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NU 155 – MEDICAL-SURGICAL NURSING I Exam 3 Practice | 2026
Questions with Verified Answers & Rationales
Question 1
A client with heart failure reports a 3-lb weight gain overnight
and worsening dyspnea. Which action should the nurse take
first?
A. Document the findings
B. Notify the provider and assess for fluid overload
C. Encourage rest
D. Decrease IV fluids without an order
Answer: B
Rationale: Rapid weight gain and worsening dyspnea suggest
fluid overload; the nurse should assess and notify the provider
promptly.
Question 2
Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
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Answer: B
Rationale: Troponin I is the most specific and sensitive
biomarker for myocardial injury.
Question 3
A client is receiving alteplase for an acute ischemic stroke.
Which finding requires immediate discontinuation of the
infusion?
A. New severe headache and decreased level of consciousness
B. Blood pressure 150/90 mmHg
C. Heart rate 88 bpm
D. Mild oozing at the IV site
Answer: A
Rationale: Severe headache and decreased LOC may indicate
intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy.
Question 4
Which ECG finding indicates a client is at risk for torsades de
pointes and sudden cardiac death?
A. Prolonged QT interval
B. Sinus bradycardia
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C. Premature atrial contractions
D. First-degree AV block
Answer: A
Rationale: Prolonged QT interval increases risk of ventricular
arrhythmias and sudden cardiac death.
Question 5
A client with peripheral arterial disease asks why walking causes
leg pain. Which response is most accurate?
A. "The pain is from muscle spasms."
B. "Your muscles are not getting enough blood flow during
exercise."
C. "The pain is from nerve damage."
D. "Your veins are not working properly."
Answer: B
Rationale: Intermittent claudication is ischemic muscle pain
caused by inadequate arterial blood flow during exercise.
Question 6
Which finding is most concerning in a client with a new
murmur, fever, and positive blood cultures?
A. Mild fatigue
B. Splinter hemorrhages and Janeway lesions
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C. Occasional dry cough
D. Slight weight loss
Answer: B
Rationale: Splinter hemorrhages, Janeway lesions, Osler nodes,
and a new murmur suggest infective endocarditis.
Question 7
A client with heart failure is prescribed furosemide. Which lab
should be monitored closely?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium only
Answer: B
Rationale: Furosemide causes potassium loss; hypokalemia can
lead to dysrhythmias.
Question 8
A client has a blood pressure of 150/90 in the right arm and
130/80 in the left arm. What does this suggest?
A. Normal variation
B. Coarctation of the aorta or subclavian artery stenosis
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NU 155 – MEDICAL-SURGICAL NURSING I Exam 3 Practice | 2026
Questions with Verified Answers & Rationales
Question 1
A client with heart failure reports a 3-lb weight gain overnight
and worsening dyspnea. Which action should the nurse take
first?
A. Document the findings
B. Notify the provider and assess for fluid overload
C. Encourage rest
D. Decrease IV fluids without an order
Answer: B
Rationale: Rapid weight gain and worsening dyspnea suggest
fluid overload; the nurse should assess and notify the provider
promptly.
Question 2
Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
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, Page |2
Answer: B
Rationale: Troponin I is the most specific and sensitive
biomarker for myocardial injury.
Question 3
A client is receiving alteplase for an acute ischemic stroke.
Which finding requires immediate discontinuation of the
infusion?
A. New severe headache and decreased level of consciousness
B. Blood pressure 150/90 mmHg
C. Heart rate 88 bpm
D. Mild oozing at the IV site
Answer: A
Rationale: Severe headache and decreased LOC may indicate
intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy.
Question 4
Which ECG finding indicates a client is at risk for torsades de
pointes and sudden cardiac death?
A. Prolonged QT interval
B. Sinus bradycardia
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C. Premature atrial contractions
D. First-degree AV block
Answer: A
Rationale: Prolonged QT interval increases risk of ventricular
arrhythmias and sudden cardiac death.
Question 5
A client with peripheral arterial disease asks why walking causes
leg pain. Which response is most accurate?
A. "The pain is from muscle spasms."
B. "Your muscles are not getting enough blood flow during
exercise."
C. "The pain is from nerve damage."
D. "Your veins are not working properly."
Answer: B
Rationale: Intermittent claudication is ischemic muscle pain
caused by inadequate arterial blood flow during exercise.
Question 6
Which finding is most concerning in a client with a new
murmur, fever, and positive blood cultures?
A. Mild fatigue
B. Splinter hemorrhages and Janeway lesions
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C. Occasional dry cough
D. Slight weight loss
Answer: B
Rationale: Splinter hemorrhages, Janeway lesions, Osler nodes,
and a new murmur suggest infective endocarditis.
Question 7
A client with heart failure is prescribed furosemide. Which lab
should be monitored closely?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium only
Answer: B
Rationale: Furosemide causes potassium loss; hypokalemia can
lead to dysrhythmias.
Question 8
A client has a blood pressure of 150/90 in the right arm and
130/80 in the left arm. What does this suggest?
A. Normal variation
B. Coarctation of the aorta or subclavian artery stenosis
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