NR-329 Midterm Exam Blueprint: Managing
Acute and Chronic Complex Conditions 2026-
2027 latest update
1. A nurse is caring for a patient with left-sided heart failure.
Which assessment finding is most expected?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Left-sided heart failure causes pulmonary congestion, leading to
crackles, dyspnea, and orthopnea.
2. Which laboratory value is most important to monitor in a
patient receiving furosemide?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Answer: C. Potassium
Loop diuretics increase potassium excretion, placing the patient at
risk for hypokalemia.
3. A patient with COPD has barrel chest. This finding is caused by:
A. Increased airway resistance
B. Chronic lung hyperinflation
C. Weak respiratory muscles
D. Decreased surfactant
,Answer: B. Chronic lung hyperinflation
Air trapping over time leads to lung hyperinflation and barrel chest
formation.
4. The nurse teaches a patient with asthma about peak flow
meters. Which instruction is correct?
A. Use it after taking bronchodilators
B. Record the lowest reading
C. Exhale forcefully into the device
D. Inhale deeply through the device
Answer: C. Exhale forcefully into the device
Peak flow meters measure the force of exhalation to assess airway
obstruction.
5. A patient reports chest pain relieved by rest. This finding
suggests:
A. Myocardial infarction
B. Stable angina
C. Unstable angina
D. Heart failure
Answer: B. Stable angina
Stable angina occurs with exertion and is relieved by rest or
nitroglycerin.
6. Which electrolyte imbalance is most concerning in a patient
with chronic kidney disease?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypophosphatemia
,Answer: B. Hyperkalemia
Impaired kidney function reduces potassium excretion, increasing the
risk for life-threatening dysrhythmias.
7. A patient with diabetes reports shakiness and diaphoresis. The
nurse should first:
A. Administer insulin
B. Check blood glucose
C. Encourage exercise
D. Administer glucagon
Answer: B. Check blood glucose
Symptoms suggest hypoglycemia, which must be confirmed before
intervention.
8. Which assessment finding indicates hypovolemia?
A. Bounding pulses
B. Hypertension
C. Dry mucous membranes
D. Crackles in lungs
Answer: C. Dry mucous membranes
Fluid volume deficit presents with dry mucous membranes,
hypotension, and tachycardia.
9. The priority nursing action for a patient with suspected
myocardial infarction is:
A. Obtain a detailed history
B. Administer oxygen
C. Draw cardiac enzymes
D. Give aspirin
, Answer: B. Administer oxygen
Oxygen improves myocardial oxygenation and is a priority
intervention.
10. A patient with pneumonia has decreased oxygen
saturation. Which position improves ventilation?
A. Supine
B. Prone
C. High-Fowler’s
D. Trendelenburg
Answer: C. High-Fowler’s
This position maximizes lung expansion and gas exchange.
11. Which finding is expected in right-sided heart failure?
A. Pulmonary edema
B. Crackles
C. Jugular vein distention
D. Dyspnea
Answer: C. Jugular vein distention
Right-sided failure causes systemic venous congestion.
12. The nurse administers nitroglycerin for angina. Which side
effect should be anticipated?
A. Hypertension
B. Bradycardia
C. Headache
D. Hypoglycemia
Answer: C. Headache
Nitroglycerin causes vasodilation, commonly leading to headaches.
Acute and Chronic Complex Conditions 2026-
2027 latest update
1. A nurse is caring for a patient with left-sided heart failure.
Which assessment finding is most expected?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in the lungs
D. Hepatomegaly
Answer: C. Crackles in the lungs
Left-sided heart failure causes pulmonary congestion, leading to
crackles, dyspnea, and orthopnea.
2. Which laboratory value is most important to monitor in a
patient receiving furosemide?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Answer: C. Potassium
Loop diuretics increase potassium excretion, placing the patient at
risk for hypokalemia.
3. A patient with COPD has barrel chest. This finding is caused by:
A. Increased airway resistance
B. Chronic lung hyperinflation
C. Weak respiratory muscles
D. Decreased surfactant
,Answer: B. Chronic lung hyperinflation
Air trapping over time leads to lung hyperinflation and barrel chest
formation.
4. The nurse teaches a patient with asthma about peak flow
meters. Which instruction is correct?
A. Use it after taking bronchodilators
B. Record the lowest reading
C. Exhale forcefully into the device
D. Inhale deeply through the device
Answer: C. Exhale forcefully into the device
Peak flow meters measure the force of exhalation to assess airway
obstruction.
5. A patient reports chest pain relieved by rest. This finding
suggests:
A. Myocardial infarction
B. Stable angina
C. Unstable angina
D. Heart failure
Answer: B. Stable angina
Stable angina occurs with exertion and is relieved by rest or
nitroglycerin.
6. Which electrolyte imbalance is most concerning in a patient
with chronic kidney disease?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypophosphatemia
,Answer: B. Hyperkalemia
Impaired kidney function reduces potassium excretion, increasing the
risk for life-threatening dysrhythmias.
7. A patient with diabetes reports shakiness and diaphoresis. The
nurse should first:
A. Administer insulin
B. Check blood glucose
C. Encourage exercise
D. Administer glucagon
Answer: B. Check blood glucose
Symptoms suggest hypoglycemia, which must be confirmed before
intervention.
8. Which assessment finding indicates hypovolemia?
A. Bounding pulses
B. Hypertension
C. Dry mucous membranes
D. Crackles in lungs
Answer: C. Dry mucous membranes
Fluid volume deficit presents with dry mucous membranes,
hypotension, and tachycardia.
9. The priority nursing action for a patient with suspected
myocardial infarction is:
A. Obtain a detailed history
B. Administer oxygen
C. Draw cardiac enzymes
D. Give aspirin
, Answer: B. Administer oxygen
Oxygen improves myocardial oxygenation and is a priority
intervention.
10. A patient with pneumonia has decreased oxygen
saturation. Which position improves ventilation?
A. Supine
B. Prone
C. High-Fowler’s
D. Trendelenburg
Answer: C. High-Fowler’s
This position maximizes lung expansion and gas exchange.
11. Which finding is expected in right-sided heart failure?
A. Pulmonary edema
B. Crackles
C. Jugular vein distention
D. Dyspnea
Answer: C. Jugular vein distention
Right-sided failure causes systemic venous congestion.
12. The nurse administers nitroglycerin for angina. Which side
effect should be anticipated?
A. Hypertension
B. Bradycardia
C. Headache
D. Hypoglycemia
Answer: C. Headache
Nitroglycerin causes vasodilation, commonly leading to headaches.
