PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Page 1 | Passing Score: 80%
PNH NURSING PROGRAM
PNH301 - TEST 2 | QUESTIONS AND
ANSWERS | 2026/2027 | WITH COMPLETE
SOLUTION!! 2026/2027
NURSING · Official Exam 2026/2027
75 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-15
Section 2 Respiratory Disorders Q16-30
Section 3 Hematological and Immune Disorders Q31-45
Section 4 Neurological Disorders Q46-60
Section 5 Musculoskeletal and Integumentary Disorders Q61-75
Instructions: Select the single best answer for each question. This exam is designed for PNH301 Test 2 preparation. Passing score: 80%
(60 questions correct).
,ECTION 1 | Cardiovascular Disorders | Q1-Q15 | PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/202
Q1 Question 1 of 75
A 68-year-old male presents to the emergency department with crushing substernal chest
pain radiating to his left arm, diaphoresis, and nausea that began 45 minutes ago. His ECG
shows ST-segment elevation in leads V1 through V4. Which intervention should the nurse
anticipate as the highest priority?
A. Administer thrombolytic therapy or prepare for percutaneous coronary intervention
B. Obtain a 12-lead ECG and serial cardiac enzymes every 8 hours
C. Place the patient on continuous cardiac monitoring and bed rest
D. Administer a beta-blocker and assess for contraindications
Correct Answer: A
Rationale:
The patient is presenting with an acute ST-elevation myocardial infarction (STEMI) of the anterior wall. The highest
priority intervention is immediate reperfusion, either through thrombolytic therapy or percutaneous coronary
intervention (PCI), to minimize myocardial damage. While cardiac monitoring and beta-blockers are important,
reperfusion takes precedence. Serial enzymes alone do not treat the infarction.
Q2 Question 2 of 75
A 72-year-old female with a history of atrial fibrillation is admitted with sudden onset of
left-sided weakness, facial droop, and slurred speech that began two hours ago. A
non-contrast CT scan of the head shows no hemorrhage. Which medication should the
nurse prepare to administer?
A. Alteplase (tPA) intravenously within the therapeutic window
B. Aspirin 325 mg orally immediately
C. Heparin drip at 18 units/kg/hr continuous infusion
D. Warfarin 5 mg orally for anticoagulation initiation
Correct Answer: A
Rationale:
The patient is experiencing an acute ischemic stroke with symptom onset within the 3-4.5 hour window for tPA.
Alteplase is the standard of care for dissolving the clot and restoring perfusion in eligible patients. Aspirin and heparin
are used in stroke management but not as first-line reperfusion agents. Warfarin takes days to achieve therapeutic
anticoagulation.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 2 of 1
,Q3 Question 3 of 75
A 55-year-old male with hypertension and type 2 diabetes presents for a routine follow-up.
His blood pressure is 162/98 mmHg, and he reports occasional headaches and blurred
vision. His current medications include metformin and lisinopril 10 mg daily. What is the
most appropriate nursing action?
A. Advise the provider to titrate the lisinopril dose upward and reinforce dietary sodium
restriction
B. Instruct the patient to double his lisinopril dose immediately at home
C. Document the findings and reassess at the next scheduled visit in three months
D. Administer a rapid-acting antihypertensive such as nitroprusside in the clinic
Correct Answer: A
Rationale:
The patient has uncontrolled stage 2 hypertension on current therapy, requiring medication adjustment. Titrating the
ACE inhibitor upward while reinforcing lifestyle modifications is the appropriate step. Doubling medication without
provider guidance is unsafe. Reassessing in three months with this level of elevation risks target organ damage.
Nitroprusside is reserved for hypertensive emergencies.
Q4 Question 4 of 75
A 60-year-old female is admitted with acute decompensated heart failure presenting with
dyspnea at rest, bilateral crackles throughout the lung fields, and 3+ pitting edema in both
lower extremities. Her BNP level is 1,840 pg/mL. Which assessment finding indicates the
most immediate concern?
A. Oxygen saturation of 88% on room air with labored breathing
B. Weight gain of 4 pounds over the past three days
C. Jugular venous distension of 8 cm above the sternal angle
D. Bounding peripheral pulses with a widened pulse pressure
Correct Answer: A
Rationale:
An oxygen saturation of 88% with labored breathing indicates significant respiratory compromise requiring immediate
intervention such as supplemental oxygen and possibly noninvasive ventilation. While weight gain, JVD, and bounding
pulses are all signs of heart failure exacerbation, hypoxemia poses the most immediate threat to life and must be
addressed first.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 3 of 1
, Q5 Question 5 of 75
A 48-year-old male with a mechanical mitral valve replacement presents with an INR of 1.4
on his routine laboratory draw. He reports missing several doses of warfarin over the past
week due to a gastrointestinal illness. Which action should the nurse take first?
A. Notify the provider immediately about the subtherapeutic INR in a patient with a
mechanical valve
B. Instruct the patient to take three times his normal warfarin dose tonight
C. Advise the patient to increase his intake of vitamin K-rich foods
D. Document the finding and remind the patient to resume his regular dose
Correct Answer: A
Rationale:
A mechanical heart valve requires strict anticoagulation with a target INR of 2.5-3.5. An INR of 1.4 is dangerously
subtherapeutic, placing the patient at high risk for valve thrombosis and thromboembolic events. The provider must be
notified immediately for dose adjustment or bridge therapy. Self-adjusting warfarin doses is unsafe, and vitamin K
would further lower the INR.
Q6 Question 6 of 75
A 70-year-old male with a history of peripheral artery disease complains of new-onset pain
in his right calf that occurs at rest, worsens when he elevates his leg in bed, and is partially
relieved by dangling his leg over the side of the bed. His right foot appears pale and cool to
the touch. What does this presentation most likely indicate?
A. Critical limb ischemia requiring urgent vascular surgery evaluation
B. Acute deep vein thrombosis requiring immediate anticoagulation
C. Intermittent claudication managed with exercise therapy alone
D. Cellulitis of the lower extremity requiring antibiotic therapy
Correct Answer: A
Rationale:
Rest pain that worsens with elevation and improves with dependency is the hallmark of critical limb ischemia, the most
severe form of peripheral artery disease. This indicates severe arterial insufficiency and carries a high risk of limb loss
without urgent intervention. DVT typically causes pain that worsens with dependency, not elevation. Claudication
occurs with activity, not at rest.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 4 of 1
PNH NURSING PROGRAM
PNH301 - TEST 2 | QUESTIONS AND
ANSWERS | 2026/2027 | WITH COMPLETE
SOLUTION!! 2026/2027
NURSING · Official Exam 2026/2027
75 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-15
Section 2 Respiratory Disorders Q16-30
Section 3 Hematological and Immune Disorders Q31-45
Section 4 Neurological Disorders Q46-60
Section 5 Musculoskeletal and Integumentary Disorders Q61-75
Instructions: Select the single best answer for each question. This exam is designed for PNH301 Test 2 preparation. Passing score: 80%
(60 questions correct).
,ECTION 1 | Cardiovascular Disorders | Q1-Q15 | PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/202
Q1 Question 1 of 75
A 68-year-old male presents to the emergency department with crushing substernal chest
pain radiating to his left arm, diaphoresis, and nausea that began 45 minutes ago. His ECG
shows ST-segment elevation in leads V1 through V4. Which intervention should the nurse
anticipate as the highest priority?
A. Administer thrombolytic therapy or prepare for percutaneous coronary intervention
B. Obtain a 12-lead ECG and serial cardiac enzymes every 8 hours
C. Place the patient on continuous cardiac monitoring and bed rest
D. Administer a beta-blocker and assess for contraindications
Correct Answer: A
Rationale:
The patient is presenting with an acute ST-elevation myocardial infarction (STEMI) of the anterior wall. The highest
priority intervention is immediate reperfusion, either through thrombolytic therapy or percutaneous coronary
intervention (PCI), to minimize myocardial damage. While cardiac monitoring and beta-blockers are important,
reperfusion takes precedence. Serial enzymes alone do not treat the infarction.
Q2 Question 2 of 75
A 72-year-old female with a history of atrial fibrillation is admitted with sudden onset of
left-sided weakness, facial droop, and slurred speech that began two hours ago. A
non-contrast CT scan of the head shows no hemorrhage. Which medication should the
nurse prepare to administer?
A. Alteplase (tPA) intravenously within the therapeutic window
B. Aspirin 325 mg orally immediately
C. Heparin drip at 18 units/kg/hr continuous infusion
D. Warfarin 5 mg orally for anticoagulation initiation
Correct Answer: A
Rationale:
The patient is experiencing an acute ischemic stroke with symptom onset within the 3-4.5 hour window for tPA.
