NSG 4100 Adult Health III Assessment 4 with
Complete Solutions
Cardiovascular Disorders: ACS, MI, ECG findings, cardiac biomarkers, reperfusion
therapy.
Heart Failure: HFrEF, HFpEF, HFmrEF, pathophysiology, clinical manifestations.
Post-MI Complications: Dysrhythmias, cardiogenic shock, papillary muscle rupture,
tamponade
Cardiovascular Disorders
Q1. A patient with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin. Which intervention is priority?
• A. Administer morphine sulfate
• B. Increase IV fluids
• C. Place patient in Trendelenburg
• D. Prepare for chest physiotherapy
Answer: A. Administer morphine sulfate
Rationale: Morphine relieves pain, decreases myocardial oxygen demand, and reduces
anxiety. Trendelenburg and fluids worsen cardiac workload; chest physiotherapy is not
indicated.
Q2. Which lab finding confirms myocardial infarction?
• A. Elevated CK-MB
• B. Elevated troponin I
• C. Elevated LDH
• D. Elevated AST
Answer: B. Elevated troponin I
Rationale: Troponin is the most specific and sensitive biomarker for myocardial injury.
Heart Failure
Q3. A patient with left-sided heart failure presents with dyspnea and orthopnea. Which
assessment finding is expected?
, • A. Jugular vein distention
• B. Crackles in lungs
• C. Hepatomegaly
• D. Peripheral edema
Answer: B. Crackles in lungs
Rationale: Left-sided HF causes pulmonary congestion; right-sided HF causes
systemic congestion (JVD, hepatomegaly, edema).
Q4. Which medication improves survival in HFrEF?
• A. Digoxin
• B. Furosemide
• C. ACE inhibitors
• D. Nitroglycerin
Answer: C. ACE inhibitors
Rationale: ACE inhibitors reduce afterload and improve long-term survival; digoxin and
diuretics relieve symptoms but don’t improve mortality.
Neurological Emergencies
Q5. A patient with ischemic stroke is admitted. What is the priority intervention?
• A. Administer aspirin immediately
• B. Prepare for tPA administration
• C. Begin rehabilitation exercises
• D. Provide high-protein diet
Answer: B. Prepare for tPA administration
Rationale: tPA within 3–4.5 hours improves outcomes; aspirin is used if tPA is
contraindicated.
Q6. Which sign indicates increased intracranial pressure?
• A. Bradycardia, hypertension, irregular respirations
• B. Tachycardia, hypotension, tachypnea
• C. Fever, chills, diaphoresis
• D. Polyuria, polydipsia, weight loss
Answer: A. Bradycardia, hypertension, irregular respirations
Rationale: This is Cushing’s triad, a hallmark of increased ICP.
, Metabolic Disorders
Q7. A patient with DKA presents with fruity breath and Kussmaul respirations. What is
the initial treatment?
• A. IV insulin infusion
• B. IV potassium replacement
• C. IV normal saline
• D. IV bicarbonate
Answer: C. IV normal saline
Rationale: Fluid resuscitation is the first step; insulin follows once potassium is
checked.
Q8. Which complication is associated with pheochromocytoma?
• A. Severe hypertension
• B. Hypoglycemia
• C. Bradycardia
• D. Hypotension
Answer: A. Severe hypertension
Rationale: Catecholamine-secreting tumor causes episodic hypertension, headaches,
sweating, palpitations.
Renal Disorders
Q9. A patient with ESRD is scheduled for hemodialysis. Which lab value requires
immediate attention?
• A. Potassium 6.2 mmol/L
• B. Hemoglobin 11 g/dL
• C. Calcium 8.5 mg/dL
• D. Sodium 138 mmol/L
Answer: A. Potassium 6.2 mmol/L
Rationale: Hyperkalemia is life-threatening and requires urgent dialysis.
Q10. Which dietary restriction is appropriate for ESRD?
