EAQ WITH NGN: CARDIAC EXAM WITH ANSWER KEY–
2026 EDITION
Instructions
• Total scored items: 22 (6 per case study, plus 4 stand-alone NGN questions at the
end)
• Partial credit is awarded for matrix/grid, select-all-that-apply, and drag-and-drop
items.
• For each case study, answer questions in order; you cannot return to a previous
question.
• A detailed answer key with rationales is provided after the exam.
Case Study 1: Acute Decompensated Heart Failure
Scenario
The nurse on a telemetry unit receives report on a new admission, Mrs. Carolyn Davis, a
72-year-old African American female. She was brought to the emergency department by
her daughter with reports of difficulty breathing and inability to walk short distances
without becoming extremely short of breath. Mrs. Davis has a history of obesity,
hypertension, coronary artery disease, and diabetes mellitus. She reports fatigue related
to difficulty sleeping at night as a result of a nonproductive cough that is unresolved
with cough drops. She reports a weight gain of 10 pounds in the past week, despite a
decreased appetite. Her daughter reports that her mother has been unable to care for
herself as a result of the fatigue and increasing shortness of breath. She states, "She has
not showered in over a week."
Page 1 of 16 Chamberlain University College of Nursing
,Electronic Health Record (EHR)
History & Physical
• Age: 72 years
• Sex: Female
• Race: African American
• Past Medical History: Hypertension, coronary artery disease, diabetes mellitus
(type 2), obesity
• Social History: Lives alone in a two-story home; retired teacher; nonsmoker;
reports drinking 1–2 glasses of wine occasionally
• Allergies: No known drug allergies
• Home Medications: Lisinopril 20 mg daily, metformin 500 mg twice daily, aspirin
81 mg daily, atorvastatin 40 mg daily
Vital Signs (on admission)
Parameter Value
Temperature 98.8°F (37.1°C)
Heart rate 118 bpm
Respiratory rate 26 breaths/min
Blood pressure 162/94 mm Hg
SpO₂ 88% on room air
Physical Assessment Findings
• Cardiovascular: Sinus tachycardia with occasional premature ventricular
contractions (PVCs); no murmur noted; jugular venous distension present at 45
degrees; 2+ pitting edema in bilateral lower extremities
• Respiratory: Tachypnea; inspiratory crackles auscultated throughout bilateral
lung bases; use of accessory muscles noted
• Neurological: Alert and oriented to person, place, and time; follows commands;
no focal deficits
• Integumentary: Skin warm and dry; capillary refill <3 seconds
Page 2 of 16 Chamberlain University College of Nursing
, • Gastrointestinal: Bowel sounds present in all four quadrants; abdomen soft,
nontender
Laboratory Results (on admission)
Lab Result Reference Range
BNP 1,250 pg/mL <100 pg/mL
Troponin I 0.08 ng/mL <0.04 ng/mL
Serum creatinine 1.4 mg/dL 0.6–1.2 mg/dL
Potassium 4.2 mEq/L 3.5–5.0 mEq/L
Hemoglobin 11.5 g/dL 12.0–16.0 g/dL
Questions
Question 1 (Cloze/Drop-Down – Recognizing Cues)
From the options provided, select the most likely potential condition and the most
anticipated medication.
The nurse is preparing a plan of care for the client. Based on the information provided,
the potential condition is [ Select: A. Acute Kidney Injury / B. Heart Failure / C.
Pneumonia / D. Pulmonary Embolism ] and the anticipated medication is [ Select: A.
Metoprolol / B. Furosemide / C. Albuterol / D. Heparin ] .
Question 2 (Matrix/Grid – Analyzing Cues)
The nurse reviews the assessment data. For each finding, indicate whether
it supports the diagnosis of acute decompensated heart failure (ADHF) or does not
support ADHF.
