NU 185 MEDICAL-SURGICAL NURSING II –
COMPREHENSIVE EXAM REVIEW QUESTIONS &
ANSWERS WITH RATIONALES
TOPIC 1: CARDIOVASCULAR SYSTEM (Cardiac Anatomy & Function)
Q1: Which layer of the heart is responsible for the forceful contractions that
pump blood throughout the body?
☑ Correct Answer: Myocardium
📝 Rationale: The myocardium is the thick, muscular middle layer responsible for
the heart's contractions and pumping action. The epicardium is the outer layer,
the endocardium lines the inner chambers, and the pericardium is the sac
surrounding the heart .
Q2: Which of the following correctly describes the flow of oxygenated blood?
☑ Correct Answer: Pulmonary veins → left atrium → left ventricle
📝 Rationale: Oxygenated blood returns from the lungs through the pulmonary
veins to the left atrium, then moves to the left ventricle before being pumped to
the rest of the body. Deoxygenated blood flows right atrium → right ventricle →
pulmonary artery .
,Q3: Which vessel type is responsible for gas exchange at the tissue level?
☑ Correct Answer: Capillaries
📝 Rationale: Capillaries are the smallest blood vessels where oxygen and carbon
dioxide exchange occurs between blood and tissues. Arteries carry blood away
from the heart; veins return blood to the heart .
Q4: Which vessel carries deoxygenated blood away from the heart?
☑ Correct Answer: Pulmonary artery
📝 Rationale: The pulmonary artery carries deoxygenated blood from the right
ventricle to the lungs for oxygenation. The aorta carries oxygenated blood to the
body .
Q5: What is cardiac output (CO)?
☑ Correct Answer: Measure of pumping ability; CO = HR × SV
📝 Rationale: Cardiac output is the volume of blood pumped by the heart per
minute. It is calculated by multiplying heart rate (HR) by stroke volume (SV).
Normal CO is 4-8 L/min .
TOPIC 2: CARDIAC LABORATORY VALUES & DIAGNOSTICS
,Q6: A patient presents with chest pain. Which lab value is the most specific for
diagnosing a myocardial infarction?
☑ Correct Answer: Troponin
📝 Rationale: Troponin is the gold standard for diagnosing myocardial infarction
because of its high specificity to cardiac muscle and long elevation time after
injury (remains elevated for 7-10 days post-MI) .
Q7: A patient presents with shortness of breath, fatigue, and peripheral edema.
Which lab value would best support a diagnosis of heart failure?
☑ Correct Answer: BNP: 450 pg/mL
📝 Rationale: BNP (B-type Natriuretic Peptide) is elevated in response to
ventricular stretch and fluid overload, which are common in heart failure. A level
above 100 pg/mL is indicative of heart failure .
Q8: Which statement about myoglobin is most accurate?
☑ Correct Answer: It is an early but non-specific marker
📝 Rationale: Myoglobin rises quickly after muscle injury (including cardiac), but it
is not specific to heart muscle. Troponin remains the preferred cardiac
biomarker .
, Q9: A female patient receives her lipid panel results: Total cholesterol: 210
mg/dL, LDL: 140 mg/dL, HDL: 50 mg/dL, Triglycerides: 130 mg/dL. Which result
should concern the nurse the most?
☑ Correct Answer: LDL: 140 mg/dL
📝 Rationale: LDL ("bad" cholesterol) should be under 130 mg/dL. High LDL
increases the risk of atherosclerosis and cardiovascular disease. HDL of 50 mg/dL
is acceptable for females .
Q10: Which HDL level would be considered normal for a male patient?
☑ Correct Answer: 55 mg/dL
📝 Rationale: Normal HDL for males is greater than 45 mg/dL. A value of 55
mg/dL is within the desired range. Higher HDL is protective against heart disease .
TOPIC 3: CARDIAC PROCEDURES & DIAGNOSTIC TESTS
Q11: A nurse explains that a left heart catheterization is planned for a patient.
The patient asks, "How will they insert the catheter?" What is the nurse's best
response?
☑ Correct Answer: "It will be inserted through an artery, usually in your groin or
wrist."
