NUR 2063 Pathophysiology Exam 2: NUR
2063 Pathophysiology Exam 2 Study Guide:
Updated Solution 2026/2027
1. A nurse is caring for a client admitted with acute heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral 2+ pitting edema in the ankles
B. Blood pressure of 150/90 mm Hg
C. Crackles throughout both lung fields and oxygen saturation of 84%
D. Weight gain of 2 lb (0.9 kg) over 24 hours
Correct Answer: C
Rationale: This client is experiencing severe pulmonary edema, resulting in impaired gas
exchange and hypoxemia. An oxygen saturation of 84% indicates inadequate oxygenation
requiring immediate intervention.
2. A client with left-sided heart failure is being assessed. Which finding should the nurse
identify as a manifestation of left-sided heart failure?
A. Dependent edema in the lower extremities
B. Pink-tinged frothy sputum
C. Jugular vein distention
D. Hepatomegaly
Correct Answer: B
Rationale: Pink-tinged frothy sputum indicates pulmonary edema, a key manifestation of left-
sided heart failure due to backup of blood into the pulmonary circulation. Dependent edema,
JVD, and hepatomegaly are signs of right-sided heart failure.
3. A client receiving packed red blood cells suddenly develops chills, fever, and flank pain.
What should the nurse do first?
A. Notify the provider
B. Slow the infusion
C. Stop the transfusion
D. Administer acetaminophen
Correct Answer: C
Rationale: These findings suggest an acute hemolytic transfusion reaction. Immediate actions
,include stopping the transfusion, maintaining IV access with normal saline using new tubing,
notifying the provider and blood bank, monitoring vital signs, and obtaining blood and urine
specimens as ordered.
4. A client with atrial fibrillation is prescribed warfarin. The nurse educates the client that
they must avoid eating large amounts of which foods?
A. Bananas and oranges
B. Green leafy vegetables (spinach, kale)
C. Grapefruit juice
D. Dairy products
Correct Answer: B
Rationale: Green leafy vegetables are high in Vitamin K, which antagonizes the effect of
warfarin. Patients should maintain consistent Vitamin K intake rather than avoid it completely.
5. A nurse is monitoring a client who is receiving opioid analgesia. Which findings should the
nurse identify as adverse effects of opioid analgesics? (Select all that apply.)
A. Urinary incontinence
B. Diarrhea
C. Bradypnea
D. Orthostatic hypotension
E. Nausea
Correct Answer: C, D, E
Rationale: Adverse effects of opioids include bradypnea (respiratory depression), orthostatic
hypotension, nausea, constipation (not diarrhea), and urinary retention (not incontinence).
6. A client with deep vein thrombosis is started on IV heparin. Which laboratory value should
the nurse monitor to evaluate the therapeutic efficacy of heparin?
A. PT/INR
B. aPTT
C. Platelet count
D. D-dimer
Correct Answer: B
Rationale: Heparin is monitored using the aPTT. The goal is typically 1.5-2.5 times the control
value. PT/INR is used to monitor warfarin. Platelet count is monitored to detect HIT. D-dimer is a
diagnostic test for DVT/PE.
7. A client on warfarin has an INR of 4.5 without bleeding. Which action is most appropriate?
, A. Administer vitamin K 10 mg subcutaneously
B. Withhold warfarin and recheck INR in 24-48 hours
C. Give fresh frozen plasma immediately
D. Increase warfarin dose
Correct Answer: B
Rationale: For an asymptomatic patient with INR 4.5-10, guidelines recommend withholding
warfarin (no vitamin K unless high bleeding risk). Recheck INR in 1-2 days.
8. A patient on clopidogrel is scheduled for elective surgery. When should clopidogrel be
stopped?
A. 2 days before surgery
B. 5 days before surgery
C. 10 days before surgery
D. 14 days before surgery
Correct Answer: B
Rationale: Clopidogrel irreversibly inhibits P2Y12; platelet function recovers in 5-7 days (new
platelets). Guidelines recommend stopping 5 days pre-op for most non-cardiac surgeries.
9. A nurse is assessing a client who is 12 hours postoperative following a total hip
arthroplasty. Which finding requires immediate intervention?
A. Pain rated 6 on a 0-10 scale
B. Temperature of 100.2°F (37.9°C)
C. Sudden shortness of breath and chest pain
D. Drainage of 50 mL of serosanguineous fluid from the surgical drain
Correct Answer: C
Rationale: Sudden dyspnea and chest pain in a postoperative orthopedic client strongly suggest
a pulmonary embolism (PE), a life-threatening complication requiring immediate intervention.
10. The nurse receives all of the following stat orders for a patient with a pulmonary
embolism. Which one should the nurse question?
