NURS231 PATHOPHYSIOLOGY MODULE 3
ACTUAL ASSESSMENT 2026 COMPLETE
SOLVED QUESTIONS
◉ Match the following descriptions to correct abnormal heart sound
1) ___ whoosing sound from lack of oxygenation blood to valves,
causing valvular dysfunction. If new onset, indicates ischemia or
infarct is affecting the valves
2) extra heart sound that can be an early sign of acute HF; watch for
pts w acute MI or others at risk for HF
3) grating heart sound caused by inflammation in the pericardium
watch for pts w acute MI. Answer: 1) murmurs
2) S3
3) pericardial friction rub
◉ Other than assessment of symptoms, what is used in the diagnosis
of ACS?. Answer: -troponin (elevated)
-12 lead ECG (ST segment changes)
-cardiac cath (visualize blockage)
-imaging assessment (areas of low myocardial perfusion)
-exercise electrocardiography/ stress test
-pharmacologic stress echocardiogram using
dobutamine/persantine
,-myocardial nuclear perfusion imaging
-echocardiogram
◉ What lab test is very sepecific & selective to cardiac damage that
will release within 30-60 mins of injury onset?
*helpful to distinguish between ACS (elevated) & chronic stable
angina (normal). Answer: Cardiac biomarkers like Troponin
◉ What is the care for a pt w ACS?
*doesn't matter if acute MI or unstable angina, if have symptoms of
ischemia/infact you treat the same. Answer: -monitor & support
ABC; be prepared to start CPR & defibrillation
-have pt chew high dose aspirin (160-325mg)
-have pt place nitro under tongue
-start 4L O2 & titrate if SpO2 <90%
-start IV morphine if pain unrelieved by nitro
-obtain 12 lead ECG if ST elevation
-brief hx & physical exam
-check contraindications for fibrinolytic therapy
-obtain initial cardiac marker levels, electrolytes, & coag
-obtain portable CXR
-position of comfort; semi-folwers
-quiet calm environment
,◉ What are the different types of routes for nitro for pts w ACS?
*should notice effects within 3-5 mins. Answer: 1) IV; given @ the
hospital for tight control by titrating dose
2) sublingual; place under tongue, get med refilled if expired, call
911 if pain not resolved after 5 mins of 1st dose
3) transdermal; wear gloves, no rubbing, massaging, or heat; may be
removed at night and replaced in the morning for prevention
◉ The physician orders nitro 20 mcgs/min. On hand is 50
mgs/250ml. At what rate will you program the infusion pump
(ml/hr)?. Answer: 6 ml/hr
xml/hr= 250ml/50mg x 1mg/1,000mcg x 20mcg/min x 60min/hr
◉ What med is given to decrease the afterload and preload by
dilating the coronary arteries? What is a potential adverse effect?.
Answer: Nitroglycerin
*hypotension and headahce bc vasodilation increases ICP
◉ Pt reported to ED w acute MI symptoms like chest pain,
diaphoresis, nausea, & BP 138/84. Physician ordered nitro to start at
, 10 mcg/min. The nurse administered IV, waited 5-10 mins then
reassessed. What should the nurse do in the following situations
1) pt still has chest pain and BP now 135/82
2) pts chest pain and other associated symptoms gone and BP now
120/80
3) pts chest pain is gone and BP now 98/40. Answer: 1) increase by
5 mcg/min to a total of 15 mcg/min
2) Leave pt at dose & continue to monitor
3) reduce rate bc pts BP dropped which doesn't help coronary
arteries perfuse; then reassess and report to physician
◉ What is the nurses role for administering IV nitro?. Answer: -
titrate to effect on BP and chest pain
-titrate 5-10 mcg/min every 5-10 mins
-max dose 200 mcg/min
-decreases dose if hypotensive
-maintain dose if chest pain resolved and normal BP
◉ What is the treatment of pt w ACS?. Answer: 1) Drug therapy:
--Aspirin for antiplatelet
--Beta blocker to decrease myocardial workload & O2 demand
--ACEI/ARBS to decrease myocardial workload & O2 demand
--Thrombolytic therapy to break up clot
ACTUAL ASSESSMENT 2026 COMPLETE
SOLVED QUESTIONS
◉ Match the following descriptions to correct abnormal heart sound
1) ___ whoosing sound from lack of oxygenation blood to valves,
causing valvular dysfunction. If new onset, indicates ischemia or
infarct is affecting the valves
2) extra heart sound that can be an early sign of acute HF; watch for
pts w acute MI or others at risk for HF
3) grating heart sound caused by inflammation in the pericardium
watch for pts w acute MI. Answer: 1) murmurs
2) S3
3) pericardial friction rub
◉ Other than assessment of symptoms, what is used in the diagnosis
of ACS?. Answer: -troponin (elevated)
-12 lead ECG (ST segment changes)
-cardiac cath (visualize blockage)
-imaging assessment (areas of low myocardial perfusion)
-exercise electrocardiography/ stress test
-pharmacologic stress echocardiogram using
dobutamine/persantine
,-myocardial nuclear perfusion imaging
-echocardiogram
◉ What lab test is very sepecific & selective to cardiac damage that
will release within 30-60 mins of injury onset?
