NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
COPD (chronic obstructive pulmonary disease) - ans-involving the airways, pulmonary
parenchyma, or both
-characterized by persistent airflow limitations
-preventable and treatable but not fully reversible
-chronic bronchitis and emphysema
Risk factors for COPD - ans- Smoking or smoke exposure
- Alpha-1 antitrypsin deficiency (AATD)
- Occupational dusts and chemicals
- Indoor an Outdoor air pollution
Emphysema (pink puffer) - answheezing in lungs
pathophysiology of chronic bronchitis - ans-cough and sputum production for at least 3
month in each of 2 consecutive years
-ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous
can plug the airways
-alveoli is damaged and the fibroses and alveolar macrophage function diminishes
-pt more susceptible to respiratory infections
Emphysema background - ans-abnormal distention of air spaces beyond the terminal
bronchioles with destruction of the walls of alveoli (shown with wheezing)
-mainly caused from smoking and infection
-can lead to hypoxemia
-can lead to increased pulmonary artery pressure and can cause right sided heart failure
clinical manifestation of chronic bronchitis - ans-sputum production
-cough
-dyspnea
-"barrel chest"
-weight loss result to dyspnea
-fatigue
-crackles in lungs
-peripheral edema-ankles-(right HF)
Complications of COPD - ans-acute respiratory failure/insufficiency
-pulmonary hypertension
-pneumonia
-chronic atelectasis
-pneumothorax
-cor pulmonale (can be caused by the low o2 in the vessels from the COPD. this causes strain
from the pulmonary HTN on R V and cause HF)
Diagnostic test/ Assessment COPD - ans-PFT
-spirometry
-ABGs (not enough to diagnosis COPD)
-chest x-ray
-hx and physical exam
-6 minute walk test
-serum x1-antitrypsin levels
,NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
Medical management of COPD - ans-smoking cessation
-drug therapy
-provide o2 therapy/breathing exercises
-bronchodilators prior to meals
-low carb (takes co2 to break it down), high protein, high cal
-pneumococcal vaccine
-flu vaccine
-pulmonary rehabilitation
-good nutritional
medications for COPD - ans-bronchodilators, MDIs(mulit-dose inhaler)(beta-adrenergic
agonists, muscarinic atagonists/ anticholinergics, combination agents),
-corticosteroids,
-antibiotics,
-mucolytics,
-antitussives
OSA manifestations - ans-arousal during sleep
-insomnia
-excessive daytime sleepiness
-witnessed apnea episodes
-loud snoring with periods of no breathing for 10 seconds or longer for at least 5 times per
hour
-hard time to complete task
-interpersonal hardship
-impaired memory
3S
-Snoring , sleeplessness, and significant other reports of apneic periods
Risk factors for OSA - ans-Obesity - [BMI] greater than 30 kg/m2
-Older than age 65
-Neck circumference >16 inches
-Male
-Postmenopausal women
long term effect of OSA - ans-HTN
-cardia dysrhythmias
-arteriosclerosis
-HF
-cardiovascular related mortality
-stroke
treatment of OSA - ans-CPAP/BiPAP
-weight loss
-avoid alcohol
-positional therapy
-mandibular advancement device (MAD)
,NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
-medications
-low flow nasal 02
-surgery if nothing else works
acute coronary syndrome (ACS) - ans•Deterioration of once stable plaque leads to rupture,
platelet aggregation, and thrombus
•Prolonged ischemia; not immediately reversible; includes:
•Non-ST elevation acute coronary syndrome
•Unstable angina and non-ST segment elevation myocardial infarction (NSTEMI)
•ST-segment-elevation myocardial infarction (STEMI)
Gerontologic considerations for the heart - ans•Risk for cardiovascular disease (CVD)
increases
•CVD is the leading cause of death in adults greater than 65 years of age
•Blood vessels thicken and become less elastic
•Dependent edema
•Increased risk of falls
•Orthostatic hypotension
cardiac marker ACS - ansTroponin -rises within 4 to 6 hours peaks 10 to 24 hours detected
for up to 10 to 14 days
Copeptin- detected immediately with MI
Creatine Kinase (CK-MB)- rises in 3 to 6 hours, peaks in 12 to 24 hours return to baseline
within 12 to 48 hours
other blood studies (C-reactive protein (CRP), cardiac natriuretic peptide markers(BNP), lipid
panel, lipoproteins)
Major modifiable risk factors for CAD - ans•High serum lipids #2
