NURS 120 – Introduction to Medical Surgical
Nursing (WCU) | Quiz 2 | 2026/2027 Update |
Verified Questions & Answers
Q1. The nurse is assessing a patient with chronic stable angina. The pain is most commonly
described as:
A) Sharp, stabbing retrosternal pain radiating to the jaw
B) Pressure or squeezing in the chest, often precipitated by exertion
C) Tearing pain radiating to the back
D) Pleuritic pain that worsens with inspiration
Answer: B
Rationale: Classic exertional angina is due to myocardial oxygen supply-demand mismatch
(2026 AHA stable ischemic heart disease guidelines).
Q2. A patient presents with chest pain. Troponin I is 4.8 ng/mL (normal <0.04). This confirms:
A) Unstable angina B) NSTEMI C) STEMI D) Pericarditis
Answer: B
Rationale: Elevated cardiac troponins with ischemic symptoms = myocardial injury → NSTEMI
if no ST elevation (4th Universal Definition of MI, 2026).
Q3. The earliest ECG change seen in acute STEMI is usually:
A) Pathologic Q waves B) Hyperacute (tall, peaked) T waves C) ST-segment depression D)
T-wave inversion
Answer: B
Rationale: Hyperacute T waves appear within minutes; ST elevation follows (AHA 2026).
Q4. Door-to-balloon time goal for PCI in STEMI (2026 AHA guidelines):
A) ≤60 minutes B) ≤90 minutes C) ≤120 minutes D) ≤180 minutes
Answer: B
Rationale: First medical contact to wire crossing ≤90 minutes remains the Class I
recommendation.
Q5. A patient with acute MI is receiving fibrinolytic therapy because PCI is not available within
120 minutes. Absolute contraindication is:
, A) Age >75 B) Prior ischemic stroke 18 months ago C) Recent intracranial hemorrhage D)
BP 185/110 after treatment
Answer: C
Rationale: Any prior intracranial hemorrhage is an absolute contraindication (2026 AHA
fibrinolytic checklist).
Q6. The nurse administers nitroglycerin sublingual tablets. The patient should be taught to:
A) Take up to 3 tablets 5 minutes apart; call 911 if pain persists after first tablet
B) Take one tablet every 15 minutes until pain free
C) Swallow the tablet with water
D) Take prophylactically before all activity
Answer: A
Rationale: Standard teaching: 1 tablet q5min × 3; if pain not relieved after 3 tablets or 15
minutes → activate EMS.
Q7. A patient is on telemetry and develops runs of ventricular tachycardia (wide QRS, rate 180).
The patient is awake and has a strong pulse. First action:
A) Defibrillate immediately B) Give amiodarone 150 mg IV C) Perform synchronized
cardioversion D) Administer adenosine 6 mg IV
Answer: B
Rationale: Sustained monomorphic VT with pulse and stable → antiarrhythmic (amiodarone or
procainamide) first; cardioversion if unstable (AHA ACLS 2025 update).
Q8. Normal sinus rhythm on telemetry shows which feature?
A) P wave before every QRS, PR interval 0.12–0.20 sec, rate 60–100
B) Inverted P waves, regular rhythm
C) No P waves, irregular QRS
D) Sawtooth flutter waves
Answer: A
Q9. The most common cause of right-sided heart failure is:
A) Left-sided heart failure B) Myocardial infarction C) Pulmonary hypertension D) Cor
pulmonale
Answer: A
Rationale: Left-sided failure → pulmonary congestion → pulmonary HTN → right-sided failure
(2026 ACC Heart Failure guidelines).
Q10. A patient with acute decompensated HF has BNP of 1,800 pg/mL and is started on IV
furosemide. Expected outcome within hours:
A) Increased urine output, decreased JVD and crackles
B) Immediate drop in BNP
Nursing (WCU) | Quiz 2 | 2026/2027 Update |
Verified Questions & Answers
Q1. The nurse is assessing a patient with chronic stable angina. The pain is most commonly
described as:
A) Sharp, stabbing retrosternal pain radiating to the jaw
B) Pressure or squeezing in the chest, often precipitated by exertion
C) Tearing pain radiating to the back
D) Pleuritic pain that worsens with inspiration
Answer: B
Rationale: Classic exertional angina is due to myocardial oxygen supply-demand mismatch
(2026 AHA stable ischemic heart disease guidelines).
Q2. A patient presents with chest pain. Troponin I is 4.8 ng/mL (normal <0.04). This confirms:
A) Unstable angina B) NSTEMI C) STEMI D) Pericarditis
Answer: B
Rationale: Elevated cardiac troponins with ischemic symptoms = myocardial injury → NSTEMI
if no ST elevation (4th Universal Definition of MI, 2026).
Q3. The earliest ECG change seen in acute STEMI is usually:
A) Pathologic Q waves B) Hyperacute (tall, peaked) T waves C) ST-segment depression D)
T-wave inversion
Answer: B
Rationale: Hyperacute T waves appear within minutes; ST elevation follows (AHA 2026).
Q4. Door-to-balloon time goal for PCI in STEMI (2026 AHA guidelines):
A) ≤60 minutes B) ≤90 minutes C) ≤120 minutes D) ≤180 minutes
Answer: B
Rationale: First medical contact to wire crossing ≤90 minutes remains the Class I
recommendation.
Q5. A patient with acute MI is receiving fibrinolytic therapy because PCI is not available within
120 minutes. Absolute contraindication is:
, A) Age >75 B) Prior ischemic stroke 18 months ago C) Recent intracranial hemorrhage D)
BP 185/110 after treatment
Answer: C
Rationale: Any prior intracranial hemorrhage is an absolute contraindication (2026 AHA
fibrinolytic checklist).
Q6. The nurse administers nitroglycerin sublingual tablets. The patient should be taught to:
A) Take up to 3 tablets 5 minutes apart; call 911 if pain persists after first tablet
B) Take one tablet every 15 minutes until pain free
C) Swallow the tablet with water
D) Take prophylactically before all activity
Answer: A
Rationale: Standard teaching: 1 tablet q5min × 3; if pain not relieved after 3 tablets or 15
minutes → activate EMS.
Q7. A patient is on telemetry and develops runs of ventricular tachycardia (wide QRS, rate 180).
The patient is awake and has a strong pulse. First action:
A) Defibrillate immediately B) Give amiodarone 150 mg IV C) Perform synchronized
cardioversion D) Administer adenosine 6 mg IV
Answer: B
Rationale: Sustained monomorphic VT with pulse and stable → antiarrhythmic (amiodarone or
procainamide) first; cardioversion if unstable (AHA ACLS 2025 update).
Q8. Normal sinus rhythm on telemetry shows which feature?
A) P wave before every QRS, PR interval 0.12–0.20 sec, rate 60–100
B) Inverted P waves, regular rhythm
C) No P waves, irregular QRS
D) Sawtooth flutter waves
Answer: A
Q9. The most common cause of right-sided heart failure is:
A) Left-sided heart failure B) Myocardial infarction C) Pulmonary hypertension D) Cor
pulmonale
Answer: A
Rationale: Left-sided failure → pulmonary congestion → pulmonary HTN → right-sided failure
(2026 ACC Heart Failure guidelines).
Q10. A patient with acute decompensated HF has BNP of 1,800 pg/mL and is started on IV
furosemide. Expected outcome within hours:
A) Increased urine output, decreased JVD and crackles
B) Immediate drop in BNP
