MDC III (NUR 2502) Exam 1 Ultimate
Comprehensive Review: High-Yield
Practice Questions with In-Depth
Rationales, Prioritization Strategies, and
Core Concept Mastery Covering
Cardiovascular, Respiratory, Renal,
Endocrine, Hematologic, Neurological,
Sepsis, Burns, and Fluid/Electrolyte
Disorders – Rasmussen University Newest
Curriculum-Aligned Study Guide
Cardiovascular Disorders
1. A nurse is caring for a client with heart failure who has crackles in
the lungs, edema, and jugular venous distention. Which prescribed
medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
,Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid volume
overload, the primary cause of the client's symptoms (crackles, edema,
JVD). Rapid diuresis is the priority to decrease preload and relieve
pulmonary congestion. Digoxin increases contractility but is not first-line;
metoprolol and lisinopril are long-term management agents.
2. A client with acute coronary syndrome is receiving a continuous
heparin infusion. The aPTT is 110 seconds (normal 25-35 seconds).
What is the nurse's priority action?
A) Increase the infusion rate
B) Continue the infusion and monitor
C) Stop the infusion and notify the provider
D) Administer vitamin K
Answer: C) Stop the infusion and notify the provider
Rationale: The therapeutic aPTT for heparin is typically 1.5-2.5 times the
normal value (approx. 60-80 seconds). An aPTT of 110 seconds indicates a
significant overdose, placing the client at high risk for bleeding. The
infusion should be stopped immediately and the provider notified.
Protamine sulfate, not vitamin K, is the antidote for heparin.
3. A client is 2 days post-MI and reports shortness of breath. The nurse
notes a new S3 heart sound and crackles in the lung bases. Which
complication should the nurse suspect?
, A) Cardiac tamponade
B) Left-sided heart failure
C) Pulmonary embolism
D) Pericarditis
Answer: B) Left-sided heart failure
Rationale: An S3 heart sound ("ventricular gallop") and crackles are classic
signs of left-sided heart failure, indicating fluid backup into the pulmonary
circulation. This is a common complication post-MI due to impaired left
ventricular function.
4. The nurse is preparing to administer amiodarone IV to a client with
ventricular tachycardia. Which assessment finding would require the
nurse to hold the medication and notify the provider?
A) Heart rate 110 bpm
B) Blood pressure 98/62 mmHg
C) QTc interval 520 msec
D) Potassium 4.0 mEq/L
Answer: C) QTc interval 520 msec
Rationale: Amiodarone prolongs the QT interval and can cause torsades de
pointes. A QTc >500 msec is a critical finding and the medication should be
held. Normal QTc is <440 msec in males and <470 msec in females.
5. A client with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
, A) Heart rate 68 bpm
B) Yellow-tinged vision
C) Serum digoxin level 1.2 ng/mL
D) Blood pressure 130/80 mmHg
Answer: B) Yellow-tinged vision
Rationale: Yellow-tinged or halo vision is a classic sign of digoxin toxicity.
Other signs include nausea, vomiting, bradycardia, and visual disturbances.
Therapeutic digoxin level is 0.8-2.0 ng/mL, so a level of 1.2 ng/mL is within
therapeutic range.
6. A client is receiving an IV nitroglycerin infusion for acute coronary
syndrome. Which assessment finding indicates the medication is
effective?
A) Heart rate increases from 80 to 100 bpm
B) Blood pressure decreases from 150/90 to 110/70 mmHg
C) Chest pain decreases from 7/10 to 3/10
D) Respiratory rate increases from 16 to 22 breaths/min
Answer: C) Chest pain decreases from 7/10 to 3/10
Rationale: Nitroglycerin is a vasodilator that reduces preload and afterload,
decreasing myocardial oxygen demand and relieving anginal chest pain.
Pain relief is the primary indicator of effectiveness.
7. A nurse is assessing a client with peripheral arterial disease (PAD).
Which finding is most consistent with this condition?
