NUR 355 Exam 3: Acute & Chronic Health Disruptions in
Adults I V2 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A patient with left-sided heart failure presents with increasing shortness of breath. Which lung sound is
most commonly associated with this condition?
A. Absent breath sounds
B. Stridor
C. Wheezing
D. Crackles
Ans: D
Explanation: Left-sided heart failure leads to pulmonary congestion and fluid accumulation in the
alveoli. Crackles are typical during auscultation as air moves through this fluid. This occurs because the
left ventricle cannot pump effectively, causing pressure to back up into the lungs. Nurses must assess
respiratory status frequently to detect early signs of worsening edema. Managing fluid overload is critical
to improving oxygenation for these patients.
2. Which clinical manifestation is a hallmark sign of right-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
C. Orthopnea
D. Pulmonary edema
Ans: A
,Explanation: Right-sided heart failure results in systemic venous congestion and fluid backup into the
body. Peripheral edema is a primary finding due to increased hydrostatic pressure in the systemic
circulation. Patients may also exhibit jugular venous distention and hepatomegaly as fluid accumulates.
This differs from left-sided failure, which primarily impacts the pulmonary system. Monitoring daily
weights is the most accurate way to track fluid retention in these clients.
3. A patient is prescribed Digoxin for heart failure. Which laboratory value should the nurse monitor most
closely to prevent toxicity?
A. Potassium
B. Calcium
C. Sodium
D. Chloride
Ans: A
Explanation: Hypokalemia significantly increases the risk of digoxin toxicity because potassium and
digoxin compete for binding sites. When potassium levels are low, more digoxin can bind to the sodium-
potassium ATPase pump. Nurses must monitor for signs of toxicity like visual disturbances or nausea.
Maintaining a normal potassium range is vital for patient safety while on this medication. Patients on
diuretics are at an even higher risk for this dangerous electrolyte imbalance.
4. Which of the following is the priority intervention for a patient experiencing an acute asthma attack?
A. Administering a short-acting beta agonist (SABA)
B. Starting intravenous corticosteroids
C. Administering a long-acting beta agonist (LABA)
D. Performing chest physiotherapy
, Ans: A
Explanation: Short-acting beta agonists serve as the primary rescue medication for acute bronchospasm.
These drugs work quickly to relax smooth muscle in the airways and improve airflow. Albuterol is the
most common example used in emergency respiratory situations. LABAs are not appropriate for acute
attacks because they have a slower onset of action. Nurses should assess breath sounds before and after
administration to evaluate effectiveness.
5. In a patient with Chronic Obstructive Pulmonary Disease (COPD), what is the primary drive for breathing?
A. Low oxygen levels
B. Elevated carbon dioxide levels
C. High blood pH
D. Low bicarbonate levels
Ans: A
Explanation: Patients with chronic COPD often become insensitive to high levels of carbon dioxide over
time. Consequently, their respiratory drive shifts to being triggered by low oxygen levels, known as
hypoxic drive. Giving high concentrations of oxygen can potentially suppress this drive and cause
respiratory arrest. Nurses should aim for oxygen saturation levels between 88% and 92% in these
patients. Careful monitoring of arterial blood gases is essential when adjusting oxygen therapy.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is considered the gold
standard for confirmation?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
Adults I V2 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A patient with left-sided heart failure presents with increasing shortness of breath. Which lung sound is
most commonly associated with this condition?
A. Absent breath sounds
B. Stridor
C. Wheezing
D. Crackles
Ans: D
Explanation: Left-sided heart failure leads to pulmonary congestion and fluid accumulation in the
alveoli. Crackles are typical during auscultation as air moves through this fluid. This occurs because the
left ventricle cannot pump effectively, causing pressure to back up into the lungs. Nurses must assess
respiratory status frequently to detect early signs of worsening edema. Managing fluid overload is critical
to improving oxygenation for these patients.
2. Which clinical manifestation is a hallmark sign of right-sided heart failure?
A. Peripheral edema
B. Dyspnea on exertion
C. Orthopnea
D. Pulmonary edema
Ans: A
,Explanation: Right-sided heart failure results in systemic venous congestion and fluid backup into the
body. Peripheral edema is a primary finding due to increased hydrostatic pressure in the systemic
circulation. Patients may also exhibit jugular venous distention and hepatomegaly as fluid accumulates.
This differs from left-sided failure, which primarily impacts the pulmonary system. Monitoring daily
weights is the most accurate way to track fluid retention in these clients.
3. A patient is prescribed Digoxin for heart failure. Which laboratory value should the nurse monitor most
closely to prevent toxicity?
A. Potassium
B. Calcium
C. Sodium
D. Chloride
Ans: A
Explanation: Hypokalemia significantly increases the risk of digoxin toxicity because potassium and
digoxin compete for binding sites. When potassium levels are low, more digoxin can bind to the sodium-
potassium ATPase pump. Nurses must monitor for signs of toxicity like visual disturbances or nausea.
Maintaining a normal potassium range is vital for patient safety while on this medication. Patients on
diuretics are at an even higher risk for this dangerous electrolyte imbalance.
4. Which of the following is the priority intervention for a patient experiencing an acute asthma attack?
A. Administering a short-acting beta agonist (SABA)
B. Starting intravenous corticosteroids
C. Administering a long-acting beta agonist (LABA)
D. Performing chest physiotherapy
, Ans: A
Explanation: Short-acting beta agonists serve as the primary rescue medication for acute bronchospasm.
These drugs work quickly to relax smooth muscle in the airways and improve airflow. Albuterol is the
most common example used in emergency respiratory situations. LABAs are not appropriate for acute
attacks because they have a slower onset of action. Nurses should assess breath sounds before and after
administration to evaluate effectiveness.
5. In a patient with Chronic Obstructive Pulmonary Disease (COPD), what is the primary drive for breathing?
A. Low oxygen levels
B. Elevated carbon dioxide levels
C. High blood pH
D. Low bicarbonate levels
Ans: A
Explanation: Patients with chronic COPD often become insensitive to high levels of carbon dioxide over
time. Consequently, their respiratory drive shifts to being triggered by low oxygen levels, known as
hypoxic drive. Giving high concentrations of oxygen can potentially suppress this drive and cause
respiratory arrest. Nurses should aim for oxygen saturation levels between 88% and 92% in these
patients. Careful monitoring of arterial blood gases is essential when adjusting oxygen therapy.
6. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is considered the gold
standard for confirmation?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
