1
NU155/ NU 155 Medical-Surgical Nursing I
Guide Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Cardiovascular Disorders
1. A patient with heart failure reports waking up at night gasping for air. The nurse recognizes
this manifestation as:
A. Orthopnea
B. Dyspnea on exertion
C. Paroxysmal nocturnal dyspnea
D. Crackles
C. Paroxysmal nocturnal dyspnea [CORRECT]
Rationale: Paroxysmal nocturnal dyspnea (PND) occurs when fluid redistributes from the legs
and dependent areas back into the vascular system while lying down, increasing pulmonary
venous pressure and causing sudden shortness of breath a few hours after falling asleep.
2. The nurse is caring for a client receiving digoxin (Lanoxin) for heart failure. Which finding
requires immediate intervention?
A. Heart rate of 68 bpm
B. Serum potassium level of 3.0 mEq/L
C. Blood pressure of 118/76 mmHg
D. Complaint of mild fatigue
B. Serum potassium level of 3.0 mEq/L [CORRECT]
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin competes with potassium
for binding sites; low potassium levels enhance the binding of digoxin to cardiac cells, increasing
the risk of life-threatening dysrhythmias.
,2
3. A patient is admitted with acute decompensated heart failure. Which medication is the
cornerstone of therapy to reduce preload and alleviate symptoms?
A. Metoprolol (Lopressor)
B. Enalapril (Vasotec)
C. Furosemide (Lasix)
D. Digoxin (Lanoxin)
C. Furosemide (Lasix) [CORRECT]
Rationale: Loop diuretics like furosemide are the cornerstone of acute decompensated heart
failure management to rapidly reduce fluid overload (preload), alleviate pulmonary edema, and
improve oxygenation.
4. When teaching a patient about angina pectoris, the nurse explains that stable angina is
typically:
A. Relieved by rest and nitroglycerin
B. Precipitated by minimal exertion or at rest
C. Characterized by prolonged pain lasting over 20 minutes
D. Unresponsive to nitroglycerin
A. Relieved by rest and nitroglycerin [CORRECT]
Rationale: Stable angina is chest pain that occurs with a predictable amount of exertion or stress
and is relieved by rest or nitroglycerin. Unstable angina occurs at rest, is more severe, and is not
easily relieved.
5. A client presents to the Emergency Department with chest pain. The nurse anticipates the
physician will order which medication regimen immediately (MONA)?
A. Morphine, Oxygen, Nitroglycerin, Aspirin
B. Metoprolol, Ondansetron, Naloxone, Atenolol
C. Magnesium, Omeprazole, Niacin, Atorvastatin
D. Milrinone, Nitroprusside, Amiodarone, Aspirin
A. Morphine, Oxygen, Nitroglycerin, Aspirin [CORRECT]
,3
Rationale: MONA is the standard mnemonic for the initial management of acute coronary
syndrome (MI). Morphine reduces pain and anxiety, Oxygen improves oxygenation,
Nitroglycerin vasodilates coronary arteries, and Aspirin inhibits platelet aggregation.
6. The nurse is monitoring a patient post-myocardial infarction for signs of left-sided heart
failure. Which assessment finding is most indicative of this complication?
A. Hepatomegaly
B. Jugular vein distention (JVD)
C. Bilateral crackles in the lung bases
D. Dependent edema in the lower extremities
C. Bilateral crackles in the lung bases [CORRECT]
Rationale: Left-sided heart failure causes backup of blood into the left atrium and pulmonary
veins, leading to pulmonary congestion and edema, manifested as crackles. The other options are
signs of right-sided heart failure.
7. A patient with hypertension is prescribed Losartan (Cozaar). The nurse explains that this
medication works by:
A. Blocking the conversion of angiotensin I to angiotensin II
B. Inhibiting the reabsorption of sodium in the kidneys
C. Blocking angiotensin II receptors
D. Reducing sympathetic nervous system activity
C. Blocking angiotensin II receptors [CORRECT]
Rationale: Losartan is an Angiotensin II Receptor Blocker (ARB). It prevents angiotensin II from
binding to its receptors, causing vasodilation and reduced aldosterone secretion, lowering blood
pressure.
