NUR 209 Medical-Surgical Nursing II Exam 3
Questions and Answers
(Set 1: Cardiac)
1. A patient with left-sided heart failure is most likely to exhibit which symptom?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion due to impaired left
ventricular function, causing crackles. Peripheral edema and JVD are more typical of right-sided
failure.
2. Which lab value is most critical to monitor in a patient receiving furosemide?
A. Hemoglobin
B. Potassium
C. Calcium
D. Glucose
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, increasing the risk of
arrhythmias.
3. A patient with atrial fibrillation is prescribed warfarin. Which teaching point is
essential?
A. Avoid foods high in vitamin C
B. Maintain consistent intake of vitamin K
C. Increase fluid intake to 3 L/day
D. Take medication only when symptomatic
,Rationale: Vitamin K intake affects warfarin’s effectiveness. Consistency is key to maintaining
therapeutic INR levels.
4. Which intervention is priority for a patient experiencing chest pain unrelieved by
nitroglycerin?
A. Administer morphine
B. Notify the healthcare provider immediately
C. Encourage deep breathing
D. Apply warm compresses
Rationale: Persistent chest pain may indicate myocardial infarction. Immediate provider
notification ensures rapid intervention.
5. A nurse is caring for a patient post-CABG. Which finding requires immediate action?
A. Mild incisional pain
B. Low-grade fever
C. Chest tube output >200 mL/hr
D. Heart rate 88 bpm
Rationale: Excessive chest tube drainage suggests hemorrhage and requires urgent intervention.
Set 2: Respiratory & Renal
6. A patient with COPD is most likely to have which ABG result?
A. pH 7.48, PaCO₂ 30 mmHg
B. pH 7.32, PaCO₂ 55 mmHg
C. pH 7.40, PaCO₂ 40 mmHg
D. pH 7.50, PaCO₂ 28 mmHg
Rationale: COPD causes chronic CO₂ retention, leading to respiratory acidosis.
7. Which nursing intervention is priority during an acute asthma attack?
A. Encourage fluids
,B. Administer short-acting bronchodilator
C. Provide chest physiotherapy
D. Teach pursed-lip breathing
Rationale: Rapid bronchodilation relieves airway obstruction during acute attacks.
8. A patient with pneumonia reports pleuritic chest pain. Which finding supports this
diagnosis?
A. Dull percussion note
B. Crackles in affected lung fields
C. Hyperresonance
D. Decreased tactile fremitus
Rationale: Pneumonia causes alveolar consolidation, producing crackles.
9. Which oxygen delivery device provides the most precise FiO₂?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Rationale: Venturi masks deliver controlled, precise oxygen concentrations.
10. A patient with ARDS is intubated. Which finding requires immediate action?
A. SpO₂ 92%
B. Peak inspiratory pressure suddenly increases
C. Respiratory rate 20/min
D. FiO₂ 40%
Rationale: Rising inspiratory pressures suggest worsening lung compliance or obstruction.
11. Which lab value is most concerning in a patient with chronic kidney disease?
, A. Hemoglobin 12 g/Dl
B. Potassium 6.2 mEq/L
C. Calcium 9.0 mg/dL
D. BUN 25 mg/dL
Rationale: Hyperkalemia can cause life-threatening arrhythmias.
12. A patient on hemodialysis reports muscle cramps. Which electrolyte imbalance is
likely?
A. Hypernatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Rationale: Dialysis can lower calcium, leading to neuromuscular irritability.
13. Which dietary teaching is appropriate for a patient with ESRD?
A. Increase potassium-rich foods
B. Restrict protein intake
C. Liberalize sodium intake
D. Avoid carbohydrates
Rationale: Protein restriction reduces nitrogenous waste accumulation.
14. A patient with nephrotic syndrome is at risk for which complication?
A. Hypoglycemia
B. Infection
C. Hypertension crisis
D. Hyperthyroidism
Rationale: Protein loss in urine reduces immune defenses, increasing infection risk.
