NUR 220 | NUR 220 Medical Surgical Nursing Exam
2 Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Baltimore
City Community College
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD).
Which clinical finding should the nurse expect?
A. Increased chest expansion
B. Oversized trachea
C. Barrel-shaped chest
D. Decreased lung resonance
Correct Answer: C
Expert Explanation: COPD patients often develop a barrel chest due to chronic air
trapping in the alveoli. This condition results from the long-term hyperinflation of
the lungs over time. The increased anteroposterior diameter is a hallmark
diagnostic physical assessment finding. Other options like increased chest
expansion are incorrect because lung compliance is actually reduced. Nurses should
recognize this visual indicator to assess the severity of obstructive disease.
2. Which laboratory value is most specific for diagnosing a patient with acute heart
failure?
A. Serum Potassium level
,B. Blood Urea Nitrogen (BUN)
C. B-type Natriuretic Peptide (BNP)
D. White Blood Cell count
Correct Answer: C
Expert Explanation: BNP is a hormone secreted by the ventricles in response to
high pressure and volume expansion. It serves as a primary biomarker to
distinguish cardiac causes of dyspnea from respiratory ones. Higher levels of BNP
correlate directly with the severity of heart failure exacerbations. While potassium
and BUN are monitored, they do not confirm the diagnosis of heart failure.
Monitoring BNP helps the nurse evaluate the effectiveness of diuretic therapy over
time.
3. A client with hypertension is prescribed Lisinopril. Which side effect is most
common with this medication?
A. Excessive hair growth
B. Dry, persistent cough
C. Increased heart rate
D. Orange-colored urine
Correct Answer: B
,Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a
nonproductive cough due to bradykinin accumulation. This side effect is a frequent
reason for patients discontinuing the medication in clinical practice. The nurse must
inform the patient that this is a known pharmacological reaction to the drug. If the
cough becomes intolerable, the provider may switch the patient to an ARB.
Assessing the patient’s respiratory status helps differentiate this side effect from
other lung issues.
4. Which oxygen delivery device provides the highest concentration of oxygen for a
spontaneously breathing patient?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Correct Answer: D
Expert Explanation: The non-rebreather mask can deliver oxygen concentrations
between 60% and 90% when fitted properly. It utilizes a reservoir bag and one-way
valves to prevent the inhalation of room air. This device is typically used in
emergency situations where high-flow oxygen is urgently required. The nasal
, cannula and simple mask provide significantly lower percentages of oxygen. Nurses
must ensure the reservoir bag remains inflated to prevent carbon dioxide buildup.
5. A patient is diagnosed with Right-Sided Heart Failure. Which assessment finding
should the nurse expect?
A. Pulmonary edema
B. Jugular Venous Distention (JVD)
C. Dry hacking cough
D. Crackles in lung bases
Correct Answer: B
Expert Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation. This leads to visible JVD, peripheral edema, and
hepatomegaly as fluid accumulates in the body. Pulmonary edema and crackles are
typically signs of left-sided heart failure instead. The nurse should measure
abdominal girth and check for pitting edema in the lower extremities. Accurate
assessment helps in determining the efficacy of systemic fluid management
strategies.
6. When teaching a patient about lifestyle modifications for hypertension, which
dietary change is most important?
A. Increasing sodium intake
2 Version 1 | Questions with Correct Answers and
Expert Explanation for Each Question | Baltimore
City Community College
1. A nurse is assessing a client with chronic obstructive pulmonary disease (COPD).
Which clinical finding should the nurse expect?
A. Increased chest expansion
B. Oversized trachea
C. Barrel-shaped chest
D. Decreased lung resonance
Correct Answer: C
Expert Explanation: COPD patients often develop a barrel chest due to chronic air
trapping in the alveoli. This condition results from the long-term hyperinflation of
the lungs over time. The increased anteroposterior diameter is a hallmark
diagnostic physical assessment finding. Other options like increased chest
expansion are incorrect because lung compliance is actually reduced. Nurses should
recognize this visual indicator to assess the severity of obstructive disease.
2. Which laboratory value is most specific for diagnosing a patient with acute heart
failure?
A. Serum Potassium level
,B. Blood Urea Nitrogen (BUN)
C. B-type Natriuretic Peptide (BNP)
D. White Blood Cell count
Correct Answer: C
Expert Explanation: BNP is a hormone secreted by the ventricles in response to
high pressure and volume expansion. It serves as a primary biomarker to
distinguish cardiac causes of dyspnea from respiratory ones. Higher levels of BNP
correlate directly with the severity of heart failure exacerbations. While potassium
and BUN are monitored, they do not confirm the diagnosis of heart failure.
Monitoring BNP helps the nurse evaluate the effectiveness of diuretic therapy over
time.
3. A client with hypertension is prescribed Lisinopril. Which side effect is most
common with this medication?
A. Excessive hair growth
B. Dry, persistent cough
C. Increased heart rate
D. Orange-colored urine
Correct Answer: B
,Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a
nonproductive cough due to bradykinin accumulation. This side effect is a frequent
reason for patients discontinuing the medication in clinical practice. The nurse must
inform the patient that this is a known pharmacological reaction to the drug. If the
cough becomes intolerable, the provider may switch the patient to an ARB.
Assessing the patient’s respiratory status helps differentiate this side effect from
other lung issues.
4. Which oxygen delivery device provides the highest concentration of oxygen for a
spontaneously breathing patient?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Correct Answer: D
Expert Explanation: The non-rebreather mask can deliver oxygen concentrations
between 60% and 90% when fitted properly. It utilizes a reservoir bag and one-way
valves to prevent the inhalation of room air. This device is typically used in
emergency situations where high-flow oxygen is urgently required. The nasal
, cannula and simple mask provide significantly lower percentages of oxygen. Nurses
must ensure the reservoir bag remains inflated to prevent carbon dioxide buildup.
5. A patient is diagnosed with Right-Sided Heart Failure. Which assessment finding
should the nurse expect?
A. Pulmonary edema
B. Jugular Venous Distention (JVD)
C. Dry hacking cough
D. Crackles in lung bases
Correct Answer: B
Expert Explanation: Right-sided heart failure causes blood to back up into the
systemic venous circulation. This leads to visible JVD, peripheral edema, and
hepatomegaly as fluid accumulates in the body. Pulmonary edema and crackles are
typically signs of left-sided heart failure instead. The nurse should measure
abdominal girth and check for pitting edema in the lower extremities. Accurate
assessment helps in determining the efficacy of systemic fluid management
strategies.
6. When teaching a patient about lifestyle modifications for hypertension, which
dietary change is most important?
A. Increasing sodium intake
