Medical-Surgical Nursing Notes
Comprehensive Quiz Guide: 100+ Questions with Verified Answers
Section 1: Cardiovascular System (Questions 1-20)
1. What are the classic signs of myocardial infarction (MI)?
Answer: Crushing chest pain radiating to left arm/jaw, diaphoresis, nausea,
shortness of breath, anxiety. Women may present with atypical symptoms
like fatigue, indigestion, or back pain.
2. What is the priority intervention for a patient with chest pain?
Answer: Administer oxygen, obtain 12-lead ECG within 10 minutes,
establish IV access, give aspirin (160-325 mg chewed), administer
nitroglycerin sublingual if not contraindicated, and notify physician
immediately.
3. What does the acronym MONA stand for in MI treatment?
Answer: Morphine (for pain), Oxygen (if SpO2 <90%), Nitroglycerin (for
chest pain), and Aspirin (antiplatelet). Note: Current guidelines emphasize
oxygen only if hypoxic.
4. What are the troponin levels in myocardial infarction?
Answer: Troponin I and T are cardiac-specific enzymes that rise 2-4 hours
after MI, peak at 24 hours, and remain elevated for 1-3 weeks. They are the
gold standard for MI diagnosis.
5. What is the difference between STEMI and NSTEMI?
Answer: STEMI (ST-Elevation MI) shows ST-segment elevation on ECG
indicating complete coronary artery occlusion requiring immediate
reperfusion. NSTEMI shows ST depression or T-wave changes with partial
occlusion.
6. What are modifiable risk factors for coronary artery disease?
, Answer: Smoking, hypertension, hyperlipidemia, diabetes, obesity,
sedentary lifestyle, and stress. Non-modifiable: age, gender, family history,
race.
7. What is the therapeutic INR range for atrial fibrillation?
Answer: 2.0-3.0. Atrial fibrillation increases stroke risk due to blood pooling
and clot formation in atria, requiring anticoagulation.
8. What are signs of left-sided heart failure?
Answer: Pulmonary congestion symptoms: dyspnea, orthopnea, paroxysmal
nocturnal dyspnea (PND), crackles, pink frothy sputum, cough, fatigue, and
tachycardia.
9. What are signs of right-sided heart failure?
Answer: Systemic congestion: peripheral edema, jugular venous distension
(JVD), hepatomegaly, ascites, weight gain, and dependent edema.
10. What dietary modifications are recommended for heart failure?
Answer: Sodium restriction (2 grams/day), fluid restriction (1.5-2 liters/day
if severe), weight monitoring (daily, same time), and heart-healthy diet low
in saturated fats.
11. What medications are used in heart failure management?
Answer: ACE inhibitors or ARBs, beta-blockers, diuretics (loop diuretics like
furosemide), aldosterone antagonists (spironolactone), and digoxin for rate
control.
12. What is the normal ejection fraction?
Answer: 55-70%. Heart failure with reduced ejection fraction (HFrEF) is
<40%. HFpEF (preserved) is ≥50% with diastolic dysfunction.
13. What are the four stages of hypertension?
, Answer: Normal (<120/80), Elevated (120-129/<80), Stage 1 (130-139/80-
89), Stage 2 (≥140/90). Hypertensive crisis: >180/120 requiring immediate
attention.
14. What is orthostatic hypotension?
Answer: Drop in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3
minutes of standing. Increases fall risk, especially in elderly patients.
15. What are complications of uncontrolled hypertension?
Answer: Stroke, myocardial infarction, heart failure, kidney disease,
retinopathy, peripheral arterial disease, and aortic aneurysm.
16. What is pericarditis?
Answer: Inflammation of the pericardium causing sharp, stabbing chest pain
that worsens with deep breathing/lying flat and improves sitting forward.
May have pericardial friction rub.
17. What is cardiac tamponade?
Answer: Life-threatening compression of heart by fluid in pericardial sac
causing Beck's triad: hypotension, muffled heart sounds, and JVD. Requires
emergency pericardiocentesis.
18. What is peripheral arterial disease (PAD)?
Answer: Atherosclerosis of peripheral arteries causing intermittent
claudication (leg pain with exercise relieved by rest), diminished pulses, cool
extremities, hair loss, and poor wound healing.
19. What is the ankle-brachial index (ABI)?
Answer: Ratio of ankle BP to brachial BP. Normal: 0.91-1.30. PAD: <0.90.
Values <0.40 indicate severe disease with rest pain.
