N176 EXAM 3 PRACTICE EXAM | 2026–2027
N176 EXAM 3 PRACTICE EXAM 2026–2027
100 Original Questions • Answers • Rationales • Clinical Pearls
Adult Health Nursing Review
Original study material; not an official exam, leaked exam, or reproduction of a proprietary test bank.
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
How to Use This Practice Exam
• Answer each question before reviewing the answer and rationale.
• Use rationales to identify the safest response and the clinical principle being tested.
• Follow current provider orders, facility policy, clinical guidance, and applicable nursing scope of practice.
• Assumption: N176 refers to Hondros NUR 176, Concepts of Adult Health Nursing for Practical Nurse I. Confirm your
course syllabus and exam blueprint before relying on course-specific alignment.
Topic Map
• Cardiovascular: 18 questions
• Gastrointestinal: 17 questions
• Hematology: 11 questions
• Peripheral Vascular: 3 questions
• Renal/Fluids: 12 questions
• Perioperative: 7 questions
• Safety/Pharmacology: 11 questions
• Older Adult Care: 3 questions
• Respiratory: 2 questions
• Diabetes: 3 questions
• Neurologic: 3 questions
• Priority: 10 questions
Practice Questions
Cardiovascular
Question 1. A client reports crushing chest pressure, diaphoresis, and nausea. What should the nurse do first?
A. Offer a full meal
B. Encourage walking
C. Wait 30 minutes before reassessing
D. Activate the chest-pain response and obtain a prompt ECG
Correct Answer: D. Activate the chest-pain response and obtain a prompt ECG
Rationale: Possible acute coronary syndrome is time-sensitive. Rapid assessment, ECG acquisition, and escalation
help identify ischemia and expedite treatment.
Why the other options are incorrect: A: Offer a full meal — not the best answer because it does not address the priority or
conflicts with the clinical safety principle in this scenario. B: Encourage walking — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. C: Wait 30 minutes before reassessing —
not the best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Suspected ACS requires immediate assessment and escalation.
Clinical Pearl: Do not delay evaluation of new chest pressure.
Question 2. A client with heart failure has worsening dyspnea, crackles, and a 2-kg weight gain in three days.
What is most concerning?
A. Mild thirst after walking
B. Stable appetite
C. Worsening respiratory symptoms with crackles
D. Dry skin on elbows
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
Correct Answer: C. Worsening respiratory symptoms with crackles
Rationale: Crackles and worsening dyspnea suggest pulmonary congestion; rapid weight gain supports fluid
retention and requires prompt assessment.
Why the other options are incorrect: A: Mild thirst after walking — not the best answer because it does not address the
priority or conflicts with the clinical safety principle in this scenario. B: Stable appetite — not the best answer because it
does not address the priority or conflicts with the clinical safety principle in this scenario. D: Dry skin on elbows — not the
best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Daily weights help identify fluid accumulation.
Clinical Pearl: Report rapid weight gain according to the care plan.
Question 3. Which instruction is appropriate for chronic heart failure?
A. Stop diuretics when urination increases
B. Use potassium-based salt substitutes freely
C. Weigh daily under consistent conditions
D. Drink extra fluids when edema appears
Correct Answer: C. Weigh daily under consistent conditions
Rationale: Consistent daily weights can reveal fluid accumulation early. Medication changes, potassium-containing
substitutes, and increased fluids require individualized guidance.
Why the other options are incorrect: A: Stop diuretics when urination increases — not the best answer because it does
not address the priority or conflicts with the clinical safety principle in this scenario. B: Use potassium-based salt
substitutes freely — not the best answer because it does not address the priority or conflicts with the clinical safety
principle in this scenario. D: Drink extra fluids when edema appears — not the best answer because it does not address
the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Self-monitoring and adherence support heart-failure management.
Clinical Pearl: Use the same scale and similar clothing each morning.
Question 4. A client taking digoxin reports nausea and yellow-green halos. What should the nurse do?
A. Give an extra dose
B. Withhold the dose and promptly notify the prescriber
C. Document it as harmless
D. Encourage exercise and continue as usual
Correct Answer: B. Withhold the dose and promptly notify the prescriber
Rationale: Visual changes and gastrointestinal symptoms may indicate toxicity, which can cause dysrhythmias.
Prompt evaluation may include pulse, renal function, electrolytes, and drug level.
Why the other options are incorrect: A: Give an extra dose — not the best answer because it does not address the priority
or conflicts with the clinical safety principle in this scenario. C: Document it as harmless — not the best answer because it
does not address the priority or conflicts with the clinical safety principle in this scenario. D: Encourage exercise and
continue as usual — not the best answer because it does not address the priority or conflicts with the clinical safety
principle in this scenario.
Key Concept: Digoxin toxicity can cause visual and GI symptoms.
Clinical Pearl: Low potassium and impaired renal function can increase toxicity risk.
Question 5. Before administering a beta blocker, which assessment is especially important?
