ALVON
NUR 221 EXAM 2
Cardiovascular System
1. A patient with heart failure is prescribed furosemide. What is the priority nursing
assessment?
A. Heart rate
B. Blood glucose
C. Lung sounds
D. Potassium level
Answer: D. Potassium level
Rationale: Furosemide is a loop diuretic that can cause potassium loss, leading to
hypokalemia.
,ALVON
2. Which ECG finding is most concerning for a patient with chest pain?
A. Sinus bradycardia
B. T-wave inversion
C. ST segment elevation
D. Premature atrial contractions
Answer: C. ST segment elevation
Rationale: ST elevation is a hallmark of acute myocardial infarction.
3. What is the primary goal in the care of a patient with atrial fibrillation?
A. Increase fluid intake
B. Prevent stroke
C. Promote rest
D. Lower blood pressure
Answer: B. Prevent stroke
Rationale: Atrial fibrillation increases the risk of clot formation and stroke;
anticoagulation is key.
Respiratory System
4. A patient with COPD is receiving oxygen via nasal cannula at 5 L/min. What is the
best action?
A. Continue therapy
B. Increase the flow to 6 L/min
C. Reduce the flow to 2 L/min
D. Call the provider
Answer: C. Reduce the flow to 2 L/min
Rationale: High oxygen flow in COPD can suppress the respiratory drive.
5. What assessment finding indicates a pneumothorax?
A. Rhonchi
B. Bilateral crackles
C. Tracheal deviation
D. Productive cough
, ALVON
Answer: C. Tracheal deviation
Rationale: A tension pneumothorax can shift the trachea away from the affected
side.
Perioperative Nursing
6. What is the priority nursing intervention immediately post-op?
A. Monitor bowel sounds
B. Assess surgical site
C. Check pain level
D. Maintain airway and breathing
Answer: D. Maintain airway and breathing
Rationale: Airway management is the first priority in the immediate postoperative
period.
7. Which client statement indicates a need for further teaching before surgery?
A. "I will not eat after midnight."
B. "I will remove my nail polish."
C. "I will bring my dentures."
D. "I will wear my hearing aid in the OR."
Answer: D. "I will wear my hearing aid in the OR."
Rationale: Removable prosthetics should be taken out before surgery unless
approved by the surgical team.
Fluid, Electrolyte, and Acid-Base Balance
8. Which electrolyte imbalance is associated with muscle weakness and cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: B. Hypokalemia
Rationale: Low potassium affects muscle and heart function.
NUR 221 EXAM 2
Cardiovascular System
1. A patient with heart failure is prescribed furosemide. What is the priority nursing
assessment?
A. Heart rate
B. Blood glucose
C. Lung sounds
D. Potassium level
Answer: D. Potassium level
Rationale: Furosemide is a loop diuretic that can cause potassium loss, leading to
hypokalemia.
,ALVON
2. Which ECG finding is most concerning for a patient with chest pain?
A. Sinus bradycardia
B. T-wave inversion
C. ST segment elevation
D. Premature atrial contractions
Answer: C. ST segment elevation
Rationale: ST elevation is a hallmark of acute myocardial infarction.
3. What is the primary goal in the care of a patient with atrial fibrillation?
A. Increase fluid intake
B. Prevent stroke
C. Promote rest
D. Lower blood pressure
Answer: B. Prevent stroke
Rationale: Atrial fibrillation increases the risk of clot formation and stroke;
anticoagulation is key.
Respiratory System
4. A patient with COPD is receiving oxygen via nasal cannula at 5 L/min. What is the
best action?
A. Continue therapy
B. Increase the flow to 6 L/min
C. Reduce the flow to 2 L/min
D. Call the provider
Answer: C. Reduce the flow to 2 L/min
Rationale: High oxygen flow in COPD can suppress the respiratory drive.
5. What assessment finding indicates a pneumothorax?
A. Rhonchi
B. Bilateral crackles
C. Tracheal deviation
D. Productive cough
, ALVON
Answer: C. Tracheal deviation
Rationale: A tension pneumothorax can shift the trachea away from the affected
side.
Perioperative Nursing
6. What is the priority nursing intervention immediately post-op?
A. Monitor bowel sounds
B. Assess surgical site
C. Check pain level
D. Maintain airway and breathing
Answer: D. Maintain airway and breathing
Rationale: Airway management is the first priority in the immediate postoperative
period.
7. Which client statement indicates a need for further teaching before surgery?
A. "I will not eat after midnight."
B. "I will remove my nail polish."
C. "I will bring my dentures."
D. "I will wear my hearing aid in the OR."
Answer: D. "I will wear my hearing aid in the OR."
Rationale: Removable prosthetics should be taken out before surgery unless
approved by the surgical team.
Fluid, Electrolyte, and Acid-Base Balance
8. Which electrolyte imbalance is associated with muscle weakness and cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: B. Hypokalemia
Rationale: Low potassium affects muscle and heart function.