COMPREHENSIVE EXAM REVIEW QUESTIONS &
ANSWERS WITH RATIONALES
TOPIC 1: CARDIOVASCULAR SYSTEM (Cardiac Anatomy & Function)
Q1: Which layer of the heart is responsible for the forceful contractions that
pump blood throughout the body?
☑ Correct Answer: Myocardium
📝 Rationale: The myocardium is the thick, muscular middle layer responsible for
the heart's contractions and pumping action. The epicardium is the outer layer,
the endocardium lines the inner chambers, and the pericardium is the sac
surrounding the heart .
Q2: Which of the following correctly describes the flow of oxygenated blood?
☑ Correct Answer: Pulmonary veins → left atrium → left ventricle
📝 Rationale: Oxygenated blood returns from the lungs through the pulmonary
veins to the left atrium, then moves to the left ventricle before being pumped to
the rest of the body. Deoxygenated blood flows right atrium → right ventricle →
pulmonary artery .
,Q3: Which vessel type is responsible for gas exchange at the tissue level?
☑ Correct Answer: Capillaries
📝 Rationale: Capillaries are the smallest blood vessels where oxygen and carbon
dioxide exchange occurs between blood and tissues. Arteries carry blood away
from the heart; veins return blood to the heart .
Q4: Which vessel carries deoxygenated blood away from the heart?
☑ Correct Answer: Pulmonary artery
📝 Rationale: The pulmonary artery carries deoxygenated blood from the right
ventricle to the lungs for oxygenation. The aorta carries oxygenated blood to the
body .
Q5: What is cardiac output (CO)?
☑ Correct Answer: Measure of pumping ability; CO = HR × SV
📝 Rationale: Cardiac output is the volume of blood pumped by the heart per
minute. It is calculated by multiplying heart rate (HR) by stroke volume (SV).
Normal CO is 4-8 L/min .
TOPIC 2: CARDIAC LABORATORY VALUES & DIAGNOSTICS
,Q6: A patient presents with chest pain. Which lab value is the most specific for
diagnosing a myocardial infarction?
☑ Correct Answer: Troponin
📝 Rationale: Troponin is the gold standard for diagnosing myocardial infarction
because of its high specificity to cardiac muscle and long elevation time after
injury (remains elevated for 7-10 days post-MI) .
Q7: A patient presents with shortness of breath, fatigue, and peripheral edema.
Which lab value would best support a diagnosis of heart failure?
☑ Correct Answer: BNP: 450 pg/mL
📝 Rationale: BNP (B-type Natriuretic Peptide) is elevated in response to
ventricular stretch and fluid overload, which are common in heart failure. A level
above 100 pg/mL is indicative of heart failure .
Q8: Which statement about myoglobin is most accurate?
☑ Correct Answer: It is an early but non-specific marker
📝 Rationale: Myoglobin rises quickly after muscle injury (including cardiac), but it
is not specific to heart muscle. Troponin remains the preferred cardiac
biomarker .
, Q9: A female patient receives her lipid panel results: Total cholesterol: 210
mg/dL, LDL: 140 mg/dL, HDL: 50 mg/dL, Triglycerides: 130 mg/dL. Which result
should concern the nurse the most?
☑ Correct Answer: LDL: 140 mg/dL
📝 Rationale: LDL ("bad" cholesterol) should be under 130 mg/dL. High LDL
increases the risk of atherosclerosis and cardiovascular disease. HDL of 50 mg/dL
is acceptable for females .
Q10: Which HDL level would be considered normal for a male patient?
☑ Correct Answer: 55 mg/dL
📝 Rationale: Normal HDL for males is greater than 45 mg/dL. A value of 55
mg/dL is within the desired range. Higher HDL is protective against heart disease .
TOPIC 3: CARDIAC PROCEDURES & DIAGNOSTIC TESTS
Q11: A nurse explains that a left heart catheterization is planned for a patient.
The patient asks, "How will they insert the catheter?" What is the nurse's best
response?
☑ Correct Answer: "It will be inserted through an artery, usually in your groin or
wrist."
