PNH 301 Final Exam | Questions and Answers
| 2026 Updated | 100% Correct - Seneca
College.
PNH 301 Final Exam Practice Questions
Course: Healing Practices for the Practical Nurse III | Seneca College
Format: Multiple Choice & SATA
Answer Key & Rationales: Provided after each question
Section 1: Cardiovascular Pathophysiology
1. Which of the following statements regarding cor pulmonale is the basis for
the nurse's response when teaching a client?
A) Pulmonary congestion secondary to left ventricular failure
B) Excess serous fluid collection in the alveoli caused by retained respiratory
secretions
C) Right ventricular hypertrophy secondary to increased pulmonary vascular
resistance
D) Left ventricular hypertrophy secondary to systemic hypertension
Answer: C. Right ventricular hypertrophy secondary to increased pulmonary
vascular resistance
Rationale: Cor pulmonale is right ventricular hypertrophy and dilatation secondary
to pulmonary hypertension. The increased pulmonary vascular resistance forces
the right ventricle to work harder, leading to hypertrophy .
,2. The nurse is assessing a client who has chronic peripheral artery disease (PAD)
of the legs and an ulcer on the left great toe. Which of the following findings
should the nurse expect?
A) A positive Homans' sign
B) Swollen, dry, scaly ankles
C) Prolonged capillary refill in all the toes
D) A large amount of drainage from the ulcer
Answer: C. Prolonged capillary refill in all the toes
Rationale: In peripheral artery disease, reduced arterial blood flow leads to
prolonged capillary refill time (greater than 3 seconds) in the affected extremity. A
positive Homans' sign is associated with deep vein thrombosis. Swollen ankles
suggest venous insufficiency. Arterial ulcers typically have minimal drainage due to
poor perfusion .
3. How does defibrillation differ from cardioversion?
A) Defibrillation requires a greater dose of electrical current
B) Defibrillation is synchronized to countershock during the QRS complex
C) Cardioversion is indicated only for treatment of atrial tachydysrhythmias
D) Cardioversion may be done on a nonemergency basis with sedation of the
client
Answer: D. Cardioversion may be done on a nonemergency basis with sedation
of the client
Rationale: Cardioversion is typically performed on a nonemergency, elective basis
with sedation because the shock is synchronized to the R wave to avoid inducing
ventricular fibrillation. Defibrillation is an emergency procedure for pulseless
rhythms (V-fib, pulseless V-tach) and delivers an unsynchronized shock .
, 4. Which of the following is true regarding a client with an implantable cardiac
defibrillator (ICD)?
A) Antidysrhythmia medications can be discontinued
B) All members of the client's family should learn CPR
C) The client may drive immediately after device implantation
D) The client should avoid microwave ovens
Answer: B. All members of the client's family should learn CPR
Rationale: All family members should learn CPR, as ICD shocks may not always
restore a perfusing rhythm and the patient may become unresponsive.
Antiarrhythmic medications are often continued alongside ICD therapy. Driving
restrictions apply for a period after implantation. Microwave ovens do not
interfere with modern ICD function .
5. The nurse is caring for a client with angina who has been prescribed nadolol
(a beta-blocker). Which parameter should the nurse assess to determine
whether the drug is effective?
A) Decreased blood pressure and apical pulse rate
B) Fewer complaints of having cold hands and feet
C) Improvement in the quality of the peripheral pulses
D) The ability to do daily activities without chest discomfort
Answer: D. The ability to do daily activities without chest discomfort
Rationale: The effectiveness of antianginal therapy is best measured by the
client's ability to perform activities of daily living without chest discomfort or
anginal episodes. While decreased heart rate and blood pressure are expected
effects, they are not the primary outcome measure. Beta-blockers can worsen
peripheral circulation, causing cold extremities as a side effect .
| 2026 Updated | 100% Correct - Seneca
College.
PNH 301 Final Exam Practice Questions
Course: Healing Practices for the Practical Nurse III | Seneca College
Format: Multiple Choice & SATA
Answer Key & Rationales: Provided after each question
Section 1: Cardiovascular Pathophysiology
1. Which of the following statements regarding cor pulmonale is the basis for
the nurse's response when teaching a client?
A) Pulmonary congestion secondary to left ventricular failure
B) Excess serous fluid collection in the alveoli caused by retained respiratory
secretions
C) Right ventricular hypertrophy secondary to increased pulmonary vascular
resistance
D) Left ventricular hypertrophy secondary to systemic hypertension
Answer: C. Right ventricular hypertrophy secondary to increased pulmonary
vascular resistance
Rationale: Cor pulmonale is right ventricular hypertrophy and dilatation secondary
to pulmonary hypertension. The increased pulmonary vascular resistance forces
the right ventricle to work harder, leading to hypertrophy .
,2. The nurse is assessing a client who has chronic peripheral artery disease (PAD)
of the legs and an ulcer on the left great toe. Which of the following findings
should the nurse expect?
A) A positive Homans' sign
B) Swollen, dry, scaly ankles
C) Prolonged capillary refill in all the toes
D) A large amount of drainage from the ulcer
Answer: C. Prolonged capillary refill in all the toes
Rationale: In peripheral artery disease, reduced arterial blood flow leads to
prolonged capillary refill time (greater than 3 seconds) in the affected extremity. A
positive Homans' sign is associated with deep vein thrombosis. Swollen ankles
suggest venous insufficiency. Arterial ulcers typically have minimal drainage due to
poor perfusion .
3. How does defibrillation differ from cardioversion?
A) Defibrillation requires a greater dose of electrical current
B) Defibrillation is synchronized to countershock during the QRS complex
C) Cardioversion is indicated only for treatment of atrial tachydysrhythmias
D) Cardioversion may be done on a nonemergency basis with sedation of the
client
Answer: D. Cardioversion may be done on a nonemergency basis with sedation
of the client
Rationale: Cardioversion is typically performed on a nonemergency, elective basis
with sedation because the shock is synchronized to the R wave to avoid inducing
ventricular fibrillation. Defibrillation is an emergency procedure for pulseless
rhythms (V-fib, pulseless V-tach) and delivers an unsynchronized shock .
, 4. Which of the following is true regarding a client with an implantable cardiac
defibrillator (ICD)?
A) Antidysrhythmia medications can be discontinued
B) All members of the client's family should learn CPR
C) The client may drive immediately after device implantation
D) The client should avoid microwave ovens
Answer: B. All members of the client's family should learn CPR
Rationale: All family members should learn CPR, as ICD shocks may not always
restore a perfusing rhythm and the patient may become unresponsive.
Antiarrhythmic medications are often continued alongside ICD therapy. Driving
restrictions apply for a period after implantation. Microwave ovens do not
interfere with modern ICD function .
5. The nurse is caring for a client with angina who has been prescribed nadolol
(a beta-blocker). Which parameter should the nurse assess to determine
whether the drug is effective?
A) Decreased blood pressure and apical pulse rate
B) Fewer complaints of having cold hands and feet
C) Improvement in the quality of the peripheral pulses
D) The ability to do daily activities without chest discomfort
Answer: D. The ability to do daily activities without chest discomfort
Rationale: The effectiveness of antianginal therapy is best measured by the
client's ability to perform activities of daily living without chest discomfort or
anginal episodes. While decreased heart rate and blood pressure are expected
effects, they are not the primary outcome measure. Beta-blockers can worsen
peripheral circulation, causing cold extremities as a side effect .
