NSG 430 Exam 2 — Adult Health Nursing II
Exam
Grand Canyon University | 75 Questions |
90 Minutes | 90% to Pass
Cardiovascular Disorders (Q1–Q18)
Q1: A patient with chronic heart failure asks the nurse why daily weights are recorded every
morning. Which response by the nurse is most accurate?
A. "Daily weights tell us how much food you have been eating."
B. "A weight gain of 1 kg reflects approximately 1 liter of retained fluid and is the best
indicator of fluid status." [CORRECT]
C. "Daily weights measure the effectiveness of your blood pressure medication."
D. "Weight changes help us adjust your oxygen flow rate."
Correct Answer: B
Rationale: Daily weights are the most reliable indicator of fluid retention in heart failure; 1 kg
of weight gain ≈ 1 L of fluid. Weights should be measured at the same time daily, on the same
scale, with similar clothing. Food intake, BP medications, and oxygen settings are not
measured by weight trends.
Q2: The nurse is reviewing the chart of a patient newly diagnosed with heart failure. An
echocardiogram shows an ejection fraction of 32%. How should the nurse interpret this
finding?
A. Preserved ejection fraction with diastolic dysfunction
B. Normal systolic function requiring no treatment
C. Diastolic dysfunction best treated with calcium channel blockers alone
D. Reduced ejection fraction consistent with HFrEF and systolic dysfunction [CORRECT]
Correct Answer: D
,Rationale: An EF <40% defines HFrEF (systolic dysfunction), treated with ACE inhibitors/ARBs,
beta-blockers, and diuretics. HFpEF (EF ≥50%) involves diastolic dysfunction. An EF of 32% is
abnormal and always requires treatment.
Q3: A patient admitted with dyspnea has a BNP level of 850 pg/mL. How should the nurse
interpret this result?
A. It is markedly elevated and supports a diagnosis of heart failure. [CORRECT]
B. It is within normal limits and rules out heart failure.
C. It indicates hypokalemia secondary to diuretic therapy.
D. It is diagnostic of an acute myocardial infarction.
Correct Answer: A
Rationale: BNP >100 pg/mL is elevated and strongly supports heart failure as the cause of
dyspnea; levels rise with ventricular wall stretch. BNP does not measure potassium and is not
diagnostic of MI (troponin is).
Q4: A patient with a history of heart failure reports a 3-kg weight gain in 4 days. Which
findings indicate the patient is experiencing a heart failure exacerbation? (Select all that
apply.)
A. Increasing shortness of breath with activity
B. New onset of orthopnea
C. Decreasing BNP level
D. Peripheral edema and ascites
E. Crackles heard on auscultation
F. Improved exercise tolerance
Correct Answer: A, B, D, E
Rationale: Exacerbation findings reflect fluid overload: dyspnea, orthopnea, edema/ascites,
and crackles. BNP rises (not decreases) with worsening HF, and exercise tolerance worsens
rather than improves.
Q5: Which discharge teaching statement by the patient with heart failure indicates a need for
further instruction?
A. "I will weigh myself every morning after I urinate."
, B. "I will call my provider if I gain more than 2 pounds in a day."
C. "I will take my diuretic at bedtime so it doesn't interfere with my activities." [CORRECT]
D. "I will limit my daily sodium intake."
Correct Answer: C
Rationale: Diuretics should be taken in the morning (and early afternoon if twice daily) to
avoid nocturia and sleep disruption. The other statements reflect correct self-monitoring and
sodium restriction.
Q6: Which patient complaint is most concerning for acute coronary syndrome?
A. Chest discomfort that occurs only with deep inspiration and resolves when sitting up
B. Substernal chest pressure radiating to the left arm, unrelieved by rest or nitroglycerin,
accompanied by diaphoresis and nausea [CORRECT]
C. Sharp chest pain reproduced by pressing on the sternum
D. Burning chest discomfort that occurs 30 minutes after meals and is relieved by antacids
Correct Answer: B
Rationale: Cardiac ischemic pain is pressure-like, radiating, exertional or at rest (in ACS), and
unrelieved by nitroglycerin, often with autonomic symptoms (diaphoresis, nausea). Pleuritic,
reproducible, and meal-related pain suggest non-cardiac causes.
Q7: The nurse suspects acute coronary syndrome. Which laboratory test is the most specific
and sensitive indicator of myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I or T [CORRECT]
D. WBC count
Correct Answer: C
Rationale: Cardiac troponins are the most sensitive and specific biomarkers of myocardial
necrosis and remain elevated for days. Myoglobin rises early but is nonspecific; CK-MB is less
specific; WBC is nonspecific.
Q8: A patient arrives in the ED with suspected STEMI. Which action should the nurse
anticipate FIRST?
