NR569 Final Exam (NEW UPDATED VERSION) LATEST ACTUAL EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ [2025-2026]
NR 569
1. Patient presents with sudden chest pain radiating to the left arm and jaw. BP 150/90, HR 110.
First action:
Answer: Obtain 12-lead ECG and cardiac enzymes
Rationale: Sudden chest pain with radiation may indicate acute MI; rapid assessment guides
emergent intervention.
2. Patient with suspected acute MI develops shortness of breath and crackles in lungs. Priority
intervention:
Answer: Apply supplemental oxygen and assess for pulmonary edema
Rationale: MI can cause left-sided heart failure; oxygen and monitoring prevent hypoxia.
3. Patient with chest pain and hypotension, ECG shows ST elevation in inferior leads. Best next
step:
Answer: Notify cardiology for emergent reperfusion therapy
Rationale: ST-elevation MI requires rapid reperfusion to minimize myocardial damage.
4. Patient with palpitations and HR 160, irregularly irregular. Likely diagnosis:
Answer: Atrial fibrillation
Rationale: Irregularly irregular rhythm suggests AF; treatment focuses on rate control and
anticoagulation.
5. Patient with chest discomfort, nausea, diaphoresis. Troponin elevated. Priority:
Answer: Administer aspirin (if not contraindicated) and oxygen
Rationale: Early antiplatelet therapy improves outcomes in ACS.
6. Patient with acute heart failure presents with edema, dyspnea, JVD. First action:
Answer: Administer IV diuretics and monitor vital signs
Rationale: Reduces fluid overload and relieves symptoms.
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2026 Graded A+ EXAM
, 7. Patient post-MI develops hypotension and muffled heart sounds. Likely complication:
Answer: Cardiac tamponade
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) indicates tamponade;
emergent intervention required.
8. Patient with chest pain and BP 180/100. HR 90. Likely diagnosis:
Answer: Hypertensive emergency
Rationale: Severe elevation with end-organ symptoms requires immediate BP reduction.
9. Patient post-MI develops new S3 and crackles. Assessment:
Answer: Acute left-sided heart failure
Rationale: S3 and pulmonary congestion indicate volume overload; prompt management
required.
10. Patient with atrial fibrillation is asymptomatic. Next step:
Answer: Assess stroke risk (CHA2DS2-VASc) and consider anticoagulation
Rationale: Prevents thromboembolic complications even if patient is asymptomatic.
11. Patient presents with chest pain and ST depression. Best action:
Answer: Evaluate for unstable angina or non-ST elevation MI
Rationale: ST depression may indicate subendocardial ischemia; requires urgent but non-
emergent intervention.
12. Patient post-CABG develops hypotension, tachycardia, decreased urine output. Priority:
Answer: Assess for cardiogenic shock
Rationale: Early recognition of decreased cardiac output is critical for management.
13. Patient with known heart failure gains 5 lbs in 2 days. Action:
Answer: Administer diuretics and assess fluid status
Rationale: Rapid weight gain indicates fluid retention; early intervention prevents
decompensation.
14. Patient presents with syncope during exertion. Likely cardiac cause:
Answer: Arrhythmia or structural heart disease
Rationale: Syncope on exertion may indicate dangerous arrhythmias or outflow obstruction.
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2026 Graded A+ EXAM
, 15. Patient with chest pain relieved by rest, ECG normal. Likely diagnosis:
Answer: Stable angina
Rationale: Pain pattern consistent with exertional angina; managed with medications and risk
factor control.
16. Patient with STEMI develops severe hypotension and tachycardia. Immediate action:
Answer: Start IV fluids cautiously and prepare for inotropic support
Rationale: Cardiogenic shock post-MI requires hemodynamic support.
17. Patient post-MI develops new mitral regurgitation murmur. Likely cause:
Answer: Papillary muscle rupture
Rationale: Mechanical complication of MI; emergent surgical intervention may be needed.
18. Patient presents with palpitations, dizziness, HR 220. Likely rhythm:
Answer: Supraventricular tachycardia
Rationale: Rapid HR with sudden onset suggests SVT; management may include vagal
maneuvers or adenosine.
19. Patient with NSTEMI has troponin elevation and mild chest pain. Next step:
Answer: Initiate antiplatelet therapy and monitor
Rationale: Early treatment reduces risk of progression to STEMI.
20. Patient post-MI develops sudden hypotension and neck vein distention. Likely cause:
Answer: Right ventricular infarction
Rationale: RV infarct presents with hypotension, JVD, clear lungs; requires fluid resuscitation.
21. Patient with severe hypertension and chest pain radiating to back. Priority:
Answer: Evaluate for aortic dissection
Rationale: Acute aortic dissection is life-threatening; imaging and BP control are urgent.
22. Patient with chest pain, diaphoresis, HR 120, BP 90/60. Best next step:
Answer: Begin ACS protocol and notify provider
Rationale: Signs of unstable angina or MI with hypotension require immediate attention.
