2026 ACTUAL FINAL EXAM WITH COMPLETE DETAILED
QUESTIONS AND 100 CORRECT VERIFIED ANSWERS ALREADY
A+ GRADED BRAND NEW!!!
1. A client with heart failure reports a 5-pound weight gain in 3 days. Which action should the nurse take
first?
A) Restrict oral fluids to 1 L per day
B) Auscultate lung sounds
C) Administer furosemide as ordered
D) Check blood glucose level
CORRECT ANSWER: B – Auscultate lung sounds to assess for pulmonary congestion (crackles). Rationale:
Weight gain suggests fluid retention; lung assessment guides urgency and intervention.
2. A client with acute myocardial infarction (MI) develops jugular vein distention, hypotension, and
muffled heart sounds. The nurse suspects:
A) Cardiogenic shock
B) Cardiac tamponade
C) Left ventricular failure
D) Pulmonary embolism
**CORRECT ANSWER: B – Beck’s triad (hypotension, JVD, muffled heart sounds) indicates cardiac
tamponade. Rationale: Tamponade is a medical emergency requiring pericardiocentesis.**
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,**3. A client is prescribed digoxin. Which finding indicates toxicity?**
A) Heart rate of 62 bpm
B) Visual halos (yellow-green) around lights
C) Serum potassium 4.0 mEq/L
D) Ankle edema
CORRECT ANSWER: B – Visual disturbances (halos, blurring) are classic signs of digoxin toxicity.
Rationale: Other signs include nausea, vomiting, bradycardia, and arrhythmias.
4. A client with unstable angina is receiving heparin IV. Which laboratory value requires immediate
notification of the provider?
A) aPTT 70 seconds (normal 30-40)
B) Platelet count 80,000/mm³
C) INR 1.2
D) Hemoglobin 13 g/dL
CORRECT ANSWER: B – Thrombocytopenia (HIT) can occur with heparin; platelets <100,000 or 50% drop
from baseline. Rationale: aPTT 70 is therapeutic (1.5-2.5x normal).
5. A client post-cardiac catheterization via femoral artery reports severe groin pain and a pulsatile mass.
What is the priority action?
A) Apply pressure above the site
B) Notify the provider immediately
C) Elevate the leg
D) Administer morphine
,CORRECT ANSWER: B – Pulsatile mass suggests pseudoaneurysm or retroperitoneal bleed. Rationale:
Requires immediate ultrasound and possible surgical repair or thrombin injection.
6. A client with heart failure has an ejection fraction (EF) of 25%. Which medication is most likely to
improve survival?
A) Furosemide
B) Metoprolol succinate
C) Digoxin
D) Hydralazine
CORRECT ANSWER: B – Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce mortality in
HFrEF. Rationale: Furosemide treats symptoms only; digoxin reduces hospitalizations but not mortality.
**7. A client with atrial fibrillation is prescribed warfarin. Which INR range is typically therapeutic?**
A) 1.0-1.5
B) 2.0-3.0
C) 3.5-4.5
D) 4.0-5.0
CORRECT ANSWER: B – For atrial fibrillation, INR 2.0-3.0 is target for stroke prevention. Rationale:
Mechanical valves may require 2.5-3.5.
8. A client reports chest pain that radiates to the jaw, occurs at rest, and is relieved by nitroglycerin. This
is most consistent with:
A) Stable angina
, B) Unstable angina
C) Pericarditis
D) Aortic dissection
CORRECT ANSWER: B – Unstable angina occurs at rest or with minimal exertion and is a medical
emergency. Rationale: Stable angina occurs with exertion; pericarditis pain is positional; dissection is
tearing pain.
9. A client with hypertension is started on lisinopril. Which finding requires immediate discontinuation?
A) Dry cough
B) Serum potassium 5.5 mEq/L
C) Angioedema (swelling of lips/tongue)
D) Dizziness with standing
CORRECT ANSWER: C – Angioedema is a life-threatening allergic reaction to ACE inhibitors. Rationale:
Dry cough is common but not emergent; mild hyperkalemia may be managed; dizziness is expected.
10. A client with infective endocarditis has a temperature of 102°F. Blood cultures are ordered. When
should the nurse obtain them?
A) Immediately after giving antibiotic
B) Before first dose of antibiotics
C) Only if fever spikes above 104°F
D) After antipyretics are given
CORRECT ANSWER: B – Blood cultures must be obtained before starting antibiotics to maximize yield.
Rationale: Antibiotics will sterilize blood cultures, making diagnosis difficult.