NUR 6121 EXAM 2 2026 – VERIFIED Q&A
WITH RATIONALES | WPU STUDY GUIDE
• This verified Q&A study guide is designed to help you master exam content
through active recall — read each question, attempt an answer before looking, then
review the EXPERT RATIONALE to reinforce understanding.
• Each item includes five clearly labeled options, a highlighted correct answer, and
a detailed EXPERT RATIONALE to build clinical reasoning, not just memorization.
1. A patient presents with crushing chest pain radiating to the left arm,
diaphoresis, and nausea. Which of the following is the priority nursing
intervention?
A. Administer oral aspirin and reassess in 30 minutes
B. Obtain a 12-lead ECG and notify the physician immediately
C. Place the patient in Trendelenburg position and apply oxygen
D. Draw cardiac enzymes and wait for results before acting
E. Administer nitroglycerin and discharge the patient
✓ Correct Answer: B. Obtain a 12-lead ECG and notify the physician
immediately EXPERT RATIONALE: These are classic signs of acute myocardial
infarction. A 12-lead ECG confirms ischemia and guides immediate treatment. Early
identification and physician notification is the priority to initiate reperfusion therapy
within the golden hour.
2. Which cardiac enzyme is considered the most specific and sensitive
biomarker for myocardial infarction?
A. Creatine kinase (CK-MB)
B. Lactate dehydrogenase (LDH)
C. Myoglobin
D. Troponin I
,E. Aspartate aminotransferase (AST)
✓ Correct Answer: D. Troponin I EXPERT RATIONALE: Troponin I is highly specific
to cardiac muscle and rises within 3–6 hours of myocardial injury, remaining
elevated for up to 10 days. It is the gold standard biomarker for diagnosing AMI.
3. A nurse is caring for a patient with heart failure. Which finding indicates
worsening of the condition?
A. Urine output of 60 mL/hour
B. Blood pressure of 118/76 mmHg
C. Weight gain of 3 pounds in 2 days
D. SpO₂ of 97% on room air
E. Clear bilateral lung sounds
✓ Correct Answer: C. Weight gain of 3 pounds in 2 days EXPERT RATIONALE:
Rapid weight gain in heart failure patients indicates fluid retention and worsening
congestion. A gain of 2–3 pounds in 24–48 hours warrants immediate medical
attention as it reflects decompensation.
4. Which of the following medications is a first-line treatment for
hypertension in a patient with diabetes and chronic kidney disease?
A. Calcium channel blocker
B. Beta-blocker
C. ACE inhibitor
D. Loop diuretic
E. Alpha-blocker
✓ Correct Answer: C. ACE inhibitor EXPERT RATIONALE: ACE inhibitors reduce
intraglomerular pressure and proteinuria, providing both antihypertensive and
,renoprotective effects in diabetic and CKD patients. They are the standard of care in
this population.
5. A patient with atrial fibrillation is started on warfarin. Which laboratory
value is used to monitor therapeutic efficacy?
A. Partial thromboplastin time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
E. Fibrinogen level
✓ Correct Answer: C. International Normalized Ratio (INR) EXPERT RATIONALE:
INR is standardized to monitor warfarin therapy. For atrial fibrillation, a therapeutic
INR range of 2.0–3.0 reduces thromboembolic risk while minimizing bleeding
complications.
6. Which of the following is a classic sign of right-sided heart failure?
A. Pulmonary edema
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Jugular venous distension (JVD)
E. S3 gallop heart sound
✓ Correct Answer: D. Jugular venous distension (JVD) EXPERT RATIONALE:
Right-sided heart failure leads to systemic venous congestion. Increased venous
pressure causes JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary
edema and orthopnea are hallmarks of left-sided failure.
, 7. A nurse is assessing a patient with suspected deep vein thrombosis (DVT).
Which clinical test involves dorsiflexion of the foot to assess for calf pain?
A. Homan's sign
B. McMurray's test
C. Trendelenburg test
D. Allen test
E. Romberg test
✓ Correct Answer: A. Homan's sign EXPERT RATIONALE: Homan's sign involves
dorsiflexion of the foot with the knee slightly flexed; pain in the calf may suggest
DVT. However, it has low sensitivity and specificity and should be used alongside
Doppler ultrasound.
8. Which of the following rhythms on an ECG is characterized by absent P
waves and an irregularly irregular ventricular rate?
A. Ventricular tachycardia
B. Sinus bradycardia
C. Atrial fibrillation
D. Second-degree AV block
E. Junctional rhythm
✓ Correct Answer: C. Atrial fibrillation EXPERT RATIONALE: Atrial fibrillation
results from disorganized atrial electrical activity, causing absent identifiable P
waves and an irregularly irregular ventricular response. It significantly increases the
risk of stroke and systemic embolism.
9. A patient receiving IV heparin has a PTT of 220 seconds. What is the priority
nursing action?
