,Galen NSG 3850 Exam 4 | Pathophysiology for
Nurses II (2026) Actual Q&A PDF
1. Which finding is characteristic of fluid overload in a patient with heart
failure?
A) Orthostatic hypotension and dry mucous membranes
B) Crackles in all lung fields, jugular venous distention, and pitting edema
C) Flat neck veins and poor skin turgor
D) Decreased urine output and weight loss
Correct Answer: Crackles in all lung fields, jugular venous distention, and pitting
edema
Rationale: Fluid overload in heart failure manifests as pulmonary crackles, JVD,
and peripheral edema. These signs reflect increased intravascular volume and
congestion. Orthostatic hypotension indicates fluid deficit, while flat neck veins
and poor turgor suggest dehydration.
2. The nurse is reviewing the medication list of a patient admitted with acute
decompensated heart failure. Which drug is the first-line agent to rapidly reduce
preload?
A) Digoxin
B) Carvedilol
C) Lisinopril
D) Furosemide
Correct Answer: Furosemide
,Rationale: Furosemide is a loop diuretic that promptly decreases preload by
promoting diuresis, relieving pulmonary congestion. Digoxin improves
contractility but does not rapidly reduce volume. Beta-blockers and ACE
inhibitors are long-term therapies.
3. A patient with heart failure on digoxin reports anorexia, nausea, and seeing
yellow-green halos. The nurse suspects which condition?
A) Digoxin toxicity
B) Hypokalemia
C) Worsening heart failure
D) Pulmonary embolism
Correct Answer: Digoxin toxicity
Rationale: Anorexia, nausea, vomiting, and visual disturbances are classic early
signs of digoxin toxicity. The nurse should hold the drug, check serum digoxin
and potassium levels, and notify the provider.
4. A patient with heart failure receiving furosemide develops dizziness and a
systolic blood pressure drop of 20 mm Hg upon standing. The nurse interprets
this as:
A) Orthostatic hypotension due to fluid volume deficit
B) Expected therapeutic effect of the diuretic
C) Onset of cardiogenic shock
D) Electrolyte imbalance from potassium loss
, Correct Answer: Orthostatic hypotension due to fluid volume deficit
Rationale: Orthostatic hypotension is a hallmark sign of intravascular volume
depletion caused by excessive diuresis. The nurse should monitor fluid status,
hold the diuretic if indicated, and implement safety measures.
5. A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L.
Which clinical manifestation should the nurse anticipate?
A) Muscle weakness and risk for life-threatening dysrhythmias
B) Tetany and positive Chvostek’s sign
C) Bounding pulse and flushed skin
D) Increased deep tendon reflexes
Correct Answer: Muscle weakness and risk for life-threatening dysrhythmias
Rationale: Severe hyperkalemia depresses neuromuscular function, causing
muscle weakness and potentially fatal cardiac arrhythmias such as ventricular
fibrillation. Tetany is seen in hypocalcemia; bounding pulse is not characteristic.
6. A patient with CKD stage 4 reports persistent bone pain. The nurse attributes
this primarily to which pathophysiological process?
A) Uremic neuropathy
B) Chronic kidney disease mineral bone disorder
C) Osteoporosis from steroid use
D) Gouty arthritis
Nurses II (2026) Actual Q&A PDF
1. Which finding is characteristic of fluid overload in a patient with heart
failure?
A) Orthostatic hypotension and dry mucous membranes
B) Crackles in all lung fields, jugular venous distention, and pitting edema
C) Flat neck veins and poor skin turgor
D) Decreased urine output and weight loss
Correct Answer: Crackles in all lung fields, jugular venous distention, and pitting
edema
Rationale: Fluid overload in heart failure manifests as pulmonary crackles, JVD,
and peripheral edema. These signs reflect increased intravascular volume and
congestion. Orthostatic hypotension indicates fluid deficit, while flat neck veins
and poor turgor suggest dehydration.
2. The nurse is reviewing the medication list of a patient admitted with acute
decompensated heart failure. Which drug is the first-line agent to rapidly reduce
preload?
A) Digoxin
B) Carvedilol
C) Lisinopril
D) Furosemide
Correct Answer: Furosemide
,Rationale: Furosemide is a loop diuretic that promptly decreases preload by
promoting diuresis, relieving pulmonary congestion. Digoxin improves
contractility but does not rapidly reduce volume. Beta-blockers and ACE
inhibitors are long-term therapies.
3. A patient with heart failure on digoxin reports anorexia, nausea, and seeing
yellow-green halos. The nurse suspects which condition?
A) Digoxin toxicity
B) Hypokalemia
C) Worsening heart failure
D) Pulmonary embolism
Correct Answer: Digoxin toxicity
Rationale: Anorexia, nausea, vomiting, and visual disturbances are classic early
signs of digoxin toxicity. The nurse should hold the drug, check serum digoxin
and potassium levels, and notify the provider.
4. A patient with heart failure receiving furosemide develops dizziness and a
systolic blood pressure drop of 20 mm Hg upon standing. The nurse interprets
this as:
A) Orthostatic hypotension due to fluid volume deficit
B) Expected therapeutic effect of the diuretic
C) Onset of cardiogenic shock
D) Electrolyte imbalance from potassium loss
, Correct Answer: Orthostatic hypotension due to fluid volume deficit
Rationale: Orthostatic hypotension is a hallmark sign of intravascular volume
depletion caused by excessive diuresis. The nurse should monitor fluid status,
hold the diuretic if indicated, and implement safety measures.
5. A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L.
Which clinical manifestation should the nurse anticipate?
A) Muscle weakness and risk for life-threatening dysrhythmias
B) Tetany and positive Chvostek’s sign
C) Bounding pulse and flushed skin
D) Increased deep tendon reflexes
Correct Answer: Muscle weakness and risk for life-threatening dysrhythmias
Rationale: Severe hyperkalemia depresses neuromuscular function, causing
muscle weakness and potentially fatal cardiac arrhythmias such as ventricular
fibrillation. Tetany is seen in hypocalcemia; bounding pulse is not characteristic.
6. A patient with CKD stage 4 reports persistent bone pain. The nurse attributes
this primarily to which pathophysiological process?
A) Uremic neuropathy
B) Chronic kidney disease mineral bone disorder
C) Osteoporosis from steroid use
D) Gouty arthritis
