Hondros NUR 205 Final Exam: Medical-Surgical
Nursing Actual Exam Complete Questions &
Rationales | Med Surg Foundations | Pass
Guaranteed - A+ Graded
Cardiovascular & Respiratory Disorders
Q1: The nurse is caring for a client admitted with heart failure who is receiving
furosemide (Lasix). Which assessment finding indicates the medication is effective?
A. Dry, hacking cough
B. Weight loss of 2 pounds in 24 hours
C. Blood pressure of 110/70 mm Hg
D. Heart rate of 110 beats per minute [CORRECT]
Correct Answer: B
Rationale: In heart failure, the goal of diuretic therapy like Lasix is to remove excess
fluid volume; weight loss is the most direct indicator of fluid loss. An elevated heart rate
often persists or can be a sign of compensation, and while a stable blood pressure is
good, it doesn't reflect fluid removal as directly as daily weight.
Q2: A client with chronic obstructive pulmonary disease (COPD) is receiving 2 L/min of
oxygen via nasal cannula. The client asks the nurse why the oxygen flow isn't increased
because they feel short of breath. What is the nurse’s best response?
A. "Increasing the oxygen will cause you to breathe too slowly and retain carbon
dioxide."
B. "Higher levels of oxygen can damage your lungs and cause fibrosis."
C. "Your doctor has prescribed the maximum safe amount of oxygen for you."
D. "We need to keep your oxygen saturation low to stimulate your bone marrow."
[CORRECT]
Correct Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe; increasing the
oxygen flow can suppress their respiratory drive, leading to carbon dioxide retention and
respiratory failure. This is a core safety concept we teach in managing chronic lung
conditions.
Q3: The nurse is assessing a client 2 hours after a cardiac catheterization via the right
femoral artery. Which finding requires immediate notification of the provider?
A. Slight bruising around the puncture site
,B. Blood pressure of 100/60 mm Hg
C. Complaint of back pain and coolness in the right foot
D. Heart rate of 88 beats per minute [CORRECT]
Correct Answer: C
Rationale: Back pain and loss of pulse or coolness in the affected limb are classic signs
of retroperitoneal bleeding or arterial occlusion, which are life-threatening complications
post-cardiac cath. These require immediate intervention compared to slight bruising or
vital signs within normal limits.
Q4: When teaching a client about lifestyle modifications for hypertension, which
instruction is most important for the nurse to include?
A. "Limit your sodium intake to no more than 2,300 mg per day."
B. "Engage in moderate aerobic activity for at least 30 minutes most days."
C. "Take your blood pressure medication at the same time every day."
D. "Avoid smoking and limit alcohol consumption to no more than one drink per day for
women." [CORRECT]
Correct Answer: A
Rationale: While all these options are important for managing hypertension, sodium
restriction is often the first line of dietary defense and has the most direct impact on fluid
volume and blood pressure control. It is emphasized heavily in the DASH diet, which is
the standard of care.
Q5: A client with angina pectoris is prescribed nitroglycerin sublingual tablets. The nurse
instructs the client to do which of the following if chest pain occurs?
A. Take one tablet every 5 minutes for a total of three doses, then call EMS.
B. Chew the tablet thoroughly and swallow with water.
C. Place one tablet under the tongue and call 911 immediately if pain is not relieved in 5
minutes.
D. Take the tablet with food to prevent gastric upset. [CORRECT]
Correct Answer: C
Rationale: The standard protocol for nitroglycerin is to take one dose immediately; if
pain is unrelieved after 5 minutes, call emergency services (911) immediately because
this indicates a possible myocardial infarction. You can take up to three doses while
waiting for EMS, but calling for help is the priority safety action.
Q6: The nurse enters the room of a client who is 2 days postoperative from abdominal
surgery and finds the client gasping for air, clutching their chest, and unable to speak.
What is the nurse’s FIRST action?
A. Check the client's vital signs.
B. Administer a PRN dose of albuterol.
C. Activate the rapid response team.
, D. Assess the client's airway and breath sounds. [CORRECT]
Correct Answer: D
Rationale: In any acute change of status, we always start with the ABCs (Airway,
Breathing, Circulation). The client is in obvious respiratory distress; you must
immediately determine if the airway is patent and if they are breathing effectively before
calling the team or looking up medication orders.
Q7: A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse knows
that therapeutic effect is monitored using which laboratory value?
A. Prothrombin time (PT) and International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Bleeding time [CORRECT]
Correct Answer: A
Rationale: Warfarin affects the extrinsic coagulation pathway, so we monitor PT and
INR. aPTT is used for heparin. Keeping the INR within the therapeutic range (usually
2.0 to 3.0 for afib) prevents clots while minimizing bleeding risk.
Q8: The nurse is caring for a client with a chest tube connected to a water-seal drainage
system. During assessment, the nurse notes continuous bubbling in the water-seal
chamber. What does this finding indicate?
A. The system is functioning correctly.
B. An air leak is present in the thoracic cavity or system.
C. The suction pressure is too high.
D. The lung has fully re-expanded. [CORRECT]
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates that air is entering
the system from an external source (like a loose connection) or internally from a leak in
the lung pleura. Intermittent bubbling on expiration is normal, but continuous bubbling is
a red flag that requires investigation.
Q9: A client with pneumonia has a productive cough with thick yellow-green sputum.
The client’s temperature is 101°F (38.3°C). Which intervention should the nurse perform
first?
A. Administer antipyretics.
B. Encourage increased fluid intake.
C. Provide oral hygiene.
D. Obtain a sputum specimen for culture and sensitivity. [CORRECT]
Correct Answer: D
Rationale: The priority is to treat the infection effectively. We need to obtain the sputum
specimen before initiating antibiotic therapy to ensure the culture results accurately
Nursing Actual Exam Complete Questions &
Rationales | Med Surg Foundations | Pass
Guaranteed - A+ Graded
Cardiovascular & Respiratory Disorders
Q1: The nurse is caring for a client admitted with heart failure who is receiving
furosemide (Lasix). Which assessment finding indicates the medication is effective?
