NUR 425 Exam 3: Acute & Chronic Health Disruptions In
Adults II V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A nurse is caring for a patient experiencing chest pain. Which cardiac biomarker is most specific for
identifying acute myocardial injury?
A. Myoglobin
B. Troponin I
C. Creatine Kinase (CK-MB)
D. Lactate Dehydrogenase
Ans: B
Explanation: Troponin I is considered the gold standard for diagnosing a myocardial infarction due to its
high specificity. It is released into the bloodstream when heart muscle damage occurs. This level typically
rises within 2 to 4 hours after the onset of chest pain. Nurses monitor these levels serially to determine
the extent of the damage over time. Unlike other markers, troponin stays elevated for up to two weeks
after the event.
2. A patient is diagnosed with left-sided heart failure. Which clinical manifestation should the nurse expect
to find during assessment?
A. Peripheral edema
B. Jugular venous distension
C. Crackles in the lungs
D. Splenomegaly
Ans: C
,Explanation: Left-sided heart failure primarily affects the pulmonary system because blood backs up
into the left atrium and pulmonary veins. This increased pressure causes fluid to leak into the alveoli,
resulting in crackles. Patients often experience shortness of breath and orthopnea due to this fluid
accumulation. Peripheral edema and jugular venous distension are more commonly associated with
right-sided failure. Careful lung auscultation is a priority assessment for these patients.
3. A nurse is preparing to administer Nitroglycerin sublingually to a patient with stable angina. What is the
primary action of this medication?
A. Increased heart rate
B. Decreased blood glucose
C. Vasodilation of coronary arteries
D. Constriction of peripheral vessels
Ans: C
Explanation: Nitroglycerin acts by relaxing the smooth muscles in the vascular system. This relaxation
leads to the dilation of coronary arteries, which increases oxygen supply to the myocardium. It also
reduces preload by dilating peripheral veins, thereby decreasing the workload of the heart. Patients
should be taught to take this medication at the first sign of chest pain. Effective vasodilation helps relieve
the ischemic pain associated with angina.
4. Which heart rhythm is characterized by a ‘sawtooth’ pattern of P waves on an ECG?
A. Atrial Fibrillation
B. Sinus Bradycardia
C. Ventricular Tachycardia
D. Atrial Flutter
, Ans: D
Explanation: Atrial flutter is easily identified by the presence of uniform sawtooth-shaped waves known
as F-waves. These waves represent rapid atrial depolarization occurring at a rate of 250 to 350 beats per
minute. The ventricular rate is typically slower because the AV node cannot conduct every impulse. This
rhythm increases the risk of blood clots and stroke if not managed. Treatment often involves medications
or electrical cardioversion.
5. A patient presents with a potassium level of 6.2 mEq/L. Which ECG change is the nurse most likely to
observe?
A. ST-segment depression
B. Tall, peaked T waves
C. Prominent U waves
D. Prolonged QT interval
Ans: B
Explanation: Hyperkalemia is a serious electrolyte imbalance that significantly affects cardiac
conduction. Tall, peaked T waves are one of the earliest signs seen on an electrocardiogram. As potassium
levels rise further, the QRS complex may widen and the P wave may disappear. This condition can lead to
life-threatening arrhythmias like ventricular fibrillation. The nurse must notify the provider immediately
and prepare for potassium-lowering treatments.
6. The nurse is assessing a patient with right-sided heart failure. Which finding is consistent with this
diagnosis?
A. Productive cough with pink frothy sputum
B. Wheezing
Adults II V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A nurse is caring for a patient experiencing chest pain. Which cardiac biomarker is most specific for
identifying acute myocardial injury?
A. Myoglobin
B. Troponin I
C. Creatine Kinase (CK-MB)
D. Lactate Dehydrogenase
Ans: B
Explanation: Troponin I is considered the gold standard for diagnosing a myocardial infarction due to its
high specificity. It is released into the bloodstream when heart muscle damage occurs. This level typically
rises within 2 to 4 hours after the onset of chest pain. Nurses monitor these levels serially to determine
the extent of the damage over time. Unlike other markers, troponin stays elevated for up to two weeks
after the event.
2. A patient is diagnosed with left-sided heart failure. Which clinical manifestation should the nurse expect
to find during assessment?
A. Peripheral edema
B. Jugular venous distension
C. Crackles in the lungs
D. Splenomegaly
Ans: C
,Explanation: Left-sided heart failure primarily affects the pulmonary system because blood backs up
into the left atrium and pulmonary veins. This increased pressure causes fluid to leak into the alveoli,
resulting in crackles. Patients often experience shortness of breath and orthopnea due to this fluid
accumulation. Peripheral edema and jugular venous distension are more commonly associated with
right-sided failure. Careful lung auscultation is a priority assessment for these patients.
3. A nurse is preparing to administer Nitroglycerin sublingually to a patient with stable angina. What is the
primary action of this medication?
A. Increased heart rate
B. Decreased blood glucose
C. Vasodilation of coronary arteries
D. Constriction of peripheral vessels
Ans: C
Explanation: Nitroglycerin acts by relaxing the smooth muscles in the vascular system. This relaxation
leads to the dilation of coronary arteries, which increases oxygen supply to the myocardium. It also
reduces preload by dilating peripheral veins, thereby decreasing the workload of the heart. Patients
should be taught to take this medication at the first sign of chest pain. Effective vasodilation helps relieve
the ischemic pain associated with angina.
4. Which heart rhythm is characterized by a ‘sawtooth’ pattern of P waves on an ECG?
A. Atrial Fibrillation
B. Sinus Bradycardia
C. Ventricular Tachycardia
D. Atrial Flutter
, Ans: D
Explanation: Atrial flutter is easily identified by the presence of uniform sawtooth-shaped waves known
as F-waves. These waves represent rapid atrial depolarization occurring at a rate of 250 to 350 beats per
minute. The ventricular rate is typically slower because the AV node cannot conduct every impulse. This
rhythm increases the risk of blood clots and stroke if not managed. Treatment often involves medications
or electrical cardioversion.
5. A patient presents with a potassium level of 6.2 mEq/L. Which ECG change is the nurse most likely to
observe?
A. ST-segment depression
B. Tall, peaked T waves
C. Prominent U waves
D. Prolonged QT interval
Ans: B
Explanation: Hyperkalemia is a serious electrolyte imbalance that significantly affects cardiac
conduction. Tall, peaked T waves are one of the earliest signs seen on an electrocardiogram. As potassium
levels rise further, the QRS complex may widen and the P wave may disappear. This condition can lead to
life-threatening arrhythmias like ventricular fibrillation. The nurse must notify the provider immediately
and prepare for potassium-lowering treatments.
6. The nurse is assessing a patient with right-sided heart failure. Which finding is consistent with this
diagnosis?
A. Productive cough with pink frothy sputum
B. Wheezing
