❖ Spring Semester 2026 | D239 Adult Health II Exam Study Guide for
Nursing Students | 300+ High-Yield Practice Questions with
Detailed Rationales, Key Adult Care Concepts, Complex Clinical
Scenarios, NCLEX Exam Preparation, Critical Thinking, Evidence-
Based Nursing Practice, and Comprehensive Review for University
Exams and Clinical Assessments
Question 1
Which of the following is the priority nursing intervention for a patient experiencing
acute chest pain?
A) Administer aspirin
B) Provide oxygen
C) Perform a cardiac assessment
D) Initiate an intravenous line
Correct Answer: B) Provide oxygen
Rationale: In cases of acute chest pain, the priority is to ensure the patient's
oxygenation. Administering oxygen can help alleviate hypoxia, which is critical during
potential myocardial ischemia. While aspirin and cardiac assessments are vital,
ensuring that the patient receives adequate oxygen is the initial priority.
Question 2
In the management of a patient with heart failure, which dietary modification is
most important?
A) Increase sodium intake
B) Decrease fluid intake
C) Increase protein intake
D) Maintain a high-calorie diet
Correct Answer: B) Decrease fluid intake
Rationale: Patients with heart failure often experience fluid retention due to the heart's
inability to pump effectively. Reducing fluid intake helps minimize the workload on the
heart and prevent complications such as pulmonary edema and hypertension.
Monitoring sodium intake is also crucial, but reducing fluid is typically prioritized.
Question 3
What is the expected nursing intervention for a patient undergoing a blood
transfusion?
A) Administer the transfusion at a rapid rate
B) Monitor vital signs every 30 minutes
,C) Use only normal saline for the transfusion
D) Pre-medicate with antihistamines
Correct Answer: C) Use only normal saline for the transfusion
Rationale: When administering a blood transfusion, it’s critical to use normal saline to
maintain patency and avoid incompatible reactions. Rapid infusion can cause
transfusion reactions, and vital signs should be monitored before, during, and after the
transfusion according to facility protocols, typically every 15 minutes initially. Pre-
medication may be required in specific cases but is not a standard intervention for all
patients.
Question 4
A patient with diabetes is admitted to the hospital with ketoacidosis. What is the
most appropriate initial treatment?
A) Administer insulin
B) Provide IV glucose
C) Increase oral fluids
D) Administer bicarbonate
Correct Answer: A) Administer insulin
Rationale: The primary treatment for diabetic ketoacidosis (DKA) is the administration
of insulin to reduce blood glucose levels and resolve ketoacidosis. While hydration and
electrolyte replacement are also critical components of the overall treatment plan,
insulin administration is the first-line intervention in managing ketoacidosis.
Question 5
Which assessment finding is most concerning for a patient with liver cirrhosis?
A) Jaundice
B) Ascites
C) Confusion
D) Edema
Correct Answer: C) Confusion
Rationale: Confusion in a patient with liver cirrhosis may indicate hepatic
encephalopathy, a serious complication resulting from the liver's inability to detoxify
ammonia and other substances. Although jaundice, ascites, and edema are common
findings in liver disease, confusion signals a potential life-threatening condition
requiring immediate intervention.
Question 6
,A patient with hypertension is prescribed a diuretic. Which lab value should the
nurse monitor closely?
A) Potassium
B) Sodium
C) Calcium
D) Glucose
Correct Answer: A) Potassium
Rationale: Diuretics, especially loop and thiazide types, can lead to potassium
depletion. Monitoring potassium levels is crucial to prevent hypokalemia, which can
cause arrhythmias and muscle weakness.
Question 7
What is the primary goal of treatment for a patient with chronic obstructive
pulmonary disease (COPD)?
A) Cure the disease
B) Prevent exacerbations
C) Increase exercise tolerance
D) Normalize lung function
Correct Answer: B) Prevent exacerbations
Rationale: COPD is a progressive disease with no cure. The primary goal is to prevent
exacerbations that can lead to hospitalization and deterioration of health, focusing on
management strategies and lifestyle changes.
