NR 330 Exam 2: Adult Health II - Chamberlain University
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with left-sided heart failure is admitted to the ICU. Which assessment finding most accurately
reflects the pathophysiology of this condition?
A. Jugular venous distension and peripheral edema.
B. Crackles upon lung auscultation and dyspnea.
C. Hepatomegaly and abdominal girth increase.
D. Splenomegaly and anorexia.
Correct Answer: B
Rationale: Left-sided heart failure results in the inability of the left ventricle to pump blood efficiently
into systemic circulation. This causes blood to back up into the pulmonary veins and capillaries,
increasing hydrostatic pressure. The fluid then leaks into the alveoli, manifesting as crackles, orthopnea,
and paroxysmal nocturnal dyspnea. In contrast, right-sided heart failure presents with systemic venous
congestion such as peripheral edema and jugular distension. Monitoring respiratory status is the highest
priority for these patients to prevent acute respiratory failure.
2. A client presents with symptoms of an Acute Myocardial Infarction (AMI). Which cardiac biomarker is
most specific for myocardial injury and typically elevates within 3 to 4 hours?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Troponin I
,Correct Answer: D
Rationale: Troponin I is a highly specific protein found only in myocardial muscle, making it the gold
standard for diagnosing MI. It begins to rise within 3 to 6 hours after injury and can remain elevated for
up to 10 to 14 days. While CK-MB is also used, it is less specific because it can be found in skeletal muscle
as well. Myoglobin rises faster than Troponin but lacks the specificity required for a definitive cardiac
diagnosis. Prompt identification of elevated troponin levels allows for early intervention and reperfusion
therapy.
3. A patient is diagnosed with Atrial Fibrillation (AFib) with a rapid ventricular response. What is the primary
reason for initiating anticoagulation therapy in this patient?
A. To prevent the formation of mural thrombi in the atria.
B. To dissolve existing clots in the coronary arteries.
C. To decrease the heart rate and improve cardiac output.
D. To convert the rhythm back to normal sinus rhythm.
Correct Answer: A
Rationale: In Atrial Fibrillation, the atria quiver instead of contracting effectively, leading to blood stasis
in the auricular appendages. This stasis promotes the formation of mural thrombi, which can embolize
and cause an ischemic stroke. Anticoagulants like Warfarin or NOACs are administered to prevent this
specific complication. They do not directly control the heart rate or convert the rhythm, which requires
beta-blockers or cardioversion. Assessing the patient’s stroke risk using the CHA2DS2-VASc score is a
standard nursing practice.
4. Which pathophysiological mechanism is most characteristic of Acute Respiratory Distress Syndrome
(ARDS)?
A. Increased compliance of the lung tissue.
, B. Increased permeability of the alveolar-capillary membrane.
C. Primary failure of the right ventricle.
D. Localized infection in the lower lobes.
Correct Answer: B
Rationale: ARDS is characterized by a systemic inflammatory response that damages the alveolar-
capillary membrane. This damage results in increased permeability, allowing protein-rich fluid to flood
the alveoli and cause non-cardiogenic pulmonary edema. The loss of surfactant leads to alveolar collapse
and severe ventilation-perfusion (V/Q) mismatching. Patients typically exhibit refractory hypoxemia,
which does not improve with supplemental oxygen alone. Effective management often requires
mechanical ventilation with high levels of Positive End-Expiratory Pressure (PEEP).
5. A client is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is currently considered
the gold standard for confirming this diagnosis?
A. Chest X-ray
B. Computed Tomographic Pulmonary Angiography (CTPA)
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Correct Answer: B
Rationale: Computed Tomographic Pulmonary Angiography (CTPA) provides a direct visualization of the
pulmonary vasculature and is highly sensitive for detecting emboli. While a D-dimer test can help rule out
a PE, it is non-specific and can be elevated due to various inflammatory states. Chest X-rays are usually
normal in the early stages of PE and are used primarily to rule out other conditions. ABGs may show
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with left-sided heart failure is admitted to the ICU. Which assessment finding most accurately
reflects the pathophysiology of this condition?
