NYU Meyers College of Nursing AE3 Exam 1
QUESTIONS WITH COMPLETE SOLUTIONS
Course
AE 3
✅ 1. A patient with chronic hypertension is prescribed lisinopril. What is the primary
mechanism of action of this drug?
Answer:
Lisinopril is an ACE inhibitor. It works by:
Blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor
Resulting in vasodilation, reduced blood pressure, and decreased aldosterone secretion,
which lowers fluid retention
Clinical significance: Lowers afterload and reduces cardiovascular remodeling in hypertensive
and heart failure patients.
✅ 2. Differentiate between stable angina and unstable angina.
Answer:
Feature Stable Angina Unstable Angina
Onset Predictable, with exertion/stress Sudden, can occur at rest
Duration Short, <10 minutes Longer, >10 minutes
Relief Relieved by rest or nitroglycerin Often not relieved by rest/meds
Pathophysiology Fixed atherosclerotic plaque Plaque rupture + thrombus
Urgency Not emergent Medical emergency
Implication: Unstable angina is part of acute coronary syndrome and may precede myocardial
infarction.
✅ 3. A patient has a potassium level of 2.9 mEq/L. What are two ECG changes you might
see?
Answer:
This is hypokalemia. ECG changes may include:
Flattened or inverted T waves
, Presence of U waves
ST depression
Clinical risk: Ventricular arrhythmias and digitalis toxicity if on digoxin.
✅ 4. How does the renin-angiotensin-aldosterone system (RAAS) regulate blood pressure?
Answer:
Low BP triggers renin release from the kidneys
Renin converts angiotensinogen to angiotensin I
ACE converts angiotensin I to angiotensin II (vasoconstrictor)
Angiotensin II also stimulates aldosterone release
Aldosterone promotes Na⁺ and H₂O retention, increasing blood volume → ↑ BP
Clinical Relevance: Dysregulation contributes to chronic hypertension and heart failure.
✅ 5. A patient taking furosemide develops muscle weakness and cramps. What lab
abnormality do you suspect and why?
Answer:
Suspect hypokalemia due to furosemide’s mechanism of action:
Loop diuretic → inhibits Na⁺/K⁺/2Cl⁻ reabsorption in ascending loop of Henle
Leads to K⁺ loss in urine → muscle cramps, arrhythmias, weakness
Nursing priority: Check potassium levels, supplement if needed.
✅ 6. Explain the difference between obstructive and restrictive lung disease using an
example of each.
Answer:
Obstructive (e.g., COPD, asthma):
o Airflow limitation, especially on exhalation
o ↑ Residual volume, ↑ TLC
o Symptoms: wheezing, prolonged expiration
, Restrictive (e.g., pulmonary fibrosis):
o ↓ Lung compliance/expansion
o ↓ TLC, FVC
o Symptoms: dyspnea, tachypnea without wheeze
Pulmonary function tests (PFTs) help differentiate them.
✅ 7. A patient on insulin reports shakiness, sweating, and confusion. What is the
immediate nursing action?
Answer:
Symptoms suggest hypoglycemia. Immediate action:
Check blood glucose
If <70 mg/dL and patient is conscious:
o Give 15g of rapid-acting glucose (e.g., juice, glucose tabs)
Recheck in 15 minutes and repeat if needed
If unconscious: administer glucagon IM or IV dextrose
Prevention: Educate about insulin timing, meals, and recognizing early signs.
✅ 8. Describe the pathophysiology of Type 2 Diabetes Mellitus.
Answer:
Insulin resistance in peripheral tissues (muscle, fat)
Inadequate compensatory insulin secretion from pancreatic β-cells
Leads to chronic hyperglycemia
Associated with metabolic syndrome, obesity, inflammation
Complications: Microvascular (retinopathy, nephropathy), macrovascular (stroke, MI)
✅ 9. What are three priority nursing interventions for a patient experiencing fluid volume
overload due to heart failure?
