NUR 417 Final Exam (2026/2027) – Care of Adult II | Concordia University St. Paul | 100 Practice Questions with Verified Answers

NUR 417 FINAL EXAM (2026/2027) | CARE OF ADULT II |
CONCORDIA UNIVERSITY ST. PAUL (PDF):
EXAMS OF NURSING COMPREHENSIVE ASSESSMENT
Nursing Comprehensive Assessment • 100 Questions
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Introduction
The NUR 417 Final Examination in Care of Adult II evaluates a nursing student’s mastery of
complex adult health disorders and critical care decision making. Rather than testing recall in
isolation, the examination emphasizes applied professional judgment through realistic clinical
scenarios drawn from eight core domains: Complex Cardiovascular and Hemodynamic Disorders;
Advanced Respiratory and Pulmonary Pathophysiology; Neurological and Neurosurgical Care;
Endocrine and Metabolic Alterations; Gastrointestinal and Hepatic Disorders; Renal and Urological
Dysfunction; Oncology and Palliative Care; and Multisystem Complications and Critical Care
Nursing. Each scenario reflects decisions nurses encounter when balancing hemodynamic stability,
oxygenation, neurologic protection, metabolic correction, and compassionate end-of-life
coordination. Successful performance verifies a candidate’s competence for academic progression
and confirms the sound judgment required for adult health nursing clinical execution.

Question 1. The earliest indicator of worsening heart failure is:
A. Increasing dyspnea at rest with weight gain
B. Stable daily weight
C. Decreased jugular distention
D. Improved activity tolerance
Correct Answer: A — Increasing dyspnea at rest with weight gain
Rationale: Congestion raises breathlessness and weight. Improvement markers suggest
compensation.

Question 2. A patient in cardiogenic shock exhibits:
A. Bradycardia with high output
B. Hypotension with cool clammy extremities
C. Normal pressure with vasodilation
D. Hypertension with warm flushing
Correct Answer: B — Hypotension with cool clammy extremities
Rationale: Failing output vasoconstricts skin. Warm high-output states define other shocks.

Question 3. The priority assessment finding in aortic dissection is:
A. Tearing chest pain radiating to the back

, B. Painless gradual swelling
C. Sharp pain relieved by leaning forward
D. Pain worsening with inspiration only
Correct Answer: A — Tearing chest pain radiating to the back
Rationale: Dissection pain classically tears toward the back. Positional and pleuritic patterns
differ.

Question 4. Which laboratory value guides warfarin dosing?
A. Hemoglobin level
B. Activated partial thromboplastin time
C. International normalized ratio
D. Platelet count
Correct Answer: C — International normalized ratio
Rationale: The ratio tracks vitamin K pathway antagonism. PTT monitors heparin instead.

Question 5. A patient with an abdominal aortic aneurysm reports sudden severe back and flank
pain. The nurse should:
A. Prepare for immediate surgical evaluation
B. Apply a heating pad
C. Reassess in two hours
D. Encourage ambulation
Correct Answer: A — Prepare for immediate surgical evaluation
Rationale: New pain suggests expansion or rupture. Delay and comfort measures waste
survival time.

Question 6. The hallmark pressure finding in cardiac tamponade is:
A. Widened pulse pressure
B. Loud murmur with thrill
C. Bounding irregular apex
D. Pulsus paradoxus with muffled sounds
Correct Answer: D — Pulsus paradoxus with muffled sounds
Rationale: Pericardial fluid blunts filling on inspiration. The other signs point elsewhere.

Question 7. ST elevation in two contiguous leads indicates:
A. Normal variant in all adults
B. Old stable scar only
C. Pericarditis always
D. Acute coronary occlusion requiring reperfusion
Correct Answer: D — Acute coronary occlusion requiring reperfusion
Rationale: Elevation marks transmural injury. Reperfusion decisions follow immediately.

, Question 8. First-line drug therapy for chronic systolic heart failure includes:
A. Daily diuretics only forever
B. Pure digoxin monotherapy
C. ACE inhibitors with beta blockers
D. Oral calcium boluses alone
Correct Answer: C — ACE inhibitors with beta blockers
Rationale: Neurohormonal blockade extends survival. Single-agent routines under-treat.

Question 9. Atrial fibrillation risk is primarily from thromboembolic stroke, so treatment includes:
A. Lifetime antibiotic coverage
B. Chronic oxygen therapy
C. Anticoagulation per stroke risk scoring
D. Potassium supplementation
Correct Answer: C — Anticoagulation per stroke risk scoring
Rationale: Clot prevention anchors management. The alternatives target unrelated risks.

Question 10. After coronary artery bypass grafting, sternal precautions exist to prevent:
A. Peripheral neuropathy
B. Weight gain
C. Sternal wound dehiscence
