NR324 Adult Health I Exam Complete
Exam-Style Questions with Detailed
Rationales 2026/2027 Edition | A+ Graded |
Pass Guaranteed
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
Q1. A client with heart failure reports a weight gain of 4 pounds in 24 hours. Which action should the
nurse take first?
A. Assess lung sounds
B. Restrict fluids to 1000 mL/day
C. Administer furosemide as ordered
D. Notify the provider immediately
VERIFIED ANSWERS: A. Assess lung sounds
Rationale: Rapid weight gain indicates fluid retention. The nurse should first assess for signs of fluid
overload (crackles, dyspnea, JVD) before notifying the provider or administering diuretics.
Q2. A client with heart failure has crackles in both lungs and 3+ pitting edema. Which medication does
the nurse expect to administer?
A. Metoprolol
B. Furosemide
C. Lisinopril
D. Digoxin
VERIFIED ANSWERS: B. Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid overload, improving crackles and edema.
Metoprolol and lisinopril are for long-term management; digoxin improves contractility but does not
directly reduce fluid.
Q3. A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A. Heart rate 72/min
B. Visual changes (yellow-green halos around lights)
,C. Blood pressure 130/80
D. Weight loss
VERIFIED ANSWERS: B. Visual changes
Rationale: Visual changes (yellow-green halos, blurred vision) are classic signs of digoxin toxicity. Other
signs include nausea, vomiting, anorexia, bradycardia, and dysrhythmias.
Q4. A client with heart failure and a potassium level of 3.2 mEq/L is taking digoxin. The nurse should
monitor for which complication?
A. Increased risk of digoxin toxicity
B. Decreased risk of digoxin toxicity
C. No change in digoxin effect
D. Increased digoxin excretion
VERIFIED ANSWERS: A. Increased risk of digoxin toxicity
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity by increasing cardiac
sensitivity to digoxin. Potassium must be maintained at normal levels.
Q5. Which of the following is a sign of right-sided heart failure?
A. Peripheral edema and jugular vein distension
B. Crackles in lung bases
C. Paroxysmal nocturnal dyspnea
D. Orthopnea
VERIFIED ANSWERS: A. Peripheral edema and JVD
Rationale: Right-sided heart failure causes systemic congestion: peripheral edema, JVD, hepatomegaly,
ascites. Crackles, PND, and orthopnea indicate left-sided heart failure.
Q6. Which of the following is a sign of left-sided heart failure?
A. Crackles and dyspnea
B. Peripheral edema
C. Jugular vein distension
D. Hepatomegaly
VERIFIED ANSWERS: A. Crackles and dyspnea
Rationale: Left-sided heart failure causes pulmonary congestion: crackles, dyspnea, orthopnea,
paroxysmal nocturnal dyspnea. Right-sided failure causes systemic congestion.
,Q7. A client with hypertension is prescribed hydrochlorothiazide. Which laboratory value should the
nurse monitor closely?
A. Potassium (risk of hypokalemia)
B. Sodium
C. Calcium
D. Magnesium
VERIFIED ANSWERS: A. Potassium
Rationale: Hydrochlorothiazide (thiazide diuretic) causes potassium wasting, leading to hypokalemia.
Hypokalemia increases the risk of dysrhythmias, especially in clients taking digoxin.
Q8. A client with angina pectoris is prescribed nitroglycerin sublingual. Which instruction should the
nurse include?
A. "Place the tablet under your tongue and allow it to dissolve."
B. "Swallow the tablet with a full glass of water."
C. "Chew the tablet for faster absorption."
D. "Take the tablet with food to prevent nausea."
VERIFIED ANSWERS: A. Place under tongue
Rationale: Nitroglycerin sublingual must be placed under the tongue and allowed to dissolve for rapid
absorption through the oral mucosa. Swallowing or chewing delays absorption.
Q9. A client with chest pain is prescribed nitroglycerin 0.4 mg sublingual every 5 minutes for up to 3
doses. The pain is unrelieved after the first dose. Which action should the nurse take?
