NUR417 / NUR 417 EXAM 1, 2, 3 &
FINAL EXAM | Actual Questions and
Answers | Latest 2026/2027 Update |
Graded A+ | 100% Assured Pass (Care of
Adult II at Concordia)
Q1. A patient with acute decompensated heart failure presents with severe
dyspnea, pink frothy sputum, and crackles throughout all lung fields. Which
intervention should the nurse prioritize?
A) Administer IV digoxin
B) Position the patient in high Fowler's with legs dangling
C) Prepare for immediate endotracheal intubation
D) Administer a 500 mL normal saline bolus
Correct Answer: B
Rationale: High Fowler's position with legs dangling reduces venous return
(preload) and lung congestion, providing immediate relief. Digoxin is not first-line for
acute failure; fluids would worsen the condition. Intubation may be needed later but
is not the priority.
Q2. A patient is receiving IV nitroglycerin for acute pulmonary edema. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Heart rate increases from 88 to 102 bpm
B) Blood pressure decreases from 180/95 to 140/80
,C) Urine output decreases to 20 mL/hr
D) Respiratory rate increases from 20 to 28
Correct Answer: B
Rationale: Nitroglycerin causes venous and arterial vasodilation, reducing preload
and afterload, which lowers blood pressure and decreases pulmonary congestion.
A slight increase in HR is a compensatory effect, not the desired primary outcome.
Decreased urine output and increased RR are signs of worsening failure.
Q3. A patient with an anterior wall ST-elevation myocardial infarction (STEMI)
is at highest risk for which complication?
A) Right ventricular failure
B) Complete heart block
C) Papillary muscle rupture
D) Left ventricular pump failure (cardiogenic shock)
Correct Answer: D
Rationale: Anterior wall STEMIs involve the left anterior descending (LAD) artery,
which supplies a large portion of the left ventricle, leading to significant pump
failure and cardiogenic shock. Right ventricular failure and heart block are more
common in inferior MI; papillary muscle rupture is a mechanical complication less
common than pump failure in anterior MI.
Q4. Which EKG finding is most consistent with acute pericarditis?
A) ST-segment elevation in all leads with a concave upward ("saddleback")
appearance
B) Deep Q waves in leads II, III, and aVF
,C) ST-segment depression with T-wave inversion
D) Peaked T waves and widened QRS
Correct Answer: A
Rationale: Acute pericarditis typically presents with diffuse, concave upward ST-
segment elevation (saddleback) across multiple leads. Q waves indicate past MI;
ST depression with T inversion indicates ischemia; peaked T waves suggest
hyperkalemia.
Q5. A patient with heart failure is prescribed carvedilol. Which statement
indicates the patient understands the purpose of this medication?
A) "This drug will make my heart beat stronger and faster."
B) "This drug will help decrease the workload on my heart and slow the progression
of heart failure."
C) "This drug will eliminate the fluid buildup in my lungs immediately."
D) "This drug is a diuretic that will help me urinate more."
Correct Answer: B
Rationale: Carvedilol is a beta-blocker that reduces sympathetic stimulation,
decreases heart rate, and improves left ventricular remodeling, slowing HF
progression. It does not increase contractility (that's digoxin), is not a diuretic, and
does not provide immediate relief of fluid overload.
Q6. A patient with atrial fibrillation is started on warfarin. The nurse should
monitor which laboratory value to evaluate therapeutic effectiveness?
A) Platelet count
B) INR (International Normalized Ratio)
, C) aPTT (activated partial thromboplastin time)
D) Serum potassium
Correct Answer: B
Rationale: Warfarin's therapeutic effect is monitored using INR, with a target
typically between 2.0 and 3.0 for atrial fibrillation. Platelets monitor for heparin-
induced thrombocytopenia; aPTT monitors heparin; potassium is not related to
warfarin therapy.
Q7. During a cardiac catheterization via the femoral artery, the patient
suddenly reports severe back pain and the nurse notes a decreasing blood
pressure. What is the nurse's priority action?
A) Administer IV pain medication
B) Notify the healthcare provider immediately
C) Elevate the patient's legs
D) Check the patient's blood glucose
Correct Answer: B
Rationale: Severe back pain with hypotension in a patient post-catheterization
suggests retroperitoneal bleeding, a life-threatening complication. The nurse must
notify the provider immediately; pain medication would mask symptoms; elevating
legs is a general shock measure but does not address the specific emergency.
Q8. The nurse is caring for a patient with a pulmonary artery catheter. Which
reading indicates increased left ventricular preload?
