Shadow Health Focused Exam: Chest Pain – Brian Foster
Comprehensive Review 150 Questions with Answers and Rationales
2026 latest updated exam reliable for A+ GRADE
1. What is the most likely cause of Brian Foster’s chest pain?
A) Stable angina
B) Myocardial infarction
C) Gastroesophageal reflux disease (GERD)
D) Costochondritis
Rationale: The patient reports exertional chest pain relieved by rest, characteristic of stable
angina due to transient myocardial ischemia.
2. What is the most important initial nursing assessment for Mr. Foster’s chest pain?
A) Assess vital signs and obtain a 12-lead ECG
B) Check temperature and glucose
C) Perform full body assessment
D) Administer pain medication immediately
Rationale: For suspected cardiac pain, ECG and vital sign assessment are priority to identify
ischemia or infarction.
3. Which question helps determine the quality of the patient’s pain?
A) “Can you describe what the pain feels like?”
B) “When did the pain start?”
C) “What makes it worse?”
D) “Does the pain radiate anywhere?”
Rationale: Asking the patient to describe the pain elicits the quality (e.g., sharp, dull, pressure-
like).
4. Which of the following findings would most likely indicate a cardiac cause of chest pain?
A) Pain radiating to the left arm and jaw
B) Pain relieved by antacids
C) Pain reproducible with palpation
D) Pain after meals only
Rationale: Radiation to the arm or jaw is typical of cardiac ischemic pain.
,5. What is the most appropriate nursing intervention when the patient reports chest pain rated
8/10?
A) Stop activity, place patient in semi-Fowler’s, and administer oxygen
B) Ask the patient to continue walking
C) Provide water and food
D) Reassess in 30 minutes
Rationale: Reducing myocardial oxygen demand and improving oxygen supply are priority
actions.
6. Which diagnostic test confirms myocardial ischemia?
A) 12-lead ECG
B) Chest X-ray
C) Pulmonary function test
D) Complete blood count
Rationale: ECG changes such as ST depression or T-wave inversion confirm ischemia.
7. Which medication class is typically prescribed to relieve angina symptoms?
A) Nitrates
B) Antibiotics
C) Antihistamines
D) Corticosteroids
Rationale: Nitrates dilate coronary arteries and reduce cardiac workload, relieving angina.
8. Mr. Foster takes nitroglycerin for chest pain. Which instruction is most important?
A) Take one tablet sublingually; if pain persists, call 911 after three doses, 5 minutes apart
B) Swallow the tablet with water
C) Use as needed for any kind of pain
D) Take on an empty stomach only
Rationale: Nitroglycerin must be taken sublingually and emergency care sought if pain persists.
9. Which lifestyle change should the nurse emphasize for managing angina?
A) Stop smoking and adopt a heart-healthy diet
B) Increase caffeine intake
C) Avoid all physical activity
,D) Skip breakfast to lose weight
Rationale: Smoking cessation and diet modifications reduce cardiac risk factors.
10. Which lab value is most useful for evaluating myocardial injury?
A) Troponin I
B) Hemoglobin
C) Sodium
D) D-dimer
Rationale: Elevated troponin levels are specific markers of myocardial injury.
11. Which question best assesses the onset of the chest pain?
A) “When did you first notice the pain?”
B) “How bad is the pain?”
C) “Where is the pain located?”
D) “What were you doing when it started?”
Rationale: Asking when the pain began identifies timing and potential triggers.
12. Which statement by Mr. Foster indicates he understands nitroglycerin use?
A) “I’ll sit down before taking it to avoid dizziness.”
B) “I can take as many as I need.”
C) “I’ll store it in my bathroom.”
D) “It’s okay if the tablets turn to powder.”
Rationale: Nitroglycerin can cause hypotension; sitting prevents falls from dizziness.
13. Mr. Foster’s pain is 4/10 after rest and nitroglycerin. What is the next nursing action?
A) Reassess vital signs and pain, document the response
B) Call the provider immediately
C) Administer another medication
D) Discharge the patient
Rationale: Ongoing reassessment ensures therapy effectiveness and safety.
14. What finding suggests Mr. Foster’s pain may not be cardiac in origin?
A) Pain reproducible on palpation of the chest wall
B) Pain radiating to the left arm
C) Pain with exertion
, D) Pain with diaphoresis
Rationale: Musculoskeletal pain can be localized and reproducible on palpation.
15. Which education point is essential regarding risk factor modification?
A) Manage blood pressure, cholesterol, and glucose levels
B) Limit water intake
C) Eat more red meat
D) Avoid fruits and vegetables
Rationale: Controlling metabolic risk factors prevents progression of coronary disease.
16. Which part of the focused assessment best evaluates cardiac function?
A) Inspect, palpate, and auscultate the precordium
B) Assess bowel sounds
C) Examine the skin for bruising
D) Check reflexes
Rationale: Cardiac examination focuses on heart sounds, rhythm, and precordial pulsations.
17. Which heart sound is associated with heart failure and increased filling pressures?
A) S3 gallop
B) S1
C) S2
D) Murmur
Rationale: S3 indicates rapid ventricular filling in heart failure.
18. Which nursing intervention prevents myocardial oxygen demand from increasing?
A) Minimize physical exertion and emotional stress
B) Encourage deep breathing exercises
C) Provide large meals
D) Increase caffeine intake
Rationale: Reducing exertion and stress lowers cardiac workload.
