EXAM2 NR 545 (ACTUAL 2025) QUESTIONS AND
VERIFIED ANSWERS.
Chest Pain AKA Angina Patho
Patho: Chest pain associated with decreased blood flow or
ischemia to the myocardial tissue.
Chest pain PA
Physical Assessment: chest heaviness
Pressure
Squeezing
Fullness
Pain radiates to left shoulder, arm, or jaw.
Elevation of blood pressure during attack
HTN Dx
Dx: after two consecutive clinic visits with BP readings above
130/80
potassium- Low potassium can increase BP
Sodium- high sodium levels can elevate BP
Blood glucose and HgA1C to assess for hyperglycemia and
diabetes.
,Lipid panel to assess for hyperlipidemia or metabolic
syndrome.
Creatinine and blood urea nitrogen and ultrasound of kidneys
to assess for secondary hypertension.
TSH and T4 to assess for secondary hypertension due to
abnormal thyroid function.
HTN Tx
Pharm: Modifiable lifestyle changes
Low sodium diet
First Line Treatment
Thiazides -Hydrochlorothiazide- diuretic. Thiazide diuretics
inhibits sodium absorption.
ACE inhibitor (ACEI) Accupril: Angiotensin-converting
enzyme (ACE) inhibitors, inhibits conversion of Angiotensin I
to Angiotensin II.
Angiotensin receptor blocker (ARB) Valsartan- blocks
Angiotensin II that constricts blood vessels.
,Calcium channel blockers (CCBs)- Amlodipine. Calcium
channel blockers relax smooth muscles of the blood vessels
and the myocardium.
Ethnic considerations when prescribing:
Thiazides or Calcium channel blockers (CCBs) are first line
for African Americans.
Angiotensin-converting enzyme (ACE I) for patients with
coronary artery disease, heart failure or kidney failure.
Angiotensin II receptor blockers (ARB), ACEI, Thiazides, or
CCBs for Whites/Caucasian.
ACEI or ARB for patients with chronic kidney disease with or
without diabetes for all races and ages.
ACEI, ARB, or CCBs for diabetes in non-Blacks.
1st line during pregnancy Labetalol
Pathway for impulses of cardiac conduction
The SA node starts the sequence by causing the atrial muscles
to contract. That's why doctors sometimes call it the
anatomical pacemaker.
, Next, the signal travels to the AV node, through the bundle of
HIS, down the bundle branches, and through the Purkinje
fibers, causing the ventricles to contract.
Coronary Artery Disease
damage or disease in the hearts major blood vessels
Buildup of plaque
Can lead to heart attack.
Stenosis
The valve flaps become thick or stiff and sometimes can join
together. The valve opening becomes narrowed. Less blood
can flow through the narrowed valve.
Regurgitation.
The valve flaps may not close tightly, causing blood to leak
backward.
Prolapse.
VERIFIED ANSWERS.
Chest Pain AKA Angina Patho
Patho: Chest pain associated with decreased blood flow or
ischemia to the myocardial tissue.
Chest pain PA
Physical Assessment: chest heaviness
Pressure
Squeezing
Fullness
Pain radiates to left shoulder, arm, or jaw.
Elevation of blood pressure during attack
HTN Dx
Dx: after two consecutive clinic visits with BP readings above
130/80
potassium- Low potassium can increase BP
Sodium- high sodium levels can elevate BP
Blood glucose and HgA1C to assess for hyperglycemia and
diabetes.
,Lipid panel to assess for hyperlipidemia or metabolic
syndrome.
Creatinine and blood urea nitrogen and ultrasound of kidneys
to assess for secondary hypertension.
TSH and T4 to assess for secondary hypertension due to
abnormal thyroid function.
HTN Tx
Pharm: Modifiable lifestyle changes
Low sodium diet
First Line Treatment
Thiazides -Hydrochlorothiazide- diuretic. Thiazide diuretics
inhibits sodium absorption.
ACE inhibitor (ACEI) Accupril: Angiotensin-converting
enzyme (ACE) inhibitors, inhibits conversion of Angiotensin I
to Angiotensin II.
Angiotensin receptor blocker (ARB) Valsartan- blocks
Angiotensin II that constricts blood vessels.
,Calcium channel blockers (CCBs)- Amlodipine. Calcium
channel blockers relax smooth muscles of the blood vessels
and the myocardium.
Ethnic considerations when prescribing:
Thiazides or Calcium channel blockers (CCBs) are first line
for African Americans.
Angiotensin-converting enzyme (ACE I) for patients with
coronary artery disease, heart failure or kidney failure.
Angiotensin II receptor blockers (ARB), ACEI, Thiazides, or
CCBs for Whites/Caucasian.
ACEI or ARB for patients with chronic kidney disease with or
without diabetes for all races and ages.
ACEI, ARB, or CCBs for diabetes in non-Blacks.
1st line during pregnancy Labetalol
Pathway for impulses of cardiac conduction
The SA node starts the sequence by causing the atrial muscles
to contract. That's why doctors sometimes call it the
anatomical pacemaker.
, Next, the signal travels to the AV node, through the bundle of
HIS, down the bundle branches, and through the Purkinje
fibers, causing the ventricles to contract.
Coronary Artery Disease
damage or disease in the hearts major blood vessels
Buildup of plaque
Can lead to heart attack.
Stenosis
The valve flaps become thick or stiff and sometimes can join
together. The valve opening becomes narrowed. Less blood
can flow through the narrowed valve.
Regurgitation.
The valve flaps may not close tightly, causing blood to leak
backward.
Prolapse.
