NUR 242 MEDICAL-SURGICAL NURSING EXAM 2 REVIEW
2026/2027 | Questions and Verified Answers | 100% Correct |
Galen College | Pass Guaranteed
Cardiovascular Disorders: Hypertension, CAD, Heart Failure,
Dysrhythmias, Valvular Disease, Pericarditis & Endocarditis
Q1: A 58-year-old male presents with blood pressure readings of 168/102 mmHg on
three separate occasions. He has no known secondary cause. This is classified as:
A. Secondary hypertension
B. Primary (essential) hypertension [CORRECT]
C. Hypertensive emergency
D. White coat hypertension
Correct Answer: B
Rationale: Primary hypertension has no identifiable cause and develops gradually over
years. Secondary hypertension (A) has specific causes (renal, endocrine). This isn't an
emergency (C) without target organ damage or severe symptoms. White coat (D) is
elevated only in clinical settings.
Q2: The nurse is educating a patient with newly diagnosed hypertension about lifestyle
modifications. Which dietary recommendation is most appropriate?
A. Increase sodium intake to maintain fluid balance
B. Follow the DASH diet with emphasis on fruits, vegetables, and low-fat dairy
[CORRECT]
C. Consume more red meat for iron supplementation
D. Eliminate all carbohydrates from the diet
Correct Answer: B
,Rationale: The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes fruits,
vegetables, whole grains, and low-fat dairy while limiting sodium. Sodium should be
restricted, not increased (A). Red meat isn't specifically recommended (C), and
eliminating carbs (D) isn't part of hypertension management.
Q3: A patient with heart failure is prescribed furosemide 40 mg daily. The nurse should
monitor for which electrolyte imbalance?
A. Hyperkalemia
B. Hyponatremia and hypokalemia [CORRECT]
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Loop diuretics like furosemide cause sodium and potassium wasting, leading
to hyponatremia and hypokalemia. They don't cause hyperkalemia (A)—that's seen with
potassium-sparing diuretics like spironolactone. Calcium (C) and magnesium (D)
imbalances aren't primary concerns with furosemide.
Q4: Which cardiac enzyme rises within 3-4 hours after myocardial injury, peaks at 24
hours, and is the preferred biomarker for diagnosing MI?
A. CK-MB
B. Troponin I or T [CORRECT]
C. Myoglobin
D. LDH
Correct Answer: B
Rationale: Troponins are most specific for cardiac muscle and remain elevated for days,
making them preferred for MI diagnosis. CK-MB (A) rises in 4-6 hours and is less
specific. Myoglobin (C) rises quickly but isn't cardiac-specific. LDH (D) is outdated for
MI diagnosis.
,Q5: A patient with unstable angina is prescribed nitroglycerin. The nurse should instruct
the patient to:
A. Swallow the tablet immediately for faster absorption
B. Place one tablet under the tongue and call 911 if pain persists after 5 minutes
[CORRECT]
C. Take the medication with food to prevent stomach upset
D. Crush the tablet and mix with water
Correct Answer: B
Rationale: Nitroglycerin is sublingual for rapid absorption—swallowing (A) destroys
effectiveness. If pain persists after 5 minutes, calling 911 is critical as this may indicate
MI. Food (C) isn't needed; crushing (D) isn't necessary for sublingual administration.
Q6: Left-sided heart failure is characterized by which clinical manifestation?
A. Jugular venous distention and hepatomegaly
B. Dyspnea, orthopnea, and pulmonary crackles [CORRECT]
C. Peripheral edema and ascites
D. Weight gain and increased abdominal girth
Correct Answer: B
Rationale: Left-sided HF causes pulmonary congestion (dyspnea, orthopnea,
paroxysmal nocturnal dyspnea, crackles, S3 gallop). Options A, C, and D describe
right-sided HF (systemic congestion: JVD, hepatomegaly, peripheral edema, ascites).
Q7: The nurse is caring for a patient with atrial fibrillation. Which intervention is the
highest priority?
A. Rate control with beta-blockers
B. Anticoagulation to prevent stroke [CORRECT]
C. Immediate cardioversion
D. Digoxin loading dose
Correct Answer: B
, Rationale: AFib carries high stroke risk due to atrial blood stasis—anticoagulation
(warfarin, DOACs) is critical. Rate control (A) matters but stroke prevention takes
priority. Immediate cardioversion (C) is for unstable patients; digoxin (D) is for rate
control but not first priority.
Q8: A patient with a mechanical heart valve replacement asks why they must take
warfarin for life. The best response is:
A. "Mechanical valves are prone to infection requiring antibiotics"
B. "Blood tends to clot on mechanical valves, and warfarin prevents this" [CORRECT]
C. "Warfarin helps the valve function more efficiently"
D. "This is only necessary for the first year after surgery"
Correct Answer: B
Rationale: Mechanical valves are thrombogenic due to material surface—lifelong
anticoagulation prevents valve thrombosis and systemic emboli. Bioprosthetic valves
don't require lifelong warfarin. Infection prophylaxis (A) is different; warfarin doesn't
improve function (C); it's lifelong, not one year (D).
Q9: A patient presents with chest pain that worsens when lying supine and improves
when leaning forward. The nurse auscultates a friction rub. These findings suggest:
A. Stable angina
B. Acute pericarditis [CORRECT]
C. Mitral regurgitation
D. Aortic stenosis
Correct Answer: B
Rationale: Positional chest pain (worse supine, better leaning forward) and pericardial
friction rub are classic for pericarditis. Stable angina (A) is exertional; mitral
regurgitation (C) causes pansystolic murmur; aortic stenosis (D) causes systolic
ejection murmur and syncope/angina/dyspnea.
