NSG223 Exam 2
Medical-Surgical Nursing II
Guide Questions & Verified Answers | 100% Correct | Grade A
Herzing University | 2026-2027 Curriculum Update
50 Questions | 5 Sections | Comprehensive Rationales
, NSG223 Exam 2: Medical-Surgical Nursing II Herzing University | 2026-2027
NSG223 Exam 2: Medical-Surgical Nursing II
Comprehensive Examination | 50 Questions | 2026-2027
Section 1: Heart Failure, Cardiomyopathy, and Valvular Disorders (Q1-Q15)
Q1: A 68-year-old patient with a history of hypertension and coronary artery disease presents to the emergency
department with dyspnea at rest, orthopnea, and a new S3 gallop. The nurse recognizes these findings as classic
manifestations of which condition?
A. Right-sided heart failure
B. Left-sided heart failure [CORRECT]
C. Cor pulmonale
D. Cardiac tamponade
Correct Answer: B
Rationale: Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND), pulmonary crackles, S3 gallop, and fatigue are hallmark
assessment findings of left-sided heart failure resulting from inadequate left ventricular output causing blood to back up into the
pulmonary circulation. Right-sided heart failure presents with peripheral edema, JVD, hepatomegaly, and ascites due to blood backing up
into the systemic venous circulation. Cor pulmonale is right heart failure secondary to pulmonary disease. Cardiac tamponade presents
with muffled heart sounds, JVD, and hypotension (Beck triad).
Q2: A nurse is assessing a patient admitted with heart failure. The patient has jugular venous distension (JVD), 3+
pitting edema of bilateral lower extremities, hepatomegaly, and a recent 8-pound weight gain over two weeks. The
nurse interprets these findings as consistent with which type of heart failure?
A. Left-sided heart failure with pulmonary congestion
B. Biventricular heart failure with predominantly right-sided manifestations [CORRECT]
C. Acute myocardial infarction
D. Pulmonary embolism
Correct Answer: B
Rationale: JVD, peripheral edema, hepatomegaly, ascites, and rapid weight gain are classic manifestations of right-sided heart failure, in
which inadequate right ventricular output causes blood to back up into the systemic venous circulation. The most common cause of
right-sided heart failure is left-sided heart failure, making biventricular failure a likely scenario. Left-sided heart failure primarily
produces pulmonary symptoms such as dyspnea and crackles. MI presents with chest pain and ECG changes. Pulmonary embolism
presents with sudden dyspnea and pleuritic chest pain.
Q3: A patient with chronic heart failure has a BNP level of 650 pg/mL. The nurse understands that this laboratory
value indicates which of the following?
A. The BNP is within normal range and heart failure is unlikely
B. Mild elevation suggesting early cardiac stress
C. Significant elevation consistent with heart failure, as BNP greater than 100 pg/mL supports the diagnosis
[CORRECT]
D. The patient is in acute kidney injury requiring dialysis
Correct Answer: C
Rationale: B-type Natriuretic Peptide (BNP) is a cardiac biomarker released from ventricular myocytes in response to ventricular stretch
and volume overload. A BNP level exceeding 100 pg/mL is consistent with a diagnosis of heart failure, and levels of 650 pg/mL indicate
significant elevation. BNP is used both to support the diagnosis and to monitor treatment response. While BNP can be affected by renal
function, a level of 650 pg/mL in the appropriate clinical context is primarily indicative of heart failure, not acute kidney injury.
Page 2
Medical-Surgical Nursing II
Guide Questions & Verified Answers | 100% Correct | Grade A
Herzing University | 2026-2027 Curriculum Update
50 Questions | 5 Sections | Comprehensive Rationales
, NSG223 Exam 2: Medical-Surgical Nursing II Herzing University | 2026-2027
NSG223 Exam 2: Medical-Surgical Nursing II
Comprehensive Examination | 50 Questions | 2026-2027
Section 1: Heart Failure, Cardiomyopathy, and Valvular Disorders (Q1-Q15)
Q1: A 68-year-old patient with a history of hypertension and coronary artery disease presents to the emergency
department with dyspnea at rest, orthopnea, and a new S3 gallop. The nurse recognizes these findings as classic
manifestations of which condition?
A. Right-sided heart failure
B. Left-sided heart failure [CORRECT]
C. Cor pulmonale
D. Cardiac tamponade
Correct Answer: B
Rationale: Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND), pulmonary crackles, S3 gallop, and fatigue are hallmark
assessment findings of left-sided heart failure resulting from inadequate left ventricular output causing blood to back up into the
pulmonary circulation. Right-sided heart failure presents with peripheral edema, JVD, hepatomegaly, and ascites due to blood backing up
into the systemic venous circulation. Cor pulmonale is right heart failure secondary to pulmonary disease. Cardiac tamponade presents
with muffled heart sounds, JVD, and hypotension (Beck triad).
Q2: A nurse is assessing a patient admitted with heart failure. The patient has jugular venous distension (JVD), 3+
pitting edema of bilateral lower extremities, hepatomegaly, and a recent 8-pound weight gain over two weeks. The
nurse interprets these findings as consistent with which type of heart failure?
A. Left-sided heart failure with pulmonary congestion
B. Biventricular heart failure with predominantly right-sided manifestations [CORRECT]
C. Acute myocardial infarction
D. Pulmonary embolism
Correct Answer: B
Rationale: JVD, peripheral edema, hepatomegaly, ascites, and rapid weight gain are classic manifestations of right-sided heart failure, in
which inadequate right ventricular output causes blood to back up into the systemic venous circulation. The most common cause of
right-sided heart failure is left-sided heart failure, making biventricular failure a likely scenario. Left-sided heart failure primarily
produces pulmonary symptoms such as dyspnea and crackles. MI presents with chest pain and ECG changes. Pulmonary embolism
presents with sudden dyspnea and pleuritic chest pain.
Q3: A patient with chronic heart failure has a BNP level of 650 pg/mL. The nurse understands that this laboratory
value indicates which of the following?
A. The BNP is within normal range and heart failure is unlikely
B. Mild elevation suggesting early cardiac stress
C. Significant elevation consistent with heart failure, as BNP greater than 100 pg/mL supports the diagnosis
[CORRECT]
D. The patient is in acute kidney injury requiring dialysis
Correct Answer: C
Rationale: B-type Natriuretic Peptide (BNP) is a cardiac biomarker released from ventricular myocytes in response to ventricular stretch
and volume overload. A BNP level exceeding 100 pg/mL is consistent with a diagnosis of heart failure, and levels of 650 pg/mL indicate
significant elevation. BNP is used both to support the diagnosis and to monitor treatment response. While BNP can be affected by renal
function, a level of 650 pg/mL in the appropriate clinical context is primarily indicative of heart failure, not acute kidney injury.
Page 2