Comprehensive Review: High-Yield
Practice Questions with In-Depth
Rationales, Prioritization Strategies, and
Core Concept Mastery Covering
Cardiovascular, Respiratory, Renal,
Endocrine, Hematologic, Neurological,
Sepsis, Burns, and Fluid/Electrolyte
Disorders – Rasmussen University Newest
Curriculum-Aligned Study Guide
Cardiovascular Disorders
1. A nurse is caring for a client with heart failure who has crackles in
the lungs, edema, and jugular venous distention. Which prescribed
medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
,Answer: B) Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid volume
overload, the primary cause of the client's symptoms (crackles, edema,
JVD). Rapid diuresis is the priority to decrease preload and relieve
pulmonary congestion. Digoxin increases contractility but is not first-line;
metoprolol and lisinopril are long-term management agents.
2. A client with acute coronary syndrome is receiving a continuous
heparin infusion. The aPTT is 110 seconds (normal 25-35 seconds).
What is the nurse's priority action?
A) Increase the infusion rate
B) Continue the infusion and monitor
C) Stop the infusion and notify the provider
D) Administer vitamin K
Answer: C) Stop the infusion and notify the provider
Rationale: The therapeutic aPTT for heparin is typically 1.5-2.5 times the
normal value (approx. 60-80 seconds). An aPTT of 110 seconds indicates a
significant overdose, placing the client at high risk for bleeding. The
infusion should be stopped immediately and the provider notified.
Protamine sulfate, not vitamin K, is the antidote for heparin.
3. A client is 2 days post-MI and reports shortness of breath. The nurse
notes a new S3 heart sound and crackles in the lung bases. Which
complication should the nurse suspect?
, A) Cardiac tamponade
B) Left-sided heart failure
C) Pulmonary embolism
D) Pericarditis
Answer: B) Left-sided heart failure
Rationale: An S3 heart sound ("ventricular gallop") and crackles are classic
signs of left-sided heart failure, indicating fluid backup into the pulmonary
circulation. This is a common complication post-MI due to impaired left
ventricular function.
4. The nurse is preparing to administer amiodarone IV to a client with
ventricular tachycardia. Which assessment finding would require the
nurse to hold the medication and notify the provider?
A) Heart rate 110 bpm
B) Blood pressure 98/62 mmHg
C) QTc interval 520 msec
D) Potassium 4.0 mEq/L
Answer: C) QTc interval 520 msec
Rationale: Amiodarone prolongs the QT interval and can cause torsades de
pointes. A QTc >500 msec is a critical finding and the medication should be
held. Normal QTc is <440 msec in males and <470 msec in females.
5. A client with heart failure is prescribed digoxin. Which finding
indicates digoxin toxicity?
, A) Heart rate 68 bpm
B) Yellow-tinged vision
C) Serum digoxin level 1.2 ng/mL
D) Blood pressure 130/80 mmHg
Answer: B) Yellow-tinged vision
Rationale: Yellow-tinged or halo vision is a classic sign of digoxin toxicity.
Other signs include nausea, vomiting, bradycardia, and visual disturbances.
Therapeutic digoxin level is 0.8-2.0 ng/mL, so a level of 1.2 ng/mL is within
therapeutic range.
6. A client is receiving an IV nitroglycerin infusion for acute coronary
syndrome. Which assessment finding indicates the medication is
effective?
A) Heart rate increases from 80 to 100 bpm
B) Blood pressure decreases from 150/90 to 110/70 mmHg
C) Chest pain decreases from 7/10 to 3/10
D) Respiratory rate increases from 16 to 22 breaths/min
Answer: C) Chest pain decreases from 7/10 to 3/10
Rationale: Nitroglycerin is a vasodilator that reduces preload and afterload,
decreasing myocardial oxygen demand and relieving anginal chest pain.
Pain relief is the primary indicator of effectiveness.
7. A nurse is assessing a client with peripheral arterial disease (PAD).
Which finding is most consistent with this condition?
