NSG 223 Exam 1
Medical-Surgical Nursing II
Herzing University | 2026/2027 Academic Year
Guide Questions and Verified Answers
50 Questions | 5 Sections | Comprehensive Rationales
Aligned with Herzing University NSG 223 Course Outcomes
, NSG223 Medical-Surgical Nursing II Exam 1 | Herzing University 2026/2027
Section 1: Cardiac Stress Testing, Cardiac Catheterization, and Diagnostic Procedures
Q1: Which of the following is an absolute contraindication to cardiac stress testing?
A. Controlled hypertension with medication compliance
B. Within 48 hours of an acute myocardial infarction [CORRECT]
C. Type 2 diabetes mellitus with HbA1c of 7.2%
D. Mild aortic stenosis with asymptomatic status
Correct Answer: B
Rationale: Absolute contraindications to cardiac stress testing include being within 48 hours of an acute MI, unstable angina, and
uncontrolled symptomatic dysrhythmias. These conditions place the patient at unacceptable risk for cardiac decompensation during
the stress test. Controlled hypertension, diabetes, and asymptomatic mild valve disease are not absolute contraindications.
Q2: A patient is scheduled for a cardiac stress test. Which instruction should the nurse include in pre-procedure
teaching?
A. "Eat a full meal 1 hour before the test to maintain blood glucose."
B. "Fast for 3 hours and avoid caffeine and tobacco before the test." [CORRECT]
C. "Take your beta-blocker as usual on the morning of the test."
D. "You may drink coffee on the morning of the test but avoid food."
Correct Answer: B
Rationale: Patient preparation for cardiac stress testing includes fasting for 3 hours and avoiding caffeine and tobacco. Caffeine
and nicotine can affect heart rate and blood pressure responses during the test. Beta-blockers may be held before testing to allow
the heart rate to reach the target. Eating a full meal is contraindicated due to the fasting requirement.
Q3: During a treadmill stress test, the patient reports dizziness and chest discomfort. The target heart rate has
not been reached. What is the most appropriate nursing action?
A. Encourage the patient to continue since the target heart rate has not been achieved
B. Stop the test immediately, as patient instability is a termination criterion [CORRECT]
C. Slow the treadmill speed but continue the test
D. Administer sublingual nitroglycerin and continue monitoring
Correct Answer: B
Rationale: Termination criteria for cardiac stress testing include the target heart rate being reached OR the patient becoming
unstable. Dizziness, chest pain, and discomfort are signs of instability that require immediate termination of the test. The nurse
should not encourage continuation when the patient exhibits these symptoms, even if the target heart rate has not been reached.
Q4: A patient is unable to walk on a treadmill for cardiac stress testing. Which pharmacologic agent would the
nurse anticipate being used to simulate exercise?
A. Metoprolol
B. Dobutamine [CORRECT]
C. Diltiazem
D. Furosemide
Correct Answer: B
Rationale: Dobutamine is used for pharmacologic stress testing in patients who are unable to walk on a treadmill. Dobutamine
increases heart rate and myocardial contractility, simulating the cardiovascular effects of exercise. Other pharmacologic stress
agents include dipyridamole, adenosine, and regadenoson, which work through vasodilation rather than increasing contractility.
Q5: Which of the following are medications used in pharmacologic stress testing? (Select the best answer.)
Page 2
Medical-Surgical Nursing II
Herzing University | 2026/2027 Academic Year
Guide Questions and Verified Answers
50 Questions | 5 Sections | Comprehensive Rationales
Aligned with Herzing University NSG 223 Course Outcomes
, NSG223 Medical-Surgical Nursing II Exam 1 | Herzing University 2026/2027
Section 1: Cardiac Stress Testing, Cardiac Catheterization, and Diagnostic Procedures
Q1: Which of the following is an absolute contraindication to cardiac stress testing?
A. Controlled hypertension with medication compliance
B. Within 48 hours of an acute myocardial infarction [CORRECT]
C. Type 2 diabetes mellitus with HbA1c of 7.2%
D. Mild aortic stenosis with asymptomatic status
Correct Answer: B
Rationale: Absolute contraindications to cardiac stress testing include being within 48 hours of an acute MI, unstable angina, and
uncontrolled symptomatic dysrhythmias. These conditions place the patient at unacceptable risk for cardiac decompensation during
the stress test. Controlled hypertension, diabetes, and asymptomatic mild valve disease are not absolute contraindications.
Q2: A patient is scheduled for a cardiac stress test. Which instruction should the nurse include in pre-procedure
teaching?
A. "Eat a full meal 1 hour before the test to maintain blood glucose."
B. "Fast for 3 hours and avoid caffeine and tobacco before the test." [CORRECT]
C. "Take your beta-blocker as usual on the morning of the test."
D. "You may drink coffee on the morning of the test but avoid food."
Correct Answer: B
Rationale: Patient preparation for cardiac stress testing includes fasting for 3 hours and avoiding caffeine and tobacco. Caffeine
and nicotine can affect heart rate and blood pressure responses during the test. Beta-blockers may be held before testing to allow
the heart rate to reach the target. Eating a full meal is contraindicated due to the fasting requirement.
Q3: During a treadmill stress test, the patient reports dizziness and chest discomfort. The target heart rate has
not been reached. What is the most appropriate nursing action?
A. Encourage the patient to continue since the target heart rate has not been achieved
B. Stop the test immediately, as patient instability is a termination criterion [CORRECT]
C. Slow the treadmill speed but continue the test
D. Administer sublingual nitroglycerin and continue monitoring
Correct Answer: B
Rationale: Termination criteria for cardiac stress testing include the target heart rate being reached OR the patient becoming
unstable. Dizziness, chest pain, and discomfort are signs of instability that require immediate termination of the test. The nurse
should not encourage continuation when the patient exhibits these symptoms, even if the target heart rate has not been reached.
Q4: A patient is unable to walk on a treadmill for cardiac stress testing. Which pharmacologic agent would the
nurse anticipate being used to simulate exercise?
A. Metoprolol
B. Dobutamine [CORRECT]
C. Diltiazem
D. Furosemide
Correct Answer: B
Rationale: Dobutamine is used for pharmacologic stress testing in patients who are unable to walk on a treadmill. Dobutamine
increases heart rate and myocardial contractility, simulating the cardiovascular effects of exercise. Other pharmacologic stress
agents include dipyridamole, adenosine, and regadenoson, which work through vasodilation rather than increasing contractility.
Q5: Which of the following are medications used in pharmacologic stress testing? (Select the best answer.)
Page 2