Assessment Finding Supports ADHF Does Not Support ADHF
Jugular venous distension ◯ ◯
BNP of 1,250 pg/mL ◯ ◯
Page 3 of 16 Chamberlain University College of Nursing
2026 EDITION
Instructions
• Total scored items: 22 (6 per case study, plus 4 stand-alone NGN questions at the
end)
• Partial credit is awarded for matrix/grid, select-all-that-apply, and drag-and-drop
items.
• For each case study, answer questions in order; you cannot return to a previous
question.
• A detailed answer key with rationales is provided after the exam.
Case Study 1: Acute Decompensated Heart Failure
Scenario
The nurse on a telemetry unit receives report on a new admission, Mrs. Carolyn Davis, a
72-year-old African American female. She was brought to the emergency department by
her daughter with reports of difficulty breathing and inability to walk short distances
without becoming extremely short of breath. Mrs. Davis has a history of obesity,
hypertension, coronary artery disease, and diabetes mellitus. She reports fatigue related
to difficulty sleeping at night as a result of a nonproductive cough that is unresolved
with cough drops. She reports a weight gain of 10 pounds in the past week, despite a
decreased appetite. Her daughter reports that her mother has been unable to care for
herself as a result of the fatigue and increasing shortness of breath. She states, "She has
not showered in over a week."
Page 1 of 16 Chamberlain University College of Nursing
,Electronic Health Record (EHR)
History & Physical
• Age: 72 years
• Sex: Female
• Race: African American
• Past Medical History: Hypertension, coronary artery disease, diabetes mellitus
(type 2), obesity
• Social History: Lives alone in a two-story home; retired teacher; nonsmoker;
reports drinking 1–2 glasses of wine occasionally
• Allergies: No known drug allergies
• Home Medications: Lisinopril 20 mg daily, metformin 500 mg twice daily, aspirin
81 mg daily, atorvastatin 40 mg daily
Vital Signs (on admission)
Parameter Value
Temperature 98.8°F (37.1°C)
Heart rate 118 bpm
Respiratory rate 26 breaths/min
Blood pressure 162/94 mm Hg
SpO₂ 88% on room air
Physical Assessment Findings
• Cardiovascular: Sinus tachycardia with occasional premature ventricular
contractions (PVCs); no murmur noted; jugular venous distension present at 45
degrees; 2+ pitting edema in bilateral lower extremities
• Respiratory: Tachypnea; inspiratory crackles auscultated throughout bilateral
lung bases; use of accessory muscles noted
• Neurological: Alert and oriented to person, place, and time; follows commands;
no focal deficits
• Integumentary: Skin warm and dry; capillary refill <3 seconds
Page 2 of 16 Chamberlain University College of Nursing
, • Gastrointestinal: Bowel sounds present in all four quadrants; abdomen soft,
nontender
Laboratory Results (on admission)
Lab Result Reference Range
BNP 1,250 pg/mL <100 pg/mL
Troponin I 0.08 ng/mL <0.04 ng/mL
Serum creatinine 1.4 mg/dL 0.6–1.2 mg/dL
Potassium 4.2 mEq/L 3.5–5.0 mEq/L
Hemoglobin 11.5 g/dL 12.0–16.0 g/dL
Questions
Question 1 (Cloze/Drop-Down – Recognizing Cues)
From the options provided, select the most likely potential condition and the most
anticipated medication.
The nurse is preparing a plan of care for the client. Based on the information provided,
the potential condition is [ Select: A. Acute Kidney Injury / B. Heart Failure / C.
Pneumonia / D. Pulmonary Embolism ] and the anticipated medication is [ Select: A.
Metoprolol / B. Furosemide / C. Albuterol / D. Heparin ] .
Question 2 (Matrix/Grid – Analyzing Cues)
The nurse reviews the assessment data. For each finding, indicate whether
it supports the diagnosis of acute decompensated heart failure (ADHF) or does not
support ADHF.
Assessment Finding Supports ADHF Does Not Support ADHF
Jugular venous distension ◯ ◯
BNP of 1,250 pg/mL ◯ ◯
Page 3 of 16 Chamberlain University College of Nursing
