NUR 417 Final Exam– Care of Adult II –
Concordia University St. PaulQuestions
and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
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1. A patient is admitted with acute decompensated heart failure.
Which assessment finding is the most reliable indicator of the
patient’s fluid volume status?
A) Blood pressure
B) Daily weight
C) Intake and output
D) Peripheral edema
Answer: B
Rationale: Daily weight is the most reliable and objective indicator of
fluid volume status in heart failure. A weight gain of 1 kg represents
approximately 1 liter of fluid retention.
2. A nurse is caring for a patient receiving intravenous furosemide
(Lasix) for heart failure. Which electrolyte imbalance should the
nurse monitor for closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to
excrete potassium, leading to hypokalemia. This increases the risk
of cardiac dysrhythmias, especially in patients on digoxin.
3. A patient with a history of myocardial infarction (MI) reports chest
pain unrelieved by nitroglycerin. The ECG shows ST-segment
elevation. Which medication should the nurse anticipate
administering first?
A) Aspirin
B) Atropine
,C) Nitroglycerin IV
D) Morphine
Answer: A
Rationale: Aspirin prevents platelet aggregation and is the first-line
medication administered during an acute MI to prevent further clot
formation and reduce mortality.
4. Which finding in a patient with aortic stenosis requires the
nurse’s immediate attention?
A) Loud systolic murmur
B) Exertional dyspnea
C) Syncope on exertion
D) Palpitations
Answer: C
Rationale: Syncope on exertion in aortic stenosis indicates severe
outflow obstruction and reduced cardiac output, posing a high risk
for sudden cardiac death.
5. A patient is admitted with hypertensive crisis (BP 220/120
mmHg). The nurse notes a nitroprusside (Nipride) infusion is
running. What is the priority nursing action?
A) Monitor for thiocyanate toxicity
B) Ensure the patient is in a high-Fowler’s position
C) Titrate the infusion to lower BP to 120/80 immediately
D) Assess the IV site for infiltration
Answer: A
Rationale: Nitroprusside is metabolized to cyanide and then
thiocyanate. Prolonged use or high doses can lead to fatal
thiocyanate toxicity; therefore, the nurse must monitor thiocyanate
levels and signs of toxicity.
6. A patient presents with a suspected dissecting abdominal aortic
aneurysm (AAA). Which assessment finding is classic for this
condition?
, A) Tearing, ripping back pain
B) Numbness and tingling in the legs
C) Projectile vomiting
D) Sudden, painless flank hematuria
Answer: A
Rationale: A dissecting AAA typically presents as sudden, severe,
tearing or ripping pain in the back or abdomen as the layers of the
arterial wall tear apart.
7. Which ECG change indicates that a patient with a myocardial
infarction is experiencing ongoing myocardial ischemia?
A) Pathologic Q waves
B) Peaked T waves
C) ST-segment depression
D) Tall R waves
Answer: C
Rationale: ST-segment depression on an ECG typically indicates
myocardial ischemia (inadequate blood supply to the heart muscle).
ST elevation indicates infarction.
8. A patient with a history of deep vein thrombosis (DVT) suddenly
develops shortness of breath, tachypnea, and chest pain. What is the
nurse’s priority action?
A) Elevate the legs
B) Administer a stool softener
C) Place the patient in high-Fowler’s position
D) Apply sequential compression devices
Answer: C
Rationale: The patient is likely experiencing a pulmonary embolism
(PE). Placing the patient in high-Fowler’s position facilitates
breathing and maximizes lung expansion.
Concordia University St. PaulQuestions
and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A patient is admitted with acute decompensated heart failure.
Which assessment finding is the most reliable indicator of the
patient’s fluid volume status?
A) Blood pressure
B) Daily weight
C) Intake and output
D) Peripheral edema
Answer: B
Rationale: Daily weight is the most reliable and objective indicator of
fluid volume status in heart failure. A weight gain of 1 kg represents
approximately 1 liter of fluid retention.
2. A nurse is caring for a patient receiving intravenous furosemide
(Lasix) for heart failure. Which electrolyte imbalance should the
nurse monitor for closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to
excrete potassium, leading to hypokalemia. This increases the risk
of cardiac dysrhythmias, especially in patients on digoxin.
3. A patient with a history of myocardial infarction (MI) reports chest
pain unrelieved by nitroglycerin. The ECG shows ST-segment
elevation. Which medication should the nurse anticipate
administering first?
A) Aspirin
B) Atropine
,C) Nitroglycerin IV
D) Morphine
Answer: A
Rationale: Aspirin prevents platelet aggregation and is the first-line
medication administered during an acute MI to prevent further clot
formation and reduce mortality.
4. Which finding in a patient with aortic stenosis requires the
nurse’s immediate attention?
A) Loud systolic murmur
B) Exertional dyspnea
C) Syncope on exertion
D) Palpitations
Answer: C
Rationale: Syncope on exertion in aortic stenosis indicates severe
outflow obstruction and reduced cardiac output, posing a high risk
for sudden cardiac death.
5. A patient is admitted with hypertensive crisis (BP 220/120
mmHg). The nurse notes a nitroprusside (Nipride) infusion is
running. What is the priority nursing action?
A) Monitor for thiocyanate toxicity
B) Ensure the patient is in a high-Fowler’s position
C) Titrate the infusion to lower BP to 120/80 immediately
D) Assess the IV site for infiltration
Answer: A
Rationale: Nitroprusside is metabolized to cyanide and then
thiocyanate. Prolonged use or high doses can lead to fatal
thiocyanate toxicity; therefore, the nurse must monitor thiocyanate
levels and signs of toxicity.
6. A patient presents with a suspected dissecting abdominal aortic
aneurysm (AAA). Which assessment finding is classic for this
condition?
, A) Tearing, ripping back pain
B) Numbness and tingling in the legs
C) Projectile vomiting
D) Sudden, painless flank hematuria
Answer: A
Rationale: A dissecting AAA typically presents as sudden, severe,
tearing or ripping pain in the back or abdomen as the layers of the
arterial wall tear apart.
7. Which ECG change indicates that a patient with a myocardial
infarction is experiencing ongoing myocardial ischemia?
A) Pathologic Q waves
B) Peaked T waves
C) ST-segment depression
D) Tall R waves
Answer: C
Rationale: ST-segment depression on an ECG typically indicates
myocardial ischemia (inadequate blood supply to the heart muscle).
ST elevation indicates infarction.
8. A patient with a history of deep vein thrombosis (DVT) suddenly
develops shortness of breath, tachypnea, and chest pain. What is the
nurse’s priority action?
A) Elevate the legs
B) Administer a stool softener
C) Place the patient in high-Fowler’s position
D) Apply sequential compression devices
Answer: C
Rationale: The patient is likely experiencing a pulmonary embolism
(PE). Placing the patient in high-Fowler’s position facilitates
breathing and maximizes lung expansion.