A. Blood pressure and apical pulse
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
B. Hair distribution
C. Pupil size only
D. Bowel sounds only
Correct Answer: A. Blood pressure and apical pulse
Rationale: Beta blockers can lower heart rate and blood pressure. Follow the medication order and facility-specific
hold parameters.
Why the other options are incorrect: B: Hair distribution — not the best answer because it does not address the priority
or conflicts with the clinical safety principle in this scenario. C: Pupil size only — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. D: Bowel sounds only — not the best
answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Beta blockers may cause bradycardia or hypotension.
Clinical Pearl: Use the actual prescription's parameters rather than a universal threshold.
Question 6. A client prescribed nitroglycerin reports recent use of a phosphodiesterase-5 inhibitor. What is the
concern?
A. Potential profound hypotension from the interaction
B. Severe hyperglycemia in every case
C. Immediate kidney stones
D. No clinically important interaction
Correct Answer: A. Potential profound hypotension from the interaction
Rationale: Combining nitrates with phosphodiesterase-5 inhibitors can cause profound hypotension. Clarify the
history and follow emergency protocols.
Why the other options are incorrect: B: Severe hyperglycemia in every case — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. C: Immediate kidney stones — not the
best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario. D: No
clinically important interaction — not the best answer because it does not address the priority or conflicts with the clinical
safety principle in this scenario.
Key Concept: Nitrates can lower blood pressure significantly.
Clinical Pearl: Ask about relevant erectile-dysfunction or pulmonary-hypertension medicines.
Question 7. Which finding is most consistent with left-sided heart failure?
A. Unilateral calf warmth only
B. Isolated abdominal rash
C. Chronic dry skin
D. Crackles and orthopnea
Correct Answer: D. Crackles and orthopnea
Rationale: Left-sided pump failure can cause pulmonary venous congestion, producing crackles, dyspnea, and
orthopnea.
Why the other options are incorrect: A: Unilateral calf warmth only — not the best answer because it does not address
the priority or conflicts with the clinical safety principle in this scenario. B: Isolated abdominal rash — not the best answer
because it does not address the priority or conflicts with the clinical safety principle in this scenario. C: Chronic dry skin —
not the best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Left-sided failure commonly causes pulmonary symptoms.
Clinical Pearl: Ask how many pillows the client uses to sleep.
Original educational practice resource • Not an official or actual exam
N176 EXAM 3 PRACTICE EXAM 2026–2027
100 Original Questions • Answers • Rationales • Clinical Pearls
Adult Health Nursing Review
Original study material; not an official exam, leaked exam, or reproduction of a proprietary test bank.
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
How to Use This Practice Exam
• Answer each question before reviewing the answer and rationale.
• Use rationales to identify the safest response and the clinical principle being tested.
• Follow current provider orders, facility policy, clinical guidance, and applicable nursing scope of practice.
• Assumption: N176 refers to Hondros NUR 176, Concepts of Adult Health Nursing for Practical Nurse I. Confirm your
course syllabus and exam blueprint before relying on course-specific alignment.
Topic Map
• Cardiovascular: 18 questions
• Gastrointestinal: 17 questions
• Hematology: 11 questions
• Peripheral Vascular: 3 questions
• Renal/Fluids: 12 questions
• Perioperative: 7 questions
• Safety/Pharmacology: 11 questions
• Older Adult Care: 3 questions
• Respiratory: 2 questions
• Diabetes: 3 questions
• Neurologic: 3 questions
• Priority: 10 questions
Practice Questions
Cardiovascular
Question 1. A client reports crushing chest pressure, diaphoresis, and nausea. What should the nurse do first?
A. Offer a full meal
B. Encourage walking
C. Wait 30 minutes before reassessing
D. Activate the chest-pain response and obtain a prompt ECG
Correct Answer: D. Activate the chest-pain response and obtain a prompt ECG
Rationale: Possible acute coronary syndrome is time-sensitive. Rapid assessment, ECG acquisition, and escalation
help identify ischemia and expedite treatment.
Why the other options are incorrect: A: Offer a full meal — not the best answer because it does not address the priority or
conflicts with the clinical safety principle in this scenario. B: Encourage walking — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. C: Wait 30 minutes before reassessing —
not the best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Suspected ACS requires immediate assessment and escalation.
Clinical Pearl: Do not delay evaluation of new chest pressure.
Question 2. A client with heart failure has worsening dyspnea, crackles, and a 2-kg weight gain in three days.
What is most concerning?
A. Mild thirst after walking
B. Stable appetite
C. Worsening respiratory symptoms with crackles
D. Dry skin on elbows
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
Correct Answer: C. Worsening respiratory symptoms with crackles
Rationale: Crackles and worsening dyspnea suggest pulmonary congestion; rapid weight gain supports fluid
retention and requires prompt assessment.
