NUR 283 Comprehensive II Practice Examination
NUR 283 – Medical-Surgical Nursing II
Cardiac & Vascular WITH CORRECT ANSWERS
AND IN-DEPTH RATIONALES 2026!
1. A patient with acute coronary syndrome is prescribed nitroglycerin sublingual. The
patient reports a severe headache after the first dose. What is the nurse's priority
action?
A. Hold the next dose and notify the provider.
B. Administer the prescribed PRN acetaminophen.
C. Reassure the patient that this is an expected side effect.
D. Assess the patient's blood pressure.
Correct Answer: D
Rationale:
Correct (D): Nitroglycerin is a potent vasodilator. While headache is an expected side
effect due to cerebral vasodilation, the priority is to assess blood pressure. The
headache is less dangerous than potential hypotension.
Incorrect (A): Do not hold the dose based solely on a headache unless hypotension is
present.
Incorrect (B): Administering an analgesic is appropriate after assessing vital signs.
Incorrect (C): While true, assessment takes priority over reassurance.
,2. A patient is 2 days post-myocardial infarction (MI). Which finding requires immediate
intervention by the nurse?
A. Sinus bradycardia with a heart rate of 52.
B. Blood pressure of 110/70 mmHg.
C. S3 heart sound and jugular venous distention.
D. Chest pain rated as 3 out of 10.
Correct Answer: C
Rationale:
Correct (C): An S3 heart sound (ventricular gallop) and JVD indicate left-sided heart
failure, a common and serious complication post-MI due to decreased contractility.
Incorrect (A): Sinus bradycardia is common in inferior wall MIs but is not the most
emergent finding here.
Incorrect (B): This BP is acceptable.
Incorrect (D): Chest pain is a priority, but heart failure is more immediately life-
threatening in this context.
3. The nurse is caring for a patient with heart failure who is receiving intravenous
furosemide (Lasix). Which assessment finding indicates the medication is having the
desired effect?
A. Increase in blood pressure.
B. Decrease in peripheral edema.
C. Increase in heart rate.
D. Decrease in serum potassium.
Correct Answer: B
Rationale:
,Correct (B): Furosemide is a loop diuretic used to reduce fluid overload. A decrease in
peripheral edema, along with decreased dyspnea and weight, indicates therapeutic
effectiveness.
Incorrect (A): Blood pressure may decrease due to reduced preload.
Incorrect (C): Tachycardia is not a desired effect and may indicate hypovolemia.
Incorrect (D): Hypokalemia is a side effect, not a therapeutic effect.
4. A patient with peripheral artery disease (PAD) complains of leg pain while walking.
The pain is relieved by rest. The nurse documents this as:
A. Rest pain.
B. Neuropathic pain.
C. Intermittent claudication.
D. Venous insufficiency.
Correct Answer: C
Rationale:
Correct (C): Intermittent claudication is defined as muscle pain/cramping in the legs
induced by exercise and relieved by rest, caused by inadequate blood flow.
Incorrect (A): Rest pain is a severe, constant burning pain in the foot/toes, indicating
critical ischemia.
Incorrect (B): Neuropathic pain is burning/tingling from nerve damage.
Incorrect (D): Venous insufficiency causes aching, heavy legs that are worse with
dependency.
, 5. Which assessment finding is a priority to report to the provider for a patient with a new
diagnosis of heart failure?
A. Weight gain of 1 kg (2.2 lbs) in 2 days.
B. Occasional dyspnea when walking.
C. Shortness of breath while sitting in a chair.
D. Bilateral, 1+ pitting edema in the ankles.
Correct Answer: C
Rationale:
Correct (C): Dyspnea at rest (orthopnea) is a sign of severe fluid overload and
pulmonary congestion, indicating worsening heart failure that requires immediate
intervention.
Incorrect (A): A 1 kg gain in 2 days is significant and warrants reporting, but is a sub-
acute sign.
Incorrect (B): Dyspnea on exertion is expected.
Incorrect (D): Edema is a sign of right-sided failure but is not immediately life-
threatening like pulmonary edema.
6. The nurse is preparing to administer an initial dose of digoxin (Lanoxin) to a patient
with heart failure. Which laboratory value should be reviewed prior to administration?
