NURS 326 Exam 2 Practice Questions and Answers
with Detailed Rationales (MCQs 1–100)
1. A patient with heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
A. Increased blood pressure
B. Weight gain of 2 kg in 2 days
C. Decreased shortness of breath
D. Increased crackles in lungs
Answer: C. Decreased shortness of breath
Rationale: Furosemide is a diuretic that reduces fluid overload. Improvement is seen as
reduced pulmonary congestion and improved breathing.
2. The nurse is caring for a patient with pneumonia. Which position best promotes
oxygenation?
A. Supine position
B. Trendelenburg position
C. High Fowler’s position
D. Prone position
Answer: C. High Fowler’s position
Rationale: High Fowler’s (upright) position improves lung expansion and oxygen exchange.
3. Which laboratory result is most concerning in a patient taking warfarin?
A. INR 1.5
B. INR 2.5
C. INR 3.0
D. INR 5.5
Answer: D. INR 5.5
Rationale: Normal therapeutic INR is 2–3. A value of 5.5 indicates high bleeding risk.
,4. A patient develops cyanosis and severe dyspnea. What is the nurse’s first action?
A. Take full vital signs
B. Apply oxygen immediately
C. Call the physician
D. Document the finding
Answer: B. Apply oxygen immediately
Rationale: Airway and breathing come first (ABC principle). Oxygen is the priority
intervention.
5. Which sign is an early indicator of hypovolemic shock?
A. Bradycardia
B. Warm flushed skin
C. Tachycardia
D. Increased urine output
Answer: C. Tachycardia
Rationale: The body compensates for low volume by increasing heart rate.
6. A diabetic patient has a blood glucose level of 2.8 mmol/L. What is the priority action?
A. Administer insulin
B. Give 15g fast-acting glucose
C. Restrict fluids
D. Recheck in 2 hours
Answer: B. Give 15g fast-acting glucose
Rationale: This is hypoglycemia; immediate glucose is required.
7. Which symptom is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Frothy sputum
C. Peripheral edema
, D. Hemoptysis
Answer: C. Peripheral edema
Rationale: Right-sided failure leads to systemic venous congestion.
8. A nurse is administering morphine. What is the most important assessment before
administration?
A. Pain level
B. Respiratory rate
C. Temperature
D. Blood pressure
Answer: B. Respiratory rate
Rationale: Morphine can cause respiratory depression; RR must be assessed first.
9. Which electrolyte imbalance is most associated with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase potassium loss in urine.
10. A patient is in shock. Which position is most appropriate initially?
A. Sitting upright
B. Supine with legs elevated
C. Prone position
D. Fowler’s position
Answer: B. Supine with legs elevated
Rationale: Improves venous return and cardiac output.
11. Which sign indicates fluid overload?
with Detailed Rationales (MCQs 1–100)
1. A patient with heart failure is prescribed furosemide. Which finding indicates the
medication is effective?
A. Increased blood pressure
B. Weight gain of 2 kg in 2 days
C. Decreased shortness of breath
D. Increased crackles in lungs
Answer: C. Decreased shortness of breath
Rationale: Furosemide is a diuretic that reduces fluid overload. Improvement is seen as
reduced pulmonary congestion and improved breathing.
2. The nurse is caring for a patient with pneumonia. Which position best promotes
oxygenation?
A. Supine position
B. Trendelenburg position
C. High Fowler’s position
D. Prone position
Answer: C. High Fowler’s position
Rationale: High Fowler’s (upright) position improves lung expansion and oxygen exchange.
3. Which laboratory result is most concerning in a patient taking warfarin?
A. INR 1.5
B. INR 2.5
C. INR 3.0
D. INR 5.5
Answer: D. INR 5.5
Rationale: Normal therapeutic INR is 2–3. A value of 5.5 indicates high bleeding risk.
,4. A patient develops cyanosis and severe dyspnea. What is the nurse’s first action?
A. Take full vital signs
B. Apply oxygen immediately
C. Call the physician
D. Document the finding
Answer: B. Apply oxygen immediately
Rationale: Airway and breathing come first (ABC principle). Oxygen is the priority
intervention.
5. Which sign is an early indicator of hypovolemic shock?
A. Bradycardia
B. Warm flushed skin
C. Tachycardia
D. Increased urine output
Answer: C. Tachycardia
Rationale: The body compensates for low volume by increasing heart rate.
6. A diabetic patient has a blood glucose level of 2.8 mmol/L. What is the priority action?
A. Administer insulin
B. Give 15g fast-acting glucose
C. Restrict fluids
D. Recheck in 2 hours
Answer: B. Give 15g fast-acting glucose
Rationale: This is hypoglycemia; immediate glucose is required.
7. Which symptom is most characteristic of right-sided heart failure?
A. Pulmonary edema
B. Frothy sputum
C. Peripheral edema
, D. Hemoptysis
Answer: C. Peripheral edema
Rationale: Right-sided failure leads to systemic venous congestion.
8. A nurse is administering morphine. What is the most important assessment before
administration?
A. Pain level
B. Respiratory rate
C. Temperature
D. Blood pressure
Answer: B. Respiratory rate
Rationale: Morphine can cause respiratory depression; RR must be assessed first.
9. Which electrolyte imbalance is most associated with loop diuretics?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase potassium loss in urine.
10. A patient is in shock. Which position is most appropriate initially?
A. Sitting upright
B. Supine with legs elevated
C. Prone position
D. Fowler’s position
Answer: B. Supine with legs elevated
Rationale: Improves venous return and cardiac output.
11. Which sign indicates fluid overload?
