NURS 5461 Final TEST BANK Exam With 100% Correct RATIONALED
Answers | 2026 Updated Edition | Guaranteed Pass
1. What is the most common initial symptom of Acute Coronary Syndrome (ACS) in adults
over 80 years old?
A. Chest pain
B. Nausea and vomiting
C. Shortness of breath (SOB) ✅
D. Diaphoresis
Rationale:
Older adults often present with atypical ACS symptoms, and shortness of breath is the most
common presenting complaint in adults over 80. Due to decreased nociception and
comorbidities, elderly patients frequently lack chest pain, making dyspnea a key early
symptom.
2. What is the recommended initial diagnostic test for evaluating suspected stable coronary
ischemia?
A. Resting echocardiogram
B. Exercise or pharmacologic stress test ✅
C. Coronary CT angiography
D. Cardiac catheterization
,Rationale:
A stress test is the first-line evaluation for suspected stable ischemia. It assesses
functional capacity, detects inducible ischemia, and determines if additional imaging or
invasive angiography is needed.
3. Which medication is recommended for all patients with confirmed Coronary Artery
Disease (CAD), regardless of baseline LDL level?
A. Niacin
B. Fibrates
C. Statins (HMG-CoA reductase inhibitors) ✅
D. Fish oil supplements
Rationale:
Statins are indicated in all patients with documented CAD, regardless of LDL level, because
they significantly reduce cardiovascular events by stabilizing plaques, lowering
inflammation, and reducing mortality.
4. Which medication is the treatment of choice after myocardial infarction (MI), in patients
with left ventricular ejection fraction <40%, and for chronic angina management?
A. ACE inhibitors
B. Calcium channel blockers
,C. Beta-blockers (BB) ✅
D. Long-acting nitrates
Rationale:
Beta-blockers reduce myocardial oxygen demand, prevent arrhythmias, and decrease
mortality post-MI. They improve survival in patients with EF <40% and are first-line therapy
for chronic angina.
5. Which medication is recommended as the primary anti-ischemic agent when beta-
blockers are contraindicated?
A. ACE inhibitors
B. Aspirin
C. Calcium channel blockers (CCBs) ✅
D. Statins
Rationale:
CCBs (e.g., amlodipine, diltiazem) are used when beta-blockers cannot be given due to
asthma, bradycardia, or hypotension. They relieve ischemia by increasing coronary blood
flow and decreasing oxygen demand.
6. A patient presents with chest pain and a new left bundle branch block (LBBB). What is the
recommended immediate management?
, A. Administer thrombolytics only
B. Observe and repeat ECGs
C. Primary PCI within 6–12 hours or 90–120 minutes of arrival (door-to-balloon time) ✅
D. Perform a CT angiogram
Rationale:
A new LBBB in the setting of chest pain is a STEMI equivalent, requiring urgent PCI. The goal
is 90–120 minutes door-to-balloon or within 6–12 hours from symptom onset.
7. Which diagnostic test is considered the gold standard for determining the severity of
coronary artery lesions?
A. CT coronary angiography
B. Stress echocardiography
C. Coronary angiography (cardiac catheterization) ✅
D. Cardiac MRI
Rationale:
Cardiac catheterization allows direct visualization of coronary arteries and provides
accurate assessment of stenosis severity. It also enables immediate intervention such as
stenting.
8. A grayish-white halo appears around the edge of a patient’s cornea. What is this finding
most commonly associated with?
Answers | 2026 Updated Edition | Guaranteed Pass
1. What is the most common initial symptom of Acute Coronary Syndrome (ACS) in adults
over 80 years old?
A. Chest pain
B. Nausea and vomiting
C. Shortness of breath (SOB) ✅
D. Diaphoresis
Rationale:
Older adults often present with atypical ACS symptoms, and shortness of breath is the most
common presenting complaint in adults over 80. Due to decreased nociception and
comorbidities, elderly patients frequently lack chest pain, making dyspnea a key early
symptom.
2. What is the recommended initial diagnostic test for evaluating suspected stable coronary
ischemia?
A. Resting echocardiogram
B. Exercise or pharmacologic stress test ✅
C. Coronary CT angiography
D. Cardiac catheterization
,Rationale:
A stress test is the first-line evaluation for suspected stable ischemia. It assesses
functional capacity, detects inducible ischemia, and determines if additional imaging or
invasive angiography is needed.
3. Which medication is recommended for all patients with confirmed Coronary Artery
Disease (CAD), regardless of baseline LDL level?
A. Niacin
B. Fibrates
C. Statins (HMG-CoA reductase inhibitors) ✅
D. Fish oil supplements
Rationale:
Statins are indicated in all patients with documented CAD, regardless of LDL level, because
they significantly reduce cardiovascular events by stabilizing plaques, lowering
inflammation, and reducing mortality.
4. Which medication is the treatment of choice after myocardial infarction (MI), in patients
with left ventricular ejection fraction <40%, and for chronic angina management?
A. ACE inhibitors
B. Calcium channel blockers
,C. Beta-blockers (BB) ✅
D. Long-acting nitrates
Rationale:
Beta-blockers reduce myocardial oxygen demand, prevent arrhythmias, and decrease
mortality post-MI. They improve survival in patients with EF <40% and are first-line therapy
for chronic angina.
5. Which medication is recommended as the primary anti-ischemic agent when beta-
blockers are contraindicated?
A. ACE inhibitors
B. Aspirin
C. Calcium channel blockers (CCBs) ✅
D. Statins
Rationale:
CCBs (e.g., amlodipine, diltiazem) are used when beta-blockers cannot be given due to
asthma, bradycardia, or hypotension. They relieve ischemia by increasing coronary blood
flow and decreasing oxygen demand.
6. A patient presents with chest pain and a new left bundle branch block (LBBB). What is the
recommended immediate management?
, A. Administer thrombolytics only
B. Observe and repeat ECGs
C. Primary PCI within 6–12 hours or 90–120 minutes of arrival (door-to-balloon time) ✅
D. Perform a CT angiogram
Rationale:
A new LBBB in the setting of chest pain is a STEMI equivalent, requiring urgent PCI. The goal
is 90–120 minutes door-to-balloon or within 6–12 hours from symptom onset.
7. Which diagnostic test is considered the gold standard for determining the severity of
coronary artery lesions?
A. CT coronary angiography
B. Stress echocardiography
C. Coronary angiography (cardiac catheterization) ✅
D. Cardiac MRI
Rationale:
Cardiac catheterization allows direct visualization of coronary arteries and provides
accurate assessment of stenosis severity. It also enables immediate intervention such as
stenting.
8. A grayish-white halo appears around the edge of a patient’s cornea. What is this finding
most commonly associated with?
