,NUR 242 Exam 2 Test Bank | Medical-Surgical
Nursing II | Galen College of Nursing | 2026/2027
Q&A Exam Prep PDF
1. A patient with heart failure has crackles in the lung bases and 3+ pitting edema. Which
laboratory value best indicates fluid volume status?
A) Serum sodium
B) Brain natriuretic peptide (BNP)
C) Blood urea nitrogen
D) Serum creatinine
Correct Answer: B) Brain natriuretic peptide (BNP)
Rationale: BNP is released from the ventricles in response to increased pressure and volume
overload. Elevated levels (>100 pg/mL) correlate with heart failure severity. Sodium, BUN, and
creatinine do not directly measure volume status in heart failure.
2. Which finding is most characteristic of left-sided heart failure?
A) Jugular vein distention
B) Ascites
C) Pulmonary congestion and dyspnea
D) Peripheral edema
,Correct Answer: C) Pulmonary congestion and dyspnea
Rationale: Left-sided failure backs up fluid into the lungs, causing crackles, orthopnea, and
paroxysmal nocturnal dyspnea. Right-sided failure leads to JVD, ascites, and peripheral edema.
3. A patient is taking digoxin for heart failure. Which symptom should the nurse report as a
potential sign of toxicity?
A) Increased appetite
B) Visual disturbances like yellow-green halos
C) Constipation
D) Hypertension
Correct Answer: B) Visual disturbances like yellow-green halos
Rationale: Common signs of digoxin toxicity include visual changes (yellow/green halos around
lights), nausea, vomiting, and bradycardia. Therapeutic range is 0.8-2.0 ng/mL. A heart rate
below 60 bpm should also be reported before administration.
4. Which laboratory value is most critical to monitor for a patient receiving furosemide (Lasix)?
A) Serum calcium
B) Serum sodium
C) Serum glucose
D) Serum potassium
, Correct Answer: D) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss; hypokalemia is a significant
risk factor for cardiac arrhythmias. Potassium levels should be monitored closely. Hyperkalemia
is associated with potassium-sparing diuretics and ACE inhibitors.
5. A patient newly prescribed lisinopril for hypertension develops a dry, persistent cough. What
is the nurse's best action?
A) Advise the patient to take the medication with food
B) Notify the provider as this is a common side effect of ACE inhibitors
C) Document the finding as a normal side effect
D) Instruct the patient to double the dose to suppress the cough
Correct Answer: B) Notify the provider as this is a common side effect of ACE inhibitors
Rationale: A dry cough is a common side effect of ACE inhibitors due to accumulation of
bradykinin and may require switching to an ARB. The provider should be notified for medication
adjustment; doubling the dose would not suppress the cough.
6. A nurse is interpreting a patient's cardiac rhythm strip. There are no P waves, and the QRS
complexes are irregularly irregular. This rhythm is:
A) Sinus bradycardia
B) Atrial fibrillation
Nursing II | Galen College of Nursing | 2026/2027
Q&A Exam Prep PDF
1. A patient with heart failure has crackles in the lung bases and 3+ pitting edema. Which
laboratory value best indicates fluid volume status?
A) Serum sodium
B) Brain natriuretic peptide (BNP)
C) Blood urea nitrogen
D) Serum creatinine
Correct Answer: B) Brain natriuretic peptide (BNP)
Rationale: BNP is released from the ventricles in response to increased pressure and volume
overload. Elevated levels (>100 pg/mL) correlate with heart failure severity. Sodium, BUN, and
creatinine do not directly measure volume status in heart failure.
2. Which finding is most characteristic of left-sided heart failure?
A) Jugular vein distention
B) Ascites
C) Pulmonary congestion and dyspnea
D) Peripheral edema
,Correct Answer: C) Pulmonary congestion and dyspnea
Rationale: Left-sided failure backs up fluid into the lungs, causing crackles, orthopnea, and
paroxysmal nocturnal dyspnea. Right-sided failure leads to JVD, ascites, and peripheral edema.
3. A patient is taking digoxin for heart failure. Which symptom should the nurse report as a
potential sign of toxicity?
A) Increased appetite
B) Visual disturbances like yellow-green halos
C) Constipation
D) Hypertension
Correct Answer: B) Visual disturbances like yellow-green halos
Rationale: Common signs of digoxin toxicity include visual changes (yellow/green halos around
lights), nausea, vomiting, and bradycardia. Therapeutic range is 0.8-2.0 ng/mL. A heart rate
below 60 bpm should also be reported before administration.
4. Which laboratory value is most critical to monitor for a patient receiving furosemide (Lasix)?
A) Serum calcium
B) Serum sodium
C) Serum glucose
D) Serum potassium
, Correct Answer: D) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss; hypokalemia is a significant
risk factor for cardiac arrhythmias. Potassium levels should be monitored closely. Hyperkalemia
is associated with potassium-sparing diuretics and ACE inhibitors.
5. A patient newly prescribed lisinopril for hypertension develops a dry, persistent cough. What
is the nurse's best action?
A) Advise the patient to take the medication with food
B) Notify the provider as this is a common side effect of ACE inhibitors
C) Document the finding as a normal side effect
D) Instruct the patient to double the dose to suppress the cough
Correct Answer: B) Notify the provider as this is a common side effect of ACE inhibitors
Rationale: A dry cough is a common side effect of ACE inhibitors due to accumulation of
bradykinin and may require switching to an ARB. The provider should be notified for medication
adjustment; doubling the dose would not suppress the cough.
6. A nurse is interpreting a patient's cardiac rhythm strip. There are no P waves, and the QRS
complexes are irregularly irregular. This rhythm is:
A) Sinus bradycardia
B) Atrial fibrillation