A. Serum potassium.
B. Serum sodium.
C. Blood urea nitrogen (BUN).
D. Serum calcium.
Correct Answer: A
NUR 283 – Medical-Surgical Nursing II
Cardiac & Vascular WITH CORRECT ANSWERS
AND IN-DEPTH RATIONALES 2026!
1. A patient with acute coronary syndrome is prescribed nitroglycerin sublingual. The
patient reports a severe headache after the first dose. What is the nurse's priority
action?
A. Hold the next dose and notify the provider.
B. Administer the prescribed PRN acetaminophen.
C. Reassure the patient that this is an expected side effect.
D. Assess the patient's blood pressure.
Correct Answer: D
Rationale:
Correct (D): Nitroglycerin is a potent vasodilator. While headache is an expected side
effect due to cerebral vasodilation, the priority is to assess blood pressure. The
headache is less dangerous than potential hypotension.
Incorrect (A): Do not hold the dose based solely on a headache unless hypotension is
present.
Incorrect (B): Administering an analgesic is appropriate after assessing vital signs.
Incorrect (C): While true, assessment takes priority over reassurance.
,2. A patient is 2 days post-myocardial infarction (MI). Which finding requires immediate
intervention by the nurse?
A. Sinus bradycardia with a heart rate of 52.
B. Blood pressure of 110/70 mmHg.
C. S3 heart sound and jugular venous distention.
D. Chest pain rated as 3 out of 10.
Correct Answer: C
Rationale:
Correct (C): An S3 heart sound (ventricular gallop) and JVD indicate left-sided heart
failure, a common and serious complication post-MI due to decreased contractility.
Incorrect (A): Sinus bradycardia is common in inferior wall MIs but is not the most
emergent finding here.
Incorrect (B): This BP is acceptable.
Incorrect (D): Chest pain is a priority, but heart failure is more immediately life-
threatening in this context.
3. The nurse is caring for a patient with heart failure who is receiving intravenous
furosemide (Lasix). Which assessment finding indicates the medication is having the
desired effect?
A. Increase in blood pressure.
B. Decrease in peripheral edema.
C. Increase in heart rate.
D. Decrease in serum potassium.
Correct Answer: B
Rationale:
,Correct (B): Furosemide is a loop diuretic used to reduce fluid overload. A decrease in
peripheral edema, along with decreased dyspnea and weight, indicates therapeutic
effectiveness.
Incorrect (A): Blood pressure may decrease due to reduced preload.
Incorrect (C): Tachycardia is not a desired effect and may indicate hypovolemia.
Incorrect (D): Hypokalemia is a side effect, not a therapeutic effect.
4. A patient with peripheral artery disease (PAD) complains of leg pain while walking.
The pain is relieved by rest. The nurse documents this as:
A. Rest pain.
B. Neuropathic pain.
C. Intermittent claudication.
D. Venous insufficiency.
Correct Answer: C
Rationale:
Correct (C): Intermittent claudication is defined as muscle pain/cramping in the legs
induced by exercise and relieved by rest, caused by inadequate blood flow.
Incorrect (A): Rest pain is a severe, constant burning pain in the foot/toes, indicating
critical ischemia.
Incorrect (B): Neuropathic pain is burning/tingling from nerve damage.
Incorrect (D): Venous insufficiency causes aching, heavy legs that are worse with
dependency.
, 5. Which assessment finding is a priority to report to the provider for a patient with a new
diagnosis of heart failure?
A. Weight gain of 1 kg (2.2 lbs) in 2 days.
B. Occasional dyspnea when walking.
C. Shortness of breath while sitting in a chair.
D. Bilateral, 1+ pitting edema in the ankles.
Correct Answer: C
Rationale:
Correct (C): Dyspnea at rest (orthopnea) is a sign of severe fluid overload and
pulmonary congestion, indicating worsening heart failure that requires immediate
intervention.
Incorrect (A): A 1 kg gain in 2 days is significant and warrants reporting, but is a sub-
acute sign.
Incorrect (B): Dyspnea on exertion is expected.
Incorrect (D): Edema is a sign of right-sided failure but is not immediately life-
threatening like pulmonary edema.
6. The nurse is preparing to administer an initial dose of digoxin (Lanoxin) to a patient
with heart failure. Which laboratory value should be reviewed prior to administration?
A. Serum potassium.
B. Serum sodium.
C. Blood urea nitrogen (BUN).
D. Serum calcium.
Correct Answer: A
