NR 324 Adult Health I Final Exam
2026-2027: Ultimate 200-Question
Practice Bank with Rationales
Section 1: Cardiovascular Disorders
1. A client with heart failure is prescribed furosemide (Lasix) and
digoxin (Lanoxin). Which laboratory value is most important for the
nurse to monitor?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
Answer: b. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia increases the risk of digoxin toxicity, which can lead to life-
threatening dysrhythmias.
2. A client is admitted with an acute myocardial infarction (MI). Which
medication should the nurse administer first?
a. Morphine sulfate
b. Nitroglycerin sublingual
c. Aspirin 324 mg chewed
d. Oxygen at 2 L/min
Answer: c. Aspirin 324 mg chewed
Rationale: Aspirin is a priority because it inhibits platelet aggregation and
,reduces mortality in acute MI. It should be given immediately upon
suspicion of MI. While morphine, nitroglycerin, and oxygen are also
important, aspirin is the initial, life-saving intervention.
3. A nurse is assessing a client with pericarditis. Which finding is a
classic manifestation of this condition?
a. Pain relieved by leaning forward
b. Pain that worsens with inspiration
c. A friction rub heard at the left lower sternal border
d. All of the above
Answer: d. All of the above
Rationale: Pericarditis is characterized by sharp, pleuritic chest pain that
worsens with inspiration and lying flat (relieved by leaning forward). A
pericardial friction rub is a hallmark auscultatory finding.
4. A client with hypertension is prescribed a beta-blocker. The nurse
should instruct the client to monitor for which adverse effect?
a. Tachycardia
b. Bronchospasm
c. Hyperglycemia
d. Hypokalemia
Answer: b. Bronchospasm
Rationale: Beta-blockers, especially non-selective ones, can cause
bronchospasm by blocking beta-2 receptors in the lungs. This is a
significant concern for clients with asthma or COPD.
5. The nurse is caring for a client 24 hours post-cardiac catheterization
via the femoral artery. Which assessment finding requires immediate
intervention?
a. The client reports a headache.
b. The client’s pedal pulse is palpable.
,c. The puncture site has a small, 2-cm hematoma.
d. The client reports numbness and tingling in the foot.
Answer: d. The client reports numbness and tingling in the foot.
Rationale: Numbness and tingling (paresthesia) indicate possible nerve
damage or decreased perfusion. This is a sign of potential arterial occlusion
and requires immediate assessment of the extremity.
6. Which ECG finding is characteristic of hypokalemia?
a. Tall, peaked T-waves
b. Prominent U-waves
c. Widened QRS complex
d. Prolonged PR interval
Answer: b. Prominent U-waves
Rationale: Prominent U-waves are a classic ECG sign of hypokalemia. Tall,
peaked T-waves are seen in hyperkalemia. Widened QRS and prolonged PR
intervals are associated with hyperkalemia and other electrolyte
disturbances.
7. A client with heart failure is experiencing dyspnea and frothy, pink-
tinged sputum. The nurse suspects acute pulmonary edema. What is
the priority nursing action?
a. Administer a bronchodilator.
b. Position the client in high Fowler's position.
c. Start a normal saline IV bolus.
d. Prepare for immediate intubation.
Answer: b. Position the client in high Fowler's position.
Rationale: High Fowler's position uses gravity to pull fluid from the lungs
to the lower extremities and abdomen, decreasing venous return and
alleviating dyspnea. This is the immediate first step. The IV should be kept
to a minimum, not given as a bolus.
, 8. A client is recovering from a myocardial infarction. The nurse notes
a new onset of a systolic murmur at the apex. Which complication
should the nurse suspect?
a. Cardiac tamponade
b. Ventricular aneurysm
c. Papillary muscle rupture
d. Pericarditis
Answer: c. Papillary muscle rupture
Rationale: Papillary muscle rupture is a complication of MI that leads to
acute mitral regurgitation. A new systolic murmur at the apex is the
hallmark sign. This is a medical emergency.
9. The nurse is teaching a client about atorvastatin (Lipitor). Which
instruction is most important?
a. Take the medication with grapefruit juice.
b. Monitor for muscle pain or weakness.
c. Take the medication at bedtime.
d. Expect to see results in 1-2 days.
Answer: b. Monitor for muscle pain or weakness.
Rationale: Muscle pain or weakness can be a sign of rhabdomyolysis, a
serious and potentially fatal side effect of statins. The client should report
this immediately.
10. A client with heart failure has a daily weight increase of 3 lbs (1.36
kg) in one day. The client also reports increased shortness of breath.
What is the nurse's best interpretation?
a. This is a normal fluctuation due to fluid intake.
b. The client is likely retaining fluid and may be experiencing worsening
heart failure.
