Galen Nur 3250 - Medsurg Exam 4 Practice Questions And
Answers 2026/2027 | Complete Questions And Answers
(Verified Answers) | Exam Prep | Comprehensive Exam Guide
2026&2027
1. A client with acute left-sided heart failure develops severe dyspnea, bilateral crackles,
and an oxygen saturation of 84%. Which action should the nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Obtain a daily weight
D. Prepare the client for ambulation
Answer: B
High-Fowler's positioning improves lung expansion and reduces venous return, while
supplemental oxygen addresses the immediate hypoxemia. These interventions take priority
over routine heart-failure management.
2. A client taking furosemide for heart failure reports muscle weakness and palpitations.
Which laboratory value is most important for the nurse to review?
A. Sodium 140 mEq/L
B. Calcium 9.2 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 2.0 mg/dL
Answer: C
Furosemide promotes potassium loss. Severe hypokalemia can cause muscle weakness and
potentially life-threatening dysrhythmias, making the potassium level the priority
assessment.
3. A client with chronic heart failure suddenly gains 2.5 kg over three days. Which
interpretation is most appropriate?
A. The client has gained primarily lean body mass
B. The change is expected with aging
C. The client is experiencing fluid retention
D. The client has developed hyperglycemia
Answer: C
,Rapid weight gain over several days is usually associated with fluid accumulation rather than
tissue gain and may indicate worsening heart failure.
4. A client with atrial fibrillation is prescribed warfarin. Which laboratory test is routinely
used to evaluate the therapeutic effect?
A. INR
B. Troponin
C. BNP
D. aPTT
Answer: A
Warfarin therapy is monitored primarily with the prothrombin time expressed as the
international normalized ratio, or INR.
5. A client receiving digoxin has an apical pulse of 52/min before the scheduled dose. What
should the nurse do?
A. Administer the medication with food
B. Give half the prescribed dose
C. Hold the dose and notify the provider according to protocol
D. Administer the medication and reassess in 30 minutes
Answer: C
Digoxin can slow the heart rate. A significant bradycardia before administration requires
withholding the medication and appropriate clinical notification.
6. Which finding in a client with infective endocarditis requires the most immediate
attention?
A. Fatigue after activity
B. New-onset confusion and unilateral weakness
C. Mild anorexia
D. Low-grade fever
Answer: B
Acute neurologic deficits may indicate an embolic event from vegetation. Sudden neurologic
changes require immediate assessment and intervention.
7. A client with peripheral arterial disease reports severe calf pain when walking that
resolves with rest. How should the nurse document this finding?
,A. Orthopnea
B. Intermittent claudication
C. Dependent edema
D. Venous stasis pain
Answer: B
Intermittent claudication is ischemic muscle pain caused by inadequate arterial blood flow
during activity and typically improves with rest.
8. Which assessment finding is most consistent with chronic venous insufficiency?
A. Cool, pale extremity with absent pulses
B. Pain relieved by dangling the leg
C. Brown pigmentation and edema around the ankles
D. Sudden unilateral loss of sensation
Answer: C
Venous hypertension commonly causes dependent edema, skin changes, and brown
pigmentation from hemosiderin deposition.
9. A client develops sudden chest pain, diaphoresis, and nausea. Which diagnostic marker
is most specific for myocardial injury?
A. Troponin
B. Hemoglobin
C. D-dimer
D. BNP
Answer: A
Cardiac troponins are highly sensitive and specific markers of myocardial injury and are
central to evaluation of suspected acute coronary syndrome.
10. A client with suspected myocardial infarction reports crushing substernal chest pain.
Which assessment finding requires immediate intervention?
A. Heart rate 92/min
B. Oxygen saturation 96%
C. Blood pressure 84/52 mmHg
D. Respiratory rate 18/min
Answer: C
, Severe hypotension may indicate cardiogenic shock or another life-threatening complication
of myocardial infarction and requires immediate intervention.
11. A client with COPD has chronic carbon dioxide retention. Which oxygen-delivery
approach is generally appropriate when oxygen is prescribed?
A. High-flow oxygen without monitoring
B. Controlled, low-concentration oxygen as prescribed
C. No oxygen under any circumstances
D. Oxygen by nonrebreather mask at maximum flow for every exacerbation
Answer: B
Clients with chronic hypercapnia may require carefully titrated oxygen therapy. Oxygen
should be administered according to the prescribed target saturation and monitored
response.
12. Which assessment finding is characteristic of emphysema?
A. Increased anterior-posterior chest diameter
B. Massive hemoptysis
C. Pleural friction rub
D. Sudden unilateral absent breath sounds
Answer: A
Long-standing hyperinflation associated with emphysema can produce a barrel-shaped chest
with an increased anterior-posterior diameter.
13. A client with pneumonia has a respiratory rate of 32/min, oxygen saturation of 88%,
and increasing confusion. What is the priority nursing action?
A. Encourage oral intake
B. Initiate prescribed oxygen and rapidly reassess respiratory status
C. Obtain a routine dietary history
D. Place the client flat in bed
Answer: B
Hypoxemia accompanied by tachypnea and confusion indicates impaired oxygenation.
Supporting oxygenation and promptly reassessing the client take priority.
14. A client with asthma develops severe wheezing followed by markedly diminished breath
sounds. What does this finding suggest?