A. Administer the second dose and notify the provider if pain continues after third dose
B. Wait 30 minutes before giving the second dose
C. Discontinue nitroglycerin and call a code
D. Give the second dose and increase to 0.8 mg
VERIFIED ANSWERS: A. Administer second dose
Rationale: The standard protocol for chest pain is nitroglycerin 0.4 mg SL every 5 minutes for up to 3
doses. If pain is unrelieved after 3 doses, notify the provider (possible MI).
Q10. A client with a deep vein thrombosis (DVT) is receiving heparin IV. Which finding requires
immediate action?
A. Platelet count drop from 250,000 to 70,000
, B. aPTT 70 seconds (1.5-2.5x normal)
C. Heart rate 88/min
D. Blood pressure 130/80
VERIFIED ANSWERS: A. Platelet count drop
Rationale: A significant drop in platelets (>50% or to <100,000) indicates heparin-induced
thrombocytopenia (HIT), a life-threatening complication requiring immediate heparin discontinuation.
Q11. A client with DVT is prescribed enoxaparin (Lovenox). Which instruction should the nurse
provide?
A. "Inject the medication into the abdomen, pinching a fold of skin."
B. "Inject the medication intramuscularly into the deltoid."
C. "Massage the injection site after administration."
D. "Expel the air bubble from the prefilled syringe."
VERIFIED ANSWERS: A. Inject into abdomen
Rationale: Enoxaparin (low-molecular-weight heparin) is given subcutaneously in the abdomen. The air
bubble should NOT be expelled; it ensures complete dose delivery. Do not massage the site.
Q12. A client with peripheral arterial disease (PAD) reports leg pain when walking that resolves with
rest. The nurse documents this finding as:
A. Intermittent claudication
B. Rest pain
C. Venous stasis
D. Neuropathic pain
VERIFIED ANSWERS: A. Intermittent claudication
Rationale: Intermittent claudication is muscle pain (cramping) that occurs with exercise and resolves
with rest, caused by inadequate blood flow in PAD. Rest pain indicates severe disease.
Q13. Which finding in a client with PAD is most concerning?
A. Non-healing ulcer on the great toe
B. Absent hair on lower legs
C. Thickened toenails
D. Cool skin temperature
VERIFIED ANSWERS: A. Non-healing ulcer
Exam-Style Questions with Detailed
Rationales 2026/2027 Edition | A+ Graded |
Pass Guaranteed
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
Q1. A client with heart failure reports a weight gain of 4 pounds in 24 hours. Which action should the
nurse take first?
A. Assess lung sounds
B. Restrict fluids to 1000 mL/day
C. Administer furosemide as ordered
D. Notify the provider immediately
VERIFIED ANSWERS: A. Assess lung sounds
Rationale: Rapid weight gain indicates fluid retention. The nurse should first assess for signs of fluid
overload (crackles, dyspnea, JVD) before notifying the provider or administering diuretics.
Q2. A client with heart failure has crackles in both lungs and 3+ pitting edema. Which medication does
the nurse expect to administer?
A. Metoprolol
B. Furosemide
C. Lisinopril
D. Digoxin
VERIFIED ANSWERS: B. Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid overload, improving crackles and edema.
Metoprolol and lisinopril are for long-term management; digoxin improves contractility but does not
directly reduce fluid.
Q3. A client with heart failure is prescribed digoxin. Which finding indicates digoxin toxicity?
A. Heart rate 72/min
B. Visual changes (yellow-green halos around lights)
,C. Blood pressure 130/80
D. Weight loss
VERIFIED ANSWERS: B. Visual changes
Rationale: Visual changes (yellow-green halos, blurred vision) are classic signs of digoxin toxicity. Other
signs include nausea, vomiting, anorexia, bradycardia, and dysrhythmias.
Q4. A client with heart failure and a potassium level of 3.2 mEq/L is taking digoxin. The nurse should
monitor for which complication?
A. Increased risk of digoxin toxicity
B. Decreased risk of digoxin toxicity
C. No change in digoxin effect
D. Increased digoxin excretion
VERIFIED ANSWERS: A. Increased risk of digoxin toxicity
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity by increasing cardiac
sensitivity to digoxin. Potassium must be maintained at normal levels.
Q5. Which of the following is a sign of right-sided heart failure?
