ADN Med-Surg I Exam 2: Cardiac, Respiratory, and GI Systems
2026/2027 UPDATE
1. A patient with COPD is prescribed oxygen therapy. Which of the following
delivery methods and flow rates is most appropriate for a patient who is a
carbon dioxide retainer?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 1-2 L/min
C. Simple face mask at 8 L/min
D. Venturi mask at 50% FiO2
Answer: B
Rationale: In COPD patients who retain CO2, high concentrations of oxygen can suppress
the hypoxic drive to breathe. Low-flow oxygen (1-2 L/min) is typically used to maintain an
SpO2 between 88-92%.
2. The nurse is assessing a patient with right-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Pulmonary crackles
B. Dyspnea on exertion
C. Orthopnea
D. Peripheral edema
Answer: D
Rationale: Right-sided heart failure leads to systemic venous congestion, causing
peripheral edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are
associated with left-sided heart failure.
,3. A patient is diagnosed with Peptic Ulcer Disease (PUD) caused by H. pylori.
Which combination of medications is most commonly prescribed?
A. Antacids and NSAIDs
B. Laxatives and H2 blockers
C. Beta-blockers and sucralfate
D. PPIs, clarithromycin, and amoxicillin
Answer: D
Rationale: Triple therapy for H. pylori typically includes a Proton Pump Inhibitor (PPI)
and two antibiotics (like amoxicillin and clarithromycin) to eradicate the bacteria and heal
the ulcer.
4. Which positioning is most effective for a patient experiencing acute shortness
of breath due to heart failure?
A. High-Fowler’s position
B. Supine with legs elevated
C. Prone position
D. Left lateral recumbent
Answer: A
Rationale: High-Fowler’s position (90 degrees) promotes lung expansion and reduces
venous return to the heart, which helps alleviate pulmonary congestion.
5. The nurse is educating a patient on a low-sodium diet to manage
hypertension. Which food choice indicates the patient needs further teaching?
A. Fresh steamed broccoli
B. Grilled chicken breast
C. Canned tomato soup
D. Brown rice
Answer: C
, Rationale: Canned soups are notoriously high in sodium (processing agent). Fresh
vegetables, plain grains, and fresh meats are better low-sodium options.
6. Which of the following is a classic symptom of Gastroesophageal Reflux
Disease (GERD)?
A. Pyrosis (heartburn)
B. Rebound tenderness
C. Steatorrhea
D. Hematochezia
Answer: A
Rationale: Pyrosis, or a burning sensation in the chest (heartburn), is the most common
symptom of GERD caused by acid refluxing into the esophagus.
7. A patient with asthma is using a Peak Flow Meter. If the reading falls into the
‘Yellow Zone,’ what should the nurse instruct the patient to do?
A. Continue current routine maintenance
B. Use a rescue inhaler and re-evaluate
C. Seek immediate emergency care
D. Stop all physical activity for 24 hours
Answer: B
Rationale: The Yellow Zone (50-80% of personal best) indicates caution. Patients should
use their short-acting beta-agonist (rescue inhaler) and follow their asthma action plan.
8. A patient is taking Digoxin for heart failure. Which laboratory value would
increase the risk for Digoxin toxicity?
A. Serum Sodium of 140 mEq/L
B. Serum Potassium of 3.2 mEq/L
C. Serum Calcium of 9.0 mg/dL
D. Serum Glucose of 110 mg/dL
Answer: B
2026/2027 UPDATE
1. A patient with COPD is prescribed oxygen therapy. Which of the following
delivery methods and flow rates is most appropriate for a patient who is a
carbon dioxide retainer?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 1-2 L/min
C. Simple face mask at 8 L/min
D. Venturi mask at 50% FiO2
Answer: B
Rationale: In COPD patients who retain CO2, high concentrations of oxygen can suppress
the hypoxic drive to breathe. Low-flow oxygen (1-2 L/min) is typically used to maintain an
SpO2 between 88-92%.
2. The nurse is assessing a patient with right-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Pulmonary crackles
B. Dyspnea on exertion
C. Orthopnea
D. Peripheral edema
Answer: D
Rationale: Right-sided heart failure leads to systemic venous congestion, causing
peripheral edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are
associated with left-sided heart failure.
,3. A patient is diagnosed with Peptic Ulcer Disease (PUD) caused by H. pylori.
Which combination of medications is most commonly prescribed?
A. Antacids and NSAIDs
B. Laxatives and H2 blockers
C. Beta-blockers and sucralfate
D. PPIs, clarithromycin, and amoxicillin
Answer: D
Rationale: Triple therapy for H. pylori typically includes a Proton Pump Inhibitor (PPI)
and two antibiotics (like amoxicillin and clarithromycin) to eradicate the bacteria and heal
the ulcer.
4. Which positioning is most effective for a patient experiencing acute shortness
of breath due to heart failure?
A. High-Fowler’s position
B. Supine with legs elevated
C. Prone position
D. Left lateral recumbent
Answer: A
Rationale: High-Fowler’s position (90 degrees) promotes lung expansion and reduces
venous return to the heart, which helps alleviate pulmonary congestion.
5. The nurse is educating a patient on a low-sodium diet to manage
hypertension. Which food choice indicates the patient needs further teaching?
A. Fresh steamed broccoli
B. Grilled chicken breast
C. Canned tomato soup
D. Brown rice
Answer: C
, Rationale: Canned soups are notoriously high in sodium (processing agent). Fresh
vegetables, plain grains, and fresh meats are better low-sodium options.
6. Which of the following is a classic symptom of Gastroesophageal Reflux
Disease (GERD)?
A. Pyrosis (heartburn)
B. Rebound tenderness
C. Steatorrhea
D. Hematochezia
Answer: A
Rationale: Pyrosis, or a burning sensation in the chest (heartburn), is the most common
symptom of GERD caused by acid refluxing into the esophagus.
7. A patient with asthma is using a Peak Flow Meter. If the reading falls into the
‘Yellow Zone,’ what should the nurse instruct the patient to do?
A. Continue current routine maintenance
B. Use a rescue inhaler and re-evaluate
C. Seek immediate emergency care
D. Stop all physical activity for 24 hours
Answer: B
Rationale: The Yellow Zone (50-80% of personal best) indicates caution. Patients should
use their short-acting beta-agonist (rescue inhaler) and follow their asthma action plan.
8. A patient is taking Digoxin for heart failure. Which laboratory value would
increase the risk for Digoxin toxicity?
A. Serum Sodium of 140 mEq/L
B. Serum Potassium of 3.2 mEq/L
C. Serum Calcium of 9.0 mg/dL
D. Serum Glucose of 110 mg/dL
Answer: B
