NUR 242 MEDICAL-SURGICAL NURSING
II - ADVANCED COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is experiencing increasing shortness of breath. Which
lung sound is most indicative of pulmonary edema?
A. Coarse crackles
B. Stridor
C. Pleural friction rub
D. High-pitched wheezing
Answer: A
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, causing
fluid to leak into the alveoli, which manifests as crackles (rales) on auscultation.
2. A patient is admitted with a suspected Myocardial Infarction. Which cardiac biomarker is
most specific to myocardial injury and peaks within 24 hours?
A. Myoglobin
B. Troponin I
,C. Creatine Kinase (CK-MB)
D. C-Reactive Protein
Answer: B
Conceptual Explanation: Troponin I is the gold standard for MI diagnosis because it is
highly specific to cardiac muscle and remains elevated for several days.
3. When assessing a patient with right-sided heart failure, the nurse expects to find which of
the following?
A. Dyspnea and orthopnea
B. Pulmonary congestion
C. Frothy, pink-tinged sputum
D. Jugular venous distention (JVD)
Answer: D
Conceptual Explanation: Right-sided heart failure results in systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly.
4. A patient with Atrial Fibrillation is at high risk for which complication?
A. Pulmonary hypertension
B. Ventricular tachycardia
C. Ischemic stroke
, D. Cardiac tamponade
Answer: C
Conceptual Explanation: In A-fib, the atria quiver rather than contract, leading to blood
stasis and clot formation, which can embolize to the brain.
5. Which ECG change is most indicative of an acute ST-elevation myocardial infarction
(STEMI)?
A. PR interval prolongation
B. Presence of U waves
C. ST-segment elevation of 1mm or more in two contiguous leads
D. Inverted T waves in all leads
Answer: C
Conceptual Explanation: ST-elevation in two or more contiguous leads indicates
myocardial injury that requires immediate reperfusion therapy.
6. A patient is diagnosed with Infective Endocarditis. Which assessment finding is considered
a classic sign of this condition?
A. Janeway lesions
B. Pulsus paradoxus
C. Kussmaul’s respiration
D. Widened pulse pressure
II - ADVANCED COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is experiencing increasing shortness of breath. Which
lung sound is most indicative of pulmonary edema?
A. Coarse crackles
B. Stridor
C. Pleural friction rub
D. High-pitched wheezing
Answer: A
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion, causing
fluid to leak into the alveoli, which manifests as crackles (rales) on auscultation.
2. A patient is admitted with a suspected Myocardial Infarction. Which cardiac biomarker is
most specific to myocardial injury and peaks within 24 hours?
A. Myoglobin
B. Troponin I
,C. Creatine Kinase (CK-MB)
D. C-Reactive Protein
Answer: B
Conceptual Explanation: Troponin I is the gold standard for MI diagnosis because it is
highly specific to cardiac muscle and remains elevated for several days.
3. When assessing a patient with right-sided heart failure, the nurse expects to find which of
the following?
A. Dyspnea and orthopnea
B. Pulmonary congestion
C. Frothy, pink-tinged sputum
D. Jugular venous distention (JVD)
Answer: D
Conceptual Explanation: Right-sided heart failure results in systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly.
4. A patient with Atrial Fibrillation is at high risk for which complication?
A. Pulmonary hypertension
B. Ventricular tachycardia
C. Ischemic stroke
, D. Cardiac tamponade
Answer: C
Conceptual Explanation: In A-fib, the atria quiver rather than contract, leading to blood
stasis and clot formation, which can embolize to the brain.
5. Which ECG change is most indicative of an acute ST-elevation myocardial infarction
(STEMI)?
A. PR interval prolongation
B. Presence of U waves
C. ST-segment elevation of 1mm or more in two contiguous leads
D. Inverted T waves in all leads
Answer: C
Conceptual Explanation: ST-elevation in two or more contiguous leads indicates
myocardial injury that requires immediate reperfusion therapy.
6. A patient is diagnosed with Infective Endocarditis. Which assessment finding is considered
a classic sign of this condition?
A. Janeway lesions
B. Pulsus paradoxus
C. Kussmaul’s respiration
D. Widened pulse pressure