•Hypertension (HTN) #3
•Tobacco use
•Diabetes—2-4 × greater incidence of CAD #4
•Physical inactivity / Obesity
•Chronic stress/ anxiety
•Cocaine and meth use
drug therapy for hyperlipidemia - ansHMG-CoA reductase inhibitors
-STATINS
-Fibrin acid derivatives (fenobrate, gemfibrozil, niacin)
-lipid lowering drug therapy
clinical manifestation of chronic stable angina - ansintermittent chest pain, onset caused from
physical exertion, stress, or emotional upset, may arise as pressure, heaviness, or discomfort
•Ischemic changes on 12-lead ECG—ST segment depression or T wave inversion
•ECG returns to normal when blood flow is restored and pain relieved
medication for chronic stable angina - ansnitrates (isosorbide dinitrate,
NTG)
ACE inhibitors,
b- blockers
, NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
CCB
Sodium current inhibitor (Ranolazine)
Aspirin
short acting nitrates
CAD pharmacological management - ansStatin therapy recommended:
•Patients with known CVD
•LDL cholesterol > 190 mg/dL
•Age 40 to 75 with diabetes and LDL 70 to 189 mg/dL
•Age 40 to 75 with LDL 70 to 189 mg/dL and 10-year risk for CVD at least 7.5%
Drugs that restrict lipoprotein production
•HMG-CoA reductase inhibitors: Statins
•Niacin:
•Fibric acid derivatives:(fenofibrate)
Drugs that increase lipoprotein removal:
•Bile acid sequestrates (Colesevelam)
Drugs that decrease cholesterol absorption:
•Ezetimibe (Zetia)
Antiplatelet therapy
•Low-dose aspirin (81 mg)
CAD complications - ans•Chronic stable angina
•Unstable angina
•ACS
•CHF
•Dysrhythmia
•Pericarditis
•Cardiogenic shock
•Cardiomegaly
Gold standard to identify and localize CAD - anscardiac catheterization
-visualize blockages
-open blockages
-percutaneous coronary intervention
CABG post op care - ans1) ICU + *telemetry*
2) watch for MI / stroke (elderly)
4) prevent VTE
5) arterial line for BP monitoring
Clinical manifestation of ACS/MI - anssevere chest pain, heaviness, tightness, no pain if
cardiac neuropathy, diaphoresis, increased HR/BP, cool clammy touch, crackles, decreased
renal perfusion, new murmur or abnormal heart sounds
Comprehensive Exam Study Guide
Latest Updated 2025/2026
COPD (chronic obstructive pulmonary disease) - ans-involving the airways, pulmonary
parenchyma, or both
-characterized by persistent airflow limitations
-preventable and treatable but not fully reversible
-chronic bronchitis and emphysema
Risk factors for COPD - ans- Smoking or smoke exposure
- Alpha-1 antitrypsin deficiency (AATD)
- Occupational dusts and chemicals
- Indoor an Outdoor air pollution
Emphysema (pink puffer) - answheezing in lungs
pathophysiology of chronic bronchitis - ans-cough and sputum production for at least 3
month in each of 2 consecutive years
-ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous
can plug the airways
-alveoli is damaged and the fibroses and alveolar macrophage function diminishes
-pt more susceptible to respiratory infections
Emphysema background - ans-abnormal distention of air spaces beyond the terminal
bronchioles with destruction of the walls of alveoli (shown with wheezing)
-mainly caused from smoking and infection
-can lead to hypoxemia
-can lead to increased pulmonary artery pressure and can cause right sided heart failure
clinical manifestation of chronic bronchitis - ans-sputum production
-cough
-dyspnea
-"barrel chest"
-weight loss result to dyspnea
-fatigue
-crackles in lungs
-peripheral edema-ankles-(right HF)
Complications of COPD - ans-acute respiratory failure/insufficiency
-pulmonary hypertension
-pneumonia
-chronic atelectasis
-pneumothorax
-cor pulmonale (can be caused by the low o2 in the vessels from the COPD. this causes strain
from the pulmonary HTN on R V and cause HF)
Diagnostic test/ Assessment COPD - ans-PFT
-spirometry
-ABGs (not enough to diagnosis COPD)
-chest x-ray
-hx and physical exam
-6 minute walk test
-serum x1-antitrypsin levels
,NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
Medical management of COPD - ans-smoking cessation
-drug therapy
-provide o2 therapy/breathing exercises
-bronchodilators prior to meals
-low carb (takes co2 to break it down), high protein, high cal
-pneumococcal vaccine
-flu vaccine
-pulmonary rehabilitation
-good nutritional
