LPN to ADN Bridge Exam 2: Med-Surg Cardiovascular and Respiratory
2026/2027 UPDATE
1. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Dependent edema
C. Crackles in the lungs
D. Hepatosplenomegaly
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary veins and
lungs, leading to pulmonary congestion and crackles. Options A, B, and D are signs of right-
sided heart failure.
2. The nurse is interpreting ABG results for a patient with COPD: pH 7.32, PaCO2
55 mmHg, HCO3 28 mEq/L. Which acid-base imbalance is present?
A. Metabolic acidosis, fully compensated
B. Respiratory alkalosis, uncompensated
C. Respiratory acidosis, partially compensated
D. Metabolic alkalosis, partially compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
elevated (attempting to compensate), indicating partial compensation.
,3. Which medication is considered the first-line treatment for a patient
experiencing an acute asthma attack?
A. Salmeterol
B. Montelukast
C. Fluticasone
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-agonist (SABA) used as a rescue medication for
rapid bronchodilation during an acute attack.
4. A patient with a deep vein thrombosis (DVT) suddenly develops dyspnea,
chest pain, and a cough. What is the priority nursing action?
A. Apply oxygen and notify the healthcare provider
B. Elevate the patient’s legs
C. Administer an oral anticoagulant
D. Perform a lower extremity ultrasound
Answer: A
Rationale: These are classic signs of a pulmonary embolism (PE), a life-threatening
complication of DVT. Immediate oxygenation and notification of the provider are critical.
5. When teaching a patient about nitroglycerin sublingual tablets, which
instruction is most important?
A. Swallow the tablet with a full glass of water
B. Take up to 5 tablets in 15 minutes before calling 911
C. Place the tablet under the tongue and let it dissolve
D. Store the tablets in a clear plastic container for easy access
Answer: C
Rationale: Nitroglycerin must be absorbed through the sublingual mucosa. It should not be
swallowed. Patients should call 911 if pain persists after the first dose.
, 6. Which assessment finding is a hallmark sign of a tension pneumothorax?
A. Productive cough
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Bradypnea
Answer: C
Rationale: A tension pneumothorax causes a shift in mediastinal structures, leading to
tracheal deviation away from the collapsed lung.
7. A patient is prescribed Lisinopril for hypertension. The nurse should monitor
for which common side effect?
A. Dry, persistent cough
B. Hypokalemia
C. Peripheral edema
D. Tachycardia
Answer: A
Rationale: ACE inhibitors like Lisinopril commonly cause a dry cough due to the
accumulation of bradykinin in the lungs.
8. The nurse is caring for a patient who just returned from a bronchoscopy.
What is the priority nursing intervention?
A. Offer the patient ice chips immediately
B. Encourage vigorous coughing to clear secretions
C. Keep the patient NPO until the gag reflex returns
D. Assist the patient with early ambulation
Answer: C
Rationale: Post-bronchoscopy, the throat is numbed; the nurse must ensure the gag reflex
has returned to prevent aspiration before allowing oral intake.
2026/2027 UPDATE
1. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Dependent edema
C. Crackles in the lungs
D. Hepatosplenomegaly
Answer: C
Rationale: Left-sided heart failure causes blood to back up into the pulmonary veins and
lungs, leading to pulmonary congestion and crackles. Options A, B, and D are signs of right-
sided heart failure.
2. The nurse is interpreting ABG results for a patient with COPD: pH 7.32, PaCO2
55 mmHg, HCO3 28 mEq/L. Which acid-base imbalance is present?
A. Metabolic acidosis, fully compensated
B. Respiratory alkalosis, uncompensated
C. Respiratory acidosis, partially compensated
D. Metabolic alkalosis, partially compensated
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
elevated (attempting to compensate), indicating partial compensation.
,3. Which medication is considered the first-line treatment for a patient
experiencing an acute asthma attack?
A. Salmeterol
B. Montelukast
C. Fluticasone
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-agonist (SABA) used as a rescue medication for
rapid bronchodilation during an acute attack.
4. A patient with a deep vein thrombosis (DVT) suddenly develops dyspnea,
chest pain, and a cough. What is the priority nursing action?
A. Apply oxygen and notify the healthcare provider
B. Elevate the patient’s legs
C. Administer an oral anticoagulant
D. Perform a lower extremity ultrasound
Answer: A
Rationale: These are classic signs of a pulmonary embolism (PE), a life-threatening
complication of DVT. Immediate oxygenation and notification of the provider are critical.
5. When teaching a patient about nitroglycerin sublingual tablets, which
instruction is most important?
A. Swallow the tablet with a full glass of water
B. Take up to 5 tablets in 15 minutes before calling 911
C. Place the tablet under the tongue and let it dissolve
D. Store the tablets in a clear plastic container for easy access
Answer: C
Rationale: Nitroglycerin must be absorbed through the sublingual mucosa. It should not be
swallowed. Patients should call 911 if pain persists after the first dose.
, 6. Which assessment finding is a hallmark sign of a tension pneumothorax?
A. Productive cough
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Bradypnea
Answer: C
Rationale: A tension pneumothorax causes a shift in mediastinal structures, leading to
tracheal deviation away from the collapsed lung.
7. A patient is prescribed Lisinopril for hypertension. The nurse should monitor
for which common side effect?
A. Dry, persistent cough
B. Hypokalemia
C. Peripheral edema
D. Tachycardia
Answer: A
Rationale: ACE inhibitors like Lisinopril commonly cause a dry cough due to the
accumulation of bradykinin in the lungs.
8. The nurse is caring for a patient who just returned from a bronchoscopy.
What is the priority nursing intervention?
A. Offer the patient ice chips immediately
B. Encourage vigorous coughing to clear secretions
C. Keep the patient NPO until the gag reflex returns
D. Assist the patient with early ambulation
Answer: C
Rationale: Post-bronchoscopy, the throat is numbed; the nurse must ensure the gag reflex
has returned to prevent aspiration before allowing oral intake.
