NUR 213 - COMPLEX HEALTH CONCEPTS
COMPREHENSIVE FINAL EXAM 350 UNIQUE
MULTIPLE-CHOICE QUESTIONS WITH
DETAILED RATIONALES
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SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-40)
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Question 1
A patient with heart failure is prescribed digoxin. Which assessment finding
indicates potential digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around visual images
D) Blood pressure of 128/78 mmHg
Answer: C) Yellow-green halos around visual images
Rationale: Visual disturbances, including yellow-green halos (xanthopsia), are
classic signs of digoxin toxicity. Other signs include nausea, vomiting,
anorexia, and cardiac dysrhythmias. A heart rate of 72 bpm is within normal
range. Serum potassium of 4.0 mEq/L is normal (though hypokalemia
,increases toxicity risk). Blood pressure of 128/78 mmHg is acceptable. Early
recognition of visual changes is critical for preventing severe toxicity.
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Question 2
A patient with unstable angina is receiving IV heparin. The nurse should
monitor which laboratory value most closely?
A) Serum potassium
B) Activated partial thromboplastin time (aPTT)
C) Serum creatinine
D) White blood cell count
Answer: B) Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy requires close monitoring of aPTT to maintain
therapeutic levels (typically 1.5-2.5 times control). This prevents both
inadequate anticoagulation (risk of clot progression) and excessive
anticoagulation (risk of bleeding). Potassium, creatinine, and WBC are not
directly affected by heparin therapy.
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Question 3
A patient is 2 days post-myocardial infarction. Which finding requires
immediate intervention?
A) Mild dyspnea on exertion
,B) S3 heart sound
C) Occasional premature ventricular contractions
D) Heart rate of 88 bpm
Answer: B) S3 heart sound
Rationale: An S3 heart sound in a post-MI patient indicates ventricular volume
overload and is an early sign of heart failure. This requires immediate
assessment and intervention. Mild dyspnea on exertion is expected.
Occasional PVCs are common post-MI but should be monitored. A heart rate of
88 bpm is within acceptable range.
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Question 4
The nurse is caring for a patient with pericarditis. Which position would most
likely relieve the patient's chest pain?
A) Supine
B) Prone
C) Sitting upright and leaning forward
D) Left lateral recumbent
Answer: C) Sitting upright and leaning forward
Rationale: Pericarditis pain is typically relieved by sitting upright and leaning
forward, which reduces pressure on the pericardium from the diaphragm and
other thoracic structures. Supine and left lateral positions often worsen the
pain due to increased pericardial friction.
, ---
Question 5
A patient with aortic stenosis is scheduled for valve replacement. Which
assessment finding is most concerning preoperatively?
A) Angina with exertion
B) Syncope
C) Dyspnea on exertion
D) Systolic ejection murmur
Answer: B) Syncope
Rationale: Syncope in aortic stenosis indicates severe obstruction and
inadequate cerebral perfusion, often occurring with exertion. This is a critical
finding that suggests the stenosis is life-threatening. While angina, dyspnea,
and murmur are all associated with aortic stenosis, syncope indicates the
most severe hemodynamic compromise.
---
Question 6
The nurse is administering IV nitroglycerin to a patient with acute coronary
syndrome. Which adverse effect should the nurse monitor for?
A) Hypertension
B) Tachycardia
C) Bradycardia
COMPREHENSIVE FINAL EXAM 350 UNIQUE
MULTIPLE-CHOICE QUESTIONS WITH
DETAILED RATIONALES
---
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-40)
---
Question 1
A patient with heart failure is prescribed digoxin. Which assessment finding
indicates potential digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around visual images
D) Blood pressure of 128/78 mmHg
Answer: C) Yellow-green halos around visual images
Rationale: Visual disturbances, including yellow-green halos (xanthopsia), are
classic signs of digoxin toxicity. Other signs include nausea, vomiting,
anorexia, and cardiac dysrhythmias. A heart rate of 72 bpm is within normal
range. Serum potassium of 4.0 mEq/L is normal (though hypokalemia
,increases toxicity risk). Blood pressure of 128/78 mmHg is acceptable. Early
recognition of visual changes is critical for preventing severe toxicity.
---
Question 2
A patient with unstable angina is receiving IV heparin. The nurse should
monitor which laboratory value most closely?
A) Serum potassium
B) Activated partial thromboplastin time (aPTT)
C) Serum creatinine
D) White blood cell count
Answer: B) Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy requires close monitoring of aPTT to maintain
therapeutic levels (typically 1.5-2.5 times control). This prevents both
inadequate anticoagulation (risk of clot progression) and excessive
anticoagulation (risk of bleeding). Potassium, creatinine, and WBC are not
directly affected by heparin therapy.
---
Question 3
A patient is 2 days post-myocardial infarction. Which finding requires
immediate intervention?
A) Mild dyspnea on exertion
,B) S3 heart sound
C) Occasional premature ventricular contractions
D) Heart rate of 88 bpm
Answer: B) S3 heart sound
Rationale: An S3 heart sound in a post-MI patient indicates ventricular volume
overload and is an early sign of heart failure. This requires immediate
assessment and intervention. Mild dyspnea on exertion is expected.
Occasional PVCs are common post-MI but should be monitored. A heart rate of
88 bpm is within acceptable range.
---
Question 4
The nurse is caring for a patient with pericarditis. Which position would most
likely relieve the patient's chest pain?
A) Supine
B) Prone
C) Sitting upright and leaning forward
D) Left lateral recumbent
Answer: C) Sitting upright and leaning forward
Rationale: Pericarditis pain is typically relieved by sitting upright and leaning
forward, which reduces pressure on the pericardium from the diaphragm and
other thoracic structures. Supine and left lateral positions often worsen the
pain due to increased pericardial friction.
, ---
Question 5
A patient with aortic stenosis is scheduled for valve replacement. Which
assessment finding is most concerning preoperatively?
A) Angina with exertion
B) Syncope
C) Dyspnea on exertion
D) Systolic ejection murmur
Answer: B) Syncope
Rationale: Syncope in aortic stenosis indicates severe obstruction and
inadequate cerebral perfusion, often occurring with exertion. This is a critical
finding that suggests the stenosis is life-threatening. While angina, dyspnea,
and murmur are all associated with aortic stenosis, syncope indicates the
most severe hemodynamic compromise.
---
Question 6
The nurse is administering IV nitroglycerin to a patient with acute coronary
syndrome. Which adverse effect should the nurse monitor for?
A) Hypertension
B) Tachycardia
C) Bradycardia
