,NUR 209 Exam 2 – mEdical-SURgical NURSiNg – collEgE of NURSiNg
– 2026/2027 acadEmic YEaR – 100 QUEStioNS aNd aNSwERS
covERiNg foUR coRE domaiNS || vERifiEd bY ExpERtS .
DOMAIN I: CARDIOVASCULAR AND HEMATOLOGIC DISORDERS (Questions 1–25)
Question 1
A nurse is assessing a client with hypertension. Which lifestyle modification is most important for
managing blood pressure?
A. Increasing caffeine intake
B. Reducing sodium intake
C. Decreasing physical activity
D. Increasing alcohol consumption
aNSwER: B. Reducing sodium intake
RatioNalE: Reducing sodium intake is a key lifestyle modification for managing hypertension.
The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes low sodium, fruits,
vegetables, and whole grains. Caffeine (A) should be limited, physical activity (C) should be
increased, and alcohol consumption (D) should be limited.
Question 2
A client with coronary artery disease reports chest pain that occurs with exertion and is relieved
by rest. The nurse recognizes this as:
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
aNSwER: B. Stable angina
RatioNalE: Stable angina is characterized by chest discomfort that is predictable, occurs with
exertion, and is relieved by rest or nitroglycerin. Unstable angina (A) occurs at rest or with
minimal exertion. Myocardial infarction (C) involves prolonged pain not relieved by rest.
Pericarditis (D) is associated with sharp, pleuritic pain.
Question 3
A client is prescribed digoxin for heart failure. Which finding indicates digoxin toxicity?
,A. Heart rate of 72 beats per minute
B. Serum potassium of 4.0 mEq/L
C. Nausea, vomiting, and visual disturbances
D. Blood pressure of 120/80 mmHg
aNSwER: C. Nausea, vomiting, and visual disturbances
RatioNalE: Digoxin toxicity presents with gastrointestinal symptoms (nausea, vomiting,
anorexia), visual disturbances (yellow-green halos, blurred vision), and cardiac dysrhythmias.
Hypokalemia increases the risk of digoxin toxicity. Heart rate should be assessed before
administration, with the drug held if the apical pulse is below 60 bpm.
Question 4
The nurse is assessing a client with left-sided heart failure. Which finding is most consistent with
this condition?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Ascites
aNSwER: C. Crackles in the lungs
RatioNalE: Left-sided heart failure results in pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Peripheral edema (A), jugular venous distention (B), and ascites (D)
are signs of right-sided heart failure.
Question 5
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
aNSwER: B. Serum potassium
RatioNalE: Furosemide is a loop diuretic that can cause hypokalemia (potassium wasting).
Hypokalemia can lead to cardiac dysrhythmias, especially in clients taking digoxin. Potassium
levels should be monitored closely and supplemented as needed.
Question 6
The nurse is assessing a client's ECG rhythm. The rhythm is irregularly irregular with no
discernible P waves. The nurse recognizes this as:
, A. Atrial fibrillation
B. Normal sinus rhythm
C. Ventricular tachycardia
D. Sinus bradycardia
aNSwER: A. Atrial fibrillation
RatioNalE: Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves due to chaotic atrial activity. Normal sinus rhythm (B) has regular P waves.
Ventricular tachycardia (C) presents with wide QRS complexes. Sinus bradycardia (D) is a
regular rhythm with a rate below 60 bpm.
Question 7
A client is receiving IV heparin for a pulmonary embolism. Which laboratory value should the
nurse monitor to evaluate the effectiveness of therapy?
A. International Normalized Ratio (INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Prothrombin Time (PT)
D. Platelet count
aNSwER: B. Activated Partial Thromboplastin Time (aPTT)
RatioNalE: Heparin therapy is monitored using the aPTT, with a therapeutic goal typically 1.5-
2.5 times the normal control value. INR and PT (A, C) are used to monitor warfarin therapy.
Platelet count (D) should be monitored for heparin-induced thrombocytopenia (HIT).
Question 8
The nurse is providing education to a client prescribed warfarin. Which statement by the client
indicates understanding?
A. "I can take aspirin for headaches while on warfarin."
B. "I should avoid eating green leafy vegetables."
C. "I should have my INR checked regularly."
D. "Warfarin is safe to take with all over-the-counter medications."
aNSwER: C. "I should have my INR checked regularly."
RatioNalE: Regular INR monitoring is essential for clients taking warfarin to ensure
therapeutic levels and prevent bleeding or clotting complications. Aspirin (A) should be avoided
due to increased bleeding risk. Green leafy vegetables (B) are high in vitamin K and can affect
warfarin effectiveness, but they should be consumed consistently rather than avoided entirely.
Question 9
A client with peripheral artery disease (PAD) reports leg pain when walking that is relieved by
rest. The nurse recognizes this as:
– 2026/2027 acadEmic YEaR – 100 QUEStioNS aNd aNSwERS
covERiNg foUR coRE domaiNS || vERifiEd bY ExpERtS .
DOMAIN I: CARDIOVASCULAR AND HEMATOLOGIC DISORDERS (Questions 1–25)
Question 1
A nurse is assessing a client with hypertension. Which lifestyle modification is most important for
managing blood pressure?
A. Increasing caffeine intake
B. Reducing sodium intake
C. Decreasing physical activity
D. Increasing alcohol consumption
aNSwER: B. Reducing sodium intake
RatioNalE: Reducing sodium intake is a key lifestyle modification for managing hypertension.
The DASH diet (Dietary Approaches to Stop Hypertension) emphasizes low sodium, fruits,
vegetables, and whole grains. Caffeine (A) should be limited, physical activity (C) should be
increased, and alcohol consumption (D) should be limited.
Question 2
A client with coronary artery disease reports chest pain that occurs with exertion and is relieved
by rest. The nurse recognizes this as:
A. Unstable angina
B. Stable angina
C. Myocardial infarction
D. Pericarditis
aNSwER: B. Stable angina
RatioNalE: Stable angina is characterized by chest discomfort that is predictable, occurs with
exertion, and is relieved by rest or nitroglycerin. Unstable angina (A) occurs at rest or with
minimal exertion. Myocardial infarction (C) involves prolonged pain not relieved by rest.
Pericarditis (D) is associated with sharp, pleuritic pain.
Question 3
A client is prescribed digoxin for heart failure. Which finding indicates digoxin toxicity?
,A. Heart rate of 72 beats per minute
B. Serum potassium of 4.0 mEq/L
C. Nausea, vomiting, and visual disturbances
D. Blood pressure of 120/80 mmHg
aNSwER: C. Nausea, vomiting, and visual disturbances
RatioNalE: Digoxin toxicity presents with gastrointestinal symptoms (nausea, vomiting,
anorexia), visual disturbances (yellow-green halos, blurred vision), and cardiac dysrhythmias.
Hypokalemia increases the risk of digoxin toxicity. Heart rate should be assessed before
administration, with the drug held if the apical pulse is below 60 bpm.
Question 4
The nurse is assessing a client with left-sided heart failure. Which finding is most consistent with
this condition?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Ascites
aNSwER: C. Crackles in the lungs
RatioNalE: Left-sided heart failure results in pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Peripheral edema (A), jugular venous distention (B), and ascites (D)
are signs of right-sided heart failure.
Question 5
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse
monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
aNSwER: B. Serum potassium
RatioNalE: Furosemide is a loop diuretic that can cause hypokalemia (potassium wasting).
Hypokalemia can lead to cardiac dysrhythmias, especially in clients taking digoxin. Potassium
levels should be monitored closely and supplemented as needed.
Question 6
The nurse is assessing a client's ECG rhythm. The rhythm is irregularly irregular with no
discernible P waves. The nurse recognizes this as:
, A. Atrial fibrillation
B. Normal sinus rhythm
C. Ventricular tachycardia
D. Sinus bradycardia
aNSwER: A. Atrial fibrillation
RatioNalE: Atrial fibrillation is characterized by an irregularly irregular rhythm with no
discernible P waves due to chaotic atrial activity. Normal sinus rhythm (B) has regular P waves.
Ventricular tachycardia (C) presents with wide QRS complexes. Sinus bradycardia (D) is a
regular rhythm with a rate below 60 bpm.
Question 7
A client is receiving IV heparin for a pulmonary embolism. Which laboratory value should the
nurse monitor to evaluate the effectiveness of therapy?
A. International Normalized Ratio (INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Prothrombin Time (PT)
D. Platelet count
aNSwER: B. Activated Partial Thromboplastin Time (aPTT)
RatioNalE: Heparin therapy is monitored using the aPTT, with a therapeutic goal typically 1.5-
2.5 times the normal control value. INR and PT (A, C) are used to monitor warfarin therapy.
Platelet count (D) should be monitored for heparin-induced thrombocytopenia (HIT).
Question 8
The nurse is providing education to a client prescribed warfarin. Which statement by the client
indicates understanding?
A. "I can take aspirin for headaches while on warfarin."
B. "I should avoid eating green leafy vegetables."
C. "I should have my INR checked regularly."
D. "Warfarin is safe to take with all over-the-counter medications."
aNSwER: C. "I should have my INR checked regularly."
RatioNalE: Regular INR monitoring is essential for clients taking warfarin to ensure
therapeutic levels and prevent bleeding or clotting complications. Aspirin (A) should be avoided
due to increased bleeding risk. Green leafy vegetables (B) are high in vitamin K and can affect
warfarin effectiveness, but they should be consumed consistently rather than avoided entirely.
Question 9
A client with peripheral artery disease (PAD) reports leg pain when walking that is relieved by
rest. The nurse recognizes this as:
