
Nitroglycerin Pharmacology — Mechanism, therapeutic effects, adverse
effects, and precautions.
4.
1
, 5.
Medication Safety — Assessment before administration, safe dosing, route,
and monitoring.
6.
7.
Cardiovascular Assessment — Vital signs, pain characteristics, perfusion,
and associated symptoms.
8.
9.
Clinical Judgment — Recognizing cues, analyzing findings, prioritizing
hypotheses, taking action, and evaluating outcomes.
10.
11.
Patient Education — Safe use of nitroglycerin, adverse effects, and when to
seek additional care.
12.
13.
Documentation — Objective charting of assessment, administration, response,
education, and communication.
14.
15.
SBAR Communication — Concise communication of changes in
cardiovascular status.
16.
17.
Prioritization and Escalation — Identifying persistent or worsening
symptoms requiring additional intervention.
18.
19.
Simulation Debriefing — Reflecting on clinical decisions and identifying
opportunities for improvement.
20.
2
, QUESTIONS 1-100
Q1: Junetta Cooper reports new substernal chest pressure rated 8/10. Which
nursing action should occur FIRST?
A) Administer nitroglycerin immediately without further assessment
B) Assess vital signs and obtain a focused cardiovascular and chest-pain
assessment
C) Ask the patient to ambulate to determine whether activity worsens the pain
D) Document the complaint and reassess in 30 minutes
Rationale: The correct answer is B because the nurse must rapidly establish the
patient's current hemodynamic status and characterize the chest pain before
proceeding with medication administration. Option A is incorrect because medication
safety requires appropriate assessment first. Option C is incorrect because
ambulation may increase myocardial oxygen demand. Option D is incorrect because
delaying assessment of severe chest pain may delay treatment of potentially serious
ischemia.
Q2: Which description is most characteristic of myocardial ischemic pain?
A) Brief, stabbing pain localized to one rib
B) Pressure, heaviness, squeezing, or tightness in the substernal region
C) Pain occurring exclusively when the chest wall is palpated
D) Sharp pain that occurs only during deep inspiration
Rationale: The correct answer is B because myocardial ischemia commonly produces
pressure, heaviness, squeezing, or tightness. Option A may suggest musculoskeletal or
other noncardiac pain. Option C suggests a potentially musculoskeletal component.
Option D is more consistent with pleuritic pain. However, atypical presentations can
occur, so the nurse should never rule out cardiac disease solely from symptom
description.
Q3: Before administering prescribed sublingual nitroglycerin, which finding is
most important to assess?
A) Temperature
B) Bowel sounds
C) Blood pressure and overall hemodynamic status
D) Last oral intake
Rationale: The correct answer is C because nitroglycerin produces vasodilation and
can cause hypotension. Option A is not the primary safety assessment for this
medication. Option B is unrelated to immediate nitroglycerin safety. Option D may be
relevant to other medications but is not the priority assessment before sublingual
nitroglycerin.
Q4: Junetta's blood pressure is significantly lower than her baseline and she
reports dizziness. What is the nurse's priority?
3
PHARMACOLOGY SCENARIO 1 | COMPLETE
DOCUMENTATION ASSIGNMENT, ANGINA &
NITROGLYCERIN MANAGEMENT |
2026/2027 – HERZING UNIVERSITY —
PRACTICE QUESTION BANK
INTRODUCTION
The NSG 223 Junetta Cooper vSim Pharmacology Scenario 1 practice bank
focuses on the clinical reasoning and medication-safety skills needed when caring for
a patient experiencing angina and receiving nitroglycerin therapy. It is intended for
nursing students preparing for simulation activities, pharmacology assessments,
clinical-judgment exercises, documentation assignments, and SBAR-style clinical
communication. The scenario requires more than memorizing medication facts:
students must recognize clinically significant cues, assess chest discomfort, determine
whether nitroglycerin is appropriate, administer the medication safely, monitor for
adverse effects, evaluate therapeutic response, and communicate changes in condition.
The questions below emphasize application-level reasoning and realistic nursing
decisions. They cover angina pathophysiology, nitroglycerin pharmacology,
contraindication and safety considerations, blood-pressure monitoring, adverse effects,
patient education, documentation, prioritization, clinical judgment, and escalation of
care. The items are original study questions, not reproduced university or vSim
examination questions. They are designed to complement the student's assigned vSim,
course materials, medication references, and instructor guidance.
CORE DOMAINS TESTED
1.
Angina and Myocardial Ischemia — Recognition of ischemic chest
discomfort and changes from baseline.
2.
3.
Nitroglycerin Pharmacology — Mechanism, therapeutic effects, adverse
effects, and precautions.
4.
1
, 5.
Medication Safety — Assessment before administration, safe dosing, route,
and monitoring.
6.
7.
Cardiovascular Assessment — Vital signs, pain characteristics, perfusion,
and associated symptoms.
8.
9.
Clinical Judgment — Recognizing cues, analyzing findings, prioritizing
hypotheses, taking action, and evaluating outcomes.
10.
11.
Patient Education — Safe use of nitroglycerin, adverse effects, and when to
seek additional care.
12.
13.
Documentation — Objective charting of assessment, administration, response,
education, and communication.
14.
15.
SBAR Communication — Concise communication of changes in
cardiovascular status.
16.
17.
Prioritization and Escalation — Identifying persistent or worsening
symptoms requiring additional intervention.
18.
19.
Simulation Debriefing — Reflecting on clinical decisions and identifying
opportunities for improvement.
20.
2
, QUESTIONS 1-100
Q1: Junetta Cooper reports new substernal chest pressure rated 8/10. Which
nursing action should occur FIRST?
A) Administer nitroglycerin immediately without further assessment
B) Assess vital signs and obtain a focused cardiovascular and chest-pain
assessment
C) Ask the patient to ambulate to determine whether activity worsens the pain
D) Document the complaint and reassess in 30 minutes
Rationale: The correct answer is B because the nurse must rapidly establish the
patient's current hemodynamic status and characterize the chest pain before
proceeding with medication administration. Option A is incorrect because medication
safety requires appropriate assessment first. Option C is incorrect because
ambulation may increase myocardial oxygen demand. Option D is incorrect because
delaying assessment of severe chest pain may delay treatment of potentially serious
ischemia.
Q2: Which description is most characteristic of myocardial ischemic pain?
A) Brief, stabbing pain localized to one rib
B) Pressure, heaviness, squeezing, or tightness in the substernal region
C) Pain occurring exclusively when the chest wall is palpated
D) Sharp pain that occurs only during deep inspiration
Rationale: The correct answer is B because myocardial ischemia commonly produces
pressure, heaviness, squeezing, or tightness. Option A may suggest musculoskeletal or
other noncardiac pain. Option C suggests a potentially musculoskeletal component.
Option D is more consistent with pleuritic pain. However, atypical presentations can
occur, so the nurse should never rule out cardiac disease solely from symptom
description.
Q3: Before administering prescribed sublingual nitroglycerin, which finding is
most important to assess?
A) Temperature
B) Bowel sounds
C) Blood pressure and overall hemodynamic status
D) Last oral intake
Rationale: The correct answer is C because nitroglycerin produces vasodilation and
can cause hypotension. Option A is not the primary safety assessment for this
medication. Option B is unrelated to immediate nitroglycerin safety. Option D may be
relevant to other medications but is not the priority assessment before sublingual
nitroglycerin.
Q4: Junetta's blood pressure is significantly lower than her baseline and she
reports dizziness. What is the nurse's priority?
3
