1|Page
# NURS 325 ATI MED-SURG EXAM BANK**210
HIGH-YIELD QUESTIONS | MULTIPLE CHOICE
ANSWERS + RATIONALES** FIRST-TIME PASS
GUARANTEED | A+ GRADE | PROCTORED
EXAM READY
# DOMAIN 1: CARDIOVASCULAR (40 questions)
**1. A nurse is assessing a client with heart failure who has crackles in
the lungs, jugular vein distention, and 3+ pitting edema. Which diuretic
is most appropriate?**
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
**Answer:** A
**Rationale:** Furosemide is a loop diuretic that rapidly reduces
preload in acute heart failure with fluid overload. Spironolactone is
potassium-sparing and slower. HCTZ is ineffective with reduced GFR.
Mannitol is for cerebral edema.
,2|Page
---
**2. A client post-MI develops a new, harsh holosystolic murmur at the
apex. What complication is suspected?**
A. Papillary muscle rupture
B. Ventricular septal defect
C. Pericarditis
D. Aortic stenosis
**Answer:** A
**Rationale:** Harsh holosystolic murmur at apex = mitral
regurgitation from papillary muscle rupture post-MI. VSD murmur is at
left lower sternal border. Pericarditis causes friction rub, not murmur.
---
**3. A client with atrial fibrillation is on warfarin. INR is 4.2. No
bleeding. What action?**
A. Hold warfarin and give vitamin K orally
B. Administer fresh frozen plasma
C. Hold warfarin, monitor INR tomorrow
D. Increase warfarin dose
,3|Page
**Answer:** C
**Rationale:** INR 4.2 without bleeding → hold warfarin, recheck next
day. Vitamin K reserved for INR >10 or bleeding. FFP for active
bleeding.
---
**4. Which lab value is most critical to check before administering
digoxin?**
A. Potassium
B. Calcium
C. Magnesium
D. Sodium
**Answer:** A
**Rationale:** Hypokalemia increases digoxin toxicity risk
(dysrhythmias, nausea, yellow vision). Check K+ first.
---
**5. A client with unstable angina is started on nitroglycerin IV. What
adverse effect requires immediate intervention?**
A. Headache
, 4|Page
B. Hypotension (BP 80/50)
C. Flushing
D. Tachycardia
**Answer:** B
**Rationale:** Nitroglycerin causes vasodilation → hypotension. BP
<90 systolic needs dose reduction or fluid bolus. Headache/flushing
common but not emergent.
---
**6. A client with hypertension is prescribed hydrochlorothiazide.
Which lab finding requires immediate follow-up?**
A. Sodium 135 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 100 mg/dL
D. Calcium 9.0 mg/dL
**Answer:** B
**Rationale:** HCTZ causes hypokalemia (K+ <3.5). Risk of
dysrhythmias. Replace K+.
---
# NURS 325 ATI MED-SURG EXAM BANK**210
HIGH-YIELD QUESTIONS | MULTIPLE CHOICE
ANSWERS + RATIONALES** FIRST-TIME PASS
GUARANTEED | A+ GRADE | PROCTORED
EXAM READY
# DOMAIN 1: CARDIOVASCULAR (40 questions)
**1. A nurse is assessing a client with heart failure who has crackles in
the lungs, jugular vein distention, and 3+ pitting edema. Which diuretic
is most appropriate?**
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Mannitol
**Answer:** A
**Rationale:** Furosemide is a loop diuretic that rapidly reduces
preload in acute heart failure with fluid overload. Spironolactone is
potassium-sparing and slower. HCTZ is ineffective with reduced GFR.
Mannitol is for cerebral edema.
,2|Page
---
**2. A client post-MI develops a new, harsh holosystolic murmur at the
apex. What complication is suspected?**
A. Papillary muscle rupture
B. Ventricular septal defect
C. Pericarditis
D. Aortic stenosis
**Answer:** A
**Rationale:** Harsh holosystolic murmur at apex = mitral
regurgitation from papillary muscle rupture post-MI. VSD murmur is at
left lower sternal border. Pericarditis causes friction rub, not murmur.
---
**3. A client with atrial fibrillation is on warfarin. INR is 4.2. No
bleeding. What action?**
A. Hold warfarin and give vitamin K orally
B. Administer fresh frozen plasma
C. Hold warfarin, monitor INR tomorrow
D. Increase warfarin dose
,3|Page
**Answer:** C
**Rationale:** INR 4.2 without bleeding → hold warfarin, recheck next
day. Vitamin K reserved for INR >10 or bleeding. FFP for active
bleeding.
---
**4. Which lab value is most critical to check before administering
digoxin?**
A. Potassium
B. Calcium
C. Magnesium
D. Sodium
**Answer:** A
**Rationale:** Hypokalemia increases digoxin toxicity risk
(dysrhythmias, nausea, yellow vision). Check K+ first.
---
**5. A client with unstable angina is started on nitroglycerin IV. What
adverse effect requires immediate intervention?**
A. Headache
, 4|Page
B. Hypotension (BP 80/50)
C. Flushing
D. Tachycardia
**Answer:** B
**Rationale:** Nitroglycerin causes vasodilation → hypotension. BP
<90 systolic needs dose reduction or fluid bolus. Headache/flushing
common but not emergent.
---
**6. A client with hypertension is prescribed hydrochlorothiazide.
Which lab finding requires immediate follow-up?**
A. Sodium 135 mEq/L
B. Potassium 2.8 mEq/L
C. Glucose 100 mg/dL
D. Calcium 9.0 mg/dL
**Answer:** B
**Rationale:** HCTZ causes hypokalemia (K+ <3.5). Risk of
dysrhythmias. Replace K+.
---
