HONDROS NURS 212 EXAM 1 Q&A's VERIFIED 100% CORRECT | LATEST 2026/2027 |
GRADED A+
Hondros College of Nursing NURS 212 (Medical-Surgical Nursing II) Examination | Exam 1 | Core
Domains: Cardiovascular Disorders, Respiratory Disorders, Endocrine Disorders, Fluid & Electrolyte
Imbalances, Acid-Base Balance, Perioperative Nursing, Pain Management, Pharmacology Related to
Systems | Hondros Nursing Curriculum | 2026/2027 Academic Cycle
Exam Structure
● 50-60 multiple-choice questions
● 5-10 alternate format questions (Select All That Apply, Ordered Response)
● 90-minute time limit
● Focus on application and clinical judgment
● NCLEX-style questions with Hondros-specific emphasis
● Requires 75% or higher to pass
Introduction
This Hondros NURS 212 Exam 1 study guide for the 2026/2027 academic cycle reflects the current
Hondros College of Nursing curriculum and testing blueprint. The examination evaluates nursing
knowledge and clinical judgment in caring for adult patients with cardiovascular, respiratory, and
endocrine disorders, as well as foundational concepts in fluid/electrolyte balance and perioperative care.
Content integrates pathophysiology, pharmacology, nursing interventions, and patient education required
for safe, competent practice as a professional nurse.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused
rationales that reinforce safe nursing practice, pharmacological principles, and evidence-based
interventions aligned with Hondros nursing curriculum standards.
Table of Contents (Sections)
1. Cardiovascular Disorders (CV)
2. Respiratory Disorders (Resp)
3. Endocrine Disorders (Endo)
4. Fluid/Electrolyte & Acid-Base
5. Perioperative & Pain Management
Cardiovascular Disorders (CV)
,1. A nurse is caring for a patient admitted with acute decompensated heart failure (ADHF)
exhibiting bilateral crackles, pulmonary congestion, and peripheral edema. Which
combination of medications should the nurse anticipate administering to decrease preload
and afterload? (Select all that apply.)
● A. Furosemide and Nitroglycerin
● B. Dobutamine and Metoprolol
● C. Digoxin and Spironolactone
● D. Hydrochlorothiazide and Lisinopril
● E. IV Vasopressin
A. Furosemide and Nitroglycerin, D. Hydrochlorothiazide and Lisinopril
Rationale: In ADHF management, the primary goals are reducing volume overload (preload) and
decreasing systemic vascular resistance (afterload). Furosemide (Loop Diuretic) reduces preload by
promoting diuresis. Nitroglycerin (Venodilator) reduces preload and decreases afterload. Lisinopril (ACE
Inhibitor) is essential for long-term management, decreasing afterload and preload. Hydrochlorothiazide
(Thiazide Diuretic) assists with preload reduction. Dobutamine (B) is an inotrope used for low cardiac
output, not primarily for preload/afterload reduction in congestion. Spironolactone (C) is
potassium-sparing, used for moderate-severe HF, but not the primary acute preload reducer like
furosemide.
2. A 68-year-old patient with a history of atrial fibrillation (AFib) has a prescribed heart
rate control regimen. Which finding necessitates immediate intervention by the nurse?
● A. Patient reports slight fatigue after walking up one flight of stairs.
● B. Diltiazem is prescribed to be given every 6 hours.
● C. Heart rate noted on ECG rhythm strip is 115 beats/minute.
● D. Potassium level is 3.0 mEq/L.
D. Potassium level is 3.0 mEq/L.
Rationale: Atrial fibrillation management often involves rate-control medications like Diltiazem (a
calcium channel blocker). However, hypokalemia (K+ 3.0 mEq/L) significantly increases the risk of
ventricular dysrhythmias, particularly in a patient whose heart is already predisposed to irritability due to
AFib. While a rate of 115 (C) needs monitoring and potential rate adjustment, electrolyte imbalance is a
more immediate life threat. Fatigue (A) is common in chronic AFib.
3. A nurse is teaching a patient about their new prescription for Metoprolol, a selective
beta-blocker, for hypertension. Which statement by the patient indicates proper
understanding?
● A. "I should hold this medication if my heart rate drops below 60 beats/minute."