Questions and Answers
(Set 1: Cardiac)
1. A patient with left-sided heart failure is most likely to exhibit which symptom?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Hepatomegaly
Rationale: Left-sided heart failure leads to pulmonary congestion due to impaired left
ventricular function, causing crackles. Peripheral edema and JVD are more typical of right-sided
failure.
2. Which lab value is most critical to monitor in a patient receiving furosemide?
A. Hemoglobin
B. Potassium
C. Calcium
D. Glucose
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, increasing the risk of
arrhythmias.
3. A patient with atrial fibrillation is prescribed warfarin. Which teaching point is
essential?
A. Avoid foods high in vitamin C
B. Maintain consistent intake of vitamin K
C. Increase fluid intake to 3 L/day
D. Take medication only when symptomatic
,Rationale: Vitamin K intake affects warfarin’s effectiveness. Consistency is key to maintaining
therapeutic INR levels.
4. Which intervention is priority for a patient experiencing chest pain unrelieved by
nitroglycerin?
A. Administer morphine
B. Notify the healthcare provider immediately
C. Encourage deep breathing
D. Apply warm compresses
Rationale: Persistent chest pain may indicate myocardial infarction. Immediate provider
notification ensures rapid intervention.
5. A nurse is caring for a patient post-CABG. Which finding requires immediate action?
A. Mild incisional pain
B. Low-grade fever
C. Chest tube output >200 mL/hr
D. Heart rate 88 bpm
Rationale: Excessive chest tube drainage suggests hemorrhage and requires urgent intervention.
Set 2: Respiratory & Renal
6. A patient with COPD is most likely to have which ABG result?
A. pH 7.48, PaCO₂ 30 mmHg
B. pH 7.32, PaCO₂ 55 mmHg
C. pH 7.40, PaCO₂ 40 mmHg
D. pH 7.50, PaCO₂ 28 mmHg
Rationale: COPD causes chronic CO₂ retention, leading to respiratory acidosis.
7. Which nursing intervention is priority during an acute asthma attack?
A. Encourage fluids
,B. Administer short-acting bronchodilator
C. Provide chest physiotherapy
D. Teach pursed-lip breathing
Rationale: Rapid bronchodilation relieves airway obstruction during acute attacks.
8. A patient with pneumonia reports pleuritic chest pain. Which finding supports this
diagnosis?
A. Dull percussion note
B. Crackles in affected lung fields
C. Hyperresonance
D. Decreased tactile fremitus
Rationale: Pneumonia causes alveolar consolidation, producing crackles.
9. Which oxygen delivery device provides the most precise FiO₂?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Rationale: Venturi masks deliver controlled, precise oxygen concentrations.
10. A patient with ARDS is intubated. Which finding requires immediate action?
A. SpO₂ 92%
B. Peak inspiratory pressure suddenly increases
C. Respiratory rate 20/min
D. FiO₂ 40%
Rationale: Rising inspiratory pressures suggest worsening lung compliance or obstruction.
11. Which lab value is most concerning in a patient with chronic kidney disease?
, A. Hemoglobin 12 g/Dl
B. Potassium 6.2 mEq/L
C. Calcium 9.0 mg/dL
D. BUN 25 mg/dL
Rationale: Hyperkalemia can cause life-threatening arrhythmias.
12. A patient on hemodialysis reports muscle cramps. Which electrolyte imbalance is
likely?
A. Hypernatremia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Rationale: Dialysis can lower calcium, leading to neuromuscular irritability.
13. Which dietary teaching is appropriate for a patient with ESRD?
A. Increase potassium-rich foods
B. Restrict protein intake
C. Liberalize sodium intake
D. Avoid carbohydrates
Rationale: Protein restriction reduces nitrogenous waste accumulation.
14. A patient with nephrotic syndrome is at risk for which complication?
A. Hypoglycemia
B. Infection
C. Hypertension crisis
D. Hyperthyroidism
Rationale: Protein loss in urine reduces immune defenses, increasing infection risk.
