NR509 MIDTERM EXAM TESTBANK 3 WITH 400
QUESTIONS & CORRECT ANSWERS LATEST
2026/2027
During hospital rounds, the NP visits a 37-year-old male patient with a peripherally
inserted central catheter (PICC) in the left arm. The patient verbalized that his left arm
looks bigger than his right arm. His left arm is red, tender, and hot. All the following are
possible differential diagnoses EXCEPT:
Venous thromboembolism
Cellulitis
Intravenous extravasation
Phlebitis
C
Luke Cage is a 50-year-old male with a history of hypertension, high cholesterol, and a
tobacco smoking history of 30 years. He presents to the clinic with right calf pain that
occurs after walking four blocks. He needs to sit and rest to alleviate the pain. Which
assessment finding does NOT support a diagnosis of peripheral arterial disease (PAD)?
2+ right popliteal pulse
1+ right dorsalis pedis pulse
Right lower leg feels cool
Hair loss of right lower leg
A
Patient came in for nausea and vomiting, placed on tele monitoring. At the beginning of
the shift, patient was Normal Sinus Rhythm. Now, the monitor is showing Sinus
Bradycardia to low 40s. Upon assessing patient, you notice that she is sleeping but
easily arousable. BP 128/64, HR 45, SpO2 100% on RA, RR 16. Pt does not complain
of any SOB or dizziness. What will you do next?
Call Rapid Response Team and get a 12 lead EKG
Continue to monitor patient
Give atropine 0.5mg IV Q3-5mins
Ask patient to perform vagal maneuver to increase heart rate
B
. A 60-year old male patient came in to the ED with a chief complaint of shortness of
breath during exertion and diaphoresis. Patient also complains of difficulty sleeping at
night due to cough with blood-tinged sputum and needing to sleep upright. No signs of
peripheral edema and negative JVD. With these symptoms, what is a possible
diagnosis for this patient?
Right-sided heart failure
Tuberculosis
Left-sided heart failure
Cor Pulmonale
C
,. A 82-year-old female POD 5 of right hip replacement, who refuses to wear sequential
compression device (SCDs) and early mobilization due to pain. What is the patient high-
risk for developing?
Deep Vein Thrombosis (DVT)
Stroke
Decrease range of motion on the right hip
Varicose veins
A
Patient is taking digoxin for CHF, which value/assessment is most concerning?
HR 65
Potassium 3.0
Confusion and vision problems
Digoxin level 1.2
C
Ms. Smith presents to your clinic with complaints of fatigue and a chronic cough. She
states she sleeps on her recliner most nights or on multiple pillows as she feels it is
easier to breath in this position. Based on this scenario what is this patients most likely
diagnosis?
Coronary Vascular Disease
Hypertension
Left Ventricular Heart Failure
Atrial Fibrillation
C
Mr. Jones is a 62-year-old male with history of hyperlipidemia and diabetes. He is here
for his yearly physical. When you check his vitals the blood pressure is 138/102. Per the
American Society of Hypertension what blood pressure classification would you assign
to this patient?
Prehypertension
Stage 2 hypertension
Stage 1 hypertension
Normal blood pressure
B
Your patient with a BMI of 32 is looking to improve their diet. They request your
recommendation of foods that contain healthy fats. Which of the following foods is not
an example of a food high in omega-3 fatty acids?
Corn
Salmon
Walnuts
Flaxseed
A
A 65-year-old male known case of COPD visited an outpatient clinic for a routine
checkup. The nurse practitioner performing the physical examination noticed that the
point of maximal impulse is challenging to palpate and is not found in the apex; which of
these actions would the nurse most likely do on examination to locate the PMI?
a. Palpate the xiphoid or epigastric area.
b. Palpate in the fifth intercostal space, left midclavicular line.
,c. Palpate midsternal line.
d. Palpate the right side of the chest
A
The nurse practitioner is performing a focused physical assessment for the cardiac
system on 50 years old female known case of heart failure. While assessing the carotid
artery. What does the nurse know to be true regarding carotid artery palpation?
a. Immediately palpate the carotid pulse.
b. Auscultate first to listen for bruit, then palpate.
c. Inspection is enough for carotid artery assessment.
d. Inspect, then palpate immediately.
B
The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous pulsations 5 cm above the sternal angle when the head of his
bed is elevated 45 degrees. The nurse knows that finding indicates?
a. Decrease fluid volume.
b. Increase cardiac output.
c. Narrowing of the jugular vein.
d. Elevated pressure related to heart failure.
D
Jessica, 70 years old, came to the clinic complaining of pain, tightness, heaviness, and
tingling in her left leg, which worsened during the day and prolonged standing.
Assessment findings are as follows: pitting edema 2+, near the ankle, brownish
discoloration, ulcer just above the malleolus; what should the nurse suspect?
a. chronic venous insufficiency.
b. Lymphedema.
c. chronic arterial insufficiency.
d. neuropathic ulcer.