● B. ";I should take this medication with grapefruit juice to enhance absorption."
● C. "This medicine will increase my heart rate and blood pressure."
● D. "I should not stop taking this suddenly due to risk of rebound angina."
A. "I should hold this medication if my heart rate drops below 60 beats/minute."
Rationale: Metoprolol decreases heart rate and contractility. The nurse should teach the patient to hold
the dose and notify the provider if the apical pulse (or HR) is less than 60 beats/minute (per institutional
protocol, often 50-60 bpm). Grapefruit juice interaction is associated with some calcium channel blockers,
not typically metoprolol (though interactions should always be checked). Beta-blockers decrease HR/BP,
,and abrupt cessation can cause rebound hypertension/angina (D), but holding for bradycardia (A) is the
most immediate safety instruction related to dosage administration.
4. A patient returns to the chest pain clinic 2 weeks after being discharged following an MI
managed with PCI and stent placement. The patient reports experiencing shortness of
breath and sharp chest pain only when walking up stairs, which resolves within 5 minutes
of rest. This finding is best described as:
● A. Unstable angina.
● B. Variant (Prinzmetal's) angina.
● C. Stable angina.
● D. Post-MI pericarditis.
C. Stable angina.
Rationale: Stable angina is characterized by predictable chest pain occurring with exertion or emotional
stress, which is relieved promptly by rest or nitroglycerin. Since this pain resolves reliably with rest after
exertion, it fits the definition of stable angina, despite the recent MI history. Unstable angina (A) occurs at
rest or with minimal exertion and is unpredictable. Variant angina (B) is caused by coronary artery spasm.
Post-MI pericarditis (D) usually presents as sharp pain worse on inspiration and improved by leaning
forward.
5. During immediate post-STEMI care, the nurse monitors the ECG strip. Which
dysrhythmia is the most common life-threatening complication in the first 24-48 hours
post-MI?
● A. Sinus Bradycardia
● B. Atrial Fibrillation
● C. Ventricular Fibrillation (VF)
● D. Wandering Atrial Pacemaker
C. Ventricular Fibrillation (VF)
Rationale: Ventricular Fibrillation (VF) is the most common cause of sudden cardiac death following an
MI, typically occurring in the initial hours due to myocardial irritability from ischemia or infarction. Sinus
Bradycardia (A) can occur but is less immediately life-threatening unless severe or symptomatic. Atrial
Fibrillation (B) is common but carries lower immediate mortality risk than VF.
6. A patient is prescribed 81 mg of Aspirin daily for CAD prevention. The patient states they
occasionally forget a dose. What is the nurse's best teaching intervention regarding
antiplatelet therapy?
● A. Take two doses the next day to make up for the missed dose.
● B. Stop taking the aspirin immediately if they notice any bruising.
● C. Take the missed dose as soon as remembered, unless it is almost time for the next dose.
● D. The prescribed dose is a therapeutic dose for pain relief, not prevention.
C. Take the missed dose as soon as remembered, unless it is almost time for the next dose.
Rationale: For once-daily medications like low-dose aspirin (used for antiplatelet effects), the standard
missed dose instruction is to take it when remembered unless it is close to the next scheduled dose, in
which case the missed dose is skipped. Doubling up (A) increases the risk of bleeding. Stopping
immediately upon bruising (B) ignores the need for continuous antiplatelet effect; bleeding should be
reported, but aspirin should usually not be stopped without consulting a provider. The 81 mg dose is
specifically for antiplatelet (prevention) effects, not analgesic effect (D).
, 7. Which patient finding is the hallmark sign of left-sided heart failure?
● A. Jugular vein distention (JVD).
● B. Dependent peripheral edema.
● C. Pink, frothy sputum production.
● D. Ascites and hepatomegaly.
C. Pink, frothy sputum production.
Rationale: Left-sided heart failure leads to blood backing up into the pulmonary circulation, causing
increased pulmonary hydrostatic pressure, resulting in fluid leaking into the alveoli. This manifests as
pulmonary congestion, often seen as pink, frothy sputum. JVD (A), dependent edema (B), and
ascites/hepatomegaly (D) are classic signs of right-sided heart failure, resulting from systemic venous
congestion.