8. Which client is at highest risk for developing secondary hypertension?
A. A 30-year-old with a family history of HTN
B. A 50-year-old with obstructive sleep apnea
C. A 45-year-old who smokes cigarettes
, 4
D. A 25-year-old with a high-sodium diet
B. A 50-year-old with obstructive sleep apnea [CORRECT]
Rationale: Secondary hypertension has a specific identifiable cause. Obstructive sleep apnea is a
common cause of secondary hypertension due to intermittent hypoxia and increased sympathetic
activity. The other options contribute to essential (primary) hypertension.
9. The nurse observes ventricular fibrillation (VF) on a client's cardiac monitor. What is the
priority action?
A. Administer amiodarone IV push
B. Check for a pulse and begin CPR
C. Prepare for synchronized cardioversion
D. Administer atropine IV push
B. Check for a pulse and begin CPR [CORRECT]
Rationale: VF is a lethal arrhythmia resulting in no cardiac output. The immediate priority is to
confirm pulselessness and initiate CPR (starting with compressions) followed by defibrillation as
soon as possible.
10. A patient with atrial fibrillation is prescribed warfarin (Coumadin). The nurse must teach the
patient to avoid which food high in Vitamin K?
A. Oranges
B. Spinach
C. Cheese
D. Eggs
B. Spinach [CORRECT]
Rationale: Vitamin K aids in the synthesis of clotting factors and antagonizes the effects of
warfarin. Dark leafy green vegetables like spinach are high in Vitamin K and can decrease the
INR, increasing the risk of clot formation.
11. A patient with peripheral artery disease (PAD) complains of leg pain when walking. The
nurse documents this as:
NU155/ NU 155 Medical-Surgical Nursing I
Guide Actual Exam 2026/2027 – Complete Exam-
Style Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Cardiovascular Disorders
1. A patient with heart failure reports waking up at night gasping for air. The nurse recognizes
this manifestation as:
A. Orthopnea
B. Dyspnea on exertion
C. Paroxysmal nocturnal dyspnea
D. Crackles
C. Paroxysmal nocturnal dyspnea [CORRECT]
Rationale: Paroxysmal nocturnal dyspnea (PND) occurs when fluid redistributes from the legs
and dependent areas back into the vascular system while lying down, increasing pulmonary
venous pressure and causing sudden shortness of breath a few hours after falling asleep.
2. The nurse is caring for a client receiving digoxin (Lanoxin) for heart failure. Which finding
requires immediate intervention?
A. Heart rate of 68 bpm
B. Serum potassium level of 3.0 mEq/L
C. Blood pressure of 118/76 mmHg
D. Complaint of mild fatigue
B. Serum potassium level of 3.0 mEq/L [CORRECT]
Rationale: Hypokalemia increases the risk of digoxin toxicity. Digoxin competes with potassium
for binding sites; low potassium levels enhance the binding of digoxin to cardiac cells, increasing
the risk of life-threatening dysrhythmias.
,2
3. A patient is admitted with acute decompensated heart failure. Which medication is the
cornerstone of therapy to reduce preload and alleviate symptoms?
A. Metoprolol (Lopressor)
B. Enalapril (Vasotec)
C. Furosemide (Lasix)
D. Digoxin (Lanoxin)
C. Furosemide (Lasix) [CORRECT]
Rationale: Loop diuretics like furosemide are the cornerstone of acute decompensated heart
failure management to rapidly reduce fluid overload (preload), alleviate pulmonary edema, and
improve oxygenation.