A
. During the cardiac auscultation, the nurse hears a sound immediately occurring after
the S2 at the second left intercostal space. To further assess this sound, what should
the nurse do next?
a. Have the patient turn to the left side while the nurse listens with the stethoscope bell.
b. Ask the patient to hold their breath while the nurse listens again.
c. No further assessment is needed because the nurse knows that this sound is S3.
d. Watch the patient's respiration while listening for the effect on the sound.
D
John, a 49-year-old male with a history of leukemia and hypertension, comes in the
Emergency department complaining of shortness of breath and fatigue. He also admits
to having swollen hands and feet. What could these findings indicate?
Right sided heart failure
Effects of chemotherapy
Pulmonary edema
Carpal tunnel syndrome
A
) A new nurse practitioner is being trained on the cardiac unit. She admits needing to
"brush up" on cardiac sounds and rhythms. When assessing for heart sounds, where is
, the optimal location to assess for the aortic valve?
Left sternum near the manubrium
Posterior third intercostal space
Fourth intercostal space
Second intercostal space on the right
D
A 54-year-old diabetic patient comes into the emergency department complaining of a
leg injury that will not heal. He admits using several forms of ointments and herbal
remedies but stopped since the skin "changed colors." The patient briefly mentions that
his older brother had something similar, but his leg was shiny and scaly. What is your
diagnosis?
Chronic venous insufficiency
Arterial insufficiency
Deep vein thrombosis
Diabetic ulcer
A
A 48-year-old female who was diagnosed with hypothyroidism and hypertension early in
her 30s comes in complaining of cramping leg pain. The patient admits to walking every
single day, however since it is starting to snow, she had to stop. What is your next
course of action?
Order CT venogram
Stop the assessment, admit the patient, and start heparin immediately
Send her home on Eliquis
Ask the patient more questions about her symptoms
D
Joffrey a 66-year-old male who loves to watch Sunday night football and snack in his
favorite chair that reclines comes in with a fever, shortness of breath, and dark mucus.
His kids stated he has not traveled nor has he encountered anyone with an illness. You
suspect aspiration pneumonia and understanding the anatomy of the lungs, where
would it occur?
The patient's symptoms are signs of ARDS. Intubate immediately for airway patency
Left upper lung
Right bronchus
Proximal convoluted bronchus
C
All of the following are correct steps in measuring jugular venous pressure in a patient
except.
Raise the head of bed to 90 degrees.
Measuring in vertical distance above the angle of Louis.
Have the patient turn slightly away from the side you are inspecting.
Raise the head of bed to 30 degrees.
A
You are able to hear a systolic murmur during a patient assessment. Which grade
would you categorize a palpable thrill?
1/6
2/6
QUESTIONS & CORRECT ANSWERS LATEST
2026/2027
During hospital rounds, the NP visits a 37-year-old male patient with a peripherally
inserted central catheter (PICC) in the left arm. The patient verbalized that his left arm
looks bigger than his right arm. His left arm is red, tender, and hot. All the following are
possible differential diagnoses EXCEPT:
Venous thromboembolism
Cellulitis
Intravenous extravasation
Phlebitis
C
Luke Cage is a 50-year-old male with a history of hypertension, high cholesterol, and a
tobacco smoking history of 30 years. He presents to the clinic with right calf pain that
occurs after walking four blocks. He needs to sit and rest to alleviate the pain. Which
assessment finding does NOT support a diagnosis of peripheral arterial disease (PAD)?
2+ right popliteal pulse
1+ right dorsalis pedis pulse
Right lower leg feels cool
Hair loss of right lower leg
A
Patient came in for nausea and vomiting, placed on tele monitoring. At the beginning of
the shift, patient was Normal Sinus Rhythm. Now, the monitor is showing Sinus
Bradycardia to low 40s. Upon assessing patient, you notice that she is sleeping but
easily arousable. BP 128/64, HR 45, SpO2 100% on RA, RR 16. Pt does not complain
of any SOB or dizziness. What will you do next?
Call Rapid Response Team and get a 12 lead EKG
Continue to monitor patient
Give atropine 0.5mg IV Q3-5mins
Ask patient to perform vagal maneuver to increase heart rate
B
. A 60-year old male patient came in to the ED with a chief complaint of shortness of
breath during exertion and diaphoresis. Patient also complains of difficulty sleeping at
night due to cough with blood-tinged sputum and needing to sleep upright. No signs of
peripheral edema and negative JVD. With these symptoms, what is a possible
diagnosis for this patient?
Right-sided heart failure
Tuberculosis
Left-sided heart failure
Cor Pulmonale
C
,. A 82-year-old female POD 5 of right hip replacement, who refuses to wear sequential
compression device (SCDs) and early mobilization due to pain. What is the patient high-
risk for developing?
Deep Vein Thrombosis (DVT)
Stroke
Decrease range of motion on the right hip
Varicose veins
A
Patient is taking digoxin for CHF, which value/assessment is most concerning?
HR 65
Potassium 3.0
Confusion and vision problems
Digoxin level 1.2
C
Ms. Smith presents to your clinic with complaints of fatigue and a chronic cough. She
states she sleeps on her recliner most nights or on multiple pillows as she feels it is
easier to breath in this position. Based on this scenario what is this patients most likely
diagnosis?
