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NUR 445 Final Exam — Acute & Chronic Health
Disruptions in Adults III QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
NUR 445 Final Exam — Acute & Chronic Health Disruptions in Adults III
MOSTLY TESTED EXAM COVERAGE AREAS
1. Cardiovascular Disorders and Acute Cardiac Events
2. Respiratory Disorders and Acute Respiratory Failure
3. Neurological Disorders and Altered Neurological Function
4. Renal and Urinary Disorders, Fluid Balance, and Electrolytes
5. Endocrine and Metabolic Disorders
6. Gastrointestinal, Hepatic, and Pancreatic Disorders
7. Hematologic and Immune Disorders
8. Infectious Diseases, Sepsis, and Systemic Inflammatory Responses
9. Cancer, Palliative Care, and Complex Chronic Illness Management
10. Critical Care, Multisystem Complications, Prioritization, and Clinical Judgment
QUESTIONS 1–250
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1. Which assessment finding in an adult patient with acute chest discomfort should the nurse
recognize as requiring immediate cardiovascular evaluation?
A. Mild fatigue after walking
B. New crushing substernal pressure with diaphoresis
C. Occasional indigestion after meals
D. Mild ankle swelling after prolonged standing
Answer: B
Rationale:
• Crushing substernal pressure with diaphoresis is concerning for acute myocardial ischemia.
• Immediate assessment and appropriate emergency interventions are necessary.
• Mild fatigue or dependent edema is less immediately threatening without additional findings.
2. Why should a nurse closely monitor a patient with acute myocardial infarction for changes in
cardiac rhythm during the initial treatment period?
A. Dysrhythmias can occur because ischemic myocardium disrupts normal electrical conduction
B. Dysrhythmias always indicate that myocardial oxygen demand has decreased
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C. Cardiac monitoring eliminates the need for physical assessment
D. Rhythm changes are expected and never require intervention
Answer: A
Rationale:
• Ischemic myocardial tissue can become electrically unstable.
• Ventricular and other dysrhythmias may become life-threatening.
• Continuous monitoring supports early recognition and treatment.
3. A patient with heart failure suddenly develops severe dyspnea and bilateral crackles, so which
nursing action should receive priority?
A. Encourage the patient to drink additional fluids
B. Place the patient upright and assess respiratory status immediately
C. Lower the head of the bed
D. Encourage the patient to ambulate
Answer: B
Rationale:
• Severe dyspnea and crackles can indicate acute pulmonary congestion.
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• Upright positioning can improve ventilation and reduce pulmonary venous pressure.
• Immediate respiratory assessment and escalation are appropriate.
4. Which laboratory finding would be most concerning in an adult patient receiving treatment for
severe heart failure and taking medications that affect potassium levels?
A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L
C. Chloride 102 mEq/L
D. Calcium 9.3 mg/dL
Answer: B
Rationale:
• Significant hyperkalemia can cause dangerous cardiac conduction abnormalities.
• Patients receiving medications that alter potassium balance require close monitoring.
• Severe potassium abnormalities may require urgent intervention.
5. What is the primary reason a nurse should assess daily weight in a patient with chronic heart
failure?
NUR 445 Final Exam — Acute & Chronic Health
Disruptions in Adults III QUESTIONS AND CORRECT
ANSWERS LATEST UPDATE THIS YEAR
NUR 445 Final Exam — Acute & Chronic Health Disruptions in Adults III
MOSTLY TESTED EXAM COVERAGE AREAS
1. Cardiovascular Disorders and Acute Cardiac Events
2. Respiratory Disorders and Acute Respiratory Failure
3. Neurological Disorders and Altered Neurological Function
4. Renal and Urinary Disorders, Fluid Balance, and Electrolytes
5. Endocrine and Metabolic Disorders
6. Gastrointestinal, Hepatic, and Pancreatic Disorders
7. Hematologic and Immune Disorders
8. Infectious Diseases, Sepsis, and Systemic Inflammatory Responses
9. Cancer, Palliative Care, and Complex Chronic Illness Management
10. Critical Care, Multisystem Complications, Prioritization, and Clinical Judgment
QUESTIONS 1–250
, Page 2 of 158
1. Which assessment finding in an adult patient with acute chest discomfort should the nurse
recognize as requiring immediate cardiovascular evaluation?
A. Mild fatigue after walking
B. New crushing substernal pressure with diaphoresis
C. Occasional indigestion after meals
D. Mild ankle swelling after prolonged standing
Answer: B
Rationale:
• Crushing substernal pressure with diaphoresis is concerning for acute myocardial ischemia.
• Immediate assessment and appropriate emergency interventions are necessary.
• Mild fatigue or dependent edema is less immediately threatening without additional findings.
2. Why should a nurse closely monitor a patient with acute myocardial infarction for changes in
cardiac rhythm during the initial treatment period?
A. Dysrhythmias can occur because ischemic myocardium disrupts normal electrical conduction
B. Dysrhythmias always indicate that myocardial oxygen demand has decreased
, Page 3 of 158
C. Cardiac monitoring eliminates the need for physical assessment
D. Rhythm changes are expected and never require intervention
Answer: A
Rationale:
• Ischemic myocardial tissue can become electrically unstable.
• Ventricular and other dysrhythmias may become life-threatening.
• Continuous monitoring supports early recognition and treatment.
3. A patient with heart failure suddenly develops severe dyspnea and bilateral crackles, so which
nursing action should receive priority?
A. Encourage the patient to drink additional fluids
B. Place the patient upright and assess respiratory status immediately
C. Lower the head of the bed
D. Encourage the patient to ambulate
Answer: B
Rationale:
• Severe dyspnea and crackles can indicate acute pulmonary congestion.
, Page 4 of 158
• Upright positioning can improve ventilation and reduce pulmonary venous pressure.
• Immediate respiratory assessment and escalation are appropriate.
4. Which laboratory finding would be most concerning in an adult patient receiving treatment for
severe heart failure and taking medications that affect potassium levels?
A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L
C. Chloride 102 mEq/L
D. Calcium 9.3 mg/dL
Answer: B
Rationale:
• Significant hyperkalemia can cause dangerous cardiac conduction abnormalities.
• Patients receiving medications that alter potassium balance require close monitoring.
• Severe potassium abnormalities may require urgent intervention.
5. What is the primary reason a nurse should assess daily weight in a patient with chronic heart
failure?
