Advanced Pathophysiology & Critical Care Nursing
1. A patient with heart failure is prescribed carvedilol. Which statement
best describes the mechanism of action?
A. Blocks beta-1 and beta-2 adrenergic receptors only
B. Blocks alpha-1, beta-1, and beta-2 adrenergic receptors
C. Selectively blocks beta-1 receptors only
D. Stimulates dopaminergic receptors
✓ Correct Answer: B
2. A nurse is preparing to administer digoxin. Which assessment finding
requires the nurse to hold the medication and notify the provider?
A. Blood pressure of 130/80 mmHg
B. Apical pulse of 56 bpm
C. Serum potassium of 4.0 mEq/L
D. Respiratory rate of 18 breaths/min
✓ Correct Answer: B
3. A patient is prescribed warfarin for atrial fibrillation. Which lab value
does the nurse monitor to assess therapeutic effect?
A. aPTT
B. Platelet count
C. INR
D. Bleeding time
✓ Correct Answer: C
4. A patient receiving heparin infusion develops sudden onset chest pain
and shortness of breath. The nurse suspects heparin-induced
thrombocytopenia (HIT). Which action is priority?
A. Increase the heparin dose
B. Discontinue heparin immediately
C. Administer protamine sulfate
D. Obtain a stat PT/INR
✓ Correct Answer: B
,5. Which medication is the antidote for acetaminophen overdose?
A. Flumazenil
B. Naloxone
C. N-acetylcysteine
D. Atropine
✓ Correct Answer: C
6. A patient is started on lisinopril for hypertension. Which adverse effect
should the nurse teach the patient to report immediately?
A. Mild headache
B. Dry persistent cough
C. Peripheral edema
D. Angioedema
✓ Correct Answer: D
7. A patient with type 2 diabetes is prescribed metformin. Which
contraindication must the nurse assess for before administration?
A. Mild renal impairment (GFR 70)
B. History of hypertension
C. Serum creatinine >1.5 in males
D. Age over 60
✓ Correct Answer: C
8. Which electrolyte imbalance is the nurse most concerned about when a
patient is receiving furosemide (Lasix)?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
✓ Correct Answer: B
9. A patient is receiving IV vancomycin. Which finding indicates Red Man
Syndrome?
A. Bradycardia and hypotension
B. Flushing and erythema of face and upper body
C. Fever and rigors
D. Severe hypertension
✓ Correct Answer: B
,10. Which medication classification requires monitoring of thyroid function
tests as a priority adverse effect?
A. Beta-blockers
B. ACE inhibitors
C. Amiodarone
D. Statins
✓ Correct Answer: C
11. A patient is admitted with ST-elevation myocardial infarction (STEMI).
Which intervention is the priority?
A. Administer oxygen at 2L/min via nasal cannula
B. Achieve percutaneous coronary intervention within 90 minutes
C. Obtain a chest X-ray
D. Insert a Foley catheter
✓ Correct Answer: B
12. A patient in cardiogenic shock will exhibit which hemodynamic pattern?
A. Decreased preload, decreased afterload
B. Decreased cardiac output, increased SVR
C. Increased cardiac output, decreased SVR
D. Normal cardiac output, increased preload
✓ Correct Answer: B
13. Which finding in a patient with left-sided heart failure would the nurse
expect?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary crackles
D. Hepatomegaly
✓ Correct Answer: C
14. A patient's rhythm strip shows a P wave before every QRS, PR interval
of 0.24 seconds, and QRS of 0.08 seconds. The nurse interprets this as:
A. Normal sinus rhythm
B. First-degree AV block
C. Second-degree AV block Type I
D. Third-degree AV block
✓ Correct Answer: B
, 15. A patient with hypertensive crisis has a BP of 220/130. Which
medication would the nurse anticipate administering?
A. Oral metoprolol
B. IV nicardipine
C. Sublingual nifedipine
D. Oral hydralazine
✓ Correct Answer: B
16. A nurse is caring for a patient following a cardiac catheterization via the
femoral artery. Which assessment is priority in the first hour?
A. Urine output monitoring
B. Neurovascular assessment of the affected extremity
C. Blood glucose monitoring
D. Temperature monitoring
✓ Correct Answer: B
17. Which ECG change is associated with hypokalemia?
A. Peaked T waves
B. Widened QRS
C. U waves
D. Shortened QT interval
✓ Correct Answer: C
18. A patient with aortic stenosis would exhibit which classic triad of
symptoms?
A. Chest pain, syncope, dyspnea
B. Fever, murmur, joint pain
C. Palpitations, edema, cough
D. Headache, vision changes, chest tightness
✓ Correct Answer: A
19. During telemetry monitoring, the nurse observes ventricular fibrillation.
The priority action is:
A. Administer amiodarone IV push
B. Call a code and initiate CPR
C. Perform synchronized cardioversion
D. Administer atropine 1 mg IV
✓ Correct Answer: B
1. A patient with heart failure is prescribed carvedilol. Which statement
best describes the mechanism of action?
