NURS 480 Final Exam (Medical-Surgical
Nursing) – Practice Bank
(Original Practice Questions – Not Actual
Course Items)
Instructions:
One best answer per question.
Correct answer: bold.
Rationale: italics.
Cardiovascular Nursing (1–25)
1. A patient with stable angina reports chest pain during exertion that resolves with rest. Which
medication should the nurse anticipate as first-line for symptom control?
A. Nitroglycerin SL PRN only
B. Beta-blocker
C. Digoxin
D. Furosemide
Answer: B
Rationale: Beta-blockers reduce myocardial oxygen demand and are first-line for chronic stable
angina.
2. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema and JVD
B. Hepatomegaly and ascites
C. Crackles, dyspnea, and orthopnea
D. Weight gain only
Answer: C
Rationale: Left-sided failure causes pulmonary congestion (crackles, dyspnea, orthopnea).
3. A patient with HFrEF should receive which core medication class unless contraindicated?
A. ACE inhibitor or ARB/ARNI
B. Calcium channel blocker (non-DHP)
C. NSAIDs
D. Alpha-agonists
,Answer: A
Rationale: ACEi/ARB/ARNI improve survival in HFrEF.
4. Which assessment finding suggests digoxin toxicity?
A. Tachycardia and diarrhea
B. Visual changes (yellow-green halos), nausea, bradycardia
C. Hypertension and headache
D. Hyperkalemia only
Answer: B
Rationale: GI symptoms, visual disturbances, and arrhythmias suggest digoxin toxicity.
5. A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 4 requires:
A. Aspirin only
B. Oral anticoagulation
C. No therapy
D. Antiplatelet plus dipyridamole
Answer: B
Rationale: High stroke risk warrants anticoagulation.
6. Which murmur is associated with a systolic crescendo-decrescendo sound at the right upper
sternal border radiating to the carotids?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: B
Rationale: Classic description of aortic stenosis.
7. A patient with hypertensive emergency (BP 210/120 with end-organ damage) requires:
A. Oral antihypertensives and discharge
B. IV antihypertensives in a monitored setting
C. No treatment
D. Fluid bolus
Answer: B
Rationale: Hypertensive emergency needs controlled IV BP reduction.
8. Which lifestyle modification has the greatest impact on blood pressure reduction?
A. Increasing caffeine
B. Weight loss, DASH diet, sodium reduction, regular exercise
C. High-protein diet
D. Avoiding all carbohydrates
Answer: B
Rationale: Comprehensive lifestyle changes significantly lower BP.
, 9. A patient with peripheral artery disease (PAD) typically presents with:
A. Bilateral pitting edema
B. Intermittent claudication and diminished pulses
C. Warm, red legs
D. Varicose veins only
Answer: B
Rationale: Exertional leg pain and reduced pulses indicate PAD.
10. Best initial noninvasive test to evaluate PAD:
A. CT angiography
B. Ankle-brachial index (ABI)
C. Venous Doppler
D. MRI
Answer: B
Rationale: ABI is simple and effective for PAD screening.
11. Which ECG change is most specific for acute STEMI?
A. ST-segment depression
B. T-wave inversion only
C. ST-segment elevation in contiguous leads
D. Prolonged PR interval
Answer: C
Rationale: ST elevation in contiguous leads indicates STEMI.
12. Immediate medication for suspected ACS (unless allergic/contraindicated):
A. Ibuprofen
B. Chewable aspirin
C. Acetaminophen
D. Prednisone
Answer: B
Rationale: Aspirin reduces mortality in ACS.
13. A patient with new-onset AF and RVR who is hemodynamically stable should initially receive:
A. Immediate cardioversion
B. Rate control (beta-blocker or CCB)
C. Anticoagulation only
D. No treatment
Answer: B
Rationale: Stable RVR-AF is managed first with rate control.
14. Which lab is most useful to assess heart failure severity?
A. Troponin
B. BNP or NT-proBNP
Nursing) – Practice Bank
(Original Practice Questions – Not Actual
Course Items)
Instructions:
One best answer per question.
