NURS 5434 MODULE 5 QUIZ STUDY GUIDE
(2026) | CAD & LIPIDS – CARDIOLOGY
NURSING | VERIFIED QUESTIONS & ANSWERS
WITH A+ EXAM TIPS | MUST SEE PDF
Question 1: A patient is diagnosed with coronary artery disease (CAD). Which
pathophysiological process is the primary underlying mechanism?
A. Inflammation of the pericardium leading to fluid accumulation B. Hypertrophy of the left
ventricular wall due to chronic pressure overload C. Atherosclerotic plaque formation causing
narrowing of the coronary arteries D. Thromboembolism originating from deep vein thrombosis
E. Valvular insufficiency causing backflow into the coronary circulation
CORRECT ANSWER: C. Atherosclerotic plaque formation causing narrowing of
the coronary arteries
RATIONALE: CAD is primarily caused by atherosclerosis — the buildup of lipid-laden
plaques within the intima of coronary arteries. This narrows the lumen, reduces blood flow, and
leads to myocardial ischemia. The other options describe different cardiovascular conditions
unrelated to the primary mechanism of CAD.
Question 2: A nurse is reviewing a patient's lipid panel. Which value is considered the MOST
significant independent risk factor for CAD?
A. Total cholesterol of 185 mg/dL B. HDL cholesterol of 62 mg/dL C. Triglyceride level of 140
mg/dL D. LDL cholesterol of 162 mg/dL E. VLDL cholesterol of 18 mg/dL
CORRECT ANSWER: D. LDL cholesterol of 162 mg/dL
RATIONALE: Elevated LDL (low-density lipoprotein) is the most significant independent
risk factor for CAD. LDL transports cholesterol to arterial walls where it becomes oxidized and
contributes to plaque formation. An LDL of 162 mg/dL is elevated (optimal is <100 mg/dL for
high-risk patients). HDL at 62 is actually protective.
Question 3: A patient asks the nurse what HDL cholesterol does in the body. What is the most
accurate response?
A. "HDL carries cholesterol from the liver to the tissues." B. "HDL promotes the deposition of
cholesterol in arterial walls." C. "HDL transports cholesterol from peripheral tissues back to the
,liver for excretion." D. "HDL stimulates the synthesis of triglycerides in the liver." E. "HDL
activates clotting factors that increase thrombosis risk."
CORRECT ANSWER: C. HDL transports cholesterol from peripheral tissues back
to the liver for excretion.
RATIONALE: HDL (high-density lipoprotein) performs reverse cholesterol transport —
removing excess cholesterol from peripheral tissues, including arterial walls, and returning it to
the liver for metabolism and excretion. This is why high HDL levels (>60 mg/dL) are
cardioprotective and considered a negative risk factor for CAD.
Question 4: Which of the following HDL cholesterol levels is considered a NEGATIVE
(protective) risk factor for coronary artery disease?
A. HDL of 28 mg/dL B. HDL of 35 mg/dL C. HDL of 45 mg/dL D. HDL of 55 mg/dL E. HDL of
62 mg/dL
CORRECT ANSWER: E. HDL of 62 mg/dL
RATIONALE: According to ACC/AHA guidelines, an HDL level of ≥60 mg/dL is
considered a negative (protective) risk factor for CAD, meaning it actually reduces overall
cardiovascular risk. HDL levels below 40 mg/dL (men) or 50 mg/dL (women) are considered
low and increase risk for CAD.
Question 5: A nurse is educating a patient about modifiable risk factors for CAD. Which of the
following is a NON-modifiable risk factor?
A. Hypertension B. Cigarette smoking C. Obesity D. Family history of CAD in a first-degree
male relative under age 55 E. Sedentary lifestyle
CORRECT ANSWER: D. Family history of CAD in a first-degree male relative
under age 55
RATIONALE: Family history is a non-modifiable risk factor — it cannot be changed. The
other options (hypertension, smoking, obesity, and sedentary lifestyle) are all modifiable risk
factors that can be addressed through medication, lifestyle changes, and behavioral interventions
to reduce CAD risk.