8. A patient prescribed Digoxin needs continuous cardiac monitoring. The nurse must hold
the dose and notify the provider if the apical pulse is:
● A. 105 beats/min.
● B. 72 beats/min.
● C. 55 beats/min.
● D. Irregular with frequent premature ventricular contractions (PVCs).
C. 55 beats/min.
Rationale: Digoxin toxicity can cause bradycardia. A common threshold to hold Digoxin is an apical
pulse rate below 60 beats/minute in adults. While PVCs (D) can be a sign of toxicity, bradycardia is the
most concrete, immediate parameter requiring dose suspension.
9. A patient with chronic hypertension is receiving an intravenous infusion of Labetalol
(Normodyne). The nurse understands that this medication primarily exerts its
antihypertensive effect by blocking which receptors?
● A. Alpha-1 and Beta-1 receptors only.
● B. Beta-1 receptors only.
● C. Alpha-1, Beta-1, and Beta-2 receptors.
● D. Alpha-1 and Beta-1 receptors.
D. Alpha-1 and Beta-1 receptors.
Rationale: Labetalol is a unique combination alpha- and beta-blocker. It blocks Alpha-1 receptors
(causing vasodilation) and Beta-1 receptors (decreasing heart rate and contractility). It has minimal
Beta-2 blocking effects, differentiating it from non-selective agents like propranolol.
10. A patient is being evaluated for suspected Coronary Artery Disease (CAD). Which
instruction is essential before the patient undergoes a cardiac catheterization?
● A. Maintain a strict, clear liquid diet for 24 hours prior.
● B. Check iodine and shellfish allergies.
● C. Begin taking Warfarin for prophylactic anticoagulation.
● D. Perform deep breathing exercises every 4 hours pre-procedure.
B. Check iodine and shellfish allergies.
Rationale: Cardiac catheterization requires the use of iodinated contrast dye. Allergy assessment,
particularly to iodine or shellfish (due to chemical similarities), is mandatory before administering
contrast to prevent anaphylactoid reactions. NPO status is required, but usually only for 6-8 hours prior
GRADED A+
Hondros College of Nursing NURS 212 (Medical-Surgical Nursing II) Examination | Exam 1 | Core
Domains: Cardiovascular Disorders, Respiratory Disorders, Endocrine Disorders, Fluid & Electrolyte
Imbalances, Acid-Base Balance, Perioperative Nursing, Pain Management, Pharmacology Related to
Systems | Hondros Nursing Curriculum | 2026/2027 Academic Cycle
Exam Structure
● 50-60 multiple-choice questions
● 5-10 alternate format questions (Select All That Apply, Ordered Response)
● 90-minute time limit
● Focus on application and clinical judgment
● NCLEX-style questions with Hondros-specific emphasis
● Requires 75% or higher to pass
Introduction
This Hondros NURS 212 Exam 1 study guide for the 2026/2027 academic cycle reflects the current
Hondros College of Nursing curriculum and testing blueprint. The examination evaluates nursing
knowledge and clinical judgment in caring for adult patients with cardiovascular, respiratory, and
endocrine disorders, as well as foundational concepts in fluid/electrolyte balance and perioperative care.
Content integrates pathophysiology, pharmacology, nursing interventions, and patient education required
for safe, competent practice as a professional nurse.
Answer Format
All correct answers must be presented in bold and green, followed by clearly defined, clinically focused
rationales that reinforce safe nursing practice, pharmacological principles, and evidence-based
interventions aligned with Hondros nursing curriculum standards.
Table of Contents (Sections)
1. Cardiovascular Disorders (CV)
2. Respiratory Disorders (Resp)
3. Endocrine Disorders (Endo)
4. Fluid/Electrolyte & Acid-Base
5. Perioperative & Pain Management
Cardiovascular Disorders (CV)
,1. A nurse is caring for a patient admitted with acute decompensated heart failure (ADHF)
exhibiting bilateral crackles, pulmonary congestion, and peripheral edema. Which
combination of medications should the nurse anticipate administering to decrease preload
and afterload? (Select all that apply.)
