NURS 5461 Final Exam
Questions With Correct
Answers Latest Update 2026 |
Exam Prep
NURS 5461 Final Exam Simulation
Adult-Gerontology Management Across the Continuum of
Care
Comprehensive Practice Exam — Questions 1–100
Instructions: Select the one best answer for multiple-choice questions. For SATA questions,
select all answers that apply.
Cardiovascular Disorders
1. A 72-year-old patient presents with chest pressure, diaphoresis, and nausea.
The ECG demonstrates ST-segment elevation in leads II, III, and aVF. Which
condition should the nurse suspect?
A. Inferior STEMI
B. Stable angina
C. Pericarditis
D. Pulmonary embolism
Correct Answer: A
Rationale: ST-segment elevation with acute ischemic symptoms indicates an acute STEMI.
Leads II, III, and aVF correspond to the inferior wall.
,2. Which assessment finding in a patient with acute coronary syndrome requires
the most immediate intervention?
A. Heart rate of 96/min
B. Oxygen saturation of 97%
C. New-onset ventricular fibrillation
D. Blood pressure of 138/84 mmHg
Correct Answer: C
Rationale: Ventricular fibrillation causes ineffective cardiac output and requires immediate
defibrillation and resuscitation.
3. A patient with heart failure reports worsening shortness of breath and a 3-kg
weight gain over 3 days. Which finding is most concerning?
A. Mild fatigue
B. Bilateral crackles and orthopnea
C. Heart rate of 76/min
D. Increased appetite
Correct Answer: B
Rationale: Crackles and orthopnea suggest pulmonary congestion caused by worsening heart
failure.
4. Which medications may be used as part of guideline-directed therapy for heart
failure with reduced ejection fraction? Select all that apply.
A. ACE inhibitors
B. Evidence-based beta blockers
C. Mineralocorticoid receptor antagonists
D. SGLT2 inhibitors
E. Routine NSAIDs
Correct Answers: A, B, C, D
Rationale: Several medication classes improve outcomes in HFrEF, including ACE inhibitors or
other renin-angiotensin system therapies, evidence-based beta blockers, mineralocorticoid
,receptor antagonists, and SGLT2 inhibitors. NSAIDs may worsen fluid retention and kidney
function.
5. Which finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema only
C. Pulmonary crackles
D. Enlarged liver
Correct Answer: C
Rationale: Left-sided heart failure commonly causes pulmonary congestion, resulting in
dyspnea and crackles.
6. A patient taking furosemide should be monitored closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia in every patient
D. Increased blood volume
Correct Answer: B
Rationale: Loop diuretics increase urinary potassium excretion and can cause hypokalemia.
7. Which patient should the nurse assess first?
A. Patient with chronic hypertension and BP 142/86 mmHg
B. Patient with stable angina reporting usual symptoms
C. Patient with heart failure who suddenly develops severe dyspnea and pink frothy sputum
D. Patient with controlled atrial fibrillation
Correct Answer: C
Rationale: Sudden severe dyspnea with pink frothy sputum suggests acute pulmonary edema, a
life-threatening emergency.
, 8. A patient with atrial fibrillation is prescribed an anticoagulant. The primary
purpose is to:
A. Restore sinus rhythm
B. Prevent thromboembolic stroke
C. Increase heart rate
D. Reduce cholesterol
Correct Answer: B
Rationale: Atrial fibrillation increases the risk of atrial thrombus formation and embolic stroke.
9. Which symptoms may indicate digoxin toxicity? Select all that apply.
A. Nausea and vomiting
B. Visual disturbances
C. Bradycardia
D. Confusion
E. Increased appetite
Correct Answers: A, B, C, D
Rationale: Digoxin toxicity may cause gastrointestinal symptoms, visual changes, neurologic
effects, and cardiac dysrhythmias.
10. A patient with hypertension has a blood pressure of 224/126 mmHg and
reports severe headache and blurred vision. What is the priority?
A. Recheck the BP in one month
B. Assess for acute target-organ injury
C. Encourage increased sodium intake
D. Recommend routine exercise only
Correct Answer: B
Rationale: Severe hypertension with neurologic symptoms raises concern for hypertensive
emergency and acute target-organ damage.