A. Continue the infusion at the same rate
WITH RATIONALES | WPU STUDY GUIDE
• This verified Q&A study guide is designed to help you master exam content
through active recall — read each question, attempt an answer before looking, then
review the EXPERT RATIONALE to reinforce understanding.
• Each item includes five clearly labeled options, a highlighted correct answer, and
a detailed EXPERT RATIONALE to build clinical reasoning, not just memorization.
1. A patient presents with crushing chest pain radiating to the left arm,
diaphoresis, and nausea. Which of the following is the priority nursing
intervention?
A. Administer oral aspirin and reassess in 30 minutes
B. Obtain a 12-lead ECG and notify the physician immediately
C. Place the patient in Trendelenburg position and apply oxygen
D. Draw cardiac enzymes and wait for results before acting
E. Administer nitroglycerin and discharge the patient
✓ Correct Answer: B. Obtain a 12-lead ECG and notify the physician
immediately EXPERT RATIONALE: These are classic signs of acute myocardial
infarction. A 12-lead ECG confirms ischemia and guides immediate treatment. Early
identification and physician notification is the priority to initiate reperfusion therapy
within the golden hour.
2. Which cardiac enzyme is considered the most specific and sensitive
biomarker for myocardial infarction?
A. Creatine kinase (CK-MB)
B. Lactate dehydrogenase (LDH)
C. Myoglobin
D. Troponin I
,E. Aspartate aminotransferase (AST)
✓ Correct Answer: D. Troponin I EXPERT RATIONALE: Troponin I is highly specific
to cardiac muscle and rises within 3–6 hours of myocardial injury, remaining
elevated for up to 10 days. It is the gold standard biomarker for diagnosing AMI.
3. A nurse is caring for a patient with heart failure. Which finding indicates
worsening of the condition?
A. Urine output of 60 mL/hour
B. Blood pressure of 118/76 mmHg
C. Weight gain of 3 pounds in 2 days
D. SpO₂ of 97% on room air
E. Clear bilateral lung sounds
✓ Correct Answer: C. Weight gain of 3 pounds in 2 days EXPERT RATIONALE:
Rapid weight gain in heart failure patients indicates fluid retention and worsening
congestion. A gain of 2–3 pounds in 24–48 hours warrants immediate medical
attention as it reflects decompensation.
4. Which of the following medications is a first-line treatment for
hypertension in a patient with diabetes and chronic kidney disease?
A. Calcium channel blocker
B. Beta-blocker
C. ACE inhibitor
D. Loop diuretic
E. Alpha-blocker
✓ Correct Answer: C. ACE inhibitor EXPERT RATIONALE: ACE inhibitors reduce
intraglomerular pressure and proteinuria, providing both antihypertensive and
,renoprotective effects in diabetic and CKD patients. They are the standard of care in
this population.
5. A patient with atrial fibrillation is started on warfarin. Which laboratory
value is used to monitor therapeutic efficacy?
A. Partial thromboplastin time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
E. Fibrinogen level
✓ Correct Answer: C. International Normalized Ratio (INR) EXPERT RATIONALE:
INR is standardized to monitor warfarin therapy. For atrial fibrillation, a therapeutic
INR range of 2.0–3.0 reduces thromboembolic risk while minimizing bleeding
complications.
6. Which of the following is a classic sign of right-sided heart failure?
A. Pulmonary edema
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Jugular venous distension (JVD)
E. S3 gallop heart sound
✓ Correct Answer: D. Jugular venous distension (JVD) EXPERT RATIONALE:
Right-sided heart failure leads to systemic venous congestion. Increased venous
pressure causes JVD, peripheral edema, hepatomegaly, and ascites. Pulmonary
edema and orthopnea are hallmarks of left-sided failure.
, 7. A nurse is assessing a patient with suspected deep vein thrombosis (DVT).
Which clinical test involves dorsiflexion of the foot to assess for calf pain?
A. Homan's sign
B. McMurray's test
C. Trendelenburg test
D. Allen test
E. Romberg test
✓ Correct Answer: A. Homan's sign EXPERT RATIONALE: Homan's sign involves
dorsiflexion of the foot with the knee slightly flexed; pain in the calf may suggest
DVT. However, it has low sensitivity and specificity and should be used alongside
Doppler ultrasound.
8. Which of the following rhythms on an ECG is characterized by absent P
waves and an irregularly irregular ventricular rate?
A. Ventricular tachycardia
B. Sinus bradycardia
C. Atrial fibrillation
D. Second-degree AV block
E. Junctional rhythm
✓ Correct Answer: C. Atrial fibrillation EXPERT RATIONALE: Atrial fibrillation
results from disorganized atrial electrical activity, causing absent identifiable P
waves and an irregularly irregular ventricular response. It significantly increases the
risk of stroke and systemic embolism.
9. A patient receiving IV heparin has a PTT of 220 seconds. What is the priority
nursing action?
A. Continue the infusion at the same rate