20. What is deep vein thrombosis (DVT)?
Comprehensive Quiz Guide: 100+ Questions with Verified Answers
Section 1: Cardiovascular System (Questions 1-20)
1. What are the classic signs of myocardial infarction (MI)?
Answer: Crushing chest pain radiating to left arm/jaw, diaphoresis, nausea,
shortness of breath, anxiety. Women may present with atypical symptoms
like fatigue, indigestion, or back pain.
2. What is the priority intervention for a patient with chest pain?
Answer: Administer oxygen, obtain 12-lead ECG within 10 minutes,
establish IV access, give aspirin (160-325 mg chewed), administer
nitroglycerin sublingual if not contraindicated, and notify physician
immediately.
3. What does the acronym MONA stand for in MI treatment?
Answer: Morphine (for pain), Oxygen (if SpO2 <90%), Nitroglycerin (for
chest pain), and Aspirin (antiplatelet). Note: Current guidelines emphasize
oxygen only if hypoxic.
4. What are the troponin levels in myocardial infarction?
Answer: Troponin I and T are cardiac-specific enzymes that rise 2-4 hours
after MI, peak at 24 hours, and remain elevated for 1-3 weeks. They are the
gold standard for MI diagnosis.
5. What is the difference between STEMI and NSTEMI?
Answer: STEMI (ST-Elevation MI) shows ST-segment elevation on ECG
indicating complete coronary artery occlusion requiring immediate
reperfusion. NSTEMI shows ST depression or T-wave changes with partial
occlusion.
6. What are modifiable risk factors for coronary artery disease?
, Answer: Smoking, hypertension, hyperlipidemia, diabetes, obesity,
sedentary lifestyle, and stress. Non-modifiable: age, gender, family history,
race.
7. What is the therapeutic INR range for atrial fibrillation?
Answer: 2.0-3.0. Atrial fibrillation increases stroke risk due to blood pooling
and clot formation in atria, requiring anticoagulation.
8. What are signs of left-sided heart failure?
Answer: Pulmonary congestion symptoms: dyspnea, orthopnea, paroxysmal
nocturnal dyspnea (PND), crackles, pink frothy sputum, cough, fatigue, and
tachycardia.
9. What are signs of right-sided heart failure?
Answer: Systemic congestion: peripheral edema, jugular venous distension
(JVD), hepatomegaly, ascites, weight gain, and dependent edema.
10. What dietary modifications are recommended for heart failure?
Answer: Sodium restriction (2 grams/day), fluid restriction (1.5-2 liters/day
if severe), weight monitoring (daily, same time), and heart-healthy diet low
in saturated fats.
11. What medications are used in heart failure management?
Answer: ACE inhibitors or ARBs, beta-blockers, diuretics (loop diuretics like
furosemide), aldosterone antagonists (spironolactone), and digoxin for rate
control.
12. What is the normal ejection fraction?
Answer: 55-70%. Heart failure with reduced ejection fraction (HFrEF) is
<40%. HFpEF (preserved) is ≥50% with diastolic dysfunction.
13. What are the four stages of hypertension?
, Answer: Normal (<120/80), Elevated (120-129/<80), Stage 1 (130-139/80-
89), Stage 2 (≥140/90). Hypertensive crisis: >180/120 requiring immediate
attention.
14. What is orthostatic hypotension?
Answer: Drop in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3
minutes of standing. Increases fall risk, especially in elderly patients.
15. What are complications of uncontrolled hypertension?
Answer: Stroke, myocardial infarction, heart failure, kidney disease,
retinopathy, peripheral arterial disease, and aortic aneurysm.
16. What is pericarditis?
Answer: Inflammation of the pericardium causing sharp, stabbing chest pain
that worsens with deep breathing/lying flat and improves sitting forward.
May have pericardial friction rub.
17. What is cardiac tamponade?
Answer: Life-threatening compression of heart by fluid in pericardial sac
causing Beck's triad: hypotension, muffled heart sounds, and JVD. Requires
emergency pericardiocentesis.
18. What is peripheral arterial disease (PAD)?
Answer: Atherosclerosis of peripheral arteries causing intermittent
claudication (leg pain with exercise relieved by rest), diminished pulses, cool
extremities, hair loss, and poor wound healing.
19. What is the ankle-brachial index (ABI)?
Answer: Ratio of ankle BP to brachial BP. Normal: 0.91-1.30. PAD: <0.90.
Values <0.40 indicate severe disease with rest pain.
20. What is deep vein thrombosis (DVT)?