A. Peripheral edema and jugular vein distension
B. Crackles in lung bases
C. Paroxysmal nocturnal dyspnea
D. Orthopnea
VERIFIED ANSWERS: A. Peripheral edema and JVD
Rationale: Right-sided heart failure causes systemic congestion: peripheral edema, JVD, hepatomegaly,
ascites. Crackles, PND, and orthopnea indicate left-sided heart failure.
Q6. Which of the following is a sign of left-sided heart failure?
A. Crackles and dyspnea
B. Peripheral edema
C. Jugular vein distension
D. Hepatomegaly
VERIFIED ANSWERS: A. Crackles and dyspnea
Rationale: Left-sided heart failure causes pulmonary congestion: crackles, dyspnea, orthopnea,
paroxysmal nocturnal dyspnea. Right-sided failure causes systemic congestion.
,Q7. A client with hypertension is prescribed hydrochlorothiazide. Which laboratory value should the
nurse monitor closely?
A. Potassium (risk of hypokalemia)
B. Sodium
C. Calcium
D. Magnesium
VERIFIED ANSWERS: A. Potassium
Rationale: Hydrochlorothiazide (thiazide diuretic) causes potassium wasting, leading to hypokalemia.
Hypokalemia increases the risk of dysrhythmias, especially in clients taking digoxin.
Q8. A client with angina pectoris is prescribed nitroglycerin sublingual. Which instruction should the
nurse include?
A. "Place the tablet under your tongue and allow it to dissolve."
B. "Swallow the tablet with a full glass of water."
C. "Chew the tablet for faster absorption."
D. "Take the tablet with food to prevent nausea."
VERIFIED ANSWERS: A. Place under tongue
Rationale: Nitroglycerin sublingual must be placed under the tongue and allowed to dissolve for rapid
absorption through the oral mucosa. Swallowing or chewing delays absorption.
Q9. A client with chest pain is prescribed nitroglycerin 0.4 mg sublingual every 5 minutes for up to 3
doses. The pain is unrelieved after the first dose. Which action should the nurse take?
A. Administer the second dose and notify the provider if pain continues after third dose
B. Wait 30 minutes before giving the second dose
C. Discontinue nitroglycerin and call a code
D. Give the second dose and increase to 0.8 mg
VERIFIED ANSWERS: A. Administer second dose
Rationale: The standard protocol for chest pain is nitroglycerin 0.4 mg SL every 5 minutes for up to 3
doses. If pain is unrelieved after 3 doses, notify the provider (possible MI).
Q10. A client with a deep vein thrombosis (DVT) is receiving heparin IV. Which finding requires
immediate action?
A. Platelet count drop from 250,000 to 70,000
, B. aPTT 70 seconds (1.5-2.5x normal)
C. Heart rate 88/min
D. Blood pressure 130/80
VERIFIED ANSWERS: A. Platelet count drop
Rationale: A significant drop in platelets (>50% or to <100,000) indicates heparin-induced
thrombocytopenia (HIT), a life-threatening complication requiring immediate heparin discontinuation.
Q11. A client with DVT is prescribed enoxaparin (Lovenox). Which instruction should the nurse
provide?
A. "Inject the medication into the abdomen, pinching a fold of skin."
B. "Inject the medication intramuscularly into the deltoid."
C. "Massage the injection site after administration."
D. "Expel the air bubble from the prefilled syringe."
VERIFIED ANSWERS: A. Inject into abdomen
Rationale: Enoxaparin (low-molecular-weight heparin) is given subcutaneously in the abdomen. The air
bubble should NOT be expelled; it ensures complete dose delivery. Do not massage the site.
Q12. A client with peripheral arterial disease (PAD) reports leg pain when walking that resolves with
rest. The nurse documents this finding as:
A. Intermittent claudication
B. Rest pain
C. Venous stasis
D. Neuropathic pain
VERIFIED ANSWERS: A. Intermittent claudication
Rationale: Intermittent claudication is muscle pain (cramping) that occurs with exercise and resolves
with rest, caused by inadequate blood flow in PAD. Rest pain indicates severe disease.
Q13. Which finding in a client with PAD is most concerning?
A. Non-healing ulcer on the great toe
B. Absent hair on lower legs
C. Thickened toenails
D. Cool skin temperature
VERIFIED ANSWERS: A. Non-healing ulcer
