NUR 242 MED SURG EXAM 3 -
COMPREHENSIVE PRACTICE QUESTIONS
WITH DETAILED ANSWERS 2026-2027
SECTION 1: CARDIOVASCULAR DISORDERS
Heart Failure
1. An older client with a history of congestive heart
failure expresses concern about potential exposure to
tuberculosis (TB) from his or her roommate at the
extended care facility. The roommate coughs a great deal
and sometimes spits up blood. Which is the primary reason
that the nurse pursues more information about the
roommate?
A. TB is highly contagious in all age groups
B. Older adults are more susceptible to TB infection
C. TB adversely affects older adults with chronic illness
D. The roommate's symptoms indicate active TB
Correct Answer: C. TB adversely affects older adults with
chronic illness
,Rationale: Older adults with chronic conditions such as heart
failure are at increased risk for severe complications from TB
due to age-related immune system changes and underlying
comorbidities. The nurse should pursue more information to
protect this vulnerable client .
2. When the clinic nurse is teaching a group of clients with
heart failure (HF) about dietary interventions to prevent
fluid overload, which topic will be included?
A. Use of canned vegetables for convenience
B. Use of fresh or frozen vegetables instead of canned ones
C. Limiting fluid intake to 1 liter per day
D. Increasing salt intake to maintain blood pressure
Correct Answer: B. Use of fresh or frozen vegetables
instead of canned ones
Rationale: Clients with heart failure should follow a low-sodium
diet to prevent fluid overload. Fresh or frozen vegetables
contain significantly less sodium than canned vegetables,
which often have added salt for preservation. This is the
primary dietary intervention for preventing fluid retention .
,3. Which action would the nurse take first when a client
with heart failure has an episode of paroxysmal nocturnal
dyspnea (PND)?
A. Administer oxygen via nasal cannula
B. Assist the client to sit on the edge of the bed
C. Notify the healthcare provider
D. Administer furosemide IV push
Correct Answer: B. Assist the client to sit on the edge of
the bed
Rationale: PND occurs when fluid shifts from the legs to the
lungs during sleep, causing sudden shortness of breath. The
priority action is to assist the client to sit upright to use
gravity to reduce venous return and improve oxygenation.
Oxygen may be needed next, followed by notifying the
provider .
4. When caring for a client with a diagnosis of right
ventricular heart failure, the nurse expects which
assessment findings? (Select all that apply)
A. Dependent edema
B. Swollen hands and fingers
C. Right upper quadrant discomfort
, D. Crackles in the lung bases
E. Jugular venous distention
Correct Answers: A, B, C, E
Rationale: Right-sided heart failure causes backup of blood
into the systemic venous system, leading to dependent edema,
peripheral swelling, hepatomegaly with right upper quadrant
discomfort, and jugular venous distention. Crackles in the lung
bases are more characteristic of left-sided heart failure .
5. The nurse's physical assessment of a client with heart
failure reveals tachypnea and bilateral crackles. Which is
the priority nursing intervention?
A. Administer prescribed diuretic
B. Place client in a high-Fowler position
C. Notify the healthcare provider
D. Apply oxygen via nasal cannula
Correct Answer: B. Place client in a high-Fowler position
Rationale: Tachypnea and crackles indicate pulmonary
congestion from left-sided heart failure. Placing the client in
high-Fowler position uses gravity to reduce venous return to
the heart, decreasing pulmonary congestion and improving
breathing. This is the immediate priority intervention .
COMPREHENSIVE PRACTICE QUESTIONS
WITH DETAILED ANSWERS 2026-2027
SECTION 1: CARDIOVASCULAR DISORDERS
Heart Failure
1. An older client with a history of congestive heart
failure expresses concern about potential exposure to
tuberculosis (TB) from his or her roommate at the
extended care facility. The roommate coughs a great deal
and sometimes spits up blood. Which is the primary reason
that the nurse pursues more information about the
roommate?
A. TB is highly contagious in all age groups
B. Older adults are more susceptible to TB infection
C. TB adversely affects older adults with chronic illness
D. The roommate's symptoms indicate active TB
Correct Answer: C. TB adversely affects older adults with
chronic illness
,Rationale: Older adults with chronic conditions such as heart
failure are at increased risk for severe complications from TB
due to age-related immune system changes and underlying
comorbidities. The nurse should pursue more information to
protect this vulnerable client .
2. When the clinic nurse is teaching a group of clients with
heart failure (HF) about dietary interventions to prevent
fluid overload, which topic will be included?
A. Use of canned vegetables for convenience
B. Use of fresh or frozen vegetables instead of canned ones
C. Limiting fluid intake to 1 liter per day
D. Increasing salt intake to maintain blood pressure
Correct Answer: B. Use of fresh or frozen vegetables
instead of canned ones
Rationale: Clients with heart failure should follow a low-sodium
diet to prevent fluid overload. Fresh or frozen vegetables
contain significantly less sodium than canned vegetables,
which often have added salt for preservation. This is the
primary dietary intervention for preventing fluid retention .
,3. Which action would the nurse take first when a client
with heart failure has an episode of paroxysmal nocturnal
dyspnea (PND)?
A. Administer oxygen via nasal cannula
B. Assist the client to sit on the edge of the bed
C. Notify the healthcare provider
D. Administer furosemide IV push
Correct Answer: B. Assist the client to sit on the edge of
the bed
Rationale: PND occurs when fluid shifts from the legs to the
lungs during sleep, causing sudden shortness of breath. The
priority action is to assist the client to sit upright to use
gravity to reduce venous return and improve oxygenation.
Oxygen may be needed next, followed by notifying the
provider .
4. When caring for a client with a diagnosis of right
ventricular heart failure, the nurse expects which
assessment findings? (Select all that apply)
A. Dependent edema
B. Swollen hands and fingers
C. Right upper quadrant discomfort
, D. Crackles in the lung bases
E. Jugular venous distention
Correct Answers: A, B, C, E
Rationale: Right-sided heart failure causes backup of blood
into the systemic venous system, leading to dependent edema,
peripheral swelling, hepatomegaly with right upper quadrant
discomfort, and jugular venous distention. Crackles in the lung
bases are more characteristic of left-sided heart failure .
5. The nurse's physical assessment of a client with heart
failure reveals tachypnea and bilateral crackles. Which is
the priority nursing intervention?
A. Administer prescribed diuretic
B. Place client in a high-Fowler position
C. Notify the healthcare provider
D. Apply oxygen via nasal cannula
Correct Answer: B. Place client in a high-Fowler position
Rationale: Tachypnea and crackles indicate pulmonary
congestion from left-sided heart failure. Placing the client in
high-Fowler position uses gravity to reduce venous return to
the heart, decreasing pulmonary congestion and improving
breathing. This is the immediate priority intervention .
