BNKN602 FINAL PAPER 2025/2026 QUESTIONS AND
SOLUTIONS GRADED A+ TIP
✔✔Ischaemic heart disease- Signs and symptoms - ✔✔-angina
-dizziness
-nausea
-SOB
-^HR
✔✔Myocardial infarction (MI) - ✔✔Heart attack; death of myocardial tissue (infarction)
caused by ischemia (loss of blood flow) as a result of an occlusion (plugging) of a
coronary artery; usually caused by atherosclerosis
✔✔Myocardial infarction interventions - ✔✔-Interventions for MI
-Monitor vital signs record and report
-Administer prescribed 02
-Administer prescribed GTN to promote vasodilation and therefore increase 02 delivery
-Administer prescribed aspirin to inhibit platelet formation of thrombus
-Administer prescribed opioids or analgesia to decrease chest pain and regularly
elevate pt response
-Reassure pt and family to reduce level of anxiety, therefore decrease WOB and
decrease RR
✔✔MI Types (2) - ✔✔STEMI-full thickness myocardial wall damage
Sudden, complete blockage of a coronary artery
Visible on ECG
NSTEMI-partial thickness myocardial wall damage
Partial blockage of coronary artery
Not visible on ECG-bloods required for cardiac biomarkers to diagnose
✔✔Infarction definition - ✔✔Necrosis- permanent damage
✔✔Heart attack vs. Cardiac arrest - ✔✔Heart Attack - Blood supply is blocked
(Coronary circulation problem)
Cardiac Arrest - Heart suddenly stops beating (electrical malfunction causing
arrhythmia-irregular heart beat)
✔✔Cardiac Rehabilitation - ✔✔An intervention program for education/support following
a heart attack for pt. + whanau.
-reduces risk of another heart attack
-reduce likelihood of complications following attack
-nutrition + exercise advice
,✔✔Traumatic Brain Injury (TBI) - ✔✔Traumatic brain injury is a type of acquired brain
injury caused by a blow to the head or by the head being forced to move rapidly usually
with some loss of consciousness
✔✔2 classes of injuries to the brain - ✔✔• Focal brain injuries are localised to a specific
region(s)
• Diffuse axonal injuries are widespread
✔✔Focal Brain injuries - ✔✔The force of impact from a focal brain injury typically
produces contusions- injury to brain tissue without breaking the inner pia mater.
Damage results from compression of the brain against the skull at the point of impact
and from a rebound effect at the opposite side of the skull.
✔✔Types of Ischemic stroke - ✔✔A cerebral thrombosis, (think about atherosclerotic
plaques) when a thrombus forms in a main artery (or small arteries) to the brain;
A cerebral embolism, when a blockage caused by an embolism forms in a blood vessel
somewhere else in the body & is carried in bloodstream to brain; or a blockage in the
tiny blood vessels deep within the brain
✔✔Pathophysiology of Athlerosclerosis - ✔✔1.An irritant is present e.g. lipids (LDL
cholesterol), high blood pressure (HTN), toxins (i.e. cigarette smoke), diabetes
2.Damage occurs to the endothelium - a crack or fissure is formed
3.LDL cholesterol deposits accumulate in the artery wall (tunica intima) known as fatty
streaks
4.LDL oxidises (changes), sends signal to immune system and monocytes (WBC) arrive
5.Monocytes convert to macrophages and consume the cholesterol
6.Macrophages fill up on cholesterol and die = foam cells
7.Formation of foam cells = release of cytokines (inflammatory process = vicious circle)
8.Smooth muscle cells migrate into expanding fatty plaque forming a lipid cap (using
collagen and elastin)
9.Smooth muscle cells also deposit calcium into the fatty plaque, hardening it and
causing bulging into the artery lumen
10.Blood flow is decreased (resistance is increased) and compliance is reduced (less
flexibility)
, 11.Ongoing inflammation = plaque rupture, thrombogenic material inside the cap is
exposed = arriving platelets form a thrombus
12.A thrombus is formed (either partially or fully) and occludes the artery causing
ischaemia, or ultimately infarction
✔✔Types of stroke - ✔✔Ischemic stroke
Lack of blood supply leads to ischaemia and infarction (tissue necrosis
Hemorrhagic stroke
When a blood vessel bursts, causing haemorrhage into the brain
✔✔Types of Hemorrhagic stroke - ✔✔• Inflammation & swelling cause raised ICP
• Usually sudden, often widespread damage, often fatal or poor outcome
• Intracerebral - blood bursts through the walls of an artery and leaks into the brain,
leaking blood is forced into brain tissue causing damage. Because there is little space
inside the skull the build up of blood also presses on nearby parts of the brain causing
further damage to nerve cells and brain function.
• Subarachnoid haemorrhage - bleeding into the subarachnoid space (btw inner and
middle meninges ie arachnoid and pia mater) most commonly caused by aneurysm
✔✔Signs and symptoms of meningitis - ✔✔• fever
• headache
• vomiting
• sleepy, confused, delirious, unconscious
• joint pains, aching muscles
• stiff neck
• discomfort looking at bright lights
• rash
✔✔Signs of increased ICP - ✔✔Early
-Confusion
-Drowsiness
-Headache
-Forgetfulness
-Limb weakness
-Nausea
Late
-Cushing's Triad
-Projectile vomiting
-Seizures
-Fixed and dilated pupil
SOLUTIONS GRADED A+ TIP
✔✔Ischaemic heart disease- Signs and symptoms - ✔✔-angina
-dizziness
-nausea
-SOB
-^HR
✔✔Myocardial infarction (MI) - ✔✔Heart attack; death of myocardial tissue (infarction)
caused by ischemia (loss of blood flow) as a result of an occlusion (plugging) of a
coronary artery; usually caused by atherosclerosis
✔✔Myocardial infarction interventions - ✔✔-Interventions for MI
-Monitor vital signs record and report
-Administer prescribed 02
-Administer prescribed GTN to promote vasodilation and therefore increase 02 delivery
-Administer prescribed aspirin to inhibit platelet formation of thrombus
-Administer prescribed opioids or analgesia to decrease chest pain and regularly
elevate pt response
-Reassure pt and family to reduce level of anxiety, therefore decrease WOB and
decrease RR
✔✔MI Types (2) - ✔✔STEMI-full thickness myocardial wall damage
Sudden, complete blockage of a coronary artery
Visible on ECG
NSTEMI-partial thickness myocardial wall damage
Partial blockage of coronary artery
Not visible on ECG-bloods required for cardiac biomarkers to diagnose
✔✔Infarction definition - ✔✔Necrosis- permanent damage
✔✔Heart attack vs. Cardiac arrest - ✔✔Heart Attack - Blood supply is blocked
(Coronary circulation problem)
Cardiac Arrest - Heart suddenly stops beating (electrical malfunction causing
arrhythmia-irregular heart beat)
✔✔Cardiac Rehabilitation - ✔✔An intervention program for education/support following
a heart attack for pt. + whanau.
-reduces risk of another heart attack
-reduce likelihood of complications following attack
-nutrition + exercise advice
,✔✔Traumatic Brain Injury (TBI) - ✔✔Traumatic brain injury is a type of acquired brain
injury caused by a blow to the head or by the head being forced to move rapidly usually
with some loss of consciousness
✔✔2 classes of injuries to the brain - ✔✔• Focal brain injuries are localised to a specific
region(s)
• Diffuse axonal injuries are widespread
✔✔Focal Brain injuries - ✔✔The force of impact from a focal brain injury typically
produces contusions- injury to brain tissue without breaking the inner pia mater.
Damage results from compression of the brain against the skull at the point of impact
and from a rebound effect at the opposite side of the skull.
✔✔Types of Ischemic stroke - ✔✔A cerebral thrombosis, (think about atherosclerotic
plaques) when a thrombus forms in a main artery (or small arteries) to the brain;
A cerebral embolism, when a blockage caused by an embolism forms in a blood vessel
somewhere else in the body & is carried in bloodstream to brain; or a blockage in the
tiny blood vessels deep within the brain
✔✔Pathophysiology of Athlerosclerosis - ✔✔1.An irritant is present e.g. lipids (LDL
cholesterol), high blood pressure (HTN), toxins (i.e. cigarette smoke), diabetes
2.Damage occurs to the endothelium - a crack or fissure is formed
3.LDL cholesterol deposits accumulate in the artery wall (tunica intima) known as fatty
streaks
4.LDL oxidises (changes), sends signal to immune system and monocytes (WBC) arrive
5.Monocytes convert to macrophages and consume the cholesterol
6.Macrophages fill up on cholesterol and die = foam cells
7.Formation of foam cells = release of cytokines (inflammatory process = vicious circle)
8.Smooth muscle cells migrate into expanding fatty plaque forming a lipid cap (using
collagen and elastin)
9.Smooth muscle cells also deposit calcium into the fatty plaque, hardening it and
causing bulging into the artery lumen
10.Blood flow is decreased (resistance is increased) and compliance is reduced (less
flexibility)
, 11.Ongoing inflammation = plaque rupture, thrombogenic material inside the cap is
exposed = arriving platelets form a thrombus
12.A thrombus is formed (either partially or fully) and occludes the artery causing
ischaemia, or ultimately infarction
✔✔Types of stroke - ✔✔Ischemic stroke
Lack of blood supply leads to ischaemia and infarction (tissue necrosis
Hemorrhagic stroke
When a blood vessel bursts, causing haemorrhage into the brain
✔✔Types of Hemorrhagic stroke - ✔✔• Inflammation & swelling cause raised ICP
• Usually sudden, often widespread damage, often fatal or poor outcome
• Intracerebral - blood bursts through the walls of an artery and leaks into the brain,
leaking blood is forced into brain tissue causing damage. Because there is little space
inside the skull the build up of blood also presses on nearby parts of the brain causing
further damage to nerve cells and brain function.
• Subarachnoid haemorrhage - bleeding into the subarachnoid space (btw inner and
middle meninges ie arachnoid and pia mater) most commonly caused by aneurysm
✔✔Signs and symptoms of meningitis - ✔✔• fever
• headache
• vomiting
• sleepy, confused, delirious, unconscious
• joint pains, aching muscles
• stiff neck
• discomfort looking at bright lights
• rash
✔✔Signs of increased ICP - ✔✔Early
-Confusion
-Drowsiness
-Headache
-Forgetfulness
-Limb weakness
-Nausea
Late
-Cushing's Triad
-Projectile vomiting
-Seizures
-Fixed and dilated pupil
