NSG320/ NSG 320 Exam 2 (Latest 2026/2027 Update) | Complete Exam Questions with Verified Answers and Detailed Rationales | Cardiology, Hypertension, ECG Interpretation, Heart Failure, Angina, Myocardial Infarction | A+ Graded | Grand Canyon University

INSTANT PDF DOWNLOAD This comprehensive EXAM resource for NSG 320 Exam 2 at Grand Canyon University covers Cardiology, Hypertension, ECG Interpretation, and Heart Failure for the 2026/2027 academic year. It features exam-style questions with verified answers and detailed rationales. Exam 2 Blueprint Topics: Hypertension (essential HTN, afterload, RAAS, BP classification, treatment goals) Coronary Artery Disease (atherosclerosis, LDL/HDL, risk factors, prevention) Angina & Myocardial Infarction (stable vs unstable angina, STEMI vs NSTEMI, MONA, cardiac biomarkers, door-to-balloon time) ECG Interpretation (P wave, QRS complex, PR interval, heart rate calculation, normal vs abnormal rhythms) Heart Failure (left vs right HF, HFrEF vs HFpEF, BNP, crackles, JVD, edema) Valvular Disorders (mitral stenosis, regurgitation, aortic stenosis, regurgitation, murmurs) Cardiac Diagnostics (echocardiogram, cardiac catheterization, stress test, Holter monitor) Cardiac Pharmacology (ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, diuretics, digoxin, nitroglycerin, antiplatelets, anticoagulants, statins) ECG Rhythm Recognition (normal sinus rhythm, sinus bradycardia/tachycardia, atrial fibrillation, heart blocks, PVCs, VT, VF) ECG INTERPRETATION Q1. To calculate heart rate from an ECG strip, the nurse should: Correct Answer: Count R waves in a 6-second strip and multiply by 10 Rationale: In standard ECG paper (25 mm/sec), a 6-second strip covers 30 large boxes. Multiplying the number of R waves (QRS complexes) in that strip by 10 gives beats per minute. Q2. What is the normal PR interval? Correct Answer: 0.12 to 0.20 second Rationale: The PR interval represents the time from atrial depolarization (P wave) to ventricular depolarization (QRS complex). Normal duration is 3-5 small boxes (0.12-0.20 seconds). Q3. Which finding indicates normal sinus rhythm? Correct Answer: Each P wave is followed by a QRS complex Rationale: In normal sinus rhythm, each P wave is followed by a QRS complex, PR interval is constant (0.12-0.20 sec), and rate is 60-100 bpm. Q4. A patient has a heart rate of 43 beats/minute. Which action should the nurse take first? Correct Answer: Assess the patient's level of consciousness and blood pressure Rationale: Bradycardia (HR 60) in a non-athlete may be symptomatic (dizziness, hypotension, confusion). The nurse must first assess the patient for symptoms of decreased cardiac output. Q5. The nurse is analyzing a patient's ECG. The P wave represents: Correct Answer: Atrial depolarization (contraction) Rationale: The P wave indicates electrical activation of the atria, leading to atrial contraction and emptying of blood into the ventricles. HYPERTENSION & CARDIOVASCULAR PHYSIOLOGY Q6. What is "essential hypertension"? Correct Answer: Hypertension with no specific identifiable cause Rationale: Essential (primary) hypertension accounts for 90-95% of cases with no underlying cause. Secondary hypertension results from another disease (renal artery stenosis, hyperaldosteronism, pheochromocytoma). Q7. Which normal system helps with sodium and water retention to maintain blood pressure? Correct Answer: Renin-Angiotensin-Aldosterone System (RAAS) Rationale: When blood pressure drops, the kidneys release renin, triggering a cascade that ultimately increases sodium and water retention, raising blood volume and pressure. Q8. What is the most important lifestyle modification for a patient with newly diagnosed hypertension? Correct Answer: Reducing sodium intake Rationale: The DASH diet and sodium reduction (to 2,300 mg/day, ideal 1,500 mg/day) are first-line non-pharmacologic interventions for hypertension. Q9. A patient with hypertension and diabetes should have a blood pressure goal of: Correct Answer: Less than 130/80 mm Hg Rationale: Patients with diabetes require stricter blood pressure control to reduce cardiovascular and renal complications. Q10. Which serum lipid is most strongly associated with coronary artery disease? Correct Answer: Elevated LDL cholesterol Rationale: LDL carries cholesterol TO tissues; high LDL levels correlate strongly with atherosclerosis and CAD. HEART FAILURE Q11. A patient with left ventricular failure would likely present with which lung sounds? Correct Answer: Crackles (rales) Rationale: Left-sided heart failure causes pulmonary congestion as blood backs up into the pulmonary veins and alveoli, producing crackles. Q12. Physical exam findings in right-sided heart failure include: (Select all that apply) Correct Answers: Jugular venous distention (JVD); Peripheral edema; Hepatomegaly; Ascites Rationale: Right-sided heart failure causes systemic venous congestion, leading to JVD, peripheral edema (dependent), hepatomegaly (tender, enlarged liver), and ascites. Q13. When a patient with heart failure is receiving loop diuretics, the nurse must monitor serum: Correct Answer: Potassium levels Rationale: Loop diuretics (furosemide, bumetanide, torsemide) are potassium-wasting. Hypokalemia increases the risk of digoxin toxicity and cardiac dysrhythmias. Q14. The nurse is monitoring a patient for digoxin toxicity. Which finding is of greatest concern? Correct Answer: Yellow-green halos around lights Rationale: Visual disturbances (yellow-green halos, blurred vision) are classic signs of digoxin toxicity, along with nausea, vomiting, bradycardia, and cardiac dysrhythmias. CORONARY ARTERY DISEASE & MYOCARDIAL INFARCTION Q15. A patient with chest pain is given nitroglycerin sublingually. The patient's pain is unrelieved after three doses. What should the nurse suspect? Correct Answer: Myocardial infarction Rationale: Unstable angina or MI may not be relieved by nitroglycerin. If chest pain persists after 3 nitroglycerin doses, the patient should be evaluated for acute coronary syndrome. Q16. Which cardiac biomarker is most specific for myocardial infarction? Correct Answer: Troponin I Rationale: Troponin is the most sensitive and specific cardiac biomarker for myocardial injury. It rises 2-4 hours after MI and remains elevated for 7-10 days. Q17. A patient presents with ST-segment elevation on ECG. The nurse should prepare the patient for: Correct Answer: Emergency percutaneous coronary intervention (PCI) Rationale: STEMI requires immediate reperfusion. The goal is door-to-balloon time of 90 minutes or less. Q18. The MONA protocol for acute myocardial infarction includes: (Select all that apply) Correct Answers: Morphine, Oxygen, Nitroglycerin, Aspirin