medications for COPD - ans-bronchodilators, MDIs(mulit-dose inhaler)(beta-adrenergic
agonists, muscarinic atagonists/ anticholinergics, combination agents),
-corticosteroids,
-antibiotics,
-mucolytics,
-antitussives
OSA manifestations - ans-arousal during sleep
-insomnia
-excessive daytime sleepiness
-witnessed apnea episodes
-loud snoring with periods of no breathing for 10 seconds or longer for at least 5 times per
hour
-hard time to complete task
-interpersonal hardship
-impaired memory
3S
-Snoring , sleeplessness, and significant other reports of apneic periods
Risk factors for OSA - ans-Obesity - [BMI] greater than 30 kg/m2
-Older than age 65
-Neck circumference >16 inches
-Male
-Postmenopausal women
long term effect of OSA - ans-HTN
-cardia dysrhythmias
-arteriosclerosis
-HF
-cardiovascular related mortality
-stroke
treatment of OSA - ans-CPAP/BiPAP
-weight loss
-avoid alcohol
-positional therapy
-mandibular advancement device (MAD)
,NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
-medications
-low flow nasal 02
-surgery if nothing else works
acute coronary syndrome (ACS) - ans•Deterioration of once stable plaque leads to rupture,
platelet aggregation, and thrombus
•Prolonged ischemia; not immediately reversible; includes:
•Non-ST elevation acute coronary syndrome
•Unstable angina and non-ST segment elevation myocardial infarction (NSTEMI)
•ST-segment-elevation myocardial infarction (STEMI)
Gerontologic considerations for the heart - ans•Risk for cardiovascular disease (CVD)
increases
•CVD is the leading cause of death in adults greater than 65 years of age
•Blood vessels thicken and become less elastic
•Dependent edema
•Increased risk of falls
•Orthostatic hypotension
cardiac marker ACS - ansTroponin -rises within 4 to 6 hours peaks 10 to 24 hours detected
for up to 10 to 14 days
Copeptin- detected immediately with MI
Creatine Kinase (CK-MB)- rises in 3 to 6 hours, peaks in 12 to 24 hours return to baseline
within 12 to 48 hours
other blood studies (C-reactive protein (CRP), cardiac natriuretic peptide markers(BNP), lipid
panel, lipoproteins)
Major modifiable risk factors for CAD - ans•High serum lipids #2
•Hypertension (HTN) #3
•Tobacco use
•Diabetes—2-4 × greater incidence of CAD #4
•Physical inactivity / Obesity
•Chronic stress/ anxiety
•Cocaine and meth use
drug therapy for hyperlipidemia - ansHMG-CoA reductase inhibitors
-STATINS
-Fibrin acid derivatives (fenobrate, gemfibrozil, niacin)
-lipid lowering drug therapy
clinical manifestation of chronic stable angina - ansintermittent chest pain, onset caused from
physical exertion, stress, or emotional upset, may arise as pressure, heaviness, or discomfort
•Ischemic changes on 12-lead ECG—ST segment depression or T wave inversion
•ECG returns to normal when blood flow is restored and pain relieved
medication for chronic stable angina - ansnitrates (isosorbide dinitrate,
NTG)
ACE inhibitors,
b- blockers
, NUR 150-FINAL EXAM
Comprehensive Exam Study Guide
Latest Updated 2025/2026
CCB
Sodium current inhibitor (Ranolazine)
Aspirin
short acting nitrates
CAD pharmacological management - ansStatin therapy recommended:
•Patients with known CVD
•LDL cholesterol > 190 mg/dL
•Age 40 to 75 with diabetes and LDL 70 to 189 mg/dL
•Age 40 to 75 with LDL 70 to 189 mg/dL and 10-year risk for CVD at least 7.5%
Drugs that restrict lipoprotein production
•HMG-CoA reductase inhibitors: Statins
•Niacin:
•Fibric acid derivatives:(fenofibrate)
Drugs that increase lipoprotein removal:
•Bile acid sequestrates (Colesevelam)
Drugs that decrease cholesterol absorption:
•Ezetimibe (Zetia)
Antiplatelet therapy
•Low-dose aspirin (81 mg)
CAD complications - ans•Chronic stable angina
•Unstable angina
•ACS
•CHF
•Dysrhythmia
•Pericarditis
•Cardiogenic shock
•Cardiomegaly
Gold standard to identify and localize CAD - anscardiac catheterization
-visualize blockages
-open blockages
-percutaneous coronary intervention
CABG post op care - ans1) ICU + *telemetry*
2) watch for MI / stroke (elderly)
4) prevent VTE
5) arterial line for BP monitoring
Clinical manifestation of ACS/MI - anssevere chest pain, heaviness, tightness, no pain if
cardiac neuropathy, diaphoresis, increased HR/BP, cool clammy touch, crackles, decreased
renal perfusion, new murmur or abnormal heart sounds
