**ADULT HEALTH FINAL EXAM – COMPLETE
PRACTICE 2026/2027**200+ Questions with Verified
Answers & Detailed Rationales**Cardiovascular •
Respiratory • Renal • Endocrine • Gastrointestinal •
Neurology • Immunology • Infectious Disease • Emergency &
Critical Care • Fluid/Electrolyte • Pain Management •
Professional Issues**BSN & Accelerated BSN • High-Yield
Content • First-Time Pass**
## TABLE OF CONTENTS
| Section | Topic | Questions |
| 1 | Cardiovascular Disorders | 1–25 |
| 2 | Respiratory Disorders | 26–50 |
| 3 | Renal & Genitourinary Disorders | 51–70 |
| 4 | Endocrine Disorders | 71–90 |
| 5 | Gastrointestinal Disorders | 91–110 |
| 6 | Neurological Disorders | 111–130 |
| 7 | Hematologic & Immunologic Disorders | 131–145 |
| 8 | Infectious Diseases & Sepsis | 146–160 |
| 9 | Emergency & Critical Care | 161–175 |
| 10 | Fluid, Electrolyte & Acid‑Base Disorders | 176–190 |
| 11 | Pain Management & Pharmacology | 191–200 |
| 12 | Professional Issues & Patient Safety | 201–210 |
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# 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 which
intervention as the priority?**
A) Administer aspirin and nitroglycerin and observe for 24 hours
B) Emergent reperfusion therapy (PCI or thrombolytics) within 90
minutes of arrival
C) Transfer to telemetry for continuous monitoring
D) Discharge with a prescription for aspirin and instructions to follow up
in 1 week
**Answer: B**
*Rationale:* STEMI (ST‑elevation myocardial infarction) requires
immediate reperfusion. Primary PCI (percutaneous coronary
intervention) is the gold standard, with a door‑to‑balloon goal of ≤90
minutes. Thrombolytics are used when PCI is not available within 120
minutes .
**2. A patient with heart failure with reduced ejection fraction (HFrEF,
EF 35%) is being discharged. Which medication is first‑line to reduce
mortality?**
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A) Furosemide (only for symptom relief, no mortality benefit)
B) Metoprolol succinate (β‑blocker) plus an ACE inhibitor or ARB
C) Digoxin
D) Hydralazine/isosorbide dinitrate
**Answer: B**
*Rationale:* Guideline‑directed medical therapy (GDMT) for HFrEF
includes β‑blockers (carvedilol, metoprolol succinate, bisoprolol) and
ACE inhibitors (or ARBs/ARNIs). These drugs improve survival, reduce
hospitalizations, and slow disease progression .
**3. A patient with atrial fibrillation (AF) has a CHA₂DS₂‑VASc score of
5. What should the nurse expect to be ordered?**
A) No anticoagulation
B) Aspirin 81 mg daily
C) Oral anticoagulation (warfarin or a DOAC) to prevent
thromboembolism
D) Dual antiplatelet therapy (aspirin + clopidogrel)
**Answer: C**
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*Rationale:* A CHA₂DS₂‑VASc score ≥2 in males or ≥3 in females
indicates a high risk of stroke, requiring oral anticoagulation. Aspirin is
no longer recommended for stroke prevention in AF. DOACs (apixaban,
rivaroxaban, edoxaban, dabigatran) are preferred over warfarin unless
contraindicated (e.g., mechanical heart valve) .
**4. A patient with a mechanical heart valve presents with a sudden,
cold, pulseless left leg. What should the nurse suspect?**
A) Deep vein thrombosis (DVT)
B) Arterial thromboembolism (likely from a cardiac source)
C) Venous insufficiency
D) Cellulitis
**Answer: B**
*Rationale:* Mechanical heart valves require lifelong warfarin (INR
target 2.5–3.5). Acute limb ischemia (pain, pallor, pulselessness,
paresthesia, paralysis – the “six Ps”) suggests an arterial embolism. This
is an emergency requiring vascular surgery consultation and possible
embolectomy or thrombolysis .