1
PRN 1032 - EXAM 4 LATEST 2026/2027 | MULTIPLE-
CHOICE | 40 VERIFIED Q&A | DETAILED RATIONALES |
NGN-ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: CARDIAC & RESPIRATORY - Questions 1-8
Q1: Cardiac Assessment - Chest Pain
A patient reports chest pain that radiates to the left arm and is accompanied by shortness of breath
and diaphoresis. Which action should the nurse take FIRST?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Administer aspirin
D. Assess airway, breathing, and circulation and notify the provider
Correct Answer: D
Rationale: The priority is to assess ABCs and notify the provider. Chest pain radiating to the arm with
SOB and diaphoresis suggests myocardial infarction. While nitroglycerin, ECG, and aspirin are
important interventions, assessment and provider notification come first. [100% CORRECT]
Q2: Heart Failure - Assessment
A patient with heart failure would most likely exhibit which clinical manifestation?
A. Peripheral edema and crackles in the lungs
B. Dry, hacking cough and fever
C. Hypertension and bounding pulses
D. Jugular vein flattening
Correct Answer: A
Rationale: Heart failure causes fluid backup, leading to peripheral edema (dependent edema),
crackles in the lungs (pulmonary congestion), and jugular venous distention. Dry cough and fever
suggest infection. Hypertension may be present but is not a hallmark. Jugular veins are distended,
not flattened. [100% CORRECT]
Q3: Deep Vein Thrombosis - Prevention
A postoperative patient is at risk for deep vein thrombosis (DVT). Which intervention is most
effective in preventing DVT?
A. Bed rest to prevent movement
B. Sequential compression devices (SCDs) and early ambulation
C. Restricting fluids to prevent edema
D. Positioning the patient in a dependent position
Correct Answer: B
Rationale: SCDs promote venous return and prevent stasis. Early ambulation also prevents DVT. Bed
rest, fluid restriction, and dependent positioning increase DVT risk. [100% CORRECT]
, 2
Q4: Peripheral Vascular Disease - Assessment
A nurse assessing a patient with peripheral arterial disease would most likely find:
A. Warm, pink skin on the lower extremities
B. Pallor, coolness, and diminished pulses
C. Edema and brown pigmentation
D. Distended veins and ulcers near the ankle
Correct Answer: B
Rationale: Peripheral arterial disease causes decreased arterial blood flow, leading to pallor,
coolness, diminished pulses, and hair loss on the extremities. Warm, pink skin indicates good
perfusion. Edema and brown pigmentation are signs of venous insufficiency. Distended veins and
ankle ulcers are associated with venous disease. [100% CORRECT]
Q5: Anticoagulant Therapy - Warfarin
A patient is prescribed warfarin (Coumadin). Which laboratory test is used to monitor the
therapeutic effect?
A. INR (International Normalized Ratio)
B. aPTT
C. Platelet count
D. Hemoglobin level
Correct Answer: A
Rationale: Warfarin therapy is monitored using PT/INR. The therapeutic INR goal is typically 2-3 (or
2.5-3.5 for mechanical valves). aPTT monitors heparin. Platelet count monitors thrombocytopenia.
Hemoglobin monitors anemia. [100% CORRECT]
Q6: Myocardial Infarction - Patient Education
A patient post-myocardial infarction is being discharged. Which statement indicates the patient
understands the discharge teaching?
A. "I will resume my normal activities immediately."
B. "I will take my medications only when I have chest pain."
C. "I will watch for signs of heart failure, such as weight gain and shortness of breath."
D. "I should avoid all physical activity permanently."
Correct Answer: C
Rationale: Monitoring for heart failure signs (sudden weight gain, SOB, edema) is important after
MI. Activities should be gradually resumed with a cardiac rehabilitation program. Medications should
be taken regularly, not PRN. Avoiding all activity is not recommended; gradual exercise is beneficial.
[100% CORRECT]
Q7: Respiratory Assessment - Breath Sounds
The nurse auscultates wheezing on expiration. This is most consistent with:
A. Pulmonary edema
B. Asthma or bronchospasm
PRN 1032 - EXAM 4 LATEST 2026/2027 | MULTIPLE-
CHOICE | 40 VERIFIED Q&A | DETAILED RATIONALES |
NGN-ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: CARDIAC & RESPIRATORY - Questions 1-8
Q1: Cardiac Assessment - Chest Pain
A patient reports chest pain that radiates to the left arm and is accompanied by shortness of breath
and diaphoresis. Which action should the nurse take FIRST?
A. Administer sublingual nitroglycerin
B. Obtain a 12-lead ECG
C. Administer aspirin
D. Assess airway, breathing, and circulation and notify the provider
Correct Answer: D
Rationale: The priority is to assess ABCs and notify the provider. Chest pain radiating to the arm with
SOB and diaphoresis suggests myocardial infarction. While nitroglycerin, ECG, and aspirin are
important interventions, assessment and provider notification come first. [100% CORRECT]
Q2: Heart Failure - Assessment
A patient with heart failure would most likely exhibit which clinical manifestation?
A. Peripheral edema and crackles in the lungs
B. Dry, hacking cough and fever
C. Hypertension and bounding pulses
D. Jugular vein flattening
Correct Answer: A
Rationale: Heart failure causes fluid backup, leading to peripheral edema (dependent edema),
crackles in the lungs (pulmonary congestion), and jugular venous distention. Dry cough and fever
suggest infection. Hypertension may be present but is not a hallmark. Jugular veins are distended,
not flattened. [100% CORRECT]
Q3: Deep Vein Thrombosis - Prevention
A postoperative patient is at risk for deep vein thrombosis (DVT). Which intervention is most
effective in preventing DVT?
A. Bed rest to prevent movement
B. Sequential compression devices (SCDs) and early ambulation
C. Restricting fluids to prevent edema
D. Positioning the patient in a dependent position
Correct Answer: B
Rationale: SCDs promote venous return and prevent stasis. Early ambulation also prevents DVT. Bed
rest, fluid restriction, and dependent positioning increase DVT risk. [100% CORRECT]
, 2
Q4: Peripheral Vascular Disease - Assessment
A nurse assessing a patient with peripheral arterial disease would most likely find:
A. Warm, pink skin on the lower extremities
B. Pallor, coolness, and diminished pulses
C. Edema and brown pigmentation
D. Distended veins and ulcers near the ankle
Correct Answer: B
Rationale: Peripheral arterial disease causes decreased arterial blood flow, leading to pallor,
coolness, diminished pulses, and hair loss on the extremities. Warm, pink skin indicates good
perfusion. Edema and brown pigmentation are signs of venous insufficiency. Distended veins and
ankle ulcers are associated with venous disease. [100% CORRECT]
Q5: Anticoagulant Therapy - Warfarin
A patient is prescribed warfarin (Coumadin). Which laboratory test is used to monitor the
therapeutic effect?
A. INR (International Normalized Ratio)
B. aPTT
C. Platelet count
D. Hemoglobin level
Correct Answer: A
Rationale: Warfarin therapy is monitored using PT/INR. The therapeutic INR goal is typically 2-3 (or
2.5-3.5 for mechanical valves). aPTT monitors heparin. Platelet count monitors thrombocytopenia.
Hemoglobin monitors anemia. [100% CORRECT]
Q6: Myocardial Infarction - Patient Education
A patient post-myocardial infarction is being discharged. Which statement indicates the patient
understands the discharge teaching?
A. "I will resume my normal activities immediately."
B. "I will take my medications only when I have chest pain."
C. "I will watch for signs of heart failure, such as weight gain and shortness of breath."
D. "I should avoid all physical activity permanently."
Correct Answer: C
Rationale: Monitoring for heart failure signs (sudden weight gain, SOB, edema) is important after
MI. Activities should be gradually resumed with a cardiac rehabilitation program. Medications should
be taken regularly, not PRN. Avoiding all activity is not recommended; gradual exercise is beneficial.
[100% CORRECT]
Q7: Respiratory Assessment - Breath Sounds
The nurse auscultates wheezing on expiration. This is most consistent with:
A. Pulmonary edema
B. Asthma or bronchospasm
