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NSG 6011 ADULT HEALTH 1 – FINAL EXAM
REVIEW**150+ PRACTICE QUESTIONS WITH
VERIFIED ANSWERS & DETAILED
RATIONALES**CARDIOVASCULAR • RESPIRATORY •
RENAL • ENDOCRINE • GASTROINTESTINAL •
HEMATOLOGIC • IMMUNOLOGIC •
EMERGENCY/CRITICAL CARE**HIGH-YIELD
CONTENT • GRADUATE-LEVEL • FIRST-TIME PASS**
# SECTION 1: CARDIOVASCULAR DISORDERS – Questions 1–25
**1. A patient with acute coronary syndrome (ACS) presents with ST-
segment elevation on ECG. The nurse should anticipate:**
A) Administering aspirin and nitroglycerin only
B) Emergent reperfusion therapy (PCI or thrombolytics) within 90
minutes of arrival
C) Admission to telemetry for observation
D) Discharge with follow-up in 1 week
**Answer: B**
*Rationale:* STEMI (ST-elevation myocardial infarction) requires
immediate reperfusion (primary PCI within 90 minutes or thrombolytics
within 30 minutes if PCI not available). Aspirin, nitroglycerin,
morphine, oxygen are adjuncts.
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**2. The nurse is caring for a patient with heart failure (HFrEF, EF
35%). Which medication is first-line therapy to reduce mortality?**
A) Furosemide (symptom relief, not mortality benefit)
B) Metoprolol succinate (beta-blocker) + ACE inhibitor/ARB
C) Digoxin
D) Hydralazine/isosorbide dinitrate
**Answer: B**
*Rationale:* Guideline-directed medical therapy (GDMT) for HFrEF
includes beta-blockers (carvedilol, metoprolol succinate, bisoprolol),
ACE inhibitors/ARBs/ARNIs, aldosterone antagonists, and SGLT2
inhibitors (dapagliflozin, empagliflozin).
**3. A patient with atrial fibrillation (AF) has a CHA₂DS₂-VASc score of
5. The nurse should anticipate:**
A) No anticoagulation
B) Aspirin 81 mg daily
C) Oral anticoagulation (warfarin or DOAC) to prevent
thromboembolism
D) Dual antiplatelet therapy (aspirin + clopidogrel)
**Answer: C**
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*Rationale:* CHA₂DS₂-VASc score ≥2 in males or ≥3 in females
indicates high stroke risk, requiring oral anticoagulation (warfarin or
DOAC). Aspirin is no longer recommended for AF stroke prevention.
**4. A patient with a mechanical heart valve presents with a sudden,
cold, pulseless left leg. The nurse should suspect:**
A) Deep vein thrombosis (DVT)
B) Arterial thromboembolism (likely from cardiac source) – urgent
embolectomy or thrombolytics
C) Venous insufficiency
D) Cellulitis
**Answer: B**
*Rationale:* Mechanical heart valves require lifelong warfarin (INR
target 2.5-3.5). Arterial embolism presents with acute limb ischemia
(pain, pallor, pulseless, paresthesia, paralysis – 6 Ps). Immediate
vascular surgery consult.
**5. The nurse notes that a patient on a heparin drip has an aPTT of 110
seconds (control 30 seconds, therapeutic 60-80). The nurse should:**
A) Increase the heparin drip rate
B) Decrease or hold the heparin drip (supratherapeutic)
C) Administer protamine sulfate
D) Continue at the same rate
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**Answer: B**
*Rationale:* Supratherapeutic aPTT (3× normal) increases bleeding
risk. Reduce or hold heparin per protocol. Protamine sulfate is for major
bleeding, not aPTT elevation alone.
**6. Which of the following is a contraindication to thrombolytic
therapy (tPA) in acute ischemic stroke?**
A) Onset of symptoms <4.5 hours (inclusion)
B) Intracranial hemorrhage on CT scan
C) Blood pressure 150/90 mmHg (must be <185/110)
D) Glucose 80 mg/dL
**Answer: B**
*Rationale:* Absolute contraindications: intracranial hemorrhage, active
bleeding, recent major surgery/trauma, uncontrolled hypertension
(>185/110), seizure at onset, platelet count <100,000, INR >1.7, glucose
<50 or >400.
**7. The nurse is assessing a patient with pericarditis. Which finding is
characteristic?**
A) Pleuritic chest pain that improves when leaning forward
B) Substernal chest pain radiating to the jaw
NSG 6011 ADULT HEALTH 1 – FINAL EXAM
REVIEW**150+ PRACTICE QUESTIONS WITH
VERIFIED ANSWERS & DETAILED
RATIONALES**CARDIOVASCULAR • RESPIRATORY •
RENAL • ENDOCRINE • GASTROINTESTINAL •
HEMATOLOGIC • IMMUNOLOGIC •
EMERGENCY/CRITICAL CARE**HIGH-YIELD
CONTENT • GRADUATE-LEVEL • FIRST-TIME PASS**
# SECTION 1: CARDIOVASCULAR DISORDERS – Questions 1–25
**1. A patient with acute coronary syndrome (ACS) presents with ST-
segment elevation on ECG. The nurse should anticipate:**
A) Administering aspirin and nitroglycerin only
B) Emergent reperfusion therapy (PCI or thrombolytics) within 90
minutes of arrival
C) Admission to telemetry for observation
D) Discharge with follow-up in 1 week
**Answer: B**
*Rationale:* STEMI (ST-elevation myocardial infarction) requires
immediate reperfusion (primary PCI within 90 minutes or thrombolytics
within 30 minutes if PCI not available). Aspirin, nitroglycerin,
morphine, oxygen are adjuncts.
,2|Page
**2. The nurse is caring for a patient with heart failure (HFrEF, EF
35%). Which medication is first-line therapy to reduce mortality?**
A) Furosemide (symptom relief, not mortality benefit)
B) Metoprolol succinate (beta-blocker) + ACE inhibitor/ARB
C) Digoxin
D) Hydralazine/isosorbide dinitrate
**Answer: B**
*Rationale:* Guideline-directed medical therapy (GDMT) for HFrEF
includes beta-blockers (carvedilol, metoprolol succinate, bisoprolol),
ACE inhibitors/ARBs/ARNIs, aldosterone antagonists, and SGLT2
inhibitors (dapagliflozin, empagliflozin).
**3. A patient with atrial fibrillation (AF) has a CHA₂DS₂-VASc score of
5. The nurse should anticipate:**
A) No anticoagulation
B) Aspirin 81 mg daily
C) Oral anticoagulation (warfarin or DOAC) to prevent
thromboembolism
D) Dual antiplatelet therapy (aspirin + clopidogrel)
**Answer: C**
,3|Page
*Rationale:* CHA₂DS₂-VASc score ≥2 in males or ≥3 in females
indicates high stroke risk, requiring oral anticoagulation (warfarin or
DOAC). Aspirin is no longer recommended for AF stroke prevention.
**4. A patient with a mechanical heart valve presents with a sudden,
cold, pulseless left leg. The nurse should suspect:**
A) Deep vein thrombosis (DVT)
B) Arterial thromboembolism (likely from cardiac source) – urgent
embolectomy or thrombolytics
C) Venous insufficiency
D) Cellulitis
**Answer: B**
*Rationale:* Mechanical heart valves require lifelong warfarin (INR
target 2.5-3.5). Arterial embolism presents with acute limb ischemia
(pain, pallor, pulseless, paresthesia, paralysis – 6 Ps). Immediate
vascular surgery consult.
**5. The nurse notes that a patient on a heparin drip has an aPTT of 110
seconds (control 30 seconds, therapeutic 60-80). The nurse should:**
A) Increase the heparin drip rate
B) Decrease or hold the heparin drip (supratherapeutic)
C) Administer protamine sulfate
D) Continue at the same rate
, 4|Page
**Answer: B**
*Rationale:* Supratherapeutic aPTT (3× normal) increases bleeding
risk. Reduce or hold heparin per protocol. Protamine sulfate is for major
bleeding, not aPTT elevation alone.
**6. Which of the following is a contraindication to thrombolytic
therapy (tPA) in acute ischemic stroke?**
A) Onset of symptoms <4.5 hours (inclusion)
B) Intracranial hemorrhage on CT scan
C) Blood pressure 150/90 mmHg (must be <185/110)
D) Glucose 80 mg/dL
**Answer: B**
*Rationale:* Absolute contraindications: intracranial hemorrhage, active
bleeding, recent major surgery/trauma, uncontrolled hypertension
(>185/110), seizure at onset, platelet count <100,000, INR >1.7, glucose
<50 or >400.
**7. The nurse is assessing a patient with pericarditis. Which finding is
characteristic?**
A) Pleuritic chest pain that improves when leaning forward
B) Substernal chest pain radiating to the jaw
