- | P a g e
pg. 1
NSG 430 EXAM 2 NEWET 2025 TEST BANK| ADULT HEALTH
NURSING II EXAM 2 WITH 350 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS WITH
RATIONALES) ALREADY GRADED A+|| BRAND NEW!!
A patient who has had chest pain for several hours is admitted with a diagnosis of rule out acute myocardial infarction (AMI). Which laboratory test is most specific for the nurse to monitor in determining whether the patient has had an AMI?
- Myoglobin
- Homocysteine
- C-reactive protein
- Cardiac-specific troponin
Cardiac-specific troponin Troponin levels increase about 4 to 6 hours after the onset of myocardial infarction (MI) and are highly specific indicators for MI. Myoglobin is released within 2 hours of MI, but it lacks specificity and its use is limited. The other laboratory data are useful in determining the patient's risk for developing coronary artery disease but are not helpful in determining whether an acute MI is in progress.
Diltiazem is prescribed for a patient newly diagnosed with Prinzmetal's (variant) angina. Which action of diltiazem is accurate for the nurse to include in the teaching plan?
- Reduces heart palpitations.
- Prevents coronary artery plaque. 1 / 4
- | P a g e
pg. 2
- Decreases coronary artery spasms.
- Increases contractile force of the heart.
Decreases coronary artery spasms.Prinzmetal's angina is caused by coronary artery spasm. Calcium channel blockers (e.g., diltiazem, amlodipine) are a first-line therapy for this type of angina. Lipid-lowering drugs help reduce atherosclerosis (i.e., plaque formation), and -adrenergic blockers decrease sympathetic stimulation of the heart (i.e., palpitations). Medications or activities that increase myocardial contractility will increase the incidence of angina by increasing O2 demand.
Which data indicates to the nurse that the patient with stable angina is experiencing a side effect of metoprolol?
- Patient is restless and agitated.
- Patient reports feeling anxious.
- Blood pressure is 90/54 mm Hg.
- Heart monitor shows normal sinus rhythm.
Blood pressure is 90/54 mm Hg.Patients taking -adrenergic blockers should be monitored for hypotension and bradycardia. Because this class of medication inhibits the sympathetic nervous system, restlessness, agitation, hypertension, and anxiety will not be side effects. Normal sinus rhythm is a normal and expected heart rhythm.
Nadolol (Corgard) is prescribed for a patient with chronic stable angina and left ventricular dysfunction. Which data would indicate to the nurse that the drug is effective? 2 / 4
- | P a g e
pg. 3
- Decreased blood pressure and heart rate
- Improvement in the strength of the distal pulses
- Fewer complaints of having cold hands and feet
- Participation in daily activities without chest pain
Participation in daily activities without chest pain Because the drug is ordered to improve the patient's angina, effectiveness is indicated if the patient is able to accomplish daily activities without chest pain. Blood pressure and heart rate may decrease, but these data do not indicate that the goal of decreased angina has been met. The noncardioselective -adrenergic blockers can cause peripheral vasoconstriction, so the nurse would not expect an improvement in distal pulse quality or skin temperature.
The nurse is caring for a patient who has just arrived on the telemetry unit after having cardiac catheterization. Which task could the nurse delegate to a licensed practical/vocational nurse (LPN/VN)?
- Teach the patient about the post procedure plan of care.
- Give the scheduled aspirin and lipid-lowering medication.
- Perform the initial assessment of the catheter insertion site.
- Titrate the heparin infusion according to the agency protocol.
- / 4
Give the scheduled aspirin and lipid-lowering medication.Administration of oral medications is within the scope of practice for LPNs/VNs. The initial assessment of the patient, patient teaching, and titration of IV anticoagulant medications should be done by the registered nurse (RN).
- | P a g e
pg. 4 Which electrocardiographic (ECG) change by a patient with chest pain is most important for the nurse to report rapidly to the health care provider?
- Inverted P wave
- Sinus tachycardia
- ST-segment elevation
- First-degree atrioventricular block
ST-segment elevation The patient is likely to be experiencing an ST-segment-elevation myocardial infarction. Immediate therapy with percutaneous coronary intervention or thrombolytic medication is indicated to minimize myocardial damage. The other ECG changes may also suggest a need for therapy but not as rapidly.
A patient with acute coronary syndrome has returned to the coronary care unit after having angioplasty with stent placement. Which assessment data indicate the need for immediate action by the nurse?
- Report of chest pain
- Heart rate 102 beats/min
- Pedal pulses 1+ bilaterally
- Blood pressure 103/54 mm Hg
- / 4
Report of chest pain The patient's chest pain indicates that restenosis of the coronary artery may be occurring and requires immediate actions, such as administration of oxygen and nitroglycerin, by the nurse. The other information indicates a need for ongoing assessments by the nurse.