● A. Furosemide and Nitroglycerin
● B. Dobutamine and Metoprolol
● C. Digoxin and Spironolactone
● D. Hydrochlorothiazide and Lisinopril
● E. IV Vasopressin
A. Furosemide and Nitroglycerin, D. Hydrochlorothiazide and Lisinopril
Rationale: In ADHF management, the primary goals are reducing volume overload (preload) and
decreasing systemic vascular resistance (afterload). Furosemide (Loop Diuretic) reduces preload by
promoting diuresis. Nitroglycerin (Venodilator) reduces preload and decreases afterload. Lisinopril (ACE
Inhibitor) is essential for long-term management, decreasing afterload and preload. Hydrochlorothiazide
(Thiazide Diuretic) assists with preload reduction. Dobutamine (B) is an inotrope used for low cardiac
output, not primarily for preload/afterload reduction in congestion. Spironolactone (C) is
potassium-sparing, used for moderate-severe HF, but not the primary acute preload reducer like
furosemide.
2. A 68-year-old patient with a history of atrial fibrillation (AFib) has a prescribed heart
rate control regimen. Which finding necessitates immediate intervention by the nurse?
● A. Patient reports slight fatigue after walking up one flight of stairs.
● B. Diltiazem is prescribed to be given every 6 hours.
● C. Heart rate noted on ECG rhythm strip is 115 beats/minute.
● D. Potassium level is 3.0 mEq/L.
D. Potassium level is 3.0 mEq/L.
Rationale: Atrial fibrillation management often involves rate-control medications like Diltiazem (a
calcium channel blocker). However, hypokalemia (K+ 3.0 mEq/L) significantly increases the risk of
ventricular dysrhythmias, particularly in a patient whose heart is already predisposed to irritability due to
AFib. While a rate of 115 (C) needs monitoring and potential rate adjustment, electrolyte imbalance is a
more immediate life threat. Fatigue (A) is common in chronic AFib.
3. A nurse is teaching a patient about their new prescription for Metoprolol, a selective
beta-blocker, for hypertension. Which statement by the patient indicates proper
understanding?
● A. "I should hold this medication if my heart rate drops below 60 beats/minute."
● B. ";I should take this medication with grapefruit juice to enhance absorption."
● C. "This medicine will increase my heart rate and blood pressure."
● D. "I should not stop taking this suddenly due to risk of rebound angina."
A. "I should hold this medication if my heart rate drops below 60 beats/minute."
Rationale: Metoprolol decreases heart rate and contractility. The nurse should teach the patient to hold
the dose and notify the provider if the apical pulse (or HR) is less than 60 beats/minute (per institutional
protocol, often 50-60 bpm). Grapefruit juice interaction is associated with some calcium channel blockers,
not typically metoprolol (though interactions should always be checked). Beta-blockers decrease HR/BP,
,and abrupt cessation can cause rebound hypertension/angina (D), but holding for bradycardia (A) is the
most immediate safety instruction related to dosage administration.
4. A patient returns to the chest pain clinic 2 weeks after being discharged following an MI
managed with PCI and stent placement. The patient reports experiencing shortness of
breath and sharp chest pain only when walking up stairs, which resolves within 5 minutes
of rest. This finding is best described as:
● A. Unstable angina.
● B. Variant (Prinzmetal's) angina.
● C. Stable angina.
● D. Post-MI pericarditis.
C. Stable angina.
Rationale: Stable angina is characterized by predictable chest pain occurring with exertion or emotional
stress, which is relieved promptly by rest or nitroglycerin. Since this pain resolves reliably with rest after
exertion, it fits the definition of stable angina, despite the recent MI history. Unstable angina (A) occurs at
rest or with minimal exertion and is unpredictable. Variant angina (B) is caused by coronary artery spasm.
Post-MI pericarditis (D) usually presents as sharp pain worse on inspiration and improved by leaning
forward.
5. During immediate post-STEMI care, the nurse monitors the ECG strip. Which
dysrhythmia is the most common life-threatening complication in the first 24-48 hours
post-MI?