Exam
Grand Canyon University | 75 Questions |
90 Minutes | 90% to Pass
Cardiovascular Disorders (Q1–Q18)
Q1: A patient with chronic heart failure asks the nurse why daily weights are recorded every
morning. Which response by the nurse is most accurate?
A. "Daily weights tell us how much food you have been eating."
B. "A weight gain of 1 kg reflects approximately 1 liter of retained fluid and is the best
indicator of fluid status." [CORRECT]
C. "Daily weights measure the effectiveness of your blood pressure medication."
D. "Weight changes help us adjust your oxygen flow rate."
Correct Answer: B
Rationale: Daily weights are the most reliable indicator of fluid retention in heart failure; 1 kg
of weight gain ≈ 1 L of fluid. Weights should be measured at the same time daily, on the same
scale, with similar clothing. Food intake, BP medications, and oxygen settings are not
measured by weight trends.
Q2: The nurse is reviewing the chart of a patient newly diagnosed with heart failure. An
echocardiogram shows an ejection fraction of 32%. How should the nurse interpret this
finding?
A. Preserved ejection fraction with diastolic dysfunction
B. Normal systolic function requiring no treatment
C. Diastolic dysfunction best treated with calcium channel blockers alone
D. Reduced ejection fraction consistent with HFrEF and systolic dysfunction [CORRECT]
Correct Answer: D
,Rationale: An EF <40% defines HFrEF (systolic dysfunction), treated with ACE inhibitors/ARBs,
beta-blockers, and diuretics. HFpEF (EF ≥50%) involves diastolic dysfunction. An EF of 32% is
abnormal and always requires treatment.
Q3: A patient admitted with dyspnea has a BNP level of 850 pg/mL. How should the nurse
interpret this result?
A. It is markedly elevated and supports a diagnosis of heart failure. [CORRECT]
B. It is within normal limits and rules out heart failure.
C. It indicates hypokalemia secondary to diuretic therapy.
D. It is diagnostic of an acute myocardial infarction.
Correct Answer: A
Rationale: BNP >100 pg/mL is elevated and strongly supports heart failure as the cause of
dyspnea; levels rise with ventricular wall stretch. BNP does not measure potassium and is not
diagnostic of MI (troponin is).
Q4: A patient with a history of heart failure reports a 3-kg weight gain in 4 days. Which
findings indicate the patient is experiencing a heart failure exacerbation? (Select all that
apply.)
A. Increasing shortness of breath with activity
B. New onset of orthopnea
C. Decreasing BNP level
D. Peripheral edema and ascites
E. Crackles heard on auscultation
F. Improved exercise tolerance
Correct Answer: A, B, D, E
Rationale: Exacerbation findings reflect fluid overload: dyspnea, orthopnea, edema/ascites,
and crackles. BNP rises (not decreases) with worsening HF, and exercise tolerance worsens
rather than improves.
Q5: Which discharge teaching statement by the patient with heart failure indicates a need for
further instruction?
A. "I will weigh myself every morning after I urinate."
, B. "I will call my provider if I gain more than 2 pounds in a day."
C. "I will take my diuretic at bedtime so it doesn't interfere with my activities." [CORRECT]
D. "I will limit my daily sodium intake."
Correct Answer: C
Rationale: Diuretics should be taken in the morning (and early afternoon if twice daily) to
avoid nocturia and sleep disruption. The other statements reflect correct self-monitoring and
sodium restriction.
Q6: Which patient complaint is most concerning for acute coronary syndrome?
A. Chest discomfort that occurs only with deep inspiration and resolves when sitting up
B. Substernal chest pressure radiating to the left arm, unrelieved by rest or nitroglycerin,
accompanied by diaphoresis and nausea [CORRECT]
C. Sharp chest pain reproduced by pressing on the sternum
D. Burning chest discomfort that occurs 30 minutes after meals and is relieved by antacids
Correct Answer: B
Rationale: Cardiac ischemic pain is pressure-like, radiating, exertional or at rest (in ACS), and
unrelieved by nitroglycerin, often with autonomic symptoms (diaphoresis, nausea). Pleuritic,
reproducible, and meal-related pain suggest non-cardiac causes.
Q7: The nurse suspects acute coronary syndrome. Which laboratory test is the most specific
and sensitive indicator of myocardial injury?
A. CK-MB
B. Myoglobin
C. Troponin I or T [CORRECT]
D. WBC count
Correct Answer: C
Rationale: Cardiac troponins are the most sensitive and specific biomarkers of myocardial
necrosis and remain elevated for days. Myoglobin rises early but is nonspecific; CK-MB is less
specific; WBC is nonspecific.
Q8: A patient arrives in the ED with suspected STEMI. Which action should the nurse
anticipate FIRST?
