Adult Health Nursing
60-Question Case Study Examination
Clinical reasoning • Patient scenarios • Answers & explanations
Instructions: Read each patient scenario carefully and select the single best answer. This examination is
designed for adult health nursing review and clinical application.
1. Cardiovascular
A 68-year-old patient with a history of heart failure reports increasing shortness of breath, a 3-kg weight
gain in 4 days, and swelling of both ankles. Which finding requires the nurse's priority attention?
A. Mild ankle edema at the end of the day
B. Weight gain of 3 kg in 4 days
C. Occasional fatigue after walking
D. Reduced appetite for one day
2. Cardiovascular
A patient with chest pressure, diaphoresis, and nausea arrives in the emergency department. The nurse
obtains vital signs and prepares the patient for an ECG. Which action is most appropriate while the
assessment continues?
A. Encourage the patient to walk to reduce anxiety
B. Place the patient at rest and continue rapid cardiac assessment
C. Give a large meal before diagnostic testing
D. Delay assessment until the pain resolves
3. Cardiovascular
A patient taking digoxin reports nausea and seeing yellow-green halos around lights. The apical pulse is
52/min. What should the nurse do first?
A. Administer the next dose
B. Hold the medication and notify the prescriber
C. Encourage increased activity
D. Give an additional dose with food
Adult Health Nursing Case Study Examination • Page 1
,4. Cardiovascular
A patient with atrial fibrillation is prescribed an anticoagulant. Which statement by the patient shows
understanding of the purpose of therapy?
A. 'It will dissolve every clot immediately.'
B. 'It reduces my risk of stroke from blood clots.'
C. 'It will make my heart beat normally.'
D. 'It replaces my need for blood pressure monitoring.'
5. Cardiovascular
A patient with peripheral arterial disease reports calf pain when walking that improves with rest. Which
finding is most consistent with the condition?
A. Intermittent claudication
B. Dependent edema that improves with standing
C. Warm, flushed legs with bounding pulses
D. Painless swelling after meals
6. Cardiovascular
A patient with hypertension has been prescribed an antihypertensive medication. Which home
measurement is most useful for evaluating the ongoing response?
A. Daily blood pressure readings
B. Hair growth
C. Appetite after breakfast
D. Skin temperature only
7. Respiratory
A patient with COPD is increasingly drowsy and has a respiratory rate of 8/min. Oxygen saturation is 84%.
Which finding is the greatest immediate concern?
A. Mild chronic cough
B. Slow respiratory rate with hypoxemia
C. Long smoking history
D. Barrel-shaped chest
Adult Health Nursing Case Study Examination • Page 2
, 8. Respiratory
A patient with asthma develops wheezing and difficulty speaking after exposure to a known trigger. Which
medication should the nurse expect to be used for rapid relief?
A. Short-acting bronchodilator
B. Long-term oral iron supplement
C. Stool softener
D. Antacid
9. Respiratory
A patient with pneumonia has a temperature of 39°C, respiratory rate of 30/min, and new confusion.
Which assessment finding should the nurse prioritize?
A. Mild pleuritic discomfort
B. New confusion with tachypnea
C. Decreased appetite
D. Productive cough alone
10. Respiratory
A patient recovering from surgery suddenly develops sharp chest pain, dyspnea, and tachycardia. Which
complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Otitis media
D. Cataract formation
11. Respiratory
A patient with a tracheostomy has noisy breathing and visible secretions. Oxygen saturation is falling.
What is the priority nursing action?
A. Assess airway patency and suction as indicated
B. Offer a large meal
C. Place the patient flat and leave the room
D. Delay assessment until the next scheduled round
Adult Health Nursing Case Study Examination • Page 3
60-Question Case Study Examination
Clinical reasoning • Patient scenarios • Answers & explanations
Instructions: Read each patient scenario carefully and select the single best answer. This examination is
designed for adult health nursing review and clinical application.
1. Cardiovascular
A 68-year-old patient with a history of heart failure reports increasing shortness of breath, a 3-kg weight
gain in 4 days, and swelling of both ankles. Which finding requires the nurse's priority attention?
A. Mild ankle edema at the end of the day
B. Weight gain of 3 kg in 4 days
C. Occasional fatigue after walking
D. Reduced appetite for one day
2. Cardiovascular
A patient with chest pressure, diaphoresis, and nausea arrives in the emergency department. The nurse
obtains vital signs and prepares the patient for an ECG. Which action is most appropriate while the
assessment continues?
A. Encourage the patient to walk to reduce anxiety
B. Place the patient at rest and continue rapid cardiac assessment
C. Give a large meal before diagnostic testing
D. Delay assessment until the pain resolves
3. Cardiovascular
A patient taking digoxin reports nausea and seeing yellow-green halos around lights. The apical pulse is
52/min. What should the nurse do first?
A. Administer the next dose
B. Hold the medication and notify the prescriber
C. Encourage increased activity
D. Give an additional dose with food
Adult Health Nursing Case Study Examination • Page 1
,4. Cardiovascular
A patient with atrial fibrillation is prescribed an anticoagulant. Which statement by the patient shows
understanding of the purpose of therapy?
A. 'It will dissolve every clot immediately.'
B. 'It reduces my risk of stroke from blood clots.'
C. 'It will make my heart beat normally.'
D. 'It replaces my need for blood pressure monitoring.'
5. Cardiovascular
A patient with peripheral arterial disease reports calf pain when walking that improves with rest. Which
finding is most consistent with the condition?
A. Intermittent claudication
B. Dependent edema that improves with standing
C. Warm, flushed legs with bounding pulses
D. Painless swelling after meals
6. Cardiovascular
A patient with hypertension has been prescribed an antihypertensive medication. Which home
measurement is most useful for evaluating the ongoing response?
A. Daily blood pressure readings
B. Hair growth
C. Appetite after breakfast
D. Skin temperature only
7. Respiratory
A patient with COPD is increasingly drowsy and has a respiratory rate of 8/min. Oxygen saturation is 84%.
Which finding is the greatest immediate concern?
A. Mild chronic cough
B. Slow respiratory rate with hypoxemia
C. Long smoking history
D. Barrel-shaped chest
Adult Health Nursing Case Study Examination • Page 2
, 8. Respiratory
A patient with asthma develops wheezing and difficulty speaking after exposure to a known trigger. Which
medication should the nurse expect to be used for rapid relief?
A. Short-acting bronchodilator
B. Long-term oral iron supplement
C. Stool softener
D. Antacid
9. Respiratory
A patient with pneumonia has a temperature of 39°C, respiratory rate of 30/min, and new confusion.
Which assessment finding should the nurse prioritize?
A. Mild pleuritic discomfort
B. New confusion with tachypnea
C. Decreased appetite
D. Productive cough alone
10. Respiratory
A patient recovering from surgery suddenly develops sharp chest pain, dyspnea, and tachycardia. Which
complication should the nurse suspect?
A. Pulmonary embolism
B. Constipation
C. Otitis media
D. Cataract formation
11. Respiratory
A patient with a tracheostomy has noisy breathing and visible secretions. Oxygen saturation is falling.
What is the priority nursing action?
A. Assess airway patency and suction as indicated
B. Offer a large meal
C. Place the patient flat and leave the room
D. Delay assessment until the next scheduled round
Adult Health Nursing Case Study Examination • Page 3