,Question 6: A patient is prescribed atorvastatin (Lipitor) for hyperlipidemia. The nurse should
instruct the patient to report which serious adverse effect immediately?
A. Mild headache and fatigue B. Muscle pain, tenderness, or weakness
(myopathy/rhabdomyolysis) C. Occasional loose stools D. Mild flushing of the face E. Slight
increase in appetite
CORRECT ANSWER: B. Muscle pain, tenderness, or weakness
(myopathy/rhabdomyolysis)
RATIONALE: Statins such as atorvastatin can cause myopathy, which in severe cases
progresses to rhabdomyolysis — a life-threatening breakdown of skeletal muscle that releases
myoglobin into the bloodstream, potentially causing acute kidney injury. Patients must report
muscle pain, weakness, or dark/cola-colored urine immediately.
Question 7: Which lipoprotein is directly measured in a standard lipid panel and is considered
the primary atherogenic particle?
A. Chylomicrons B. VLDL C. IDL D. LDL E. HDL
CORRECT ANSWER: D. LDL
RATIONALE: LDL (low-density lipoprotein) is the primary atherogenic lipoprotein and is
directly measured in a standard fasting lipid panel. It is the main carrier of cholesterol to
peripheral tissues and arterial walls. Elevated LDL levels are directly correlated with increased
atherosclerosis and CAD risk.
Question 8: A patient with stable angina reports chest pain that occurs with exertion and is
relieved by rest. What is the primary pathophysiology underlying this symptom?
A. Complete occlusion of a coronary artery causing myocardial necrosis B. Coronary artery
vasospasm occurring at rest without plaque C. Fixed coronary artery stenosis limiting oxygen
supply during increased demand D. Pericardial inflammation causing pleuritic chest pain E.
Aortic stenosis causing pressure overload on the left ventricle
CORRECT ANSWER: C. Fixed coronary artery stenosis limiting oxygen supply
during increased demand
RATIONALE: Stable angina results from a fixed atherosclerotic stenosis that limits
coronary blood flow. At rest, the stenosis may not restrict flow enough to cause symptoms.
, However, during exertion — when myocardial oxygen demand increases — the fixed stenosis
cannot accommodate the increased flow, causing ischemia and chest pain that resolves with rest.
Question 9: A nurse is assessing a patient who reports chest pain at rest that is unpredictable and
not related to exertion. The pain resolves spontaneously. Which condition does this most likely
describe?
A. Stable angina B. Unstable angina C. Prinzmetal's (variant) angina D. Acute STEMI E.
Pericarditis
CORRECT ANSWER: C. Prinzmetal's (variant) angina
RATIONALE: Prinzmetal's angina (variant angina) is caused by coronary artery vasospasm,
typically occurring at rest, often in the early morning hours. It is not related to exertion and may
resolve spontaneously. Unlike stable angina, it is not caused by fixed plaque stenosis but rather
by sudden arterial spasm, which temporarily occludes the artery.
Question 10: Which of the following statements best differentiates unstable angina from stable
angina?
A. Stable angina occurs at rest while unstable angina occurs only with exertion B. Unstable
angina results in permanent myocardial damage, while stable angina does not C. Unstable angina
is new onset, occurs at rest, or is increasing in frequency/severity without infarction D. Stable
angina requires immediate percutaneous coronary intervention (PCI) E. Unstable angina is
always caused by coronary vasospasm
CORRECT ANSWER: C. Unstable angina is new onset, occurs at rest, or is
increasing in frequency/severity without infarction
RATIONALE: Unstable angina is defined as angina that is new onset, occurs at rest, or is
changing in pattern (more frequent, longer duration, or less responsive to nitroglycerin) without
evidence of myocardial necrosis (troponin negative). It represents an acute coronary syndrome
and requires urgent evaluation because it can progress to MI.
Question 11: A patient is admitted with suspected acute myocardial infarction (AMI). Which
cardiac biomarker is the MOST specific and sensitive for myocardial necrosis?
