NR 545 exam 2 UPDATED ACTUAL Exam
Questions and CORRECT Answers
What is Angina? - CORRECT ANSWER - Angina, or angina pectoris, is often described
as chest pain usually precipitated by stress or exertion and relieved rapidly with rest or nitrates.
Those with angina report varying symptoms including chest pain categorized as squeezing while
others describe the pain like a heavy weight being placed on the chest. Angina is relatively
common, and usually due to atherosclerotic heart disease.
What is the Patho of Angina? - CORRECT ANSWER - Angina is chest pain that is
associated with decreased blood flow or ischemia to the myocardial tissue. The decreased blood
flow may be the result of atherosclerosis or coronary artery spasm. Neural pain receptors are
stimulated by accelerated cellular metabolism, chemical changes, and imbalances
What are signs and symptoms of Angina? - CORRECT ANSWER - - chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder and arm while others
report pain in the jaw.
Generally, the attack length can range anywhere between three minutes to twenty minutes.
Attacks reported at greater than thirty minutes are concerning and could indicate the
development of acute coronary syndrome.
What lab test are needed for angina? - CORRECT ANSWER - - Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for anemia which might be
contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome.
What are pharmacological remedies for Angina? - CORRECT ANSWER - Nitroglycerin
(Drug of choice):
,Nitroglycerin relaxes and widens the blood vessel promoting easier blood flow to the heart
muscle. Dosing of nitroglycerin is 0.3-0.6 mg by translingual spray or sublingual tablet every
five minutes, as indicated with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors
What is a myocardial infarction? - CORRECT ANSWER - (Heart Attack)
A myocardial infarction (MI) occurs when blood flow to the heart is minimized. The blockage is
most often caused by a buildup of cholesterol, which forms a plaque in the arteries that circulate
oxygenated blood flow to the myocardium. When the plaque breaks away it can form a clot,
interrupting or completely blocking blood flow and destroying a part of the heart muscle. Unlike
with an episode of angina, those experiencing a myocardial
infarction often report symptoms of pain at rest.
What is the patho of a Myocardial Infarction? - CORRECT ANSWER - During a
myocardial infarction there is an imbalance between myocardial oxygen supply and demand.
Prolonged ischemia (>30 minutes) from the lack of circulating blood flow to the myocardium
results in cellular death, further impacting the heart's ability to function. Depending on the extent
of the cell death, the heart might have decreased contractility resulting in wall function
abnormalities further placing the patient at risk for decompensation.
What are the symptoms of a Myocardial Infraction? - CORRECT ANSWER - - Sharp
radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing
, What lab test are needed for a Myocardial Infraction? - CORRECT ANSWER --
Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block.
How do you manage a Myocardial Infraction? - CORRECT ANSWER - Patients
presenting with acute myocardial infarction will need reperfusion therapy or fibrinolytic therapy.
To decrease mortality rates, reperfusion through PCI needs to be completed within 90 minutes of
presentation to the emergency room.
What is Atherosclerosis? - CORRECT ANSWER - a disease of the arteries characterized
by the deposition of plaques of fatty material on their inner walls.
What is the path of Atherosclerosis? - CORRECT ANSWER - Atherosclerosis is an
inflammatory process that begins with damage to the endothelium often the result of
hypertension, smoking, high cholesterol or other risk factors. The endothelium develops a fatty
streak which further develops into a fibrous plaque and then complicated lesion.
Physical assessment of Atherosclerosis? - CORRECT ANSWER - Family medical history
and personal medical history should be reviewed for risk factors, including level of physical
activity, tobacco, use, and dietary habits. A review of symptoms including recent and increasing
fatigue, as well as fluid retention should be completed. A medication history should be obtained
to determine risk factors including high cholesterol, hypertension, or diabetes.
While a full physical assessment should be performed, particular attention to pulse deficits, neck
vein distention, edema, and calf pain can further contribute to the diagnosis.
What are test of Atherosclerosis? - CORRECT ANSWER - - Stress tests (either exercise or
pharmacological)
- Chest x-ray
Questions and CORRECT Answers
What is Angina? - CORRECT ANSWER - Angina, or angina pectoris, is often described
as chest pain usually precipitated by stress or exertion and relieved rapidly with rest or nitrates.
Those with angina report varying symptoms including chest pain categorized as squeezing while
others describe the pain like a heavy weight being placed on the chest. Angina is relatively
common, and usually due to atherosclerotic heart disease.