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2026 Graded A+ EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND
ANSWERS) | GUARANTEED PASS A+ [2025-2026]
NR 569
1. Patient presents with sudden chest pain radiating to the left arm and jaw. BP 150/90, HR 110.
First action:
Answer: Obtain 12-lead ECG and cardiac enzymes
Rationale: Sudden chest pain with radiation may indicate acute MI; rapid assessment guides
emergent intervention.
2. Patient with suspected acute MI develops shortness of breath and crackles in lungs. Priority
intervention:
Answer: Apply supplemental oxygen and assess for pulmonary edema
Rationale: MI can cause left-sided heart failure; oxygen and monitoring prevent hypoxia.
3. Patient with chest pain and hypotension, ECG shows ST elevation in inferior leads. Best next
step:
Answer: Notify cardiology for emergent reperfusion therapy
Rationale: ST-elevation MI requires rapid reperfusion to minimize myocardial damage.
4. Patient with palpitations and HR 160, irregularly irregular. Likely diagnosis:
Answer: Atrial fibrillation
Rationale: Irregularly irregular rhythm suggests AF; treatment focuses on rate control and
anticoagulation.
5. Patient with chest discomfort, nausea, diaphoresis. Troponin elevated. Priority:
Answer: Administer aspirin (if not contraindicated) and oxygen
Rationale: Early antiplatelet therapy improves outcomes in ACS.
6. Patient with acute heart failure presents with edema, dyspnea, JVD. First action:
Answer: Administer IV diuretics and monitor vital signs
Rationale: Reduces fluid overload and relieves symptoms.
1
Page
2026 Graded A+ EXAM
, 7. Patient post-MI develops hypotension and muffled heart sounds. Likely complication:
Answer: Cardiac tamponade
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) indicates tamponade;
emergent intervention required.
8. Patient with chest pain and BP 180/100. HR 90. Likely diagnosis:
Answer: Hypertensive emergency
Rationale: Severe elevation with end-organ symptoms requires immediate BP reduction.
9. Patient post-MI develops new S3 and crackles. Assessment:
Answer: Acute left-sided heart failure
Rationale: S3 and pulmonary congestion indicate volume overload; prompt management
required.
10. Patient with atrial fibrillation is asymptomatic. Next step:
Answer: Assess stroke risk (CHA2DS2-VASc) and consider anticoagulation
Rationale: Prevents thromboembolic complications even if patient is asymptomatic.
11. Patient presents with chest pain and ST depression. Best action:
Answer: Evaluate for unstable angina or non-ST elevation MI
Rationale: ST depression may indicate subendocardial ischemia; requires urgent but non-
emergent intervention.
12. Patient post-CABG develops hypotension, tachycardia, decreased urine output. Priority:
Answer: Assess for cardiogenic shock
Rationale: Early recognition of decreased cardiac output is critical for management.
13. Patient with known heart failure gains 5 lbs in 2 days. Action:
Answer: Administer diuretics and assess fluid status
Rationale: Rapid weight gain indicates fluid retention; early intervention prevents
decompensation.
14. Patient presents with syncope during exertion. Likely cardiac cause:
Answer: Arrhythmia or structural heart disease
Rationale: Syncope on exertion may indicate dangerous arrhythmias or outflow obstruction.
2
Page
2026 Graded A+ EXAM
, 15. Patient with chest pain relieved by rest, ECG normal. Likely diagnosis:
Answer: Stable angina
Rationale: Pain pattern consistent with exertional angina; managed with medications and risk
factor control.
16. Patient with STEMI develops severe hypotension and tachycardia. Immediate action:
Answer: Start IV fluids cautiously and prepare for inotropic support
Rationale: Cardiogenic shock post-MI requires hemodynamic support.
17. Patient post-MI develops new mitral regurgitation murmur. Likely cause:
Answer: Papillary muscle rupture
Rationale: Mechanical complication of MI; emergent surgical intervention may be needed.
18. Patient presents with palpitations, dizziness, HR 220. Likely rhythm:
Answer: Supraventricular tachycardia
Rationale: Rapid HR with sudden onset suggests SVT; management may include vagal
maneuvers or adenosine.
19. Patient with NSTEMI has troponin elevation and mild chest pain. Next step:
Answer: Initiate antiplatelet therapy and monitor
Rationale: Early treatment reduces risk of progression to STEMI.
20. Patient post-MI develops sudden hypotension and neck vein distention. Likely cause:
Answer: Right ventricular infarction
Rationale: RV infarct presents with hypotension, JVD, clear lungs; requires fluid resuscitation.
21. Patient with severe hypertension and chest pain radiating to back. Priority:
Answer: Evaluate for aortic dissection
Rationale: Acute aortic dissection is life-threatening; imaging and BP control are urgent.
22. Patient with chest pain, diaphoresis, HR 120, BP 90/60. Best next step:
Answer: Begin ACS protocol and notify provider
Rationale: Signs of unstable angina or MI with hypotension require immediate attention.
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2026 Graded A+ EXAM