A. CK (creatine kinase) total B. Myoglobin C. AST (aspartate aminotransferase) D. Troponin I or
Troponin T E. LDH (lactate dehydrogenase)
(2026) | CAD & LIPIDS – CARDIOLOGY
NURSING | VERIFIED QUESTIONS & ANSWERS
WITH A+ EXAM TIPS | MUST SEE PDF
Question 1: A patient is diagnosed with coronary artery disease (CAD). Which
pathophysiological process is the primary underlying mechanism?
A. Inflammation of the pericardium leading to fluid accumulation B. Hypertrophy of the left
ventricular wall due to chronic pressure overload C. Atherosclerotic plaque formation causing
narrowing of the coronary arteries D. Thromboembolism originating from deep vein thrombosis
E. Valvular insufficiency causing backflow into the coronary circulation
CORRECT ANSWER: C. Atherosclerotic plaque formation causing narrowing of
the coronary arteries
RATIONALE: CAD is primarily caused by atherosclerosis — the buildup of lipid-laden
plaques within the intima of coronary arteries. This narrows the lumen, reduces blood flow, and
leads to myocardial ischemia. The other options describe different cardiovascular conditions
unrelated to the primary mechanism of CAD.
Question 2: A nurse is reviewing a patient's lipid panel. Which value is considered the MOST
significant independent risk factor for CAD?
A. Total cholesterol of 185 mg/dL B. HDL cholesterol of 62 mg/dL C. Triglyceride level of 140
mg/dL D. LDL cholesterol of 162 mg/dL E. VLDL cholesterol of 18 mg/dL
CORRECT ANSWER: D. LDL cholesterol of 162 mg/dL
RATIONALE: Elevated LDL (low-density lipoprotein) is the most significant independent
risk factor for CAD. LDL transports cholesterol to arterial walls where it becomes oxidized and
contributes to plaque formation. An LDL of 162 mg/dL is elevated (optimal is <100 mg/dL for
high-risk patients). HDL at 62 is actually protective.
Question 3: A patient asks the nurse what HDL cholesterol does in the body. What is the most
accurate response?
A. "HDL carries cholesterol from the liver to the tissues." B. "HDL promotes the deposition of
cholesterol in arterial walls." C. "HDL transports cholesterol from peripheral tissues back to the
,liver for excretion." D. "HDL stimulates the synthesis of triglycerides in the liver." E. "HDL
activates clotting factors that increase thrombosis risk."
CORRECT ANSWER: C. HDL transports cholesterol from peripheral tissues back
to the liver for excretion.
RATIONALE: HDL (high-density lipoprotein) performs reverse cholesterol transport —
removing excess cholesterol from peripheral tissues, including arterial walls, and returning it to
the liver for metabolism and excretion. This is why high HDL levels (>60 mg/dL) are
cardioprotective and considered a negative risk factor for CAD.
Question 4: Which of the following HDL cholesterol levels is considered a NEGATIVE
(protective) risk factor for coronary artery disease?
A. HDL of 28 mg/dL B. HDL of 35 mg/dL C. HDL of 45 mg/dL D. HDL of 55 mg/dL E. HDL of
62 mg/dL
CORRECT ANSWER: E. HDL of 62 mg/dL
RATIONALE: According to ACC/AHA guidelines, an HDL level of ≥60 mg/dL is
considered a negative (protective) risk factor for CAD, meaning it actually reduces overall
cardiovascular risk. HDL levels below 40 mg/dL (men) or 50 mg/dL (women) are considered
low and increase risk for CAD.
Question 5: A nurse is educating a patient about modifiable risk factors for CAD. Which of the
following is a NON-modifiable risk factor?
A. Hypertension B. Cigarette smoking C. Obesity D. Family history of CAD in a first-degree
male relative under age 55 E. Sedentary lifestyle
CORRECT ANSWER: D. Family history of CAD in a first-degree male relative
under age 55
RATIONALE: Family history is a non-modifiable risk factor — it cannot be changed. The
other options (hypertension, smoking, obesity, and sedentary lifestyle) are all modifiable risk
factors that can be addressed through medication, lifestyle changes, and behavioral interventions
to reduce CAD risk.
,Question 6: A patient is prescribed atorvastatin (Lipitor) for hyperlipidemia. The nurse should
instruct the patient to report which serious adverse effect immediately?
A. Mild headache and fatigue B. Muscle pain, tenderness, or weakness
(myopathy/rhabdomyolysis) C. Occasional loose stools D. Mild flushing of the face E. Slight
increase in appetite
CORRECT ANSWER: B. Muscle pain, tenderness, or weakness
(myopathy/rhabdomyolysis)
RATIONALE: Statins such as atorvastatin can cause myopathy, which in severe cases
progresses to rhabdomyolysis — a life-threatening breakdown of skeletal muscle that releases
myoglobin into the bloodstream, potentially causing acute kidney injury. Patients must report
muscle pain, weakness, or dark/cola-colored urine immediately.
Question 7: Which lipoprotein is directly measured in a standard lipid panel and is considered
the primary atherogenic particle?
A. Chylomicrons B. VLDL C. IDL D. LDL E. HDL
CORRECT ANSWER: D. LDL
RATIONALE: LDL (low-density lipoprotein) is the primary atherogenic lipoprotein and is
directly measured in a standard fasting lipid panel. It is the main carrier of cholesterol to
peripheral tissues and arterial walls. Elevated LDL levels are directly correlated with increased
atherosclerosis and CAD risk.
Question 8: A patient with stable angina reports chest pain that occurs with exertion and is
relieved by rest. What is the primary pathophysiology underlying this symptom?
A. Complete occlusion of a coronary artery causing myocardial necrosis B. Coronary artery
vasospasm occurring at rest without plaque C. Fixed coronary artery stenosis limiting oxygen
supply during increased demand D. Pericardial inflammation causing pleuritic chest pain E.
Aortic stenosis causing pressure overload on the left ventricle
CORRECT ANSWER: C. Fixed coronary artery stenosis limiting oxygen supply
during increased demand
RATIONALE: Stable angina results from a fixed atherosclerotic stenosis that limits
coronary blood flow. At rest, the stenosis may not restrict flow enough to cause symptoms.
, However, during exertion — when myocardial oxygen demand increases — the fixed stenosis
cannot accommodate the increased flow, causing ischemia and chest pain that resolves with rest.
Question 9: A nurse is assessing a patient who reports chest pain at rest that is unpredictable and
not related to exertion. The pain resolves spontaneously. Which condition does this most likely
describe?
A. Stable angina B. Unstable angina C. Prinzmetal's (variant) angina D. Acute STEMI E.
Pericarditis
CORRECT ANSWER: C. Prinzmetal's (variant) angina
RATIONALE: Prinzmetal's angina (variant angina) is caused by coronary artery vasospasm,
typically occurring at rest, often in the early morning hours. It is not related to exertion and may
resolve spontaneously. Unlike stable angina, it is not caused by fixed plaque stenosis but rather
by sudden arterial spasm, which temporarily occludes the artery.
Question 10: Which of the following statements best differentiates unstable angina from stable
angina?
A. Stable angina occurs at rest while unstable angina occurs only with exertion B. Unstable
angina results in permanent myocardial damage, while stable angina does not C. Unstable angina
is new onset, occurs at rest, or is increasing in frequency/severity without infarction D. Stable
angina requires immediate percutaneous coronary intervention (PCI) E. Unstable angina is
always caused by coronary vasospasm
CORRECT ANSWER: C. Unstable angina is new onset, occurs at rest, or is
increasing in frequency/severity without infarction
RATIONALE: Unstable angina is defined as angina that is new onset, occurs at rest, or is
changing in pattern (more frequent, longer duration, or less responsive to nitroglycerin) without
evidence of myocardial necrosis (troponin negative). It represents an acute coronary syndrome
and requires urgent evaluation because it can progress to MI.
Question 11: A patient is admitted with suspected acute myocardial infarction (AMI). Which
cardiac biomarker is the MOST specific and sensitive for myocardial necrosis?
A. CK (creatine kinase) total B. Myoglobin C. AST (aspartate aminotransferase) D. Troponin I or
Troponin T E. LDH (lactate dehydrogenase)