What is the Patho of Angina? - CORRECT ANSWER - Angina is chest pain that is
associated with decreased blood flow or ischemia to the myocardial tissue. The decreased blood
flow may be the result of atherosclerosis or coronary artery spasm. Neural pain receptors are
stimulated by accelerated cellular metabolism, chemical changes, and imbalances
What are signs and symptoms of Angina? - CORRECT ANSWER - - chest heaviness
- chest pressure
- squeezing or fullness Sometimes this pain radiates to the left shoulder and arm while others
report pain in the jaw.
Generally, the attack length can range anywhere between three minutes to twenty minutes.
Attacks reported at greater than thirty minutes are concerning and could indicate the
development of acute coronary syndrome.
What lab test are needed for angina? - CORRECT ANSWER - - Troponin
- CK-MB: to evaluate for acute coronary symptoms as well as for anemia which might be
contributing to ischemic chest pain.
- An ECG should also be obtained to rule out acute coronary syndrome.
What are pharmacological remedies for Angina? - CORRECT ANSWER - Nitroglycerin
(Drug of choice):
,Nitroglycerin relaxes and widens the blood vessel promoting easier blood flow to the heart
muscle. Dosing of nitroglycerin is 0.3-0.6 mg by translingual spray or sublingual tablet every
five minutes, as indicated with a max of 3 doses in 15 minutes.
Beta-Blockers and ACE inhibitors
What is a myocardial infarction? - CORRECT ANSWER - (Heart Attack)
A myocardial infarction (MI) occurs when blood flow to the heart is minimized. The blockage is
most often caused by a buildup of cholesterol, which forms a plaque in the arteries that circulate
oxygenated blood flow to the myocardium. When the plaque breaks away it can form a clot,
interrupting or completely blocking blood flow and destroying a part of the heart muscle. Unlike
with an episode of angina, those experiencing a myocardial
infarction often report symptoms of pain at rest.
What is the patho of a Myocardial Infarction? - CORRECT ANSWER - During a
myocardial infarction there is an imbalance between myocardial oxygen supply and demand.
Prolonged ischemia (>30 minutes) from the lack of circulating blood flow to the myocardium
results in cellular death, further impacting the heart's ability to function. Depending on the extent
of the cell death, the heart might have decreased contractility resulting in wall function
abnormalities further placing the patient at risk for decompensation.
What are the symptoms of a Myocardial Infraction? - CORRECT ANSWER - - Sharp
radiating pain (Even at rest)
- Light-headed or have increased feelings of anxiety or impending doom.
- Nausea (more common in right coronary artery occlusion)
- Vomiting
- Diaphoresis
- Syncope
- Dyspnea
- Orthopnea
- Wheezing
, What lab test are needed for a Myocardial Infraction? - CORRECT ANSWER --
Troponins
- CK-MB
- An ECG will often demonstrate ST-segment elevation or new left bundle
branch block.
How do you manage a Myocardial Infraction? - CORRECT ANSWER - Patients
presenting with acute myocardial infarction will need reperfusion therapy or fibrinolytic therapy.
To decrease mortality rates, reperfusion through PCI needs to be completed within 90 minutes of
presentation to the emergency room.
What is Atherosclerosis? - CORRECT ANSWER - a disease of the arteries characterized
by the deposition of plaques of fatty material on their inner walls.
What is the path of Atherosclerosis? - CORRECT ANSWER - Atherosclerosis is an
inflammatory process that begins with damage to the endothelium often the result of
hypertension, smoking, high cholesterol or other risk factors. The endothelium develops a fatty
streak which further develops into a fibrous plaque and then complicated lesion.
Physical assessment of Atherosclerosis? - CORRECT ANSWER - Family medical history
and personal medical history should be reviewed for risk factors, including level of physical
activity, tobacco, use, and dietary habits. A review of symptoms including recent and increasing
fatigue, as well as fluid retention should be completed. A medication history should be obtained
to determine risk factors including high cholesterol, hypertension, or diabetes.
While a full physical assessment should be performed, particular attention to pulse deficits, neck
vein distention, edema, and calf pain can further contribute to the diagnosis.
What are test of Atherosclerosis? - CORRECT ANSWER - - Stress tests (either exercise or
pharmacological)
- Chest x-ray
