NRSG 3420 Exam 3 Practice Questions & Answers
2026/2027 | Latest Question Exam Review with Rationales
Questions 1–25
1. A client with heart failure reports increasing shortness of breath and a 3-lb weight gain
over 2 days. Which finding requires the nurse's priority attention?
A. Mild ankle edema
B. Fatigue after activity
C. Increasing dyspnea at rest
D. Occasional nocturia
Answer: C
Rationale: Dyspnea at rest may indicate worsening pulmonary congestion and acute
decompensated heart failure.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Enlarged liver
B. Peripheral edema
C. Ascites
D. Crackles in the lungs
Answer: D
Rationale: Left-sided heart failure causes pulmonary congestion, often producing crackles
and dyspnea.
,3. A client taking furosemide should be monitored most closely for which electrolyte
imbalance?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase urinary potassium loss and can cause hypokalemia.
4. Which instruction should the nurse provide to a client prescribed sublingual nitroglycerin?
A. Swallow the tablet with water
B. Take it only after severe chest pain develops
C. Store tablets in a weekly pill organizer
D. Place the tablet under the tongue at the onset of chest pain
Answer: D
Rationale: Sublingual nitroglycerin is rapidly absorbed and should be used at the onset of
anginal symptoms.
5. A client receiving digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication
B. Give an additional dose
C. Hold the medication and notify the provider
D. Administer with an antacid
Answer: C
Rationale: Digoxin can cause bradycardia. The medication is generally withheld for an adult
apical pulse below 60/min.
,6. Which symptom may indicate digoxin toxicity?
A. Increased appetite
B. Hypertension
C. Yellow-green visual disturbances
D. Increased urinary output
Answer: C
Rationale: Visual changes, nausea, vomiting, and dysrhythmias are classic manifestations
of digoxin toxicity.
7. Which laboratory value should the nurse monitor for a client receiving warfarin?
A. aPTT
B. Platelet count only
C. INR
D. Troponin
Answer: C
Rationale: INR is used to monitor the therapeutic effect of warfarin.
8. Which medication is commonly used to reverse excessive warfarin anticoagulation?
A. Protamine sulfate
B. Naloxone
C. Acetylcysteine
D. Vitamin K
Answer: D
Rationale: Vitamin K promotes synthesis of clotting factors and reverses warfarin's
anticoagulant effect.
, 9. A client receiving heparin develops uncontrolled bleeding. Which medication should the
nurse anticipate administering?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Atropine
Answer: B
Rationale: Protamine sulfate is the reversal agent for unfractionated heparin.
10. Which finding is most suggestive of pulmonary embolism?
A. Gradual weight gain
B. Bradycardia
C. Sudden dyspnea and pleuritic chest pain
D. Bilateral dependent edema
Answer: C
Rationale: Pulmonary embolism commonly presents suddenly with dyspnea, pleuritic chest
pain, tachycardia, and hypoxemia.
11. A postoperative client suddenly develops shortness of breath, tachycardia, and anxiety.
What is the nurse's priority action?
A. Encourage ambulation
B. Offer oral fluids
C. Apply oxygen and assess respiratory status
D. Place the client flat
2026/2027 | Latest Question Exam Review with Rationales
Questions 1–25
1. A client with heart failure reports increasing shortness of breath and a 3-lb weight gain
over 2 days. Which finding requires the nurse's priority attention?
A. Mild ankle edema
B. Fatigue after activity
C. Increasing dyspnea at rest
D. Occasional nocturia
Answer: C
Rationale: Dyspnea at rest may indicate worsening pulmonary congestion and acute
decompensated heart failure.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Enlarged liver
B. Peripheral edema
C. Ascites
D. Crackles in the lungs
Answer: D
Rationale: Left-sided heart failure causes pulmonary congestion, often producing crackles
and dyspnea.
,3. A client taking furosemide should be monitored most closely for which electrolyte
imbalance?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase urinary potassium loss and can cause hypokalemia.
4. Which instruction should the nurse provide to a client prescribed sublingual nitroglycerin?
A. Swallow the tablet with water
B. Take it only after severe chest pain develops
C. Store tablets in a weekly pill organizer
D. Place the tablet under the tongue at the onset of chest pain
Answer: D
Rationale: Sublingual nitroglycerin is rapidly absorbed and should be used at the onset of
anginal symptoms.
5. A client receiving digoxin has an apical pulse of 52/min. What should the nurse do?
A. Administer the medication
B. Give an additional dose
C. Hold the medication and notify the provider
D. Administer with an antacid
Answer: C
Rationale: Digoxin can cause bradycardia. The medication is generally withheld for an adult
apical pulse below 60/min.
,6. Which symptom may indicate digoxin toxicity?
A. Increased appetite
B. Hypertension
C. Yellow-green visual disturbances
D. Increased urinary output
Answer: C
Rationale: Visual changes, nausea, vomiting, and dysrhythmias are classic manifestations
of digoxin toxicity.
7. Which laboratory value should the nurse monitor for a client receiving warfarin?
A. aPTT
B. Platelet count only
C. INR
D. Troponin
Answer: C
Rationale: INR is used to monitor the therapeutic effect of warfarin.
8. Which medication is commonly used to reverse excessive warfarin anticoagulation?
A. Protamine sulfate
B. Naloxone
C. Acetylcysteine
D. Vitamin K
Answer: D
Rationale: Vitamin K promotes synthesis of clotting factors and reverses warfarin's
anticoagulant effect.
, 9. A client receiving heparin develops uncontrolled bleeding. Which medication should the
nurse anticipate administering?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Atropine
Answer: B
Rationale: Protamine sulfate is the reversal agent for unfractionated heparin.
10. Which finding is most suggestive of pulmonary embolism?
A. Gradual weight gain
B. Bradycardia
C. Sudden dyspnea and pleuritic chest pain
D. Bilateral dependent edema
Answer: C
Rationale: Pulmonary embolism commonly presents suddenly with dyspnea, pleuritic chest
pain, tachycardia, and hypoxemia.
11. A postoperative client suddenly develops shortness of breath, tachycardia, and anxiety.
What is the nurse's priority action?
A. Encourage ambulation
B. Offer oral fluids
C. Apply oxygen and assess respiratory status
D. Place the client flat