19. Which sign is most concerning for an acute myocardial infarction?
A) Chest pressure unrelieved by nitroglycerin
B) Pain relieved by rest
C) Sharp pain lasting seconds
Comprehensive Review 150 Questions with Answers and Rationales
2026 latest updated exam reliable for A+ GRADE
1. What is the most likely cause of Brian Foster’s chest pain?
A) Stable angina
B) Myocardial infarction
C) Gastroesophageal reflux disease (GERD)
D) Costochondritis
Rationale: The patient reports exertional chest pain relieved by rest, characteristic of stable
angina due to transient myocardial ischemia.
2. What is the most important initial nursing assessment for Mr. Foster’s chest pain?
A) Assess vital signs and obtain a 12-lead ECG
B) Check temperature and glucose
C) Perform full body assessment
D) Administer pain medication immediately
Rationale: For suspected cardiac pain, ECG and vital sign assessment are priority to identify
ischemia or infarction.
3. Which question helps determine the quality of the patient’s pain?
A) “Can you describe what the pain feels like?”
B) “When did the pain start?”
C) “What makes it worse?”
D) “Does the pain radiate anywhere?”
Rationale: Asking the patient to describe the pain elicits the quality (e.g., sharp, dull, pressure-
like).
4. Which of the following findings would most likely indicate a cardiac cause of chest pain?
A) Pain radiating to the left arm and jaw
B) Pain relieved by antacids
C) Pain reproducible with palpation
D) Pain after meals only
Rationale: Radiation to the arm or jaw is typical of cardiac ischemic pain.
,5. What is the most appropriate nursing intervention when the patient reports chest pain rated
8/10?
A) Stop activity, place patient in semi-Fowler’s, and administer oxygen
B) Ask the patient to continue walking
C) Provide water and food
D) Reassess in 30 minutes
Rationale: Reducing myocardial oxygen demand and improving oxygen supply are priority
actions.
6. Which diagnostic test confirms myocardial ischemia?
A) 12-lead ECG
B) Chest X-ray
C) Pulmonary function test
D) Complete blood count
Rationale: ECG changes such as ST depression or T-wave inversion confirm ischemia.
7. Which medication class is typically prescribed to relieve angina symptoms?
A) Nitrates
B) Antibiotics
C) Antihistamines
D) Corticosteroids
Rationale: Nitrates dilate coronary arteries and reduce cardiac workload, relieving angina.
8. Mr. Foster takes nitroglycerin for chest pain. Which instruction is most important?
A) Take one tablet sublingually; if pain persists, call 911 after three doses, 5 minutes apart
B) Swallow the tablet with water
C) Use as needed for any kind of pain
D) Take on an empty stomach only
Rationale: Nitroglycerin must be taken sublingually and emergency care sought if pain persists.
9. Which lifestyle change should the nurse emphasize for managing angina?
A) Stop smoking and adopt a heart-healthy diet
B) Increase caffeine intake
C) Avoid all physical activity
,D) Skip breakfast to lose weight
Rationale: Smoking cessation and diet modifications reduce cardiac risk factors.
10. Which lab value is most useful for evaluating myocardial injury?
A) Troponin I
B) Hemoglobin
C) Sodium
D) D-dimer
Rationale: Elevated troponin levels are specific markers of myocardial injury.
11. Which question best assesses the onset of the chest pain?
A) “When did you first notice the pain?”
B) “How bad is the pain?”
C) “Where is the pain located?”
D) “What were you doing when it started?”
Rationale: Asking when the pain began identifies timing and potential triggers.
12. Which statement by Mr. Foster indicates he understands nitroglycerin use?
A) “I’ll sit down before taking it to avoid dizziness.”
B) “I can take as many as I need.”
C) “I’ll store it in my bathroom.”
D) “It’s okay if the tablets turn to powder.”
Rationale: Nitroglycerin can cause hypotension; sitting prevents falls from dizziness.
13. Mr. Foster’s pain is 4/10 after rest and nitroglycerin. What is the next nursing action?
A) Reassess vital signs and pain, document the response
B) Call the provider immediately
C) Administer another medication
D) Discharge the patient
Rationale: Ongoing reassessment ensures therapy effectiveness and safety.
14. What finding suggests Mr. Foster’s pain may not be cardiac in origin?
A) Pain reproducible on palpation of the chest wall
B) Pain radiating to the left arm
C) Pain with exertion
, D) Pain with diaphoresis
Rationale: Musculoskeletal pain can be localized and reproducible on palpation.
15. Which education point is essential regarding risk factor modification?
A) Manage blood pressure, cholesterol, and glucose levels
B) Limit water intake
C) Eat more red meat
D) Avoid fruits and vegetables
Rationale: Controlling metabolic risk factors prevents progression of coronary disease.
16. Which part of the focused assessment best evaluates cardiac function?
A) Inspect, palpate, and auscultate the precordium
B) Assess bowel sounds
C) Examine the skin for bruising
D) Check reflexes
Rationale: Cardiac examination focuses on heart sounds, rhythm, and precordial pulsations.
17. Which heart sound is associated with heart failure and increased filling pressures?
A) S3 gallop
B) S1
C) S2
D) Murmur
Rationale: S3 indicates rapid ventricular filling in heart failure.
18. Which nursing intervention prevents myocardial oxygen demand from increasing?
A) Minimize physical exertion and emotional stress
B) Encourage deep breathing exercises
C) Provide large meals
D) Increase caffeine intake
Rationale: Reducing exertion and stress lowers cardiac workload.
19. Which sign is most concerning for an acute myocardial infarction?
A) Chest pressure unrelieved by nitroglycerin
B) Pain relieved by rest
C) Sharp pain lasting seconds