A) Decreased cardiac output
B) Increased pulmonary artery wedge pressure (PAWP)
FINAL EXAM | Actual Questions and
Answers | Latest 2026/2027 Update |
Graded A+ | 100% Assured Pass (Care of
Adult II at Concordia)
Q1. A patient with acute decompensated heart failure presents with severe
dyspnea, pink frothy sputum, and crackles throughout all lung fields. Which
intervention should the nurse prioritize?
A) Administer IV digoxin
B) Position the patient in high Fowler's with legs dangling
C) Prepare for immediate endotracheal intubation
D) Administer a 500 mL normal saline bolus
Correct Answer: B
Rationale: High Fowler's position with legs dangling reduces venous return
(preload) and lung congestion, providing immediate relief. Digoxin is not first-line for
acute failure; fluids would worsen the condition. Intubation may be needed later but
is not the priority.
Q2. A patient is receiving IV nitroglycerin for acute pulmonary edema. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Heart rate increases from 88 to 102 bpm
B) Blood pressure decreases from 180/95 to 140/80
,C) Urine output decreases to 20 mL/hr
D) Respiratory rate increases from 20 to 28
Correct Answer: B
Rationale: Nitroglycerin causes venous and arterial vasodilation, reducing preload
and afterload, which lowers blood pressure and decreases pulmonary congestion.
A slight increase in HR is a compensatory effect, not the desired primary outcome.
Decreased urine output and increased RR are signs of worsening failure.
Q3. A patient with an anterior wall ST-elevation myocardial infarction (STEMI)
is at highest risk for which complication?
A) Right ventricular failure
B) Complete heart block
C) Papillary muscle rupture
D) Left ventricular pump failure (cardiogenic shock)
Correct Answer: D
Rationale: Anterior wall STEMIs involve the left anterior descending (LAD) artery,
which supplies a large portion of the left ventricle, leading to significant pump
failure and cardiogenic shock. Right ventricular failure and heart block are more
common in inferior MI; papillary muscle rupture is a mechanical complication less
common than pump failure in anterior MI.
Q4. Which EKG finding is most consistent with acute pericarditis?
A) ST-segment elevation in all leads with a concave upward ("saddleback")
appearance
B) Deep Q waves in leads II, III, and aVF
,C) ST-segment depression with T-wave inversion
D) Peaked T waves and widened QRS
Correct Answer: A
Rationale: Acute pericarditis typically presents with diffuse, concave upward ST-
segment elevation (saddleback) across multiple leads. Q waves indicate past MI;
ST depression with T inversion indicates ischemia; peaked T waves suggest
hyperkalemia.
Q5. A patient with heart failure is prescribed carvedilol. Which statement
indicates the patient understands the purpose of this medication?
A) "This drug will make my heart beat stronger and faster."
B) "This drug will help decrease the workload on my heart and slow the progression
of heart failure."
C) "This drug will eliminate the fluid buildup in my lungs immediately."
D) "This drug is a diuretic that will help me urinate more."
Correct Answer: B
Rationale: Carvedilol is a beta-blocker that reduces sympathetic stimulation,
decreases heart rate, and improves left ventricular remodeling, slowing HF
progression. It does not increase contractility (that's digoxin), is not a diuretic, and
does not provide immediate relief of fluid overload.
Q6. A patient with atrial fibrillation is started on warfarin. The nurse should
monitor which laboratory value to evaluate therapeutic effectiveness?
A) Platelet count
B) INR (International Normalized Ratio)
, C) aPTT (activated partial thromboplastin time)
D) Serum potassium
Correct Answer: B
Rationale: Warfarin's therapeutic effect is monitored using INR, with a target
typically between 2.0 and 3.0 for atrial fibrillation. Platelets monitor for heparin-
induced thrombocytopenia; aPTT monitors heparin; potassium is not related to
warfarin therapy.
Q7. During a cardiac catheterization via the femoral artery, the patient
suddenly reports severe back pain and the nurse notes a decreasing blood
pressure. What is the nurse's priority action?
A) Administer IV pain medication
B) Notify the healthcare provider immediately
C) Elevate the patient's legs
D) Check the patient's blood glucose
Correct Answer: B
Rationale: Severe back pain with hypotension in a patient post-catheterization
suggests retroperitoneal bleeding, a life-threatening complication. The nurse must
notify the provider immediately; pain medication would mask symptoms; elevating
legs is a general shock measure but does not address the specific emergency.
Q8. The nurse is caring for a patient with a pulmonary artery catheter. Which
reading indicates increased left ventricular preload?
A) Decreased cardiac output
B) Increased pulmonary artery wedge pressure (PAWP)