2026-2027: Ultimate 200-Question
Practice Bank with Rationales
Section 1: Cardiovascular Disorders
1. A client with heart failure is prescribed furosemide (Lasix) and
digoxin (Lanoxin). Which laboratory value is most important for the
nurse to monitor?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
Answer: b. Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss.
Hypokalemia increases the risk of digoxin toxicity, which can lead to life-
threatening dysrhythmias.
2. A client is admitted with an acute myocardial infarction (MI). Which
medication should the nurse administer first?
a. Morphine sulfate
b. Nitroglycerin sublingual
c. Aspirin 324 mg chewed
d. Oxygen at 2 L/min
Answer: c. Aspirin 324 mg chewed
Rationale: Aspirin is a priority because it inhibits platelet aggregation and
,reduces mortality in acute MI. It should be given immediately upon
suspicion of MI. While morphine, nitroglycerin, and oxygen are also
important, aspirin is the initial, life-saving intervention.
3. A nurse is assessing a client with pericarditis. Which finding is a
classic manifestation of this condition?
a. Pain relieved by leaning forward
b. Pain that worsens with inspiration
c. A friction rub heard at the left lower sternal border
d. All of the above
Answer: d. All of the above
Rationale: Pericarditis is characterized by sharp, pleuritic chest pain that
worsens with inspiration and lying flat (relieved by leaning forward). A
pericardial friction rub is a hallmark auscultatory finding.
4. A client with hypertension is prescribed a beta-blocker. The nurse
should instruct the client to monitor for which adverse effect?
a. Tachycardia
b. Bronchospasm
c. Hyperglycemia
d. Hypokalemia
Answer: b. Bronchospasm
Rationale: Beta-blockers, especially non-selective ones, can cause
bronchospasm by blocking beta-2 receptors in the lungs. This is a
significant concern for clients with asthma or COPD.
5. The nurse is caring for a client 24 hours post-cardiac catheterization
via the femoral artery. Which assessment finding requires immediate
intervention?
a. The client reports a headache.
b. The client’s pedal pulse is palpable.
,c. The puncture site has a small, 2-cm hematoma.
d. The client reports numbness and tingling in the foot.
Answer: d. The client reports numbness and tingling in the foot.
Rationale: Numbness and tingling (paresthesia) indicate possible nerve
damage or decreased perfusion. This is a sign of potential arterial occlusion
and requires immediate assessment of the extremity.
6. Which ECG finding is characteristic of hypokalemia?
a. Tall, peaked T-waves
b. Prominent U-waves
c. Widened QRS complex
d. Prolonged PR interval
Answer: b. Prominent U-waves
Rationale: Prominent U-waves are a classic ECG sign of hypokalemia. Tall,
peaked T-waves are seen in hyperkalemia. Widened QRS and prolonged PR
intervals are associated with hyperkalemia and other electrolyte
disturbances.
7. A client with heart failure is experiencing dyspnea and frothy, pink-
tinged sputum. The nurse suspects acute pulmonary edema. What is
the priority nursing action?
a. Administer a bronchodilator.
b. Position the client in high Fowler's position.
c. Start a normal saline IV bolus.
d. Prepare for immediate intubation.
Answer: b. Position the client in high Fowler's position.
Rationale: High Fowler's position uses gravity to pull fluid from the lungs
to the lower extremities and abdomen, decreasing venous return and
alleviating dyspnea. This is the immediate first step. The IV should be kept
to a minimum, not given as a bolus.
, 8. A client is recovering from a myocardial infarction. The nurse notes
a new onset of a systolic murmur at the apex. Which complication
should the nurse suspect?
a. Cardiac tamponade
b. Ventricular aneurysm
c. Papillary muscle rupture
d. Pericarditis
Answer: c. Papillary muscle rupture
Rationale: Papillary muscle rupture is a complication of MI that leads to
acute mitral regurgitation. A new systolic murmur at the apex is the
hallmark sign. This is a medical emergency.
9. The nurse is teaching a client about atorvastatin (Lipitor). Which
instruction is most important?
a. Take the medication with grapefruit juice.
b. Monitor for muscle pain or weakness.
c. Take the medication at bedtime.
d. Expect to see results in 1-2 days.
Answer: b. Monitor for muscle pain or weakness.
Rationale: Muscle pain or weakness can be a sign of rhabdomyolysis, a
serious and potentially fatal side effect of statins. The client should report
this immediately.
10. A client with heart failure has a daily weight increase of 3 lbs (1.36
kg) in one day. The client also reports increased shortness of breath.
What is the nurse's best interpretation?
a. This is a normal fluctuation due to fluid intake.
b. The client is likely retaining fluid and may be experiencing worsening
heart failure.