• A. High potassium foods
• B. High protein intake
• C. Low sodium diet
Complete Solutions
Cardiovascular Disorders: ACS, MI, ECG findings, cardiac biomarkers, reperfusion
therapy.
Heart Failure: HFrEF, HFpEF, HFmrEF, pathophysiology, clinical manifestations.
Post-MI Complications: Dysrhythmias, cardiogenic shock, papillary muscle rupture,
tamponade
Cardiovascular Disorders
Q1. A patient with acute myocardial infarction develops chest pain unrelieved by
nitroglycerin. Which intervention is priority?
• A. Administer morphine sulfate
• B. Increase IV fluids
• C. Place patient in Trendelenburg
• D. Prepare for chest physiotherapy
Answer: A. Administer morphine sulfate
Rationale: Morphine relieves pain, decreases myocardial oxygen demand, and reduces
anxiety. Trendelenburg and fluids worsen cardiac workload; chest physiotherapy is not
indicated.
Q2. Which lab finding confirms myocardial infarction?
• A. Elevated CK-MB
• B. Elevated troponin I
• C. Elevated LDH
• D. Elevated AST
Answer: B. Elevated troponin I
Rationale: Troponin is the most specific and sensitive biomarker for myocardial injury.
Heart Failure
Q3. A patient with left-sided heart failure presents with dyspnea and orthopnea. Which
assessment finding is expected?
, • A. Jugular vein distention
• B. Crackles in lungs
• C. Hepatomegaly
• D. Peripheral edema
Answer: B. Crackles in lungs
Rationale: Left-sided HF causes pulmonary congestion; right-sided HF causes
systemic congestion (JVD, hepatomegaly, edema).
Q4. Which medication improves survival in HFrEF?
• A. Digoxin
• B. Furosemide
• C. ACE inhibitors
• D. Nitroglycerin
Answer: C. ACE inhibitors
Rationale: ACE inhibitors reduce afterload and improve long-term survival; digoxin and
diuretics relieve symptoms but don’t improve mortality.
Neurological Emergencies
Q5. A patient with ischemic stroke is admitted. What is the priority intervention?
• A. Administer aspirin immediately
• B. Prepare for tPA administration
• C. Begin rehabilitation exercises
• D. Provide high-protein diet
Answer: B. Prepare for tPA administration
Rationale: tPA within 3–4.5 hours improves outcomes; aspirin is used if tPA is
contraindicated.
Q6. Which sign indicates increased intracranial pressure?
• A. Bradycardia, hypertension, irregular respirations
• B. Tachycardia, hypotension, tachypnea
• C. Fever, chills, diaphoresis
• D. Polyuria, polydipsia, weight loss
Answer: A. Bradycardia, hypertension, irregular respirations
Rationale: This is Cushing’s triad, a hallmark of increased ICP.
, Metabolic Disorders
Q7. A patient with DKA presents with fruity breath and Kussmaul respirations. What is
the initial treatment?
• A. IV insulin infusion
• B. IV potassium replacement
• C. IV normal saline
• D. IV bicarbonate
Answer: C. IV normal saline
Rationale: Fluid resuscitation is the first step; insulin follows once potassium is
checked.
Q8. Which complication is associated with pheochromocytoma?
• A. Severe hypertension
• B. Hypoglycemia
• C. Bradycardia
• D. Hypotension
Answer: A. Severe hypertension
Rationale: Catecholamine-secreting tumor causes episodic hypertension, headaches,
sweating, palpitations.
Renal Disorders
Q9. A patient with ESRD is scheduled for hemodialysis. Which lab value requires
immediate attention?
• A. Potassium 6.2 mmol/L
• B. Hemoglobin 11 g/dL
• C. Calcium 8.5 mg/dL
• D. Sodium 138 mmol/L
Answer: A. Potassium 6.2 mmol/L
Rationale: Hyperkalemia is life-threatening and requires urgent dialysis.
Q10. Which dietary restriction is appropriate for ESRD?
• A. High potassium foods
• B. High protein intake
• C. Low sodium diet
