NUR 265 Exam 3 Version 1 and 2 New
| Actual Questions and Answers | 2026
Update | 100% Correct - Galen
College of Nursing
1. A patient with heart failure has crackles, jugular vein distention, and 3+ edema. Which finding
requires the MOST immediate action?
A. Weight gain of 2 lb in one week
B. Crackles in bilateral lung bases
C. Potassium level of 3.6 mEq/L
D. Fatigue with activity
Answer: B
Rationale: Crackles indicate pulmonary congestion and impaired gas exchange, which is
immediately life-threatening.
2. Which medication reduces preload in a patient with acute heart failure?
A. Metoprolol
B. Furosemide
C. Digoxin
D. Lisinopril
Answer: B
Rationale: Loop diuretics decrease circulating volume, reducing preload and pulmonary
congestion.
3. A patient with atrial fibrillation is at greatest risk for:
A. Bradycardia
B. Stroke
C. Myocardial infarction
D. Ventricular tachycardia
Answer: B
Rationale: Atrial fibrillation promotes clot formation in the atria, increasing stroke risk.
,4. Which assessment finding suggests worsening left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Crackles
D. Jugular vein distention
Answer: C
Rationale: Left-sided failure leads to pulmonary congestion and crackles.
5. The nurse should hold digoxin if which lab value is present?
A. Potassium 4.2 mEq/L
B. Heart rate 52 bpm
C. Sodium 138 mEq/L
D. Blood pressure 130/84 mmHg
Answer: B
Rationale: Digoxin can cause bradycardia; heart rate below 60 requires holding the dose.
6. Which symptom is MOST concerning in a patient with acute coronary syndrome?
A. Nausea
B. Diaphoresis
C. Chest pain radiating to the left arm
D. Fatigue
Answer: C
Rationale: Radiating chest pain is a classic sign of myocardial ischemia.
7. A patient receiving heparin therapy should be monitored for which lab value?
A. INR
B. Platelets
C. aPTT
D. Hemoglobin A1c
Answer: C
Rationale: aPTT measures therapeutic effectiveness of heparin.
8. Which patient is at highest risk for hypertension complications?
A. 22-year-old athlete
, B. Patient with diabetes
C. Patient with BMI of 24
D. Patient who exercises daily
Answer: B
Rationale: Diabetes significantly increases cardiovascular risk.
9. Which intervention improves cardiac output?
A. Decreasing preload
B. Increasing afterload
C. Increasing heart rate excessively
D. Improving contractility
Answer: D
Rationale: Improved myocardial contractility increases cardiac output.
10. The nurse suspects cardiogenic shock when the patient exhibits:
A. Hypertension and bradycardia
B. Hypotension and cool clammy skin
C. Fever and tachypnea
D. Bounding pulses
Answer: B
Rationale: Cardiogenic shock causes poor tissue perfusion and hypotension.
Questions 11–25: Respiratory
11. Which finding indicates respiratory distress?
A. RR 12
B. SpO₂ 95%
C. Use of accessory muscles
D. Clear breath sounds
Answer: C
Rationale: Accessory muscle use signals increased work of breathing.
12. A patient with COPD should receive oxygen to maintain SpO₂ at:
A. 88–92%
| Actual Questions and Answers | 2026
Update | 100% Correct - Galen
College of Nursing
1. A patient with heart failure has crackles, jugular vein distention, and 3+ edema. Which finding
requires the MOST immediate action?
A. Weight gain of 2 lb in one week
B. Crackles in bilateral lung bases
C. Potassium level of 3.6 mEq/L
D. Fatigue with activity
Answer: B
Rationale: Crackles indicate pulmonary congestion and impaired gas exchange, which is
immediately life-threatening.
2. Which medication reduces preload in a patient with acute heart failure?
A. Metoprolol
B. Furosemide
C. Digoxin
D. Lisinopril
Answer: B
Rationale: Loop diuretics decrease circulating volume, reducing preload and pulmonary
congestion.
3. A patient with atrial fibrillation is at greatest risk for:
A. Bradycardia
B. Stroke
C. Myocardial infarction
D. Ventricular tachycardia
Answer: B
Rationale: Atrial fibrillation promotes clot formation in the atria, increasing stroke risk.
,4. Which assessment finding suggests worsening left-sided heart failure?
A. Peripheral edema
B. Ascites
C. Crackles
D. Jugular vein distention
Answer: C
Rationale: Left-sided failure leads to pulmonary congestion and crackles.
5. The nurse should hold digoxin if which lab value is present?
A. Potassium 4.2 mEq/L
B. Heart rate 52 bpm
C. Sodium 138 mEq/L
D. Blood pressure 130/84 mmHg
Answer: B
Rationale: Digoxin can cause bradycardia; heart rate below 60 requires holding the dose.
6. Which symptom is MOST concerning in a patient with acute coronary syndrome?
A. Nausea
B. Diaphoresis
C. Chest pain radiating to the left arm
D. Fatigue
Answer: C
Rationale: Radiating chest pain is a classic sign of myocardial ischemia.
7. A patient receiving heparin therapy should be monitored for which lab value?
A. INR
B. Platelets
C. aPTT
D. Hemoglobin A1c
Answer: C
Rationale: aPTT measures therapeutic effectiveness of heparin.
8. Which patient is at highest risk for hypertension complications?
A. 22-year-old athlete
, B. Patient with diabetes
C. Patient with BMI of 24
D. Patient who exercises daily
Answer: B
Rationale: Diabetes significantly increases cardiovascular risk.
9. Which intervention improves cardiac output?
A. Decreasing preload
B. Increasing afterload
C. Increasing heart rate excessively
D. Improving contractility
Answer: D
Rationale: Improved myocardial contractility increases cardiac output.
10. The nurse suspects cardiogenic shock when the patient exhibits:
A. Hypertension and bradycardia
B. Hypotension and cool clammy skin
C. Fever and tachypnea
D. Bounding pulses
Answer: B
Rationale: Cardiogenic shock causes poor tissue perfusion and hypotension.
Questions 11–25: Respiratory
11. Which finding indicates respiratory distress?
A. RR 12
B. SpO₂ 95%
C. Use of accessory muscles
D. Clear breath sounds
Answer: C
Rationale: Accessory muscle use signals increased work of breathing.
12. A patient with COPD should receive oxygen to maintain SpO₂ at:
A. 88–92%