*helpful to distinguish between ACS (elevated) & chronic stable
angina (normal). Answer: Cardiac biomarkers like Troponin
◉ What is the care for a pt w ACS?
*doesn't matter if acute MI or unstable angina, if have symptoms of
ischemia/infact you treat the same. Answer: -monitor & support
ABC; be prepared to start CPR & defibrillation
-have pt chew high dose aspirin (160-325mg)
-have pt place nitro under tongue
-start 4L O2 & titrate if SpO2 <90%
-start IV morphine if pain unrelieved by nitro
-obtain 12 lead ECG if ST elevation
-brief hx & physical exam
-check contraindications for fibrinolytic therapy
-obtain initial cardiac marker levels, electrolytes, & coag
-obtain portable CXR
-position of comfort; semi-folwers
-quiet calm environment
,◉ What are the different types of routes for nitro for pts w ACS?
*should notice effects within 3-5 mins. Answer: 1) IV; given @ the
hospital for tight control by titrating dose
2) sublingual; place under tongue, get med refilled if expired, call
911 if pain not resolved after 5 mins of 1st dose
3) transdermal; wear gloves, no rubbing, massaging, or heat; may be
removed at night and replaced in the morning for prevention
◉ The physician orders nitro 20 mcgs/min. On hand is 50
mgs/250ml. At what rate will you program the infusion pump
(ml/hr)?. Answer: 6 ml/hr
xml/hr= 250ml/50mg x 1mg/1,000mcg x 20mcg/min x 60min/hr
◉ What med is given to decrease the afterload and preload by
dilating the coronary arteries? What is a potential adverse effect?.
Answer: Nitroglycerin
*hypotension and headahce bc vasodilation increases ICP
◉ Pt reported to ED w acute MI symptoms like chest pain,
diaphoresis, nausea, & BP 138/84. Physician ordered nitro to start at
, 10 mcg/min. The nurse administered IV, waited 5-10 mins then
reassessed. What should the nurse do in the following situations
1) pt still has chest pain and BP now 135/82
2) pts chest pain and other associated symptoms gone and BP now
120/80
3) pts chest pain is gone and BP now 98/40. Answer: 1) increase by
5 mcg/min to a total of 15 mcg/min
2) Leave pt at dose & continue to monitor
3) reduce rate bc pts BP dropped which doesn't help coronary
arteries perfuse; then reassess and report to physician
◉ What is the nurses role for administering IV nitro?. Answer: -
titrate to effect on BP and chest pain
-titrate 5-10 mcg/min every 5-10 mins
-max dose 200 mcg/min
-decreases dose if hypotensive
-maintain dose if chest pain resolved and normal BP
◉ What is the treatment of pt w ACS?. Answer: 1) Drug therapy:
--Aspirin for antiplatelet
--Beta blocker to decrease myocardial workload & O2 demand
--ACEI/ARBS to decrease myocardial workload & O2 demand
--Thrombolytic therapy to break up clot
