NRSG 110 Exam 3 V3 | NRSG 110 Medical
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 3) | Ivy Tech
1. A patient presents with a heart rate of 42 bpm and reports feeling lightheaded and dizzy.
The nurse notes a blood pressure of 86/52 mmHg. Which pharmacological intervention
should the nurse anticipate first?
A. Amiodarone intravenously
B. Verapamil intravenously
C. Dopamine infusion
D. Digoxin intravenously
E. Atropine sulfate intravenously
Correct Answer: E
Atropine is the primary medication indicated for the management of symptomatic
bradycardia. It works by inhibiting the action of the vagus nerve on the sinoatrial node,
which increases the heart rate. The nurse must monitor the patient for resolution of
symptoms and improvements in hemodynamics after administration.
2. A nurse is assessing a patient receiving Digoxin for heart failure. Which clinical finding
should the nurse identify as an early sign of Digoxin toxicity?
A. Anorexia and nausea
,B. Hyperkalemia
C. Increased urinary output
D. Tachycardia
Correct Answer: A
Gastrointestinal symptoms such as anorexia, nausea, and vomiting are often the earliest
signs of digoxin toxicity. Visual disturbances, such as seeing yellow-green halos, may also
occur as toxicity progresses. It is critical to monitor serum digoxin levels and potassium
levels to prevent life-threatening arrhythmias.
3. A patient is diagnosed with left-sided heart failure. Which assessment finding is the nurse
most likely to observe?
A. Jugular venous distention
B. Crackles in the lung bases
C. Peripheral edema in the lower extremities
D. Hepatosplenomegaly
Correct Answer: B
Left-sided heart failure results in pulmonary congestion because the left ventricle cannot
effectively pump blood into the systemic circulation. This causes fluid to back up into the
pulmonary veins and capillaries, leading to crackles, dyspnea, and cough. In contrast, right-
, sided heart failure typically manifests as systemic venous congestion, including peripheral
edema and JVD.
4. When providing discharge education to a patient with chronic heart failure, which
instruction is most important regarding weight monitoring?
A. Weigh yourself once a week at the same time.
B. Notify the provider if weight gain exceeds 2 lbs in 24 hours.
C. Limit weighing to once every two weeks.
D. Report a weight gain of 10 lbs in one month.
Correct Answer: B
Daily weights are the most sensitive indicator of fluid balance changes in patients with
heart failure. A weight gain of more than 2 to 3 pounds in one day or 5 pounds in a week
indicates significant fluid retention. Early reporting allows for timely adjustments in
diuretic therapy to prevent acute pulmonary edema.
5. A patient with acute pulmonary edema is prescribed Furosemide. What is the nurse’s
priority assessment prior to administration?
A. Assess for bowel sounds
B. Measure the patient’s height
C. Check the patient’s potassium level
D. Check for peripheral pulses
Surgical Nursing II | Actual Q&A with
Rationale (NRSG110 Exam 3) | Ivy Tech
1. A patient presents with a heart rate of 42 bpm and reports feeling lightheaded and dizzy.
The nurse notes a blood pressure of 86/52 mmHg. Which pharmacological intervention
should the nurse anticipate first?
A. Amiodarone intravenously
B. Verapamil intravenously
C. Dopamine infusion
D. Digoxin intravenously
E. Atropine sulfate intravenously
Correct Answer: E
Atropine is the primary medication indicated for the management of symptomatic
bradycardia. It works by inhibiting the action of the vagus nerve on the sinoatrial node,
which increases the heart rate. The nurse must monitor the patient for resolution of
symptoms and improvements in hemodynamics after administration.
2. A nurse is assessing a patient receiving Digoxin for heart failure. Which clinical finding
should the nurse identify as an early sign of Digoxin toxicity?
A. Anorexia and nausea
,B. Hyperkalemia
C. Increased urinary output
D. Tachycardia
Correct Answer: A
Gastrointestinal symptoms such as anorexia, nausea, and vomiting are often the earliest
signs of digoxin toxicity. Visual disturbances, such as seeing yellow-green halos, may also
occur as toxicity progresses. It is critical to monitor serum digoxin levels and potassium
levels to prevent life-threatening arrhythmias.
3. A patient is diagnosed with left-sided heart failure. Which assessment finding is the nurse
most likely to observe?
A. Jugular venous distention
B. Crackles in the lung bases
C. Peripheral edema in the lower extremities
D. Hepatosplenomegaly
Correct Answer: B
Left-sided heart failure results in pulmonary congestion because the left ventricle cannot
effectively pump blood into the systemic circulation. This causes fluid to back up into the
pulmonary veins and capillaries, leading to crackles, dyspnea, and cough. In contrast, right-
, sided heart failure typically manifests as systemic venous congestion, including peripheral
edema and JVD.
4. When providing discharge education to a patient with chronic heart failure, which
instruction is most important regarding weight monitoring?
A. Weigh yourself once a week at the same time.
B. Notify the provider if weight gain exceeds 2 lbs in 24 hours.
C. Limit weighing to once every two weeks.
D. Report a weight gain of 10 lbs in one month.
Correct Answer: B
Daily weights are the most sensitive indicator of fluid balance changes in patients with
heart failure. A weight gain of more than 2 to 3 pounds in one day or 5 pounds in a week
indicates significant fluid retention. Early reporting allows for timely adjustments in
diuretic therapy to prevent acute pulmonary edema.
5. A patient with acute pulmonary edema is prescribed Furosemide. What is the nurse’s
priority assessment prior to administration?
A. Assess for bowel sounds
B. Measure the patient’s height
C. Check the patient’s potassium level
D. Check for peripheral pulses
