Herzing University NSG523 Medical-Surgical
Nursing Exam 2 (2026/2027 Actual Questions &
Answers
,
,Questions 1–25: Cardiovascular & Peripheral Vascular Systems
Question 1
A client is admitted with acute decompensated heart failure and prescribed intravenous
furosemide. Which laboratory value should the nurse monitor most closely prior to
administration?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.1 mEq/L
C. Blood urea nitrogen 18 mg/dL
D. Serum calcium 9.2 mg/dL
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion. Administering
furosemide to a client with hypokalemia (normal potassium: 3.5–5.0 mEq/L) increases the
risk of dangerous cardiac dysrhythmias, such as ventricular tachycardia or fibrillation.
Question 2
A nurse is assessing a client with left-sided heart failure. Which clinical manifestation should
the nurse expect to find?
A. Jugular venous distension
B. Peripheral edema in lower extremities
C. Crackles upon lung auscultation
, D. Hepatomegaly and right upper quadrant pain
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion because the left ventricle
cannot effectively pump blood into systemic circulation. This results in fluid backing up into
the pulmonary vasculature, causing crackles, dyspnea, orthopnea, and cough. JVD,
peripheral edema, and hepatomegaly are signs of right-sided heart failure.
Question 3
A client presenting with severe crushing chest pain receives a diagnosis of acute myocardial
infarction (MI). Which cardiac biomarker is most specific for myocardial tissue injury and
elevates within 3 to 4 hours of injury?
A. Myoglobin
B. Creatine kinase-MB (CK-MB)
C. Troponin I
D. Brain natriuretic peptide (BNP)
Correct Answer: C
Rationale: Troponin I is highly specific to cardiac tissue necrosis and rises within 3–4 hours
following cardiac injury, remaining elevated for up to 10–14 days. Myoglobin elevates early
but lacks cardiac specificity. BNP measures ventricular stretch in heart failure.
Question 4
A nurse administers sublingual nitroglycerin to a client experiencing stable angina. Which
expected side effect should the nurse educate the client about?
A. Bradycardia
Nursing Exam 2 (2026/2027 Actual Questions &
Answers
,
,Questions 1–25: Cardiovascular & Peripheral Vascular Systems
Question 1
A client is admitted with acute decompensated heart failure and prescribed intravenous
furosemide. Which laboratory value should the nurse monitor most closely prior to
administration?
A. Serum sodium 138 mEq/L
B. Serum potassium 3.1 mEq/L
C. Blood urea nitrogen 18 mg/dL
D. Serum calcium 9.2 mg/dL
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium excretion. Administering
furosemide to a client with hypokalemia (normal potassium: 3.5–5.0 mEq/L) increases the
risk of dangerous cardiac dysrhythmias, such as ventricular tachycardia or fibrillation.
Question 2
A nurse is assessing a client with left-sided heart failure. Which clinical manifestation should
the nurse expect to find?
A. Jugular venous distension
B. Peripheral edema in lower extremities
C. Crackles upon lung auscultation
, D. Hepatomegaly and right upper quadrant pain
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion because the left ventricle
cannot effectively pump blood into systemic circulation. This results in fluid backing up into
the pulmonary vasculature, causing crackles, dyspnea, orthopnea, and cough. JVD,
peripheral edema, and hepatomegaly are signs of right-sided heart failure.
Question 3
A client presenting with severe crushing chest pain receives a diagnosis of acute myocardial
infarction (MI). Which cardiac biomarker is most specific for myocardial tissue injury and
elevates within 3 to 4 hours of injury?
A. Myoglobin
B. Creatine kinase-MB (CK-MB)
C. Troponin I
D. Brain natriuretic peptide (BNP)
Correct Answer: C
Rationale: Troponin I is highly specific to cardiac tissue necrosis and rises within 3–4 hours
following cardiac injury, remaining elevated for up to 10–14 days. Myoglobin elevates early
but lacks cardiac specificity. BNP measures ventricular stretch in heart failure.
Question 4
A nurse administers sublingual nitroglycerin to a client experiencing stable angina. Which
expected side effect should the nurse educate the client about?
A. Bradycardia