A. Blocks beta-1 and beta-2 adrenergic receptors only
B. Blocks alpha-1, beta-1, and beta-2 adrenergic receptors
C. Selectively blocks beta-1 receptors only
D. Stimulates dopaminergic receptors
✓ Correct Answer: B
2. A nurse is preparing to administer digoxin. Which assessment finding
requires the nurse to hold the medication and notify the provider?
A. Blood pressure of 130/80 mmHg
B. Apical pulse of 56 bpm
C. Serum potassium of 4.0 mEq/L
D. Respiratory rate of 18 breaths/min
✓ Correct Answer: B
3. A patient is prescribed warfarin for atrial fibrillation. Which lab value
does the nurse monitor to assess therapeutic effect?
A. aPTT
B. Platelet count
C. INR
D. Bleeding time
✓ Correct Answer: C
4. A patient receiving heparin infusion develops sudden onset chest pain
and shortness of breath. The nurse suspects heparin-induced
thrombocytopenia (HIT). Which action is priority?
A. Increase the heparin dose
B. Discontinue heparin immediately
C. Administer protamine sulfate
D. Obtain a stat PT/INR
✓ Correct Answer: B
,5. Which medication is the antidote for acetaminophen overdose?
A. Flumazenil
B. Naloxone
C. N-acetylcysteine
D. Atropine
✓ Correct Answer: C
6. A patient is started on lisinopril for hypertension. Which adverse effect
should the nurse teach the patient to report immediately?
A. Mild headache
B. Dry persistent cough
C. Peripheral edema
D. Angioedema
✓ Correct Answer: D
7. A patient with type 2 diabetes is prescribed metformin. Which
contraindication must the nurse assess for before administration?
A. Mild renal impairment (GFR 70)
B. History of hypertension
C. Serum creatinine >1.5 in males
D. Age over 60
✓ Correct Answer: C
8. Which electrolyte imbalance is the nurse most concerned about when a
patient is receiving furosemide (Lasix)?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
✓ Correct Answer: B
9. A patient is receiving IV vancomycin. Which finding indicates Red Man
Syndrome?
A. Bradycardia and hypotension
B. Flushing and erythema of face and upper body
C. Fever and rigors
D. Severe hypertension
✓ Correct Answer: B
,10. Which medication classification requires monitoring of thyroid function
tests as a priority adverse effect?
A. Beta-blockers
B. ACE inhibitors
C. Amiodarone
D. Statins
✓ Correct Answer: C
11. A patient is admitted with ST-elevation myocardial infarction (STEMI).
Which intervention is the priority?
A. Administer oxygen at 2L/min via nasal cannula
B. Achieve percutaneous coronary intervention within 90 minutes
C. Obtain a chest X-ray
D. Insert a Foley catheter
✓ Correct Answer: B
12. A patient in cardiogenic shock will exhibit which hemodynamic pattern?
A. Decreased preload, decreased afterload
B. Decreased cardiac output, increased SVR
C. Increased cardiac output, decreased SVR
D. Normal cardiac output, increased preload
✓ Correct Answer: B
13. Which finding in a patient with left-sided heart failure would the nurse
expect?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary crackles
D. Hepatomegaly
✓ Correct Answer: C
14. A patient's rhythm strip shows a P wave before every QRS, PR interval
of 0.24 seconds, and QRS of 0.08 seconds. The nurse interprets this as:
A. Normal sinus rhythm
B. First-degree AV block
C. Second-degree AV block Type I
D. Third-degree AV block
✓ Correct Answer: B
, 15. A patient with hypertensive crisis has a BP of 220/130. Which
medication would the nurse anticipate administering?
A. Oral metoprolol
B. IV nicardipine
C. Sublingual nifedipine
D. Oral hydralazine
✓ Correct Answer: B
16. A nurse is caring for a patient following a cardiac catheterization via the
femoral artery. Which assessment is priority in the first hour?
A. Urine output monitoring
B. Neurovascular assessment of the affected extremity
C. Blood glucose monitoring
D. Temperature monitoring
✓ Correct Answer: B
17. Which ECG change is associated with hypokalemia?
A. Peaked T waves
B. Widened QRS
C. U waves
D. Shortened QT interval
✓ Correct Answer: C
18. A patient with aortic stenosis would exhibit which classic triad of
symptoms?
A. Chest pain, syncope, dyspnea
B. Fever, murmur, joint pain
C. Palpitations, edema, cough
D. Headache, vision changes, chest tightness
✓ Correct Answer: A
19. During telemetry monitoring, the nurse observes ventricular fibrillation.
The priority action is:
A. Administer amiodarone IV push
B. Call a code and initiate CPR
C. Perform synchronized cardioversion
D. Administer atropine 1 mg IV
✓ Correct Answer: B