Coronary Vascular Disease
Hypertension
Left Ventricular Heart Failure
Atrial Fibrillation
C
Mr. Jones is a 62-year-old male with history of hyperlipidemia and diabetes. He is here
for his yearly physical. When you check his vitals the blood pressure is 138/102. Per the
American Society of Hypertension what blood pressure classification would you assign
to this patient?
Prehypertension
Stage 2 hypertension
Stage 1 hypertension
Normal blood pressure
B
Your patient with a BMI of 32 is looking to improve their diet. They request your
recommendation of foods that contain healthy fats. Which of the following foods is not
an example of a food high in omega-3 fatty acids?
Corn
Salmon
Walnuts
Flaxseed
A
A 65-year-old male known case of COPD visited an outpatient clinic for a routine
checkup. The nurse practitioner performing the physical examination noticed that the
point of maximal impulse is challenging to palpate and is not found in the apex; which of
these actions would the nurse most likely do on examination to locate the PMI?
a. Palpate the xiphoid or epigastric area.
b. Palpate in the fifth intercostal space, left midclavicular line.
,c. Palpate midsternal line.
d. Palpate the right side of the chest
A
The nurse practitioner is performing a focused physical assessment for the cardiac
system on 50 years old female known case of heart failure. While assessing the carotid
artery. What does the nurse know to be true regarding carotid artery palpation?
a. Immediately palpate the carotid pulse.
b. Auscultate first to listen for bruit, then palpate.
c. Inspection is enough for carotid artery assessment.
d. Inspect, then palpate immediately.
B
The findings from an assessment of a 70-year-old patient with swelling in his ankles
include jugular venous pulsations 5 cm above the sternal angle when the head of his
bed is elevated 45 degrees. The nurse knows that finding indicates?
a. Decrease fluid volume.
b. Increase cardiac output.
c. Narrowing of the jugular vein.
d. Elevated pressure related to heart failure.
D
Jessica, 70 years old, came to the clinic complaining of pain, tightness, heaviness, and
tingling in her left leg, which worsened during the day and prolonged standing.
Assessment findings are as follows: pitting edema 2+, near the ankle, brownish
discoloration, ulcer just above the malleolus; what should the nurse suspect?
a. chronic venous insufficiency.
b. Lymphedema.
c. chronic arterial insufficiency.
d. neuropathic ulcer.
A
. During the cardiac auscultation, the nurse hears a sound immediately occurring after
the S2 at the second left intercostal space. To further assess this sound, what should
the nurse do next?
a. Have the patient turn to the left side while the nurse listens with the stethoscope bell.
b. Ask the patient to hold their breath while the nurse listens again.
c. No further assessment is needed because the nurse knows that this sound is S3.
d. Watch the patient's respiration while listening for the effect on the sound.
D
John, a 49-year-old male with a history of leukemia and hypertension, comes in the
Emergency department complaining of shortness of breath and fatigue. He also admits
to having swollen hands and feet. What could these findings indicate?
Right sided heart failure
Effects of chemotherapy
Pulmonary edema
Carpal tunnel syndrome
A
) A new nurse practitioner is being trained on the cardiac unit. She admits needing to
"brush up" on cardiac sounds and rhythms. When assessing for heart sounds, where is
, the optimal location to assess for the aortic valve?
Left sternum near the manubrium
Posterior third intercostal space
Fourth intercostal space
Second intercostal space on the right
D
A 54-year-old diabetic patient comes into the emergency department complaining of a
leg injury that will not heal. He admits using several forms of ointments and herbal
remedies but stopped since the skin "changed colors." The patient briefly mentions that
his older brother had something similar, but his leg was shiny and scaly. What is your
diagnosis?
Chronic venous insufficiency
Arterial insufficiency
Deep vein thrombosis
Diabetic ulcer
A
A 48-year-old female who was diagnosed with hypothyroidism and hypertension early in
her 30s comes in complaining of cramping leg pain. The patient admits to walking every
single day, however since it is starting to snow, she had to stop. What is your next
course of action?
Order CT venogram
Stop the assessment, admit the patient, and start heparin immediately
Send her home on Eliquis
Ask the patient more questions about her symptoms
D
Joffrey a 66-year-old male who loves to watch Sunday night football and snack in his
favorite chair that reclines comes in with a fever, shortness of breath, and dark mucus.
His kids stated he has not traveled nor has he encountered anyone with an illness. You
suspect aspiration pneumonia and understanding the anatomy of the lungs, where
would it occur?
The patient's symptoms are signs of ARDS. Intubate immediately for airway patency
Left upper lung
Right bronchus
Proximal convoluted bronchus
C
All of the following are correct steps in measuring jugular venous pressure in a patient
except.
Raise the head of bed to 90 degrees.
Measuring in vertical distance above the angle of Louis.
Have the patient turn slightly away from the side you are inspecting.
Raise the head of bed to 30 degrees.
A
You are able to hear a systolic murmur during a patient assessment. Which grade
would you categorize a palpable thrill?
1/6
2/6