1. Oxygen per nasal cannula at 4 L per minute
2. Enoxaparin (Lovenox) 40 mg subcutaneously
3. Troponin level
4. Computed tomography (CT) angiogram
2063 Pathophysiology Exam 2 Study Guide:
Updated Solution 2026/2027
1. A nurse is caring for a client admitted with acute heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral 2+ pitting edema in the ankles
B. Blood pressure of 150/90 mm Hg
C. Crackles throughout both lung fields and oxygen saturation of 84%
D. Weight gain of 2 lb (0.9 kg) over 24 hours
Correct Answer: C
Rationale: This client is experiencing severe pulmonary edema, resulting in impaired gas
exchange and hypoxemia. An oxygen saturation of 84% indicates inadequate oxygenation
requiring immediate intervention.
2. A client with left-sided heart failure is being assessed. Which finding should the nurse
identify as a manifestation of left-sided heart failure?
A. Dependent edema in the lower extremities
B. Pink-tinged frothy sputum
C. Jugular vein distention
D. Hepatomegaly
Correct Answer: B
Rationale: Pink-tinged frothy sputum indicates pulmonary edema, a key manifestation of left-
sided heart failure due to backup of blood into the pulmonary circulation. Dependent edema,
JVD, and hepatomegaly are signs of right-sided heart failure.
3. A client receiving packed red blood cells suddenly develops chills, fever, and flank pain.
What should the nurse do first?
A. Notify the provider
B. Slow the infusion
C. Stop the transfusion
D. Administer acetaminophen
Correct Answer: C
Rationale: These findings suggest an acute hemolytic transfusion reaction. Immediate actions
,include stopping the transfusion, maintaining IV access with normal saline using new tubing,
notifying the provider and blood bank, monitoring vital signs, and obtaining blood and urine
specimens as ordered.
4. A client with atrial fibrillation is prescribed warfarin. The nurse educates the client that
they must avoid eating large amounts of which foods?
A. Bananas and oranges
B. Green leafy vegetables (spinach, kale)
C. Grapefruit juice
D. Dairy products
Correct Answer: B
Rationale: Green leafy vegetables are high in Vitamin K, which antagonizes the effect of
warfarin. Patients should maintain consistent Vitamin K intake rather than avoid it completely.
5. A nurse is monitoring a client who is receiving opioid analgesia. Which findings should the
nurse identify as adverse effects of opioid analgesics? (Select all that apply.)
A. Urinary incontinence
B. Diarrhea
C. Bradypnea
D. Orthostatic hypotension
E. Nausea
Correct Answer: C, D, E
Rationale: Adverse effects of opioids include bradypnea (respiratory depression), orthostatic
hypotension, nausea, constipation (not diarrhea), and urinary retention (not incontinence).
6. A client with deep vein thrombosis is started on IV heparin. Which laboratory value should
the nurse monitor to evaluate the therapeutic efficacy of heparin?
A. PT/INR
B. aPTT
C. Platelet count
D. D-dimer
Correct Answer: B
Rationale: Heparin is monitored using the aPTT. The goal is typically 1.5-2.5 times the control
value. PT/INR is used to monitor warfarin. Platelet count is monitored to detect HIT. D-dimer is a
diagnostic test for DVT/PE.
7. A client on warfarin has an INR of 4.5 without bleeding. Which action is most appropriate?
, A. Administer vitamin K 10 mg subcutaneously
B. Withhold warfarin and recheck INR in 24-48 hours
C. Give fresh frozen plasma immediately
D. Increase warfarin dose
Correct Answer: B
Rationale: For an asymptomatic patient with INR 4.5-10, guidelines recommend withholding
warfarin (no vitamin K unless high bleeding risk). Recheck INR in 1-2 days.
8. A patient on clopidogrel is scheduled for elective surgery. When should clopidogrel be
stopped?
A. 2 days before surgery
B. 5 days before surgery
C. 10 days before surgery
D. 14 days before surgery
Correct Answer: B
Rationale: Clopidogrel irreversibly inhibits P2Y12; platelet function recovers in 5-7 days (new
platelets). Guidelines recommend stopping 5 days pre-op for most non-cardiac surgeries.
9. A nurse is assessing a client who is 12 hours postoperative following a total hip
arthroplasty. Which finding requires immediate intervention?
A. Pain rated 6 on a 0-10 scale
B. Temperature of 100.2°F (37.9°C)
C. Sudden shortness of breath and chest pain
D. Drainage of 50 mL of serosanguineous fluid from the surgical drain
Correct Answer: C
Rationale: Sudden dyspnea and chest pain in a postoperative orthopedic client strongly suggest
a pulmonary embolism (PE), a life-threatening complication requiring immediate intervention.
10. The nurse receives all of the following stat orders for a patient with a pulmonary
embolism. Which one should the nurse question?
1. Oxygen per nasal cannula at 4 L per minute
2. Enoxaparin (Lovenox) 40 mg subcutaneously
3. Troponin level
4. Computed tomography (CT) angiogram