Respiratory Disorders
Questions With Correct
Answers Latest Update 2026 |
Exam Prep
NURS 5461 Final Exam Simulation
Adult-Gerontology Management Across the Continuum of
Care
Comprehensive Practice Exam — Questions 1–100
Instructions: Select the one best answer for multiple-choice questions. For SATA questions,
select all answers that apply.
Cardiovascular Disorders
1. A 72-year-old patient presents with chest pressure, diaphoresis, and nausea.
The ECG demonstrates ST-segment elevation in leads II, III, and aVF. Which
condition should the nurse suspect?
A. Inferior STEMI
B. Stable angina
C. Pericarditis
D. Pulmonary embolism
Correct Answer: A
Rationale: ST-segment elevation with acute ischemic symptoms indicates an acute STEMI.
Leads II, III, and aVF correspond to the inferior wall.
,2. Which assessment finding in a patient with acute coronary syndrome requires
the most immediate intervention?
A. Heart rate of 96/min
B. Oxygen saturation of 97%
C. New-onset ventricular fibrillation
D. Blood pressure of 138/84 mmHg
Correct Answer: C
Rationale: Ventricular fibrillation causes ineffective cardiac output and requires immediate
defibrillation and resuscitation.
3. A patient with heart failure reports worsening shortness of breath and a 3-kg
weight gain over 3 days. Which finding is most concerning?
A. Mild fatigue
B. Bilateral crackles and orthopnea
C. Heart rate of 76/min
D. Increased appetite
Correct Answer: B
Rationale: Crackles and orthopnea suggest pulmonary congestion caused by worsening heart
failure.
4. Which medications may be used as part of guideline-directed therapy for heart
failure with reduced ejection fraction? Select all that apply.
A. ACE inhibitors
B. Evidence-based beta blockers
C. Mineralocorticoid receptor antagonists
D. SGLT2 inhibitors
E. Routine NSAIDs
Correct Answers: A, B, C, D
Rationale: Several medication classes improve outcomes in HFrEF, including ACE inhibitors or
other renin-angiotensin system therapies, evidence-based beta blockers, mineralocorticoid
,receptor antagonists, and SGLT2 inhibitors. NSAIDs may worsen fluid retention and kidney
function.
5. Which finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema only
C. Pulmonary crackles
D. Enlarged liver
Correct Answer: C
Rationale: Left-sided heart failure commonly causes pulmonary congestion, resulting in
dyspnea and crackles.
6. A patient taking furosemide should be monitored closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia in every patient
D. Increased blood volume
Correct Answer: B
Rationale: Loop diuretics increase urinary potassium excretion and can cause hypokalemia.
7. Which patient should the nurse assess first?
A. Patient with chronic hypertension and BP 142/86 mmHg
B. Patient with stable angina reporting usual symptoms
C. Patient with heart failure who suddenly develops severe dyspnea and pink frothy sputum
D. Patient with controlled atrial fibrillation
Correct Answer: C
Rationale: Sudden severe dyspnea with pink frothy sputum suggests acute pulmonary edema, a
life-threatening emergency.
, 8. A patient with atrial fibrillation is prescribed an anticoagulant. The primary
purpose is to:
A. Restore sinus rhythm
B. Prevent thromboembolic stroke
C. Increase heart rate
D. Reduce cholesterol
Correct Answer: B
Rationale: Atrial fibrillation increases the risk of atrial thrombus formation and embolic stroke.
9. Which symptoms may indicate digoxin toxicity? Select all that apply.
A. Nausea and vomiting
B. Visual disturbances
C. Bradycardia
D. Confusion
E. Increased appetite
Correct Answers: A, B, C, D
Rationale: Digoxin toxicity may cause gastrointestinal symptoms, visual changes, neurologic
effects, and cardiac dysrhythmias.
10. A patient with hypertension has a blood pressure of 224/126 mmHg and
reports severe headache and blurred vision. What is the priority?
A. Recheck the BP in one month
B. Assess for acute target-organ injury
C. Encourage increased sodium intake
D. Recommend routine exercise only
Correct Answer: B
Rationale: Severe hypertension with neurologic symptoms raises concern for hypertensive
emergency and acute target-organ damage.
Respiratory Disorders
