GALEN COLLEGE OF NURSING · PRACTICAL NURSING PROGRAM
NUR 242 Exam 3
Comprehensive Practice
Question Bank
Heart Failure · Congenital Cardiac Disorders · Pharmacology
Medical-Surgical Nursing Concepts · NCLEX-Style Review
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Heart Failure — Assessment & Clinical Manifestations 2
3. Heart Failure — Nursing Interventions & Priorities 4
4. Heart Failure — Medication Management (Digoxin & Furosemide) 7
5. Heart Failure — Patient Education & Discharge Teaching 10
,6. Congenital Heart Defects & Pediatric Considerations 12
7. Valvular Disorders & Cardiac Catheterization 14
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & QUESTIONS
How to Use This Guide
Read each question stem carefully, select your answer, then review the rationale to understand the clinical
reasoning behind the correct choice. Each question includes the tested concept and the source concept
from your course material. Questions marked with SATA require selecting all that apply.
Section 1: Heart Failure — Assessment & Clinical Manifestations
1 An older client with a history of congestive heart failure expresses concern about potential
exposure to tuberculosis (TB) from his or her roommate at the extended care facility. The
roommate coughs a great deal and sometimes spits up blood. Which is the primary reason
that the nurse pursues more information about the roommate?
A TB is highly contagious and requires immediate isolation
B TB adversely affects older adults with chronic illness
C The roommate's symptoms indicate active TB infection
D The client's heart failure makes TB treatment more difficult
CORRECT ANSWER: B
Rationale: Older adults with chronic illnesses such as heart failure are at increased risk for complications
from TB due to decreased immune function and physiological reserves. The primary concern is that TB
adversely affects older adults with chronic illness.
Tested Concept: TB risk in older adults with chronic illness
Source Concept: TB adversely affects older adults with chronic illness
, 2 When the clinic nurse is teaching a group of clients with heart failure (HF) about dietary
interventions to prevent fluid overload, which topic will be included?
A Use of fresh or frozen vegetables instead of canned ones
B Increasing daily fluid intake to 3 liters per day
C Adding salt to foods to improve taste
D Avoiding all fruits and vegetables
CORRECT ANSWER: A
Rationale: Canned vegetables are often high in sodium, which can contribute to fluid retention in clients
with heart failure. Teaching clients to use fresh or frozen vegetables instead of canned ones is an
important dietary intervention to prevent fluid overload.
Tested Concept: Low-sodium diet for heart failure
Source Concept: Use of fresh or frozen vegetables instead of canned ones / low sodium
3 Which action would the nurse take first when a client with heart failure has an episode of
paroxysmal nocturnal dyspnea (PND)?
A Administer oxygen at 2 L/min via nasal cannula
B Assist the client to sit on the edge of the bed
C Notify the health care provider immediately
D Administer prescribed diuretic medication
CORRECT ANSWER: B
Rationale: Paroxysmal nocturnal dyspnea (PND) occurs when fluid shifts from dependent areas to the
lungs during sleep. The first action is to assist the client to sit on the edge of the bed, which uses gravity
to help relieve pulmonary congestion and improve breathing.
Tested Concept: PND — priority nursing action
Source Concept: Which action would the nurse take first when a client with heart failure has an episode of
paroxysmal nocturnal dyspnea (PND)? Assist the client to sit on the edge of the bed.
NUR 242 Exam 3
Comprehensive Practice
Question Bank
Heart Failure · Congenital Cardiac Disorders · Pharmacology
Medical-Surgical Nursing Concepts · NCLEX-Style Review
Edition 1 · September 2026
Table of Contents
1. Instructions for Use 2
2. Heart Failure — Assessment & Clinical Manifestations 2
3. Heart Failure — Nursing Interventions & Priorities 4
4. Heart Failure — Medication Management (Digoxin & Furosemide) 7
5. Heart Failure — Patient Education & Discharge Teaching 10
,6. Congenital Heart Defects & Pediatric Considerations 12
7. Valvular Disorders & Cardiac Catheterization 14
NUR 242 · Galen College of Nursing Page 1
,NUR 242 EXAM 3 PRACTICE GUIDE INSTRUCTIONS & QUESTIONS
How to Use This Guide
Read each question stem carefully, select your answer, then review the rationale to understand the clinical
reasoning behind the correct choice. Each question includes the tested concept and the source concept
from your course material. Questions marked with SATA require selecting all that apply.
Section 1: Heart Failure — Assessment & Clinical Manifestations
1 An older client with a history of congestive heart failure expresses concern about potential
exposure to tuberculosis (TB) from his or her roommate at the extended care facility. The
roommate coughs a great deal and sometimes spits up blood. Which is the primary reason
that the nurse pursues more information about the roommate?
A TB is highly contagious and requires immediate isolation
B TB adversely affects older adults with chronic illness
C The roommate's symptoms indicate active TB infection
D The client's heart failure makes TB treatment more difficult
CORRECT ANSWER: B
Rationale: Older adults with chronic illnesses such as heart failure are at increased risk for complications
from TB due to decreased immune function and physiological reserves. The primary concern is that TB
adversely affects older adults with chronic illness.
Tested Concept: TB risk in older adults with chronic illness
Source Concept: TB adversely affects older adults with chronic illness
, 2 When the clinic nurse is teaching a group of clients with heart failure (HF) about dietary
interventions to prevent fluid overload, which topic will be included?
A Use of fresh or frozen vegetables instead of canned ones
B Increasing daily fluid intake to 3 liters per day
C Adding salt to foods to improve taste
D Avoiding all fruits and vegetables
CORRECT ANSWER: A
Rationale: Canned vegetables are often high in sodium, which can contribute to fluid retention in clients
with heart failure. Teaching clients to use fresh or frozen vegetables instead of canned ones is an
important dietary intervention to prevent fluid overload.
Tested Concept: Low-sodium diet for heart failure
Source Concept: Use of fresh or frozen vegetables instead of canned ones / low sodium
3 Which action would the nurse take first when a client with heart failure has an episode of
paroxysmal nocturnal dyspnea (PND)?
A Administer oxygen at 2 L/min via nasal cannula
B Assist the client to sit on the edge of the bed
C Notify the health care provider immediately
D Administer prescribed diuretic medication
CORRECT ANSWER: B
Rationale: Paroxysmal nocturnal dyspnea (PND) occurs when fluid shifts from dependent areas to the
lungs during sleep. The first action is to assist the client to sit on the edge of the bed, which uses gravity
to help relieve pulmonary congestion and improve breathing.
Tested Concept: PND — priority nursing action
Source Concept: Which action would the nurse take first when a client with heart failure has an episode of
paroxysmal nocturnal dyspnea (PND)? Assist the client to sit on the edge of the bed.