4. When teaching a patient about angina pectoris, the nurse explains that stable angina is
typically:
A. Relieved by rest and nitroglycerin
B. Precipitated by minimal exertion or at rest
C. Characterized by prolonged pain lasting over 20 minutes
D. Unresponsive to nitroglycerin
A. Relieved by rest and nitroglycerin [CORRECT]
Rationale: Stable angina is chest pain that occurs with a predictable amount of exertion or stress
and is relieved by rest or nitroglycerin. Unstable angina occurs at rest, is more severe, and is not
easily relieved.
5. A client presents to the Emergency Department with chest pain. The nurse anticipates the
physician will order which medication regimen immediately (MONA)?
A. Morphine, Oxygen, Nitroglycerin, Aspirin
B. Metoprolol, Ondansetron, Naloxone, Atenolol
C. Magnesium, Omeprazole, Niacin, Atorvastatin
D. Milrinone, Nitroprusside, Amiodarone, Aspirin
A. Morphine, Oxygen, Nitroglycerin, Aspirin [CORRECT]
,3
Rationale: MONA is the standard mnemonic for the initial management of acute coronary
syndrome (MI). Morphine reduces pain and anxiety, Oxygen improves oxygenation,
Nitroglycerin vasodilates coronary arteries, and Aspirin inhibits platelet aggregation.
6. The nurse is monitoring a patient post-myocardial infarction for signs of left-sided heart
failure. Which assessment finding is most indicative of this complication?
A. Hepatomegaly
B. Jugular vein distention (JVD)
C. Bilateral crackles in the lung bases
D. Dependent edema in the lower extremities
C. Bilateral crackles in the lung bases [CORRECT]
Rationale: Left-sided heart failure causes backup of blood into the left atrium and pulmonary
veins, leading to pulmonary congestion and edema, manifested as crackles. The other options are
signs of right-sided heart failure.
7. A patient with hypertension is prescribed Losartan (Cozaar). The nurse explains that this
medication works by:
A. Blocking the conversion of angiotensin I to angiotensin II
B. Inhibiting the reabsorption of sodium in the kidneys
C. Blocking angiotensin II receptors
D. Reducing sympathetic nervous system activity
C. Blocking angiotensin II receptors [CORRECT]
Rationale: Losartan is an Angiotensin II Receptor Blocker (ARB). It prevents angiotensin II from
binding to its receptors, causing vasodilation and reduced aldosterone secretion, lowering blood
pressure.
8. Which client is at highest risk for developing secondary hypertension?
A. A 30-year-old with a family history of HTN
B. A 50-year-old with obstructive sleep apnea
C. A 45-year-old who smokes cigarettes
, 4
D. A 25-year-old with a high-sodium diet
B. A 50-year-old with obstructive sleep apnea [CORRECT]
Rationale: Secondary hypertension has a specific identifiable cause. Obstructive sleep apnea is a
common cause of secondary hypertension due to intermittent hypoxia and increased sympathetic
activity. The other options contribute to essential (primary) hypertension.
9. The nurse observes ventricular fibrillation (VF) on a client's cardiac monitor. What is the
priority action?
A. Administer amiodarone IV push
B. Check for a pulse and begin CPR
C. Prepare for synchronized cardioversion
D. Administer atropine IV push
B. Check for a pulse and begin CPR [CORRECT]
Rationale: VF is a lethal arrhythmia resulting in no cardiac output. The immediate priority is to
confirm pulselessness and initiate CPR (starting with compressions) followed by defibrillation as
soon as possible.
10. A patient with atrial fibrillation is prescribed warfarin (Coumadin). The nurse must teach the
patient to avoid which food high in Vitamin K?
A. Oranges
B. Spinach
C. Cheese
D. Eggs
B. Spinach [CORRECT]
Rationale: Vitamin K aids in the synthesis of clotting factors and antagonizes the effects of
warfarin. Dark leafy green vegetables like spinach are high in Vitamin K and can decrease the
INR, increasing the risk of clot formation.
11. A patient with peripheral artery disease (PAD) complains of leg pain when walking. The
nurse documents this as:
