NUR 242 / NUR242 Medical-Surgical Nursing Exam 1
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular Disorders (Questions 1–12)
Q1: A client with heart failure is prescribed furosemide. The nurse should monitor for
which electrolyte imbalance most commonly associated with this medication?
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, causing potassium wasting
and hypokalemia.
Q2: A client presents with chest pain described as "crushing" and radiating to the left
arm. The 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. The nurse
recognizes this as indicative of:
A. Anterior wall myocardial infarction
B. Inferior wall myocardial infarction [CORRECT]
C. Lateral wall myocardial infarction
D. Posterior wall myocardial infarction
Correct Answer: B
,Rationale: Correct because ST-segment elevation in leads II, III, and aVF is
characteristic of an inferior wall MI, as these leads view the inferior (diaphragmatic)
surface of the heart supplied by the right coronary artery.
Q3: A client with hypertension is prescribed lisinopril. The nurse should instruct the
client to report which adverse effect immediately?
A. Dry cough
B. Swelling of the face, lips, or tongue (angioedema) [CORRECT]
C. Mild dizziness on standing
D. Increased urination
Correct Answer: B
Rationale: Correct because angioedema is a rare but potentially life-threatening
adverse effect of ACE inhibitors requiring immediate discontinuation and emergency
intervention.
Q4: A client in atrial fibrillation is prescribed warfarin. Which laboratory value should
the nurse monitor to ensure therapeutic anticoagulation?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR) [CORRECT]
C. Prothrombin time (PT) alone
D. Platelet count
Correct Answer: B
Rationale: Correct because warfarin therapy is monitored using INR, which
standardizes PT results across laboratories, with a therapeutic range typically of
2.0-3.0 for atrial fibrillation.
Q5: A client with peripheral arterial disease reports leg pain when walking that is
relieved by rest. The nurse documents this as:
A. Rest pain
B. Intermittent claudication [CORRECT]
C. Dependent rubor
D. Venous stasis ulcer
, Correct Answer: B
Rationale: Correct because intermittent claudication is reproducible ischemic muscle
pain precipitated by exercise and relieved by rest, characteristic of peripheral arterial
disease.
Q6: A client with acute decompensated heart failure presents with severe dyspnea,
orthopnea, and pink frothy sputum. Which position should the nurse place the client
in immediately?
A. Supine with legs elevated
B. High Fowler's or sitting upright with legs dependent [CORRECT]
C. Prone position
D. Trendelenburg position
Correct Answer: B
Rationale: Correct because high Fowler's or upright positioning with legs dependent
reduces venous return (preload), decreases pulmonary congestion, and improves
ventilation in acute pulmonary edema.
Q7: Which finding in a client with a permanent pacemaker requires immediate
nursing intervention?
A. Heart rate of 72 bpm
B. Failure to capture with pacer spikes not followed by QRS complexes [CORRECT]
C. Slight swelling at the insertion site
D. Mild discomfort at the generator site
Correct Answer: B
Rationale: Correct because failure to capture (pacer spikes without subsequent
depolarization) indicates the electrical stimulus is insufficient to trigger myocardial
contraction, potentially causing severe bradycardia or asystole.
Q8: A client with coronary artery disease is prescribed nitroglycerin sublingual
tablets. The nurse should instruct the client to:
A. Swallow the tablet immediately
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Cardiovascular Disorders (Questions 1–12)
Q1: A client with heart failure is prescribed furosemide. The nurse should monitor for
which electrolyte imbalance most commonly associated with this medication?
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypernatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, causing potassium wasting
and hypokalemia.
Q2: A client presents with chest pain described as "crushing" and radiating to the left
arm. The 12-lead ECG shows ST-segment elevation in leads II, III, and aVF. The nurse
recognizes this as indicative of:
A. Anterior wall myocardial infarction
B. Inferior wall myocardial infarction [CORRECT]
C. Lateral wall myocardial infarction
D. Posterior wall myocardial infarction
Correct Answer: B
,Rationale: Correct because ST-segment elevation in leads II, III, and aVF is
characteristic of an inferior wall MI, as these leads view the inferior (diaphragmatic)
surface of the heart supplied by the right coronary artery.
Q3: A client with hypertension is prescribed lisinopril. The nurse should instruct the
client to report which adverse effect immediately?
A. Dry cough
B. Swelling of the face, lips, or tongue (angioedema) [CORRECT]
C. Mild dizziness on standing
D. Increased urination
Correct Answer: B
Rationale: Correct because angioedema is a rare but potentially life-threatening
adverse effect of ACE inhibitors requiring immediate discontinuation and emergency
intervention.
Q4: A client in atrial fibrillation is prescribed warfarin. Which laboratory value should
the nurse monitor to ensure therapeutic anticoagulation?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR) [CORRECT]
C. Prothrombin time (PT) alone
D. Platelet count
Correct Answer: B
Rationale: Correct because warfarin therapy is monitored using INR, which
standardizes PT results across laboratories, with a therapeutic range typically of
2.0-3.0 for atrial fibrillation.
Q5: A client with peripheral arterial disease reports leg pain when walking that is
relieved by rest. The nurse documents this as:
A. Rest pain
B. Intermittent claudication [CORRECT]
C. Dependent rubor
D. Venous stasis ulcer
, Correct Answer: B
Rationale: Correct because intermittent claudication is reproducible ischemic muscle
pain precipitated by exercise and relieved by rest, characteristic of peripheral arterial
disease.
Q6: A client with acute decompensated heart failure presents with severe dyspnea,
orthopnea, and pink frothy sputum. Which position should the nurse place the client
in immediately?
A. Supine with legs elevated
B. High Fowler's or sitting upright with legs dependent [CORRECT]
C. Prone position
D. Trendelenburg position
Correct Answer: B
Rationale: Correct because high Fowler's or upright positioning with legs dependent
reduces venous return (preload), decreases pulmonary congestion, and improves
ventilation in acute pulmonary edema.
Q7: Which finding in a client with a permanent pacemaker requires immediate
nursing intervention?
A. Heart rate of 72 bpm
B. Failure to capture with pacer spikes not followed by QRS complexes [CORRECT]
C. Slight swelling at the insertion site
D. Mild discomfort at the generator site
Correct Answer: B
Rationale: Correct because failure to capture (pacer spikes without subsequent
depolarization) indicates the electrical stimulus is insufficient to trigger myocardial
contraction, potentially causing severe bradycardia or asystole.
Q8: A client with coronary artery disease is prescribed nitroglycerin sublingual
tablets. The nurse should instruct the client to:
A. Swallow the tablet immediately