Answer:
QUESTIONS WITH COMPLETE SOLUTIONS
Course
AE 3
✅ 1. A patient with chronic hypertension is prescribed lisinopril. What is the primary
mechanism of action of this drug?
Answer:
Lisinopril is an ACE inhibitor. It works by:
Blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor
Resulting in vasodilation, reduced blood pressure, and decreased aldosterone secretion,
which lowers fluid retention
Clinical significance: Lowers afterload and reduces cardiovascular remodeling in hypertensive
and heart failure patients.
✅ 2. Differentiate between stable angina and unstable angina.
Answer:
Feature Stable Angina Unstable Angina
Onset Predictable, with exertion/stress Sudden, can occur at rest
Duration Short, <10 minutes Longer, >10 minutes
Relief Relieved by rest or nitroglycerin Often not relieved by rest/meds
Pathophysiology Fixed atherosclerotic plaque Plaque rupture + thrombus
Urgency Not emergent Medical emergency
Implication: Unstable angina is part of acute coronary syndrome and may precede myocardial
infarction.
✅ 3. A patient has a potassium level of 2.9 mEq/L. What are two ECG changes you might
see?
Answer:
This is hypokalemia. ECG changes may include:
Flattened or inverted T waves
, Presence of U waves
ST depression
Clinical risk: Ventricular arrhythmias and digitalis toxicity if on digoxin.
✅ 4. How does the renin-angiotensin-aldosterone system (RAAS) regulate blood pressure?
Answer:
Low BP triggers renin release from the kidneys
Renin converts angiotensinogen to angiotensin I
ACE converts angiotensin I to angiotensin II (vasoconstrictor)
Angiotensin II also stimulates aldosterone release
Aldosterone promotes Na⁺ and H₂O retention, increasing blood volume → ↑ BP
Clinical Relevance: Dysregulation contributes to chronic hypertension and heart failure.
✅ 5. A patient taking furosemide develops muscle weakness and cramps. What lab
abnormality do you suspect and why?
Answer:
Suspect hypokalemia due to furosemide’s mechanism of action:
Loop diuretic → inhibits Na⁺/K⁺/2Cl⁻ reabsorption in ascending loop of Henle
Leads to K⁺ loss in urine → muscle cramps, arrhythmias, weakness
Nursing priority: Check potassium levels, supplement if needed.
✅ 6. Explain the difference between obstructive and restrictive lung disease using an
example of each.
Answer:
Obstructive (e.g., COPD, asthma):
o Airflow limitation, especially on exhalation
o ↑ Residual volume, ↑ TLC
o Symptoms: wheezing, prolonged expiration
, Restrictive (e.g., pulmonary fibrosis):
o ↓ Lung compliance/expansion
o ↓ TLC, FVC
o Symptoms: dyspnea, tachypnea without wheeze
Pulmonary function tests (PFTs) help differentiate them.
✅ 7. A patient on insulin reports shakiness, sweating, and confusion. What is the
immediate nursing action?
Answer:
Symptoms suggest hypoglycemia. Immediate action:
Check blood glucose
If <70 mg/dL and patient is conscious:
o Give 15g of rapid-acting glucose (e.g., juice, glucose tabs)
Recheck in 15 minutes and repeat if needed
If unconscious: administer glucagon IM or IV dextrose
Prevention: Educate about insulin timing, meals, and recognizing early signs.
✅ 8. Describe the pathophysiology of Type 2 Diabetes Mellitus.
Answer:
Insulin resistance in peripheral tissues (muscle, fat)
Inadequate compensatory insulin secretion from pancreatic β-cells
Leads to chronic hyperglycemia
Associated with metabolic syndrome, obesity, inflammation
Complications: Microvascular (retinopathy, nephropathy), macrovascular (stroke, MI)
✅ 9. What are three priority nursing interventions for a patient experiencing fluid volume
overload due to heart failure?
Answer:
