ESTUDYR
NR 545 (Exam 2) MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. Which statement best defines angina pectoris?
A. Myocardial tissue necrosis due to prolonged ischemia
B. Chest discomfort caused by transient myocardial ischemia relieved by rest or nitrates
C. Acute rupture of a coronary artery plaque
D. Inflammation of the pericardium
Correct Answer: B
Rationale: Angina results from temporary myocardial ischemia without permanent cell death
and is typically relieved by rest or nitroglycerin.
2. The pathophysiology of angina primarily involves:
A. Complete coronary artery occlusion
B. Increased parasympathetic tone
C. Imbalance between myocardial oxygen supply and demand
D. Left ventricular hypertrophy
Correct Answer: C
Rationale: Angina occurs when myocardial oxygen demand exceeds supply, most commonly
due to atherosclerosis or coronary spasm.
3. Which symptom is most characteristic of stable angina?
A. Chest pain at rest lasting >30 minutes
B. Sudden syncope
C. Chest pressure radiating to the left arm relieved by rest
D. Fever and pleuritic pain
Correct Answer: C
Rationale: Stable angina is exertional, relieved by rest, and often radiates to classic locations
such as the left arm or jaw.
,ESTUDYR
4. Which laboratory test is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I or T
D. BNP
Correct Answer: C
Rationale: Troponins are the most sensitive and specific markers of myocardial necrosis.
5. The first-line pharmacologic treatment for acute angina is:
A. Aspirin
B. Beta blockers
C. Nitroglycerin
D. ACE inhibitors
Correct Answer: C
Rationale: Nitroglycerin rapidly reduces preload and myocardial oxygen demand through
venous and coronary vasodilation.
6. Which feature differentiates myocardial infarction from angina?
A. Radiation of pain
B. Relief with nitrates
C. Presence of irreversible myocardial necrosis
D. Association with exertion
Correct Answer: C
Rationale: MI results in permanent myocardial cell death, unlike angina.
7. Prolonged myocardial ischemia (>30 minutes) leads to:
A. Reversible ischemia
B. Coronary vasospasm
C. Cellular death and loss of contractility
D. Improved collateral circulation
, ESTUDYR
Correct Answer: C
Rationale: Sustained ischemia causes irreversible myocyte death and impaired ventricular
function.
8. Which symptom is most concerning for acute myocardial infarction?
A. Chest tightness relieved by rest
B. Fatigue with exertion
C. Persistent chest pain at rest with diaphoresis
D. Mild dyspnea
Correct Answer: C
Rationale: Ongoing pain at rest with autonomic symptoms suggests MI rather than stable
angina.
9. Which ECG finding is most suggestive of an acute STEMI?
A. T-wave inversion
B. Pathologic Q waves
C. ST-segment elevation
D. Sinus tachycardia
Correct Answer: C
Rationale: ST elevation reflects transmural myocardial injury requiring urgent reperfusion.
10. The goal time for PCI in acute MI is:
A. Within 4 hours
B. Within 2 hours
C. Within 90 minutes of hospital arrival
D. Within 24 hours
Correct Answer: C
Rationale: Door-to-balloon time ≤90 minutes significantly reduces mortality.
NR 545 (Exam 2) MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. Which statement best defines angina pectoris?
A. Myocardial tissue necrosis due to prolonged ischemia
B. Chest discomfort caused by transient myocardial ischemia relieved by rest or nitrates
C. Acute rupture of a coronary artery plaque
D. Inflammation of the pericardium
Correct Answer: B
Rationale: Angina results from temporary myocardial ischemia without permanent cell death
and is typically relieved by rest or nitroglycerin.
2. The pathophysiology of angina primarily involves:
A. Complete coronary artery occlusion
B. Increased parasympathetic tone
C. Imbalance between myocardial oxygen supply and demand
D. Left ventricular hypertrophy
Correct Answer: C
Rationale: Angina occurs when myocardial oxygen demand exceeds supply, most commonly
due to atherosclerosis or coronary spasm.
3. Which symptom is most characteristic of stable angina?
A. Chest pain at rest lasting >30 minutes
B. Sudden syncope
C. Chest pressure radiating to the left arm relieved by rest
D. Fever and pleuritic pain
Correct Answer: C
Rationale: Stable angina is exertional, relieved by rest, and often radiates to classic locations
such as the left arm or jaw.
,ESTUDYR
4. Which laboratory test is most specific for myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I or T
D. BNP
Correct Answer: C
Rationale: Troponins are the most sensitive and specific markers of myocardial necrosis.
5. The first-line pharmacologic treatment for acute angina is:
A. Aspirin
B. Beta blockers
C. Nitroglycerin
D. ACE inhibitors
Correct Answer: C
Rationale: Nitroglycerin rapidly reduces preload and myocardial oxygen demand through
venous and coronary vasodilation.
6. Which feature differentiates myocardial infarction from angina?
A. Radiation of pain
B. Relief with nitrates
C. Presence of irreversible myocardial necrosis
D. Association with exertion
Correct Answer: C
Rationale: MI results in permanent myocardial cell death, unlike angina.
7. Prolonged myocardial ischemia (>30 minutes) leads to:
A. Reversible ischemia
B. Coronary vasospasm
C. Cellular death and loss of contractility
D. Improved collateral circulation
, ESTUDYR
Correct Answer: C
Rationale: Sustained ischemia causes irreversible myocyte death and impaired ventricular
function.
8. Which symptom is most concerning for acute myocardial infarction?
A. Chest tightness relieved by rest
B. Fatigue with exertion
C. Persistent chest pain at rest with diaphoresis
D. Mild dyspnea
Correct Answer: C
Rationale: Ongoing pain at rest with autonomic symptoms suggests MI rather than stable
angina.
9. Which ECG finding is most suggestive of an acute STEMI?
A. T-wave inversion
B. Pathologic Q waves
C. ST-segment elevation
D. Sinus tachycardia
Correct Answer: C
Rationale: ST elevation reflects transmural myocardial injury requiring urgent reperfusion.
10. The goal time for PCI in acute MI is:
A. Within 4 hours
B. Within 2 hours
C. Within 90 minutes of hospital arrival
D. Within 24 hours
Correct Answer: C
Rationale: Door-to-balloon time ≤90 minutes significantly reduces mortality.