● A. Sinus Bradycardia
● B. Atrial Fibrillation
● C. Ventricular Fibrillation (VF)
● D. Wandering Atrial Pacemaker
C. Ventricular Fibrillation (VF)
Rationale: Ventricular Fibrillation (VF) is the most common cause of sudden cardiac death following an
MI, typically occurring in the initial hours due to myocardial irritability from ischemia or infarction. Sinus
Bradycardia (A) can occur but is less immediately life-threatening unless severe or symptomatic. Atrial
Fibrillation (B) is common but carries lower immediate mortality risk than VF.
6. A patient is prescribed 81 mg of Aspirin daily for CAD prevention. The patient states they
occasionally forget a dose. What is the nurse's best teaching intervention regarding
antiplatelet therapy?
● A. Take two doses the next day to make up for the missed dose.
● B. Stop taking the aspirin immediately if they notice any bruising.
● C. Take the missed dose as soon as remembered, unless it is almost time for the next dose.
● D. The prescribed dose is a therapeutic dose for pain relief, not prevention.
C. Take the missed dose as soon as remembered, unless it is almost time for the next dose.
Rationale: For once-daily medications like low-dose aspirin (used for antiplatelet effects), the standard
missed dose instruction is to take it when remembered unless it is close to the next scheduled dose, in
which case the missed dose is skipped. Doubling up (A) increases the risk of bleeding. Stopping
immediately upon bruising (B) ignores the need for continuous antiplatelet effect; bleeding should be
reported, but aspirin should usually not be stopped without consulting a provider. The 81 mg dose is
specifically for antiplatelet (prevention) effects, not analgesic effect (D).
, 7. Which patient finding is the hallmark sign of left-sided heart failure?
● A. Jugular vein distention (JVD).
● B. Dependent peripheral edema.
● C. Pink, frothy sputum production.
● D. Ascites and hepatomegaly.
C. Pink, frothy sputum production.
Rationale: Left-sided heart failure leads to blood backing up into the pulmonary circulation, causing
increased pulmonary hydrostatic pressure, resulting in fluid leaking into the alveoli. This manifests as
pulmonary congestion, often seen as pink, frothy sputum. JVD (A), dependent edema (B), and
ascites/hepatomegaly (D) are classic signs of right-sided heart failure, resulting from systemic venous
congestion.
8. A patient prescribed Digoxin needs continuous cardiac monitoring. The nurse must hold
the dose and notify the provider if the apical pulse is:
● A. 105 beats/min.
● B. 72 beats/min.
● C. 55 beats/min.
● D. Irregular with frequent premature ventricular contractions (PVCs).
C. 55 beats/min.
Rationale: Digoxin toxicity can cause bradycardia. A common threshold to hold Digoxin is an apical
pulse rate below 60 beats/minute in adults. While PVCs (D) can be a sign of toxicity, bradycardia is the
most concrete, immediate parameter requiring dose suspension.
9. A patient with chronic hypertension is receiving an intravenous infusion of Labetalol
(Normodyne). The nurse understands that this medication primarily exerts its
antihypertensive effect by blocking which receptors?
● A. Alpha-1 and Beta-1 receptors only.
● B. Beta-1 receptors only.
● C. Alpha-1, Beta-1, and Beta-2 receptors.
● D. Alpha-1 and Beta-1 receptors.
D. Alpha-1 and Beta-1 receptors.
Rationale: Labetalol is a unique combination alpha- and beta-blocker. It blocks Alpha-1 receptors
(causing vasodilation) and Beta-1 receptors (decreasing heart rate and contractility). It has minimal
Beta-2 blocking effects, differentiating it from non-selective agents like propranolol.
10. A patient is being evaluated for suspected Coronary Artery Disease (CAD). Which
instruction is essential before the patient undergoes a cardiac catheterization?
● A. Maintain a strict, clear liquid diet for 24 hours prior.
● B. Check iodine and shellfish allergies.
● C. Begin taking Warfarin for prophylactic anticoagulation.
● D. Perform deep breathing exercises every 4 hours pre-procedure.
B. Check iodine and shellfish allergies.
Rationale: Cardiac catheterization requires the use of iodinated contrast dye. Allergy assessment,
particularly to iodine or shellfish (due to chemical similarities), is mandatory before administering
contrast to prevent anaphylactoid reactions. NPO status is required, but usually only for 6-8 hours prior