Answers 2026/2027 | Complete Questions And Answers
(Verified Answers) | Exam Prep | Comprehensive Exam Guide
2026&2027
1. A client with acute left-sided heart failure develops severe dyspnea, bilateral crackles,
and an oxygen saturation of 84%. Which action should the nurse take first?
A. Encourage oral fluids
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Obtain a daily weight
D. Prepare the client for ambulation
Answer: B
High-Fowler's positioning improves lung expansion and reduces venous return, while
supplemental oxygen addresses the immediate hypoxemia. These interventions take priority
over routine heart-failure management.
2. A client taking furosemide for heart failure reports muscle weakness and palpitations.
Which laboratory value is most important for the nurse to review?
A. Sodium 140 mEq/L
B. Calcium 9.2 mg/dL
C. Potassium 2.9 mEq/L
D. Magnesium 2.0 mg/dL
Answer: C
Furosemide promotes potassium loss. Severe hypokalemia can cause muscle weakness and
potentially life-threatening dysrhythmias, making the potassium level the priority
assessment.
3. A client with chronic heart failure suddenly gains 2.5 kg over three days. Which
interpretation is most appropriate?
A. The client has gained primarily lean body mass
B. The change is expected with aging
C. The client is experiencing fluid retention
D. The client has developed hyperglycemia
Answer: C
,Rapid weight gain over several days is usually associated with fluid accumulation rather than
tissue gain and may indicate worsening heart failure.
4. A client with atrial fibrillation is prescribed warfarin. Which laboratory test is routinely
used to evaluate the therapeutic effect?
A. INR
B. Troponin
C. BNP
D. aPTT
Answer: A
Warfarin therapy is monitored primarily with the prothrombin time expressed as the
international normalized ratio, or INR.
5. A client receiving digoxin has an apical pulse of 52/min before the scheduled dose. What
should the nurse do?
A. Administer the medication with food
B. Give half the prescribed dose
C. Hold the dose and notify the provider according to protocol
D. Administer the medication and reassess in 30 minutes
Answer: C
Digoxin can slow the heart rate. A significant bradycardia before administration requires
withholding the medication and appropriate clinical notification.
6. Which finding in a client with infective endocarditis requires the most immediate
attention?
A. Fatigue after activity
B. New-onset confusion and unilateral weakness
C. Mild anorexia
D. Low-grade fever
Answer: B
Acute neurologic deficits may indicate an embolic event from vegetation. Sudden neurologic
changes require immediate assessment and intervention.
7. A client with peripheral arterial disease reports severe calf pain when walking that
resolves with rest. How should the nurse document this finding?
,A. Orthopnea
B. Intermittent claudication
C. Dependent edema
D. Venous stasis pain
Answer: B
Intermittent claudication is ischemic muscle pain caused by inadequate arterial blood flow
during activity and typically improves with rest.
8. Which assessment finding is most consistent with chronic venous insufficiency?
A. Cool, pale extremity with absent pulses
B. Pain relieved by dangling the leg
C. Brown pigmentation and edema around the ankles
D. Sudden unilateral loss of sensation
Answer: C
Venous hypertension commonly causes dependent edema, skin changes, and brown
pigmentation from hemosiderin deposition.
9. A client develops sudden chest pain, diaphoresis, and nausea. Which diagnostic marker
is most specific for myocardial injury?
A. Troponin
B. Hemoglobin
C. D-dimer
D. BNP
Answer: A
Cardiac troponins are highly sensitive and specific markers of myocardial injury and are
central to evaluation of suspected acute coronary syndrome.
10. A client with suspected myocardial infarction reports crushing substernal chest pain.
Which assessment finding requires immediate intervention?
A. Heart rate 92/min
B. Oxygen saturation 96%
C. Blood pressure 84/52 mmHg
D. Respiratory rate 18/min
Answer: C
, Severe hypotension may indicate cardiogenic shock or another life-threatening complication
of myocardial infarction and requires immediate intervention.
11. A client with COPD has chronic carbon dioxide retention. Which oxygen-delivery
approach is generally appropriate when oxygen is prescribed?
A. High-flow oxygen without monitoring
B. Controlled, low-concentration oxygen as prescribed
C. No oxygen under any circumstances
D. Oxygen by nonrebreather mask at maximum flow for every exacerbation
Answer: B
Clients with chronic hypercapnia may require carefully titrated oxygen therapy. Oxygen
should be administered according to the prescribed target saturation and monitored
response.
12. Which assessment finding is characteristic of emphysema?
A. Increased anterior-posterior chest diameter
B. Massive hemoptysis
C. Pleural friction rub
D. Sudden unilateral absent breath sounds
Answer: A
Long-standing hyperinflation associated with emphysema can produce a barrel-shaped chest
with an increased anterior-posterior diameter.
13. A client with pneumonia has a respiratory rate of 32/min, oxygen saturation of 88%,
and increasing confusion. What is the priority nursing action?
A. Encourage oral intake
B. Initiate prescribed oxygen and rapidly reassess respiratory status
C. Obtain a routine dietary history
D. Place the client flat in bed
Answer: B
Hypoxemia accompanied by tachypnea and confusion indicates impaired oxygenation.
Supporting oxygenation and promptly reassessing the client take priority.
14. A client with asthma develops severe wheezing followed by markedly diminished breath
sounds. What does this finding suggest?