2026/2027 | Questions and Verified Answers | 100% Correct |
Galen College | Pass Guaranteed
Cardiovascular Disorders: Hypertension, CAD, Heart Failure,
Dysrhythmias, Valvular Disease, Pericarditis & Endocarditis
Q1: A 58-year-old male presents with blood pressure readings of 168/102 mmHg on
three separate occasions. He has no known secondary cause. This is classified as:
A. Secondary hypertension
B. Primary (essential) hypertension [CORRECT]
C. Hypertensive emergency
D. White coat hypertension
Correct Answer: B
Rationale: Primary hypertension has no identifiable cause and develops gradually over
years. Secondary hypertension (A) has specific causes (renal, endocrine). This isn't an
emergency (C) without target organ damage or severe symptoms. White coat (D) is
elevated only in clinical settings.
Q2: The nurse is educating a patient with newly diagnosed hypertension about lifestyle
modifications. Which dietary recommendation is most appropriate?
A. Increase sodium intake to maintain fluid balance
B. Follow the DASH diet with emphasis on fruits, vegetables, and low-fat dairy
[CORRECT]
C. Consume more red meat for iron supplementation
D. Eliminate all carbohydrates from the diet
Correct Answer: B
,Rationale: The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes fruits,
vegetables, whole grains, and low-fat dairy while limiting sodium. Sodium should be
restricted, not increased (A). Red meat isn't specifically recommended (C), and
eliminating carbs (D) isn't part of hypertension management.
Q3: A patient with heart failure is prescribed furosemide 40 mg daily. The nurse should
monitor for which electrolyte imbalance?
A. Hyperkalemia
B. Hyponatremia and hypokalemia [CORRECT]
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Loop diuretics like furosemide cause sodium and potassium wasting, leading
to hyponatremia and hypokalemia. They don't cause hyperkalemia (A)—that's seen with
potassium-sparing diuretics like spironolactone. Calcium (C) and magnesium (D)
imbalances aren't primary concerns with furosemide.
Q4: Which cardiac enzyme rises within 3-4 hours after myocardial injury, peaks at 24
hours, and is the preferred biomarker for diagnosing MI?
A. CK-MB
B. Troponin I or T [CORRECT]
C. Myoglobin
D. LDH
Correct Answer: B
Rationale: Troponins are most specific for cardiac muscle and remain elevated for days,
making them preferred for MI diagnosis. CK-MB (A) rises in 4-6 hours and is less
specific. Myoglobin (C) rises quickly but isn't cardiac-specific. LDH (D) is outdated for
MI diagnosis.
,Q5: A patient with unstable angina is prescribed nitroglycerin. The nurse should instruct
the patient to:
A. Swallow the tablet immediately for faster absorption
B. Place one tablet under the tongue and call 911 if pain persists after 5 minutes
[CORRECT]
C. Take the medication with food to prevent stomach upset
D. Crush the tablet and mix with water
Correct Answer: B
Rationale: Nitroglycerin is sublingual for rapid absorption—swallowing (A) destroys
effectiveness. If pain persists after 5 minutes, calling 911 is critical as this may indicate
MI. Food (C) isn't needed; crushing (D) isn't necessary for sublingual administration.
Q6: Left-sided heart failure is characterized by which clinical manifestation?
A. Jugular venous distention and hepatomegaly
B. Dyspnea, orthopnea, and pulmonary crackles [CORRECT]
C. Peripheral edema and ascites
D. Weight gain and increased abdominal girth
Correct Answer: B
Rationale: Left-sided HF causes pulmonary congestion (dyspnea, orthopnea,
paroxysmal nocturnal dyspnea, crackles, S3 gallop). Options A, C, and D describe
right-sided HF (systemic congestion: JVD, hepatomegaly, peripheral edema, ascites).
Q7: The nurse is caring for a patient with atrial fibrillation. Which intervention is the
highest priority?
A. Rate control with beta-blockers
B. Anticoagulation to prevent stroke [CORRECT]
C. Immediate cardioversion
D. Digoxin loading dose
Correct Answer: B
, Rationale: AFib carries high stroke risk due to atrial blood stasis—anticoagulation
(warfarin, DOACs) is critical. Rate control (A) matters but stroke prevention takes
priority. Immediate cardioversion (C) is for unstable patients; digoxin (D) is for rate
control but not first priority.
Q8: A patient with a mechanical heart valve replacement asks why they must take
warfarin for life. The best response is:
A. "Mechanical valves are prone to infection requiring antibiotics"
B. "Blood tends to clot on mechanical valves, and warfarin prevents this" [CORRECT]
C. "Warfarin helps the valve function more efficiently"
D. "This is only necessary for the first year after surgery"
Correct Answer: B
Rationale: Mechanical valves are thrombogenic due to material surface—lifelong
anticoagulation prevents valve thrombosis and systemic emboli. Bioprosthetic valves
don't require lifelong warfarin. Infection prophylaxis (A) is different; warfarin doesn't
improve function (C); it's lifelong, not one year (D).
Q9: A patient presents with chest pain that worsens when lying supine and improves
when leaning forward. The nurse auscultates a friction rub. These findings suggest:
A. Stable angina
B. Acute pericarditis [CORRECT]
C. Mitral regurgitation
D. Aortic stenosis
Correct Answer: B
Rationale: Positional chest pain (worse supine, better leaning forward) and pericardial
friction rub are classic for pericarditis. Stable angina (A) is exertional; mitral
regurgitation (C) causes pansystolic murmur; aortic stenosis (D) causes systolic
ejection murmur and syncope/angina/dyspnea.