Question 8
Which symptom is most indicative of left-sided heart failure?
A) Peripheral edema
B) Jugular vein distention
C) Pulmonary congestion
D) Ascites
Correct Answer: C) Pulmonary congestion
Rationale: Left-sided heart failure typically results in pulmonary congestion, leading to
symptoms like cough, dyspnea, and orthopnea. Peripheral edema and ascites are more
indicative of right-sided heart failure.
Question 9
, In planning care for a patient with respiratory failure, what is the priority nursing
intervention?
A) Administer bronchodilators
B) Maintain patent airway
C) Monitor arterial blood gases
D) Provide high-flow oxygen
Correct Answer: B) Maintain patent airway
Rationale: The priority in respiratory failure is ensuring that the airway is patent.
Without a clear airway, no other interventions (including oxygen therapy and
bronchodilators) can be effective.
Question 10
What is the most common cause of peptic ulcer disease?
A) Stress
B) H. pylori infection
C) Excessive alcohol intake
D) Smoking
Correct Answer: B) H. pylori infection
Rationale: Helicobacter pylori is the primary causative agent of peptic ulcers. Treating
H. pylori can lead to healing of the ulcer and decrease recurrence, whereas stress and
lifestyle factors can exacerbate existing conditions but are not the primary causes.
Question 11
A patient with a history of deep vein thrombosis (DVT) is on anticoagulation
therapy. What is a critical nursing responsibility?
A) Encourage increased ambulation
B) Teach the patient about vitamin K-rich foods
C) Monitor for signs of bleeding
D) Maintain strict bed rest
Correct Answer: C) Monitor for signs of bleeding
Rationale: Patients on anticoagulation therapy are at increased risk of bleeding. Close
monitoring for signs such as unusual bruising, blood in urine or stool, and prolonged
bleeding is essential for safety.
Question 12
Nursing Students | 300+ High-Yield Practice Questions with
Detailed Rationales, Key Adult Care Concepts, Complex Clinical
Scenarios, NCLEX Exam Preparation, Critical Thinking, Evidence-
Based Nursing Practice, and Comprehensive Review for University
Exams and Clinical Assessments
Question 1
Which of the following is the priority nursing intervention for a patient experiencing
acute chest pain?
A) Administer aspirin
B) Provide oxygen
C) Perform a cardiac assessment
D) Initiate an intravenous line
Correct Answer: B) Provide oxygen
Rationale: In cases of acute chest pain, the priority is to ensure the patient's
oxygenation. Administering oxygen can help alleviate hypoxia, which is critical during
potential myocardial ischemia. While aspirin and cardiac assessments are vital,
ensuring that the patient receives adequate oxygen is the initial priority.
Question 2
In the management of a patient with heart failure, which dietary modification is
most important?
A) Increase sodium intake
B) Decrease fluid intake
C) Increase protein intake
D) Maintain a high-calorie diet
Correct Answer: B) Decrease fluid intake
Rationale: Patients with heart failure often experience fluid retention due to the heart's
inability to pump effectively. Reducing fluid intake helps minimize the workload on the
heart and prevent complications such as pulmonary edema and hypertension.
Monitoring sodium intake is also crucial, but reducing fluid is typically prioritized.
Question 3
What is the expected nursing intervention for a patient undergoing a blood
transfusion?
A) Administer the transfusion at a rapid rate
B) Monitor vital signs every 30 minutes
,C) Use only normal saline for the transfusion
D) Pre-medicate with antihistamines
Correct Answer: C) Use only normal saline for the transfusion
Rationale: When administering a blood transfusion, it’s critical to use normal saline to
maintain patency and avoid incompatible reactions. Rapid infusion can cause
transfusion reactions, and vital signs should be monitored before, during, and after the
transfusion according to facility protocols, typically every 15 minutes initially. Pre-
medication may be required in specific cases but is not a standard intervention for all
patients.