A. Dry, hacking cough
B. Weight loss of 2 pounds in 24 hours
C. Blood pressure of 110/70 mm Hg
D. Heart rate of 110 beats per minute [CORRECT]
Correct Answer: B
Rationale: In heart failure, the goal of diuretic therapy like Lasix is to remove excess
fluid volume; weight loss is the most direct indicator of fluid loss. An elevated heart rate
often persists or can be a sign of compensation, and while a stable blood pressure is
good, it doesn't reflect fluid removal as directly as daily weight.
Q2: A client with chronic obstructive pulmonary disease (COPD) is receiving 2 L/min of
oxygen via nasal cannula. The client asks the nurse why the oxygen flow isn't increased
because they feel short of breath. What is the nurse’s best response?
A. "Increasing the oxygen will cause you to breathe too slowly and retain carbon
dioxide."
B. "Higher levels of oxygen can damage your lungs and cause fibrosis."
C. "Your doctor has prescribed the maximum safe amount of oxygen for you."
D. "We need to keep your oxygen saturation low to stimulate your bone marrow."
[CORRECT]
Correct Answer: A
Rationale: Clients with COPD often rely on a hypoxic drive to breathe; increasing the
oxygen flow can suppress their respiratory drive, leading to carbon dioxide retention and
respiratory failure. This is a core safety concept we teach in managing chronic lung
conditions.
Q3: The nurse is assessing a client 2 hours after a cardiac catheterization via the right
femoral artery. Which finding requires immediate notification of the provider?
A. Slight bruising around the puncture site
,B. Blood pressure of 100/60 mm Hg
C. Complaint of back pain and coolness in the right foot
D. Heart rate of 88 beats per minute [CORRECT]
Correct Answer: C
Rationale: Back pain and loss of pulse or coolness in the affected limb are classic signs
of retroperitoneal bleeding or arterial occlusion, which are life-threatening complications
post-cardiac cath. These require immediate intervention compared to slight bruising or
vital signs within normal limits.
Q4: When teaching a client about lifestyle modifications for hypertension, which
instruction is most important for the nurse to include?
A. "Limit your sodium intake to no more than 2,300 mg per day."
B. "Engage in moderate aerobic activity for at least 30 minutes most days."
C. "Take your blood pressure medication at the same time every day."
D. "Avoid smoking and limit alcohol consumption to no more than one drink per day for
women." [CORRECT]
Correct Answer: A
Rationale: While all these options are important for managing hypertension, sodium
restriction is often the first line of dietary defense and has the most direct impact on fluid
volume and blood pressure control. It is emphasized heavily in the DASH diet, which is
the standard of care.
Q5: A client with angina pectoris is prescribed nitroglycerin sublingual tablets. The nurse
instructs the client to do which of the following if chest pain occurs?
A. Take one tablet every 5 minutes for a total of three doses, then call EMS.
B. Chew the tablet thoroughly and swallow with water.
C. Place one tablet under the tongue and call 911 immediately if pain is not relieved in 5
minutes.
D. Take the tablet with food to prevent gastric upset. [CORRECT]
Correct Answer: C
Rationale: The standard protocol for nitroglycerin is to take one dose immediately; if
pain is unrelieved after 5 minutes, call emergency services (911) immediately because
this indicates a possible myocardial infarction. You can take up to three doses while
waiting for EMS, but calling for help is the priority safety action.
Q6: The nurse enters the room of a client who is 2 days postoperative from abdominal
surgery and finds the client gasping for air, clutching their chest, and unable to speak.
What is the nurse’s FIRST action?
A. Check the client's vital signs.
B. Administer a PRN dose of albuterol.
C. Activate the rapid response team.
, D. Assess the client's airway and breath sounds. [CORRECT]
Correct Answer: D
Rationale: In any acute change of status, we always start with the ABCs (Airway,
Breathing, Circulation). The client is in obvious respiratory distress; you must
immediately determine if the airway is patent and if they are breathing effectively before
calling the team or looking up medication orders.
Q7: A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse knows
that therapeutic effect is monitored using which laboratory value?
A. Prothrombin time (PT) and International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Bleeding time [CORRECT]
Correct Answer: A
Rationale: Warfarin affects the extrinsic coagulation pathway, so we monitor PT and
INR. aPTT is used for heparin. Keeping the INR within the therapeutic range (usually
2.0 to 3.0 for afib) prevents clots while minimizing bleeding risk.
Q8: The nurse is caring for a client with a chest tube connected to a water-seal drainage
system. During assessment, the nurse notes continuous bubbling in the water-seal
chamber. What does this finding indicate?
A. The system is functioning correctly.
B. An air leak is present in the thoracic cavity or system.
C. The suction pressure is too high.
D. The lung has fully re-expanded. [CORRECT]
Correct Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates that air is entering
the system from an external source (like a loose connection) or internally from a leak in
the lung pleura. Intermittent bubbling on expiration is normal, but continuous bubbling is
a red flag that requires investigation.
Q9: A client with pneumonia has a productive cough with thick yellow-green sputum.
The client’s temperature is 101°F (38.3°C). Which intervention should the nurse perform
first?
A. Administer antipyretics.
B. Encourage increased fluid intake.
C. Provide oral hygiene.
D. Obtain a sputum specimen for culture and sensitivity. [CORRECT]
Correct Answer: D
Rationale: The priority is to treat the infection effectively. We need to obtain the sputum
specimen before initiating antibiotic therapy to ensure the culture results accurately