A. Jugular venous distension and peripheral edema.
B. Crackles upon lung auscultation and dyspnea.
C. Hepatomegaly and abdominal girth increase.
D. Splenomegaly and anorexia.
Correct Answer: B
Rationale: Left-sided heart failure results in the inability of the left ventricle to pump blood efficiently
into systemic circulation. This causes blood to back up into the pulmonary veins and capillaries,
increasing hydrostatic pressure. The fluid then leaks into the alveoli, manifesting as crackles, orthopnea,
and paroxysmal nocturnal dyspnea. In contrast, right-sided heart failure presents with systemic venous
congestion such as peripheral edema and jugular distension. Monitoring respiratory status is the highest
priority for these patients to prevent acute respiratory failure.
2. A client presents with symptoms of an Acute Myocardial Infarction (AMI). Which cardiac biomarker is
most specific for myocardial injury and typically elevates within 3 to 4 hours?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. Lactate Dehydrogenase (LDH)
D. Troponin I
,Correct Answer: D
Rationale: Troponin I is a highly specific protein found only in myocardial muscle, making it the gold
standard for diagnosing MI. It begins to rise within 3 to 6 hours after injury and can remain elevated for
up to 10 to 14 days. While CK-MB is also used, it is less specific because it can be found in skeletal muscle
as well. Myoglobin rises faster than Troponin but lacks the specificity required for a definitive cardiac
diagnosis. Prompt identification of elevated troponin levels allows for early intervention and reperfusion
therapy.
3. A patient is diagnosed with Atrial Fibrillation (AFib) with a rapid ventricular response. What is the primary
reason for initiating anticoagulation therapy in this patient?
A. To prevent the formation of mural thrombi in the atria.
B. To dissolve existing clots in the coronary arteries.
C. To decrease the heart rate and improve cardiac output.
D. To convert the rhythm back to normal sinus rhythm.
Correct Answer: A
Rationale: In Atrial Fibrillation, the atria quiver instead of contracting effectively, leading to blood stasis
in the auricular appendages. This stasis promotes the formation of mural thrombi, which can embolize
and cause an ischemic stroke. Anticoagulants like Warfarin or NOACs are administered to prevent this
specific complication. They do not directly control the heart rate or convert the rhythm, which requires
beta-blockers or cardioversion. Assessing the patient’s stroke risk using the CHA2DS2-VASc score is a
standard nursing practice.
4. Which pathophysiological mechanism is most characteristic of Acute Respiratory Distress Syndrome
(ARDS)?
A. Increased compliance of the lung tissue.
, B. Increased permeability of the alveolar-capillary membrane.
C. Primary failure of the right ventricle.
D. Localized infection in the lower lobes.
Correct Answer: B
Rationale: ARDS is characterized by a systemic inflammatory response that damages the alveolar-
capillary membrane. This damage results in increased permeability, allowing protein-rich fluid to flood
the alveoli and cause non-cardiogenic pulmonary edema. The loss of surfactant leads to alveolar collapse
and severe ventilation-perfusion (V/Q) mismatching. Patients typically exhibit refractory hypoxemia,
which does not improve with supplemental oxygen alone. Effective management often requires
mechanical ventilation with high levels of Positive End-Expiratory Pressure (PEEP).
5. A client is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is currently considered
the gold standard for confirming this diagnosis?
A. Chest X-ray
B. Computed Tomographic Pulmonary Angiography (CTPA)
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Correct Answer: B
Rationale: Computed Tomographic Pulmonary Angiography (CTPA) provides a direct visualization of the
pulmonary vasculature and is highly sensitive for detecting emboli. While a D-dimer test can help rule out
a PE, it is non-specific and can be elevated due to various inflammatory states. Chest X-rays are usually
normal in the early stages of PE and are used primarily to rule out other conditions. ABGs may show
