Davis Advantage for Medical-Surgical Nursing: Making
Connections to Practice Question Bank (300+ questions
and answers with rations)
Cardiovascular Nursing
1. A patient with heart failure reports a 3-lb (1.4-kg) weight gain in 24
hours. What should the nurse do first?
A. Encourage increased oral fluids
B. Assess for manifestations of fluid overload
C. Administer a prescribed potassium supplement
D. Place the patient in Trendelenburg position
Answer: B
Rationale: Rapid weight gain is an early indicator of fluid retention in
heart failure. The nurse should assess for pulmonary and peripheral
congestion.
2. Which assessment finding is most concerning in a patient with acute
left-sided heart failure?
A. Dependent ankle edema
B. Jugular venous distention
C. Pink, frothy sputum
D. Weight gain of 1 lb
Answer: C
Rationale: Pink, frothy sputum can indicate acute pulmonary edema, a
potentially life-threatening complication requiring immediate
intervention.
3. A patient taking furosemide should be monitored most closely for
which electrolyte abnormality?
A. Hypercalcemia
,B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase urinary potassium excretion and can
cause hypokalemia.
4. Which finding is characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver
D. Peripheral cyanosis without respiratory symptoms
Answer: A
Rationale: Left ventricular failure causes pulmonary congestion,
producing crackles, dyspnea, orthopnea, and potentially pulmonary
edema.
5. A patient taking digoxin has an apical pulse of 52/min. What should
the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give the medication with food
D. Double the next dose
Answer: B
Rationale: Digoxin can cause bradycardia. A significantly low apical
pulse should prompt withholding the dose and notifying the provider
according to prescribed parameters.
6. Which finding suggests digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
,C. Hypertension
D. Increased urine output
Answer: B
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations of digoxin toxicity.
7. Which patient should the nurse assess first?
A. Patient with chronic stable angina reporting mild fatigue
B. Patient with heart failure and new severe dyspnea
C. Patient awaiting discharge instructions
D. Patient requesting a meal tray
Answer: B
Rationale: New severe dyspnea in heart failure may indicate acute
pulmonary edema and threatens airway and breathing.
8. Which symptom is most consistent with myocardial infarction?
A. Brief pain relieved immediately by repositioning
B. Crushing chest pressure with diaphoresis
C. Mild ankle edema
D. Painless hematuria
Answer: B
Rationale: MI commonly presents with persistent chest pressure or
pain, diaphoresis, nausea, dyspnea, and sometimes atypical symptoms.
9. A patient with suspected MI should have which diagnostic test
obtained promptly?
A. Colonoscopy
B. 12-lead ECG
C. Bone scan
D. Pulmonary function test
, Answer: B
Rationale: A 12-lead ECG should be obtained promptly in suspected
acute coronary syndrome to identify ischemic changes and STEMI.
10. Which medication is commonly prescribed to reduce platelet
aggregation after acute coronary syndrome?
A. Aspirin
B. Acetaminophen
C. Furosemide
D. Calcium carbonate
Answer: A
Rationale: Aspirin inhibits platelet aggregation and is a foundational
treatment in acute coronary syndrome unless contraindicated.
Respiratory Nursing
11. A patient with COPD is receiving oxygen. Which nursing principle is
most important?
A. Oxygen should always be delivered at the highest possible flow rate
B. Oxygen should be titrated according to the prescribed target
C. Oxygen is contraindicated in COPD
D. The patient should remain flat
Answer: B
Rationale: Oxygen is not contraindicated in COPD. It should be carefully
titrated to the prescribed target oxygen saturation while monitoring
respiratory status.
12. Which finding is expected in emphysema?
A. Barrel-shaped chest
B. Massive hemoptysis
Connections to Practice Question Bank (300+ questions
and answers with rations)
Cardiovascular Nursing
1. A patient with heart failure reports a 3-lb (1.4-kg) weight gain in 24
hours. What should the nurse do first?
A. Encourage increased oral fluids
B. Assess for manifestations of fluid overload
C. Administer a prescribed potassium supplement
D. Place the patient in Trendelenburg position
Answer: B
Rationale: Rapid weight gain is an early indicator of fluid retention in
heart failure. The nurse should assess for pulmonary and peripheral
congestion.
2. Which assessment finding is most concerning in a patient with acute
left-sided heart failure?
A. Dependent ankle edema
B. Jugular venous distention
C. Pink, frothy sputum
D. Weight gain of 1 lb
Answer: C
Rationale: Pink, frothy sputum can indicate acute pulmonary edema, a
potentially life-threatening complication requiring immediate
intervention.
3. A patient taking furosemide should be monitored most closely for
which electrolyte abnormality?
A. Hypercalcemia
,B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase urinary potassium excretion and can
cause hypokalemia.
4. Which finding is characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver
D. Peripheral cyanosis without respiratory symptoms
Answer: A
Rationale: Left ventricular failure causes pulmonary congestion,
producing crackles, dyspnea, orthopnea, and potentially pulmonary
edema.
5. A patient taking digoxin has an apical pulse of 52/min. What should
the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give the medication with food
D. Double the next dose
Answer: B
Rationale: Digoxin can cause bradycardia. A significantly low apical
pulse should prompt withholding the dose and notifying the provider
according to prescribed parameters.
6. Which finding suggests digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
,C. Hypertension
D. Increased urine output
Answer: B
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations of digoxin toxicity.
7. Which patient should the nurse assess first?
A. Patient with chronic stable angina reporting mild fatigue
B. Patient with heart failure and new severe dyspnea
C. Patient awaiting discharge instructions
D. Patient requesting a meal tray
Answer: B
Rationale: New severe dyspnea in heart failure may indicate acute
pulmonary edema and threatens airway and breathing.
8. Which symptom is most consistent with myocardial infarction?
A. Brief pain relieved immediately by repositioning
B. Crushing chest pressure with diaphoresis
C. Mild ankle edema
D. Painless hematuria
Answer: B
Rationale: MI commonly presents with persistent chest pressure or
pain, diaphoresis, nausea, dyspnea, and sometimes atypical symptoms.
9. A patient with suspected MI should have which diagnostic test
obtained promptly?
A. Colonoscopy
B. 12-lead ECG
C. Bone scan
D. Pulmonary function test
, Answer: B
Rationale: A 12-lead ECG should be obtained promptly in suspected
acute coronary syndrome to identify ischemic changes and STEMI.
10. Which medication is commonly prescribed to reduce platelet
aggregation after acute coronary syndrome?
A. Aspirin
B. Acetaminophen
C. Furosemide
D. Calcium carbonate
Answer: A
Rationale: Aspirin inhibits platelet aggregation and is a foundational
treatment in acute coronary syndrome unless contraindicated.
Respiratory Nursing
11. A patient with COPD is receiving oxygen. Which nursing principle is
most important?
A. Oxygen should always be delivered at the highest possible flow rate
B. Oxygen should be titrated according to the prescribed target
C. Oxygen is contraindicated in COPD
D. The patient should remain flat
Answer: B
Rationale: Oxygen is not contraindicated in COPD. It should be carefully
titrated to the prescribed target oxygen saturation while monitoring
respiratory status.
12. Which finding is expected in emphysema?
A. Barrel-shaped chest
B. Massive hemoptysis