Why the other options are incorrect: A: Mild thirst after walking — not the best answer because it does not address the
priority or conflicts with the clinical safety principle in this scenario. B: Stable appetite — not the best answer because it
does not address the priority or conflicts with the clinical safety principle in this scenario. D: Dry skin on elbows — not the
best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Daily weights help identify fluid accumulation.
Clinical Pearl: Report rapid weight gain according to the care plan.
Question 3. Which instruction is appropriate for chronic heart failure?
A. Stop diuretics when urination increases
B. Use potassium-based salt substitutes freely
C. Weigh daily under consistent conditions
D. Drink extra fluids when edema appears
Correct Answer: C. Weigh daily under consistent conditions
Rationale: Consistent daily weights can reveal fluid accumulation early. Medication changes, potassium-containing
substitutes, and increased fluids require individualized guidance.
Why the other options are incorrect: A: Stop diuretics when urination increases — not the best answer because it does
not address the priority or conflicts with the clinical safety principle in this scenario. B: Use potassium-based salt
substitutes freely — not the best answer because it does not address the priority or conflicts with the clinical safety
principle in this scenario. D: Drink extra fluids when edema appears — not the best answer because it does not address
the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Self-monitoring and adherence support heart-failure management.
Clinical Pearl: Use the same scale and similar clothing each morning.
Question 4. A client taking digoxin reports nausea and yellow-green halos. What should the nurse do?
A. Give an extra dose
B. Withhold the dose and promptly notify the prescriber
C. Document it as harmless
D. Encourage exercise and continue as usual
Correct Answer: B. Withhold the dose and promptly notify the prescriber
Rationale: Visual changes and gastrointestinal symptoms may indicate toxicity, which can cause dysrhythmias.
Prompt evaluation may include pulse, renal function, electrolytes, and drug level.
Why the other options are incorrect: A: Give an extra dose — not the best answer because it does not address the priority
or conflicts with the clinical safety principle in this scenario. C: Document it as harmless — not the best answer because it
does not address the priority or conflicts with the clinical safety principle in this scenario. D: Encourage exercise and
continue as usual — not the best answer because it does not address the priority or conflicts with the clinical safety
principle in this scenario.
Key Concept: Digoxin toxicity can cause visual and GI symptoms.
Clinical Pearl: Low potassium and impaired renal function can increase toxicity risk.
Question 5. Before administering a beta blocker, which assessment is especially important?
A. Blood pressure and apical pulse
Original educational practice resource • Not an official or actual exam
, N176 EXAM 3 PRACTICE EXAM | 2026–2027
B. Hair distribution
C. Pupil size only
D. Bowel sounds only
Correct Answer: A. Blood pressure and apical pulse
Rationale: Beta blockers can lower heart rate and blood pressure. Follow the medication order and facility-specific
hold parameters.
Why the other options are incorrect: B: Hair distribution — not the best answer because it does not address the priority
or conflicts with the clinical safety principle in this scenario. C: Pupil size only — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. D: Bowel sounds only — not the best
answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Beta blockers may cause bradycardia or hypotension.
Clinical Pearl: Use the actual prescription's parameters rather than a universal threshold.
Question 6. A client prescribed nitroglycerin reports recent use of a phosphodiesterase-5 inhibitor. What is the
concern?
A. Potential profound hypotension from the interaction
B. Severe hyperglycemia in every case
C. Immediate kidney stones
D. No clinically important interaction
Correct Answer: A. Potential profound hypotension from the interaction
Rationale: Combining nitrates with phosphodiesterase-5 inhibitors can cause profound hypotension. Clarify the
history and follow emergency protocols.
Why the other options are incorrect: B: Severe hyperglycemia in every case — not the best answer because it does not
address the priority or conflicts with the clinical safety principle in this scenario. C: Immediate kidney stones — not the
best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario. D: No
clinically important interaction — not the best answer because it does not address the priority or conflicts with the clinical
safety principle in this scenario.
Key Concept: Nitrates can lower blood pressure significantly.
Clinical Pearl: Ask about relevant erectile-dysfunction or pulmonary-hypertension medicines.
Question 7. Which finding is most consistent with left-sided heart failure?
A. Unilateral calf warmth only
B. Isolated abdominal rash
C. Chronic dry skin
D. Crackles and orthopnea
Correct Answer: D. Crackles and orthopnea
Rationale: Left-sided pump failure can cause pulmonary venous congestion, producing crackles, dyspnea, and
orthopnea.
Why the other options are incorrect: A: Unilateral calf warmth only — not the best answer because it does not address
the priority or conflicts with the clinical safety principle in this scenario. B: Isolated abdominal rash — not the best answer
because it does not address the priority or conflicts with the clinical safety principle in this scenario. C: Chronic dry skin —
not the best answer because it does not address the priority or conflicts with the clinical safety principle in this scenario.
Key Concept: Left-sided failure commonly causes pulmonary symptoms.
Clinical Pearl: Ask how many pillows the client uses to sleep.
Original educational practice resource • Not an official or actual exam
