NURS 661 Exam 3 Study Guide – Maryville
University Practice Examination Questions And
Correct Answers (Verified Answers) Plus Rationales
2027 Q&A | Instant Download Pdf
1. Which assessment finding is most characteristic of left-sided heart
failure?
A. Jugular venous distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in the lungs
Answer: D. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion
because blood backs up into the pulmonary circulation. Crackles,
dyspnea, orthopnea, and pulmonary edema are hallmark findings.
Jugular venous distention, hepatomegaly, and peripheral edema are
more commonly associated with right-sided heart failure.
,2. Which electrolyte abnormality is most likely to cause peaked T
waves on an ECG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C. Hyperkalemia
Rationale: Hyperkalemia slows cardiac conduction and initially
produces tall, peaked T waves. Severe hyperkalemia may progress to
widened QRS complexes and life-threatening dysrhythmias. The other
electrolyte disturbances produce different ECG changes.
3. A patient with chronic kidney disease has an estimated glomerular
filtration rate (eGFR) of 25 mL/min/1.73 m². This finding is consistent
with which stage?
A. Stage 2
B. Stage 3a
C. Stage 4
D. Stage 5
Answer: C. Stage 4
,Rationale: Stage 4 chronic kidney disease is defined by an eGFR of 15–
29 mL/min/1.73 m². Stage 5 is below 15 mL/min, while Stages 2 and 3
represent milder disease.
4. Which laboratory test best reflects long-term glycemic control?
A. Fasting blood glucose
B. Random glucose
C. Oral glucose tolerance test
D. Hemoglobin A1C
Answer: D. Hemoglobin A1C
Rationale: Hemoglobin A1C reflects average blood glucose over
approximately three months by measuring glycated hemoglobin. Daily
glucose tests provide only a snapshot of current blood glucose levels.
5. Which medication class provides renal protection in patients with
diabetes and hypertension?
A. Beta blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Loop diuretics
, Answer: C. ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure and slow
diabetic nephropathy progression while lowering blood pressure.
Although other antihypertensive medications lower blood pressure,
ACE inhibitors provide superior renal protection.
6. Which patient is at greatest risk for developing deep vein
thrombosis?
A. A healthy adult who exercises daily
B. A postoperative patient on prolonged bed rest
C. A teenager with seasonal allergies
D. A patient receiving antibiotics for pneumonia
Answer: B. A postoperative patient on prolonged bed rest
Rationale: Immobility, surgery, venous stasis, and tissue injury
significantly increase thrombus formation according to Virchow's
triad. Regular activity reduces venous stasis and lowers DVT risk.
7. Which arterial blood gas finding indicates metabolic acidosis?
University Practice Examination Questions And
Correct Answers (Verified Answers) Plus Rationales
2027 Q&A | Instant Download Pdf
1. Which assessment finding is most characteristic of left-sided heart
failure?
A. Jugular venous distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in the lungs
Answer: D. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion
because blood backs up into the pulmonary circulation. Crackles,
dyspnea, orthopnea, and pulmonary edema are hallmark findings.
Jugular venous distention, hepatomegaly, and peripheral edema are
more commonly associated with right-sided heart failure.
,2. Which electrolyte abnormality is most likely to cause peaked T
waves on an ECG?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C. Hyperkalemia
Rationale: Hyperkalemia slows cardiac conduction and initially
produces tall, peaked T waves. Severe hyperkalemia may progress to
widened QRS complexes and life-threatening dysrhythmias. The other
electrolyte disturbances produce different ECG changes.
3. A patient with chronic kidney disease has an estimated glomerular
filtration rate (eGFR) of 25 mL/min/1.73 m². This finding is consistent
with which stage?
A. Stage 2
B. Stage 3a
C. Stage 4
D. Stage 5
Answer: C. Stage 4
,Rationale: Stage 4 chronic kidney disease is defined by an eGFR of 15–
29 mL/min/1.73 m². Stage 5 is below 15 mL/min, while Stages 2 and 3
represent milder disease.
4. Which laboratory test best reflects long-term glycemic control?
A. Fasting blood glucose
B. Random glucose
C. Oral glucose tolerance test
D. Hemoglobin A1C
Answer: D. Hemoglobin A1C
Rationale: Hemoglobin A1C reflects average blood glucose over
approximately three months by measuring glycated hemoglobin. Daily
glucose tests provide only a snapshot of current blood glucose levels.
5. Which medication class provides renal protection in patients with
diabetes and hypertension?
A. Beta blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Loop diuretics
, Answer: C. ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure and slow
diabetic nephropathy progression while lowering blood pressure.
Although other antihypertensive medications lower blood pressure,
ACE inhibitors provide superior renal protection.
6. Which patient is at greatest risk for developing deep vein
thrombosis?
A. A healthy adult who exercises daily
B. A postoperative patient on prolonged bed rest
C. A teenager with seasonal allergies
D. A patient receiving antibiotics for pneumonia
Answer: B. A postoperative patient on prolonged bed rest
Rationale: Immobility, surgery, venous stasis, and tissue injury
significantly increase thrombus formation according to Virchow's
triad. Regular activity reduces venous stasis and lowers DVT risk.
7. Which arterial blood gas finding indicates metabolic acidosis?