NU 155 Exam 3 – Medical-Surgical
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1. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen. Which finding requires the nurse's immediate
attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 22/min
C. Increasing lethargy and confusion
D. Productive cough
Answer: C. Increasing lethargy and confusion
Rationale: Increasing confusion and lethargy can indicate
worsening hypoxemia or carbon dioxide retention and require
prompt assessment.
2. Which assessment finding is most characteristic of left-sided heart
failure?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion,
commonly producing crackles, dyspnea, and orthopnea.
,3. A client with heart failure is prescribed furosemide. Which
laboratory value is most important to monitor?
A. Calcium
B. Potassium
C. Hemoglobin
D. Platelets
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that can cause significant
potassium loss.
4. Which instruction is appropriate for a client with hypertension?
A. Increase sodium intake
B. Stop medications when blood pressure improves
C. Maintain a healthy weight and exercise regularly
D. Avoid all physical activity
Answer: C. Maintain a healthy weight and exercise regularly
Rationale: Weight management and regular physical activity are
important nonpharmacologic measures for blood-pressure control.
5. A client reports crushing substernal chest pain radiating to the left
arm. What should the nurse do first?
A. Obtain a focused assessment and vital signs
B. Give a full meal
C. Encourage ambulation
D. Place the client in Trendelenburg position
Answer: A. Obtain a focused assessment and vital signs
Rationale: Immediate assessment helps determine the client's
stability and guides urgent interventions for possible acute
coronary syndrome.
6. Which finding is most concerning in a client with myocardial
infarction?
, A. Mild anxiety
B. Heart rate of 88/min
C. New-onset ventricular dysrhythmia
D. Fatigue
Answer: C. New-onset ventricular dysrhythmia
Rationale: Ventricular dysrhythmias can rapidly become life-
threatening after myocardial infarction.
7. Which lifestyle change is most appropriate for a client with
coronary artery disease?
A. Smoking cessation
B. Increased saturated-fat intake
C. Sedentary lifestyle
D. Increased sodium intake
Answer: A. Smoking cessation
Rationale: Smoking is a major modifiable cardiovascular risk
factor.
8. A client with peripheral arterial disease reports leg pain while
walking that disappears with rest. This is called:
A. Orthopnea
B. Intermittent claudication
C. Paresthesia
D. Venous stasis
Answer: B. Intermittent claudication
Rationale: Intermittent claudication is ischemic muscle pain
triggered by activity and relieved by rest.
9. Which finding is more typical of chronic venous insufficiency than
arterial disease?
A. Cool, pale extremity
B. Diminished pulses
, C. Dependent edema
D. Pain with exercise relieved by rest
Answer: C. Dependent edema
Rationale: Venous insufficiency commonly causes edema, venous
stasis, and skin changes.
10. A client with deep-vein thrombosis suddenly develops
dyspnea and chest pain. The nurse should suspect:
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Pleural effusion
Answer: B. Pulmonary embolism
Rationale: A thrombus can dislodge and travel to the pulmonary
circulation, causing a potentially fatal pulmonary embolism.
11. Which medication is commonly used as an anticoagulant for
prevention or treatment of thromboembolism?
A. Heparin
B. Acetaminophen
C. Omeprazole
D. Furosemide
Answer: A. Heparin
Rationale: Heparin reduces clot formation and is widely used for
anticoagulation.
12. Which assessment finding suggests an upper gastrointestinal
bleed?
A. Clay-colored stool
B. Melena
C. Hematuria
D. Steatorrhea
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen. Which finding requires the nurse's immediate
attention?
A. Oxygen saturation of 90%
B. Respiratory rate of 22/min
C. Increasing lethargy and confusion
D. Productive cough
Answer: C. Increasing lethargy and confusion
Rationale: Increasing confusion and lethargy can indicate
worsening hypoxemia or carbon dioxide retention and require
prompt assessment.
2. Which assessment finding is most characteristic of left-sided heart
failure?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion,
commonly producing crackles, dyspnea, and orthopnea.
,3. A client with heart failure is prescribed furosemide. Which
laboratory value is most important to monitor?
A. Calcium
B. Potassium
C. Hemoglobin
D. Platelets
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that can cause significant
potassium loss.
4. Which instruction is appropriate for a client with hypertension?
A. Increase sodium intake
B. Stop medications when blood pressure improves
C. Maintain a healthy weight and exercise regularly
D. Avoid all physical activity
Answer: C. Maintain a healthy weight and exercise regularly
Rationale: Weight management and regular physical activity are
important nonpharmacologic measures for blood-pressure control.
5. A client reports crushing substernal chest pain radiating to the left
arm. What should the nurse do first?
A. Obtain a focused assessment and vital signs
B. Give a full meal
C. Encourage ambulation
D. Place the client in Trendelenburg position
Answer: A. Obtain a focused assessment and vital signs
Rationale: Immediate assessment helps determine the client's
stability and guides urgent interventions for possible acute
coronary syndrome.
6. Which finding is most concerning in a client with myocardial
infarction?
, A. Mild anxiety
B. Heart rate of 88/min
C. New-onset ventricular dysrhythmia
D. Fatigue
Answer: C. New-onset ventricular dysrhythmia
Rationale: Ventricular dysrhythmias can rapidly become life-
threatening after myocardial infarction.
7. Which lifestyle change is most appropriate for a client with
coronary artery disease?
A. Smoking cessation
B. Increased saturated-fat intake
C. Sedentary lifestyle
D. Increased sodium intake
Answer: A. Smoking cessation
Rationale: Smoking is a major modifiable cardiovascular risk
factor.
8. A client with peripheral arterial disease reports leg pain while
walking that disappears with rest. This is called:
A. Orthopnea
B. Intermittent claudication
C. Paresthesia
D. Venous stasis
Answer: B. Intermittent claudication
Rationale: Intermittent claudication is ischemic muscle pain
triggered by activity and relieved by rest.
9. Which finding is more typical of chronic venous insufficiency than
arterial disease?
A. Cool, pale extremity
B. Diminished pulses
, C. Dependent edema
D. Pain with exercise relieved by rest
Answer: C. Dependent edema
Rationale: Venous insufficiency commonly causes edema, venous
stasis, and skin changes.
10. A client with deep-vein thrombosis suddenly develops
dyspnea and chest pain. The nurse should suspect:
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Pleural effusion
Answer: B. Pulmonary embolism
Rationale: A thrombus can dislodge and travel to the pulmonary
circulation, causing a potentially fatal pulmonary embolism.
11. Which medication is commonly used as an anticoagulant for
prevention or treatment of thromboembolism?
A. Heparin
B. Acetaminophen
C. Omeprazole
D. Furosemide
Answer: A. Heparin
Rationale: Heparin reduces clot formation and is widely used for
anticoagulation.
12. Which assessment finding suggests an upper gastrointestinal
bleed?
A. Clay-colored stool
B. Melena
C. Hematuria
D. Steatorrhea
