GCU NSG 430 Exam 2 (PDF) | (2026/2027) Adult Health II
Exam Questions | GCU Nursing
1. A nurse is reviewing the laboratory results for a patient with heart failure. Which
finding is most indicative of worsening fluid overload?
A) Serum sodium of 138 mEq/L
B) B-type natriuretic peptide (BNP) of 800 pg/mL
C) Serum potassium of 4.2 mEq/L
D) Serum creatinine of 1.0 mg/dL
Correct Answer: B-type natriuretic peptide (BNP) of 800 pg/mL
Rationale: BNP is a neurohormone released from the ventricles in response to
increased myocardial wall tension and fluid volume. A BNP level > 100 pg/mL is
suggestive of heart failure, and levels above 400–500 pg/mL indicate significant fluid
overload and correlate with the severity of heart failure. The other lab values are within
normal limits.
2. A patient with acute decompensated heart failure (ADHF) is exhibiting severe
respiratory distress. Which position should the nurse prioritize to improve
oxygenation?
A) Supine with head of bed flat
B) Left lateral recumbent position
C) High Fowler's position with feet dangling
D) Trendelenburg position
Correct Answer: High Fowler's position with feet dangling
Rationale: High Fowler's position uses gravity to reduce venous return (preload),
thereby decreasing pulmonary congestion. Dangling the feet further reduces venous
return to the heart and helps alleviate pulmonary edema, making it the priority position
for a patient in respiratory distress from ADHF.
,3. The nurse is assessing a patient with left-sided heart failure. Which finding is most
consistent with this condition?
A) Jugular venous distention and peripheral edema
B) Dyspnea, crackles, and orthopnea
C) Ascites and hepatomegaly
D) Weight gain and dependent edema
Correct Answer: Dyspnea, crackles, and orthopnea
Rationale: Left-sided heart failure results in blood backing up into the left atrium and
pulmonary circulation, leading to pulmonary congestion. This manifests as dyspnea,
crackles (rales) in the lungs, and orthopnea (shortness of breath when lying flat). The
other options are more characteristic of right-sided heart failure.
4. A patient with right-sided heart failure would most likely exhibit which assessment
finding?
A) Crackles in the lung bases
B) Jugular venous distention and peripheral edema
C) Orthopnea and paroxysmal nocturnal dyspnea
D) Cough productive of frothy sputum
Correct Answer: Jugular venous distention and peripheral edema
Rationale: Right-sided heart failure results in blood backing up into the systemic
venous circulation, leading to jugular venous distention (JVD), peripheral edema,
ascites, and hepatomegaly. Pulmonary congestion (crackles, orthopnea) is a hallmark of
left-sided failure.
5. A patient with heart failure is prescribed digoxin. The nurse should monitor for signs
of digoxin toxicity, which include:
A) Tachycardia and hypertension
,B) Anorexia, nausea, and visual disturbances (yellow halos)
C) Hypokalemia and hyperglycemia
D) Constipation and dry mouth
Correct Answer: Anorexia, nausea, and visual disturbances (yellow halos)
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (anorexia, nausea,
vomiting), visual disturbances (yellow-green halos, blurred vision), and cardiac
dysrhythmias. Hypokalemia increases the risk of digoxin toxicity. The other options do
not represent classic signs of digoxin toxicity.
6. A patient with acute decompensated heart failure (ADHF) is receiving IV furosemide.
Which assessment finding indicates the medication is having the desired therapeutic
effect?
A) Decreased blood pressure
B) Increased urine output
C) Improved oxygen saturation
D) Decreased heart rate
Correct Answer: Increased urine output
Rationale: Furosemide is a loop diuretic that promotes diuresis by inhibiting sodium
and water reabsorption in the kidney. The desired therapeutic effect is an increase in
urine output, which reduces fluid volume overload, pulmonary congestion, and
symptoms of heart failure.
7. A patient with heart failure is on a fluid restriction of 1,500 mL per day. Which item
should the nurse instruct the patient to count toward their daily fluid allowance?
A) Ice chips
B) Jell-O
C) Soup broth
D) All of the above
, Correct Answer: All of the above
Rationale: All fluids that are liquid at room temperature, as well as foods that melt or
are liquid (like Jell-O, ice cream, soup broth), count toward the daily fluid allowance. Ice
chips also count, though typically at half the volume.
8. The nurse is providing discharge teaching to a patient with heart failure. Which
statement by the patient indicates a need for further teaching?
A) "I will weigh myself every morning before breakfast."
B) "I will report a weight gain of 2 pounds in a day or 5 pounds in a week."
C) "I will drink at least 3 liters of fluid each day to stay hydrated."
D) "I will take my diuretic as prescribed, even if I feel well."
Correct Answer: "I will drink at least 3 liters of fluid each day to stay hydrated."
Rationale: Patients with heart failure are typically on fluid restrictions to prevent fluid
overload. Drinking 3 liters of fluid per day is excessive and could exacerbate heart
failure symptoms. Daily weights and reporting sudden weight gain are key self-
management strategies.
9. A nurse is caring for a patient with pericarditis. Which finding is most concerning for
the development of cardiac tamponade?
A) Fever and chills
B) Muffled heart sounds and hypotension
C) Chest pain relieved by sitting forward
D) Pericardial friction rub
Correct Answer: Muffled heart sounds and hypotension
Exam Questions | GCU Nursing
1. A nurse is reviewing the laboratory results for a patient with heart failure. Which
finding is most indicative of worsening fluid overload?
A) Serum sodium of 138 mEq/L
B) B-type natriuretic peptide (BNP) of 800 pg/mL
C) Serum potassium of 4.2 mEq/L
D) Serum creatinine of 1.0 mg/dL
Correct Answer: B-type natriuretic peptide (BNP) of 800 pg/mL
Rationale: BNP is a neurohormone released from the ventricles in response to
increased myocardial wall tension and fluid volume. A BNP level > 100 pg/mL is
suggestive of heart failure, and levels above 400–500 pg/mL indicate significant fluid
overload and correlate with the severity of heart failure. The other lab values are within
normal limits.
2. A patient with acute decompensated heart failure (ADHF) is exhibiting severe
respiratory distress. Which position should the nurse prioritize to improve
oxygenation?
A) Supine with head of bed flat
B) Left lateral recumbent position
C) High Fowler's position with feet dangling
D) Trendelenburg position
Correct Answer: High Fowler's position with feet dangling
Rationale: High Fowler's position uses gravity to reduce venous return (preload),
thereby decreasing pulmonary congestion. Dangling the feet further reduces venous
return to the heart and helps alleviate pulmonary edema, making it the priority position
for a patient in respiratory distress from ADHF.
,3. The nurse is assessing a patient with left-sided heart failure. Which finding is most
consistent with this condition?
A) Jugular venous distention and peripheral edema
B) Dyspnea, crackles, and orthopnea
C) Ascites and hepatomegaly
D) Weight gain and dependent edema
Correct Answer: Dyspnea, crackles, and orthopnea
Rationale: Left-sided heart failure results in blood backing up into the left atrium and
pulmonary circulation, leading to pulmonary congestion. This manifests as dyspnea,
crackles (rales) in the lungs, and orthopnea (shortness of breath when lying flat). The
other options are more characteristic of right-sided heart failure.
4. A patient with right-sided heart failure would most likely exhibit which assessment
finding?
A) Crackles in the lung bases
B) Jugular venous distention and peripheral edema
C) Orthopnea and paroxysmal nocturnal dyspnea
D) Cough productive of frothy sputum
Correct Answer: Jugular venous distention and peripheral edema
Rationale: Right-sided heart failure results in blood backing up into the systemic
venous circulation, leading to jugular venous distention (JVD), peripheral edema,
ascites, and hepatomegaly. Pulmonary congestion (crackles, orthopnea) is a hallmark of
left-sided failure.
5. A patient with heart failure is prescribed digoxin. The nurse should monitor for signs
of digoxin toxicity, which include:
A) Tachycardia and hypertension
,B) Anorexia, nausea, and visual disturbances (yellow halos)
C) Hypokalemia and hyperglycemia
D) Constipation and dry mouth
Correct Answer: Anorexia, nausea, and visual disturbances (yellow halos)
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (anorexia, nausea,
vomiting), visual disturbances (yellow-green halos, blurred vision), and cardiac
dysrhythmias. Hypokalemia increases the risk of digoxin toxicity. The other options do
not represent classic signs of digoxin toxicity.
6. A patient with acute decompensated heart failure (ADHF) is receiving IV furosemide.
Which assessment finding indicates the medication is having the desired therapeutic
effect?
A) Decreased blood pressure
B) Increased urine output
C) Improved oxygen saturation
D) Decreased heart rate
Correct Answer: Increased urine output
Rationale: Furosemide is a loop diuretic that promotes diuresis by inhibiting sodium
and water reabsorption in the kidney. The desired therapeutic effect is an increase in
urine output, which reduces fluid volume overload, pulmonary congestion, and
symptoms of heart failure.
7. A patient with heart failure is on a fluid restriction of 1,500 mL per day. Which item
should the nurse instruct the patient to count toward their daily fluid allowance?
A) Ice chips
B) Jell-O
C) Soup broth
D) All of the above
, Correct Answer: All of the above
Rationale: All fluids that are liquid at room temperature, as well as foods that melt or
are liquid (like Jell-O, ice cream, soup broth), count toward the daily fluid allowance. Ice
chips also count, though typically at half the volume.
8. The nurse is providing discharge teaching to a patient with heart failure. Which
statement by the patient indicates a need for further teaching?
A) "I will weigh myself every morning before breakfast."
B) "I will report a weight gain of 2 pounds in a day or 5 pounds in a week."
C) "I will drink at least 3 liters of fluid each day to stay hydrated."
D) "I will take my diuretic as prescribed, even if I feel well."
Correct Answer: "I will drink at least 3 liters of fluid each day to stay hydrated."
Rationale: Patients with heart failure are typically on fluid restrictions to prevent fluid
overload. Drinking 3 liters of fluid per day is excessive and could exacerbate heart
failure symptoms. Daily weights and reporting sudden weight gain are key self-
management strategies.
9. A nurse is caring for a patient with pericarditis. Which finding is most concerning for
the development of cardiac tamponade?
A) Fever and chills
B) Muffled heart sounds and hypotension
C) Chest pain relieved by sitting forward
D) Pericardial friction rub
Correct Answer: Muffled heart sounds and hypotension