Question 4
A patient with diabetes is admitted to the hospital with ketoacidosis. What is the
most appropriate initial treatment?
A) Administer insulin
B) Provide IV glucose
C) Increase oral fluids
D) Administer bicarbonate
Correct Answer: A) Administer insulin
Rationale: The primary treatment for diabetic ketoacidosis (DKA) is the administration
of insulin to reduce blood glucose levels and resolve ketoacidosis. While hydration and
electrolyte replacement are also critical components of the overall treatment plan,
insulin administration is the first-line intervention in managing ketoacidosis.
Question 5
Which assessment finding is most concerning for a patient with liver cirrhosis?
A) Jaundice
B) Ascites
C) Confusion
D) Edema
Correct Answer: C) Confusion
Rationale: Confusion in a patient with liver cirrhosis may indicate hepatic
encephalopathy, a serious complication resulting from the liver's inability to detoxify
ammonia and other substances. Although jaundice, ascites, and edema are common
findings in liver disease, confusion signals a potential life-threatening condition
requiring immediate intervention.
Question 6
,A patient with hypertension is prescribed a diuretic. Which lab value should the
nurse monitor closely?
A) Potassium
B) Sodium
C) Calcium
D) Glucose
Correct Answer: A) Potassium
Rationale: Diuretics, especially loop and thiazide types, can lead to potassium
depletion. Monitoring potassium levels is crucial to prevent hypokalemia, which can
cause arrhythmias and muscle weakness.
Question 7
What is the primary goal of treatment for a patient with chronic obstructive
pulmonary disease (COPD)?
A) Cure the disease
B) Prevent exacerbations
C) Increase exercise tolerance
D) Normalize lung function
Correct Answer: B) Prevent exacerbations
Rationale: COPD is a progressive disease with no cure. The primary goal is to prevent
exacerbations that can lead to hospitalization and deterioration of health, focusing on
management strategies and lifestyle changes.
Question 8
Which symptom is most indicative of left-sided heart failure?
A) Peripheral edema
B) Jugular vein distention
C) Pulmonary congestion
D) Ascites
Correct Answer: C) Pulmonary congestion
Rationale: Left-sided heart failure typically results in pulmonary congestion, leading to
symptoms like cough, dyspnea, and orthopnea. Peripheral edema and ascites are more
indicative of right-sided heart failure.
Question 9
, In planning care for a patient with respiratory failure, what is the priority nursing
intervention?
A) Administer bronchodilators
B) Maintain patent airway
C) Monitor arterial blood gases
D) Provide high-flow oxygen
Correct Answer: B) Maintain patent airway
Rationale: The priority in respiratory failure is ensuring that the airway is patent.
Without a clear airway, no other interventions (including oxygen therapy and
bronchodilators) can be effective.
Question 10
What is the most common cause of peptic ulcer disease?
A) Stress
B) H. pylori infection
C) Excessive alcohol intake
D) Smoking
Correct Answer: B) H. pylori infection
Rationale: Helicobacter pylori is the primary causative agent of peptic ulcers. Treating
H. pylori can lead to healing of the ulcer and decrease recurrence, whereas stress and
lifestyle factors can exacerbate existing conditions but are not the primary causes.
Question 11
A patient with a history of deep vein thrombosis (DVT) is on anticoagulation
therapy. What is a critical nursing responsibility?
A) Encourage increased ambulation
B) Teach the patient about vitamin K-rich foods
C) Monitor for signs of bleeding
D) Maintain strict bed rest
Correct Answer: C) Monitor for signs of bleeding
Rationale: Patients on anticoagulation therapy are at increased risk of bleeding. Close
monitoring for signs such as unusual bruising, blood in urine or stool, and prolonged
bleeding is essential for safety.
Question 12