Alteplase is the standard of care for dissolving the clot and restoring perfusion in eligible patients. Aspirin and heparin
are used in stroke management but not as first-line reperfusion agents. Warfarin takes days to achieve therapeutic
anticoagulation.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 2 of 1
,Q3 Question 3 of 75
A 55-year-old male with hypertension and type 2 diabetes presents for a routine follow-up.
His blood pressure is 162/98 mmHg, and he reports occasional headaches and blurred
vision. His current medications include metformin and lisinopril 10 mg daily. What is the
most appropriate nursing action?
A. Advise the provider to titrate the lisinopril dose upward and reinforce dietary sodium
restriction
B. Instruct the patient to double his lisinopril dose immediately at home
C. Document the findings and reassess at the next scheduled visit in three months
D. Administer a rapid-acting antihypertensive such as nitroprusside in the clinic
Correct Answer: A
Rationale:
The patient has uncontrolled stage 2 hypertension on current therapy, requiring medication adjustment. Titrating the
ACE inhibitor upward while reinforcing lifestyle modifications is the appropriate step. Doubling medication without
provider guidance is unsafe. Reassessing in three months with this level of elevation risks target organ damage.
Nitroprusside is reserved for hypertensive emergencies.
Q4 Question 4 of 75
A 60-year-old female is admitted with acute decompensated heart failure presenting with
dyspnea at rest, bilateral crackles throughout the lung fields, and 3+ pitting edema in both
lower extremities. Her BNP level is 1,840 pg/mL. Which assessment finding indicates the
most immediate concern?
A. Oxygen saturation of 88% on room air with labored breathing
B. Weight gain of 4 pounds over the past three days
C. Jugular venous distension of 8 cm above the sternal angle
D. Bounding peripheral pulses with a widened pulse pressure
Correct Answer: A
Rationale:
An oxygen saturation of 88% with labored breathing indicates significant respiratory compromise requiring immediate
intervention such as supplemental oxygen and possibly noninvasive ventilation. While weight gain, JVD, and bounding
pulses are all signs of heart failure exacerbation, hypoxemia poses the most immediate threat to life and must be
addressed first.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 3 of 1
, Q5 Question 5 of 75
A 48-year-old male with a mechanical mitral valve replacement presents with an INR of 1.4
on his routine laboratory draw. He reports missing several doses of warfarin over the past
week due to a gastrointestinal illness. Which action should the nurse take first?
A. Notify the provider immediately about the subtherapeutic INR in a patient with a
mechanical valve
B. Instruct the patient to take three times his normal warfarin dose tonight
C. Advise the patient to increase his intake of vitamin K-rich foods
D. Document the finding and remind the patient to resume his regular dose
Correct Answer: A
Rationale:
A mechanical heart valve requires strict anticoagulation with a target INR of 2.5-3.5. An INR of 1.4 is dangerously
subtherapeutic, placing the patient at high risk for valve thrombosis and thromboembolic events. The provider must be
notified immediately for dose adjustment or bridge therapy. Self-adjusting warfarin doses is unsafe, and vitamin K
would further lower the INR.
Q6 Question 6 of 75
A 70-year-old male with a history of peripheral artery disease complains of new-onset pain
in his right calf that occurs at rest, worsens when he elevates his leg in bed, and is partially
relieved by dangling his leg over the side of the bed. His right foot appears pale and cool to
the touch. What does this presentation most likely indicate?
A. Critical limb ischemia requiring urgent vascular surgery evaluation
B. Acute deep vein thrombosis requiring immediate anticoagulation
C. Intermittent claudication managed with exercise therapy alone
D. Cellulitis of the lower extremity requiring antibiotic therapy
Correct Answer: A
Rationale:
Rest pain that worsens with elevation and improves with dependency is the hallmark of critical limb ischemia, the most
severe form of peripheral artery disease. This indicates severe arterial insufficiency and carries a high risk of limb loss
without urgent intervention. DVT typically causes pain that worsens with dependency, not elevation. Claudication
occurs with activity, not at rest.
PNH301 - TEST 2 | QUESTIONS AND ANSWERS | 2026/2027 | WITH COMPLETE SOLUTION!! 2026/2027 2026/2027 | Passing Score: 80% | Page 4 of 1