Correct answer: bold.
Rationale: italics.
Cardiovascular Nursing (1–25)
1. A patient with stable angina reports chest pain during exertion that resolves with rest. Which
medication should the nurse anticipate as first-line for symptom control?
A. Nitroglycerin SL PRN only
B. Beta-blocker
C. Digoxin
D. Furosemide
Answer: B
Rationale: Beta-blockers reduce myocardial oxygen demand and are first-line for chronic stable
angina.
2. Which finding is most characteristic of left-sided heart failure?
A. Peripheral edema and JVD
B. Hepatomegaly and ascites
C. Crackles, dyspnea, and orthopnea
D. Weight gain only
Answer: C
Rationale: Left-sided failure causes pulmonary congestion (crackles, dyspnea, orthopnea).
3. A patient with HFrEF should receive which core medication class unless contraindicated?
A. ACE inhibitor or ARB/ARNI
B. Calcium channel blocker (non-DHP)
C. NSAIDs
D. Alpha-agonists
,Answer: A
Rationale: ACEi/ARB/ARNI improve survival in HFrEF.
4. Which assessment finding suggests digoxin toxicity?
A. Tachycardia and diarrhea
B. Visual changes (yellow-green halos), nausea, bradycardia
C. Hypertension and headache
D. Hyperkalemia only
Answer: B
Rationale: GI symptoms, visual disturbances, and arrhythmias suggest digoxin toxicity.
5. A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 4 requires:
A. Aspirin only
B. Oral anticoagulation
C. No therapy
D. Antiplatelet plus dipyridamole
Answer: B
Rationale: High stroke risk warrants anticoagulation.
6. Which murmur is associated with a systolic crescendo-decrescendo sound at the right upper
sternal border radiating to the carotids?
A. Mitral regurgitation
B. Aortic stenosis
C. Aortic regurgitation
D. Mitral stenosis
Answer: B
Rationale: Classic description of aortic stenosis.
7. A patient with hypertensive emergency (BP 210/120 with end-organ damage) requires:
A. Oral antihypertensives and discharge
B. IV antihypertensives in a monitored setting
C. No treatment
D. Fluid bolus
Answer: B
Rationale: Hypertensive emergency needs controlled IV BP reduction.
8. Which lifestyle modification has the greatest impact on blood pressure reduction?
A. Increasing caffeine
B. Weight loss, DASH diet, sodium reduction, regular exercise
C. High-protein diet
D. Avoiding all carbohydrates
Answer: B
Rationale: Comprehensive lifestyle changes significantly lower BP.
, 9. A patient with peripheral artery disease (PAD) typically presents with:
A. Bilateral pitting edema
B. Intermittent claudication and diminished pulses
C. Warm, red legs
D. Varicose veins only
Answer: B
Rationale: Exertional leg pain and reduced pulses indicate PAD.
10. Best initial noninvasive test to evaluate PAD:
A. CT angiography
B. Ankle-brachial index (ABI)
C. Venous Doppler
D. MRI
Answer: B
Rationale: ABI is simple and effective for PAD screening.
11. Which ECG change is most specific for acute STEMI?
A. ST-segment depression
B. T-wave inversion only
C. ST-segment elevation in contiguous leads
D. Prolonged PR interval
Answer: C
Rationale: ST elevation in contiguous leads indicates STEMI.
12. Immediate medication for suspected ACS (unless allergic/contraindicated):
A. Ibuprofen
B. Chewable aspirin
C. Acetaminophen
D. Prednisone
Answer: B
Rationale: Aspirin reduces mortality in ACS.
13. A patient with new-onset AF and RVR who is hemodynamically stable should initially receive:
A. Immediate cardioversion
B. Rate control (beta-blocker or CCB)
C. Anticoagulation only
D. No treatment
Answer: B
Rationale: Stable RVR-AF is managed first with rate control.
14. Which lab is most useful to assess heart failure severity?
A. Troponin
B. BNP or NT-proBNP
