NU189 | NU 189 Medical-Surgical Nursing II Exam
1 v1 Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is caring for a patient with Atrial Fibrillation. Which medication should the
nurse anticipate administering to prevent thromboembolic events?
A. Warfarin
B. Atropine
C. Lisinopril
D. Furosemide
Correct Answer: A
Expert Explanation: Atrial fibrillation increases the risk of blood clots forming in
the atria due to blood stasis. Warfarin is an anticoagulant used to reduce the risk of
stroke and systemic embolism in these patients. The nurse must monitor the
patient’s PT/INR levels closely to ensure therapeutic dosing.
2. Which clinical manifestation is most characteristic of Left-Sided Heart Failure?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatomegaly
,Correct Answer: A
Expert Explanation: Left-sided heart failure causes blood to back up into the
pulmonary veins and capillaries, leading to pulmonary congestion. Crackles,
dyspnea, and orthopnea are common assessment findings associated with this fluid
shift. Peripheral edema and JVD are more commonly associated with right-sided
heart failure.
3. A patient is prescribed Digoxin 0.125 mg daily. Which assessment finding should the
nurse report immediately as a sign of toxicity?
A. Increased appetite
B. Heart rate of 82 bpm
C. Visual disturbances, such as yellow halos
D. Blood pressure of 120/80 mmHg
Correct Answer: C
Expert Explanation: Visual changes, including blurred vision or yellow-green halos,
are classic signs of digoxin toxicity. Other signs include nausea, vomiting, and
bradycardia. The nurse must assess the apical pulse for one full minute before
administration and hold the dose if the rate is below 60 bpm.
,4. What is the primary goal of administering Nitroglycerin to a patient with Angina
Pectoris?
A. To decrease myocardial oxygen demand
B. To increase blood pressure
C. To slow the heart rate
D. To increase blood glucose levels
Correct Answer: A
Expert Explanation: Nitroglycerin acts as a potent vasodilator that reduces preload
and afterload, thereby decreasing the workload of the heart. By decreasing the
workload, it reduces the myocardial oxygen demand and relieves chest pain. It
specifically dilates coronary arteries to improve blood flow to the heart muscle.
5. A patient presents with a suspected Myocardial Infarction. Which laboratory value
is the most specific indicator of cardiac muscle damage?
A. Creatinine kinase (CK)
B. Myoglobin
C. Troponin I
D. C-reactive protein
Correct Answer: C
, Expert Explanation: Troponin I and Troponin T are highly specific markers for
myocardial injury and remain elevated for several days. Unlike CK-MB, troponins
are not typically found in the blood of healthy individuals unless cardiac damage has
occurred. These levels are used to diagnose and risk-stratify patients with acute
coronary syndrome.
6. When teaching a patient about a permanent pacemaker, which instruction should
the nurse include?
A. You can safely undergo an MRI scan anytime.
B. Avoid lifting the arm on the pacemaker side above the head for several weeks.
C. Microwave ovens should be avoided entirely.
D. Check your pulse once a month.
Correct Answer: B
Expert Explanation: Patients should avoid lifting the arm on the side of the
pacemaker to prevent lead displacement during the initial healing phase. Most
modern microwaves are safe, but MRI scans are generally contraindicated unless
the pacemaker is specifically labeled as MRI-conditional. Daily pulse checks are
recommended to ensure the pacemaker is maintaining the set heart rate.
1 v1 Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is caring for a patient with Atrial Fibrillation. Which medication should the
nurse anticipate administering to prevent thromboembolic events?
A. Warfarin
B. Atropine
C. Lisinopril
D. Furosemide
Correct Answer: A
Expert Explanation: Atrial fibrillation increases the risk of blood clots forming in
the atria due to blood stasis. Warfarin is an anticoagulant used to reduce the risk of
stroke and systemic embolism in these patients. The nurse must monitor the
patient’s PT/INR levels closely to ensure therapeutic dosing.
2. Which clinical manifestation is most characteristic of Left-Sided Heart Failure?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatomegaly
,Correct Answer: A
Expert Explanation: Left-sided heart failure causes blood to back up into the
pulmonary veins and capillaries, leading to pulmonary congestion. Crackles,
dyspnea, and orthopnea are common assessment findings associated with this fluid
shift. Peripheral edema and JVD are more commonly associated with right-sided
heart failure.
3. A patient is prescribed Digoxin 0.125 mg daily. Which assessment finding should the
nurse report immediately as a sign of toxicity?
A. Increased appetite
B. Heart rate of 82 bpm
C. Visual disturbances, such as yellow halos
D. Blood pressure of 120/80 mmHg
Correct Answer: C
Expert Explanation: Visual changes, including blurred vision or yellow-green halos,
are classic signs of digoxin toxicity. Other signs include nausea, vomiting, and
bradycardia. The nurse must assess the apical pulse for one full minute before
administration and hold the dose if the rate is below 60 bpm.
,4. What is the primary goal of administering Nitroglycerin to a patient with Angina
Pectoris?
A. To decrease myocardial oxygen demand
B. To increase blood pressure
C. To slow the heart rate
D. To increase blood glucose levels
Correct Answer: A
Expert Explanation: Nitroglycerin acts as a potent vasodilator that reduces preload
and afterload, thereby decreasing the workload of the heart. By decreasing the
workload, it reduces the myocardial oxygen demand and relieves chest pain. It
specifically dilates coronary arteries to improve blood flow to the heart muscle.
5. A patient presents with a suspected Myocardial Infarction. Which laboratory value
is the most specific indicator of cardiac muscle damage?
A. Creatinine kinase (CK)
B. Myoglobin
C. Troponin I
D. C-reactive protein
Correct Answer: C
, Expert Explanation: Troponin I and Troponin T are highly specific markers for
myocardial injury and remain elevated for several days. Unlike CK-MB, troponins
are not typically found in the blood of healthy individuals unless cardiac damage has
occurred. These levels are used to diagnose and risk-stratify patients with acute
coronary syndrome.
6. When teaching a patient about a permanent pacemaker, which instruction should
the nurse include?
A. You can safely undergo an MRI scan anytime.
B. Avoid lifting the arm on the pacemaker side above the head for several weeks.
C. Microwave ovens should be avoided entirely.
D. Check your pulse once a month.
Correct Answer: B
Expert Explanation: Patients should avoid lifting the arm on the side of the
pacemaker to prevent lead displacement during the initial healing phase. Most
modern microwaves are safe, but MRI scans are generally contraindicated unless
the pacemaker is specifically labeled as MRI-conditional. Daily pulse checks are
recommended to ensure the pacemaker is maintaining the set heart rate.
