NURS 201 Quiz 3 V1 | NURS 201 Medical
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 3) | West Coast
University
1. A nurse is assessing a patient with a diagnosis of left-sided heart failure. Which of the
following findings should the nurse prioritize?
A. Increased jugular venous distention
B. Auscultation of crackles in the lung bases
C. Pitting edema in the lower extremities
D. Hepatomegaly and abdominal bloating
Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion because the left
ventricle cannot pump blood effectively into the systemic circulation. This backup causes
fluid to leak into the alveoli, which manifests as crackles or wheezes during auscultation.
Other symptoms such as JVD and peripheral edema are primary indicators of right-sided
heart failure.
2. A client is prescribed Lisinopril for the management of hypertension. Which adverse effect
should the nurse instruct the client to report immediately?
A. Development of a persistent, dry cough
,B. Occasional dizziness upon standing
C. Mild increase in urinary frequency
D. Occasional headache in the morning
Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause an accumulation of bradykinin,
leading to a persistent dry cough. This side effect is a common reason for discontinuing the
medication and switching to an Angiotensin II Receptor Blocker. While dizziness is
possible, the cough is a classic and specific side effect of ACE inhibitors that requires
medical review.
3. A nurse is reviewing the laboratory results of a patient receiving Warfarin. Which of the
following values indicates the medication is in the therapeutic range?
A. PTT of 60 seconds
B. INR of 2.5
C. Platelet count of 150,000/mm3
D. Hemoglobin of 14 g/dL
Answer: B
Rationale: For most patients on Warfarin, the therapeutic International Normalized Ratio
(INR) target is between 2.0 and 3.0. This range ensures the blood is sufficiently
, anticoagulated to prevent clots without excessive risk of bleeding. PTT is used to monitor
Heparin therapy, not Warfarin.
4. Which clinical manifestation is a hallmark sign of Peripheral Arterial Disease (PAD)?
A. Brownish discoloration of the lower legs
B. Warm and erythematous calves
C. Painless ulcers on the medial malleolus
D. Intermittent claudication
Answer: D
Rationale: Intermittent claudication is muscle pain that occurs during exercise and is
relieved by rest, signifying inadequate arterial blood flow to the tissues. It occurs because
the oxygen demand of the muscles exceeds the supply provided by narrowed arteries.
Brownish discoloration and medial ulcers are typically associated with chronic venous
insufficiency rather than PAD.
5. A patient with chronic heart failure is taking Digoxin 0.125 mg daily. Which electrolyte
imbalance increases the risk of Digoxin toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Surgical Nursing | Actual Q&A with
Rationale (NURS201 Quiz 3) | West Coast
University
1. A nurse is assessing a patient with a diagnosis of left-sided heart failure. Which of the
following findings should the nurse prioritize?
A. Increased jugular venous distention
B. Auscultation of crackles in the lung bases
C. Pitting edema in the lower extremities
D. Hepatomegaly and abdominal bloating
Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion because the left
ventricle cannot pump blood effectively into the systemic circulation. This backup causes
fluid to leak into the alveoli, which manifests as crackles or wheezes during auscultation.
Other symptoms such as JVD and peripheral edema are primary indicators of right-sided
heart failure.
2. A client is prescribed Lisinopril for the management of hypertension. Which adverse effect
should the nurse instruct the client to report immediately?
A. Development of a persistent, dry cough
,B. Occasional dizziness upon standing
C. Mild increase in urinary frequency
D. Occasional headache in the morning
Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause an accumulation of bradykinin,
leading to a persistent dry cough. This side effect is a common reason for discontinuing the
medication and switching to an Angiotensin II Receptor Blocker. While dizziness is
possible, the cough is a classic and specific side effect of ACE inhibitors that requires
medical review.
3. A nurse is reviewing the laboratory results of a patient receiving Warfarin. Which of the
following values indicates the medication is in the therapeutic range?
A. PTT of 60 seconds
B. INR of 2.5
C. Platelet count of 150,000/mm3
D. Hemoglobin of 14 g/dL
Answer: B
Rationale: For most patients on Warfarin, the therapeutic International Normalized Ratio
(INR) target is between 2.0 and 3.0. This range ensures the blood is sufficiently
, anticoagulated to prevent clots without excessive risk of bleeding. PTT is used to monitor
Heparin therapy, not Warfarin.
4. Which clinical manifestation is a hallmark sign of Peripheral Arterial Disease (PAD)?
A. Brownish discoloration of the lower legs
B. Warm and erythematous calves
C. Painless ulcers on the medial malleolus
D. Intermittent claudication
Answer: D
Rationale: Intermittent claudication is muscle pain that occurs during exercise and is
relieved by rest, signifying inadequate arterial blood flow to the tissues. It occurs because
the oxygen demand of the muscles exceeds the supply provided by narrowed arteries.
Brownish discoloration and medial ulcers are typically associated with chronic venous
insufficiency rather than PAD.
5. A patient with chronic heart failure is taking Digoxin 0.125 mg daily. Which electrolyte
imbalance increases the risk of Digoxin toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
