,NU 185/NU185 Exam 3 – Medical-Surgical Nursing
II – Actual Q&A (GCN) (Updated PDF)
1. A client with left-sided heart failure is most likely to exhibit which finding?
A) Crackles and dyspnea
B) Peripheral edema and jugular venous distention
C) Ascites and hepatomegaly
D) Weight gain and dependent edema
Correct Answer: A) Crackles and dyspnea
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, producing pulmonary congestion with crackles and dyspnea.
Peripheral edema, jugular venous distention, ascites, and hepatomegaly are
systemic signs of right-sided failure. Recognizing this distinction guides
monitoring and treatment.
2. Which assessment finding is characteristic of right-sided heart failure?
A) Pulmonary crackles
B) Peripheral edema and jugular venous distention
C) Orthopnea
D) Frothy sputum
Correct Answer: B) Peripheral edema and jugular venous distention
,Rationale: Right-sided heart failure causes blood to back up into the systemic
venous circulation, leading to peripheral edema, jugular venous distention, and
liver congestion. Pulmonary crackles, orthopnea, and frothy sputum reflect left-
sided failure and pulmonary congestion.
3. A nurse is reviewing medications for a client with heart failure. Which
medication is the first-line diuretic?
A) Digoxin
B) Metoprolol
C) Furosemide (Lasix)
D) Lisinopril
Correct Answer: C) Furosemide (Lasix)
Rationale: Furosemide is a loop diuretic and the first-line diuretic for heart
failure because it rapidly reduces fluid overload and pulmonary congestion.
Digoxin increases contractility, metoprolol is a beta blocker, and lisinopril is an
ACE inhibitor.
4. The nurse explains that digoxin is prescribed for heart failure primarily to
produce which effect?
A) Decrease heart rate
B) Decrease blood pressure
C) Remove excess fluid
D) Increase contractility of the heart muscle
Correct Answer: D) Increase contractility of the heart muscle
, Rationale: Digoxin increases the force of myocardial contraction, improving
cardiac output in heart failure. Although it can slow conduction, its primary
purpose is to increase contractility. Furosemide removes fluid, and
antihypertensives lower blood pressure.
5. Which cause is associated with secondary hypertension?
A) Genetic predisposition
B) Renal artery stenosis
C) Family history
D) Advancing age
Correct Answer: B) Renal artery stenosis
Rationale: Secondary hypertension has an identifiable cause such as renal artery
stenosis, pregnancy, or endocrine disorders. Primary hypertension is genetic or
essential. Renal artery stenosis reduces renal perfusion and activates the renin-
angiotensin system, raising blood pressure.
6. The nurse should teach a client with hypertension to follow which dietary
approach?
A) DASH diet rich in fruits, vegetables, and low-fat dairy
B) High-sodium diet
C) High saturated fat diet
D) Low-fiber diet
II – Actual Q&A (GCN) (Updated PDF)
1. A client with left-sided heart failure is most likely to exhibit which finding?
A) Crackles and dyspnea
B) Peripheral edema and jugular venous distention
C) Ascites and hepatomegaly
D) Weight gain and dependent edema
Correct Answer: A) Crackles and dyspnea
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, producing pulmonary congestion with crackles and dyspnea.
Peripheral edema, jugular venous distention, ascites, and hepatomegaly are
systemic signs of right-sided failure. Recognizing this distinction guides
monitoring and treatment.
2. Which assessment finding is characteristic of right-sided heart failure?
A) Pulmonary crackles
B) Peripheral edema and jugular venous distention
C) Orthopnea
D) Frothy sputum
Correct Answer: B) Peripheral edema and jugular venous distention
,Rationale: Right-sided heart failure causes blood to back up into the systemic
venous circulation, leading to peripheral edema, jugular venous distention, and
liver congestion. Pulmonary crackles, orthopnea, and frothy sputum reflect left-
sided failure and pulmonary congestion.
3. A nurse is reviewing medications for a client with heart failure. Which
medication is the first-line diuretic?
A) Digoxin
B) Metoprolol
C) Furosemide (Lasix)
D) Lisinopril
Correct Answer: C) Furosemide (Lasix)
Rationale: Furosemide is a loop diuretic and the first-line diuretic for heart
failure because it rapidly reduces fluid overload and pulmonary congestion.
Digoxin increases contractility, metoprolol is a beta blocker, and lisinopril is an
ACE inhibitor.
4. The nurse explains that digoxin is prescribed for heart failure primarily to
produce which effect?
A) Decrease heart rate
B) Decrease blood pressure
C) Remove excess fluid
D) Increase contractility of the heart muscle
Correct Answer: D) Increase contractility of the heart muscle
, Rationale: Digoxin increases the force of myocardial contraction, improving
cardiac output in heart failure. Although it can slow conduction, its primary
purpose is to increase contractility. Furosemide removes fluid, and
antihypertensives lower blood pressure.
5. Which cause is associated with secondary hypertension?
A) Genetic predisposition
B) Renal artery stenosis
C) Family history
D) Advancing age
Correct Answer: B) Renal artery stenosis
Rationale: Secondary hypertension has an identifiable cause such as renal artery
stenosis, pregnancy, or endocrine disorders. Primary hypertension is genetic or
essential. Renal artery stenosis reduces renal perfusion and activates the renin-
angiotensin system, raising blood pressure.
6. The nurse should teach a client with hypertension to follow which dietary
approach?
A) DASH diet rich in fruits, vegetables, and low-fat dairy
B) High-sodium diet
C) High saturated fat diet
D) Low-fiber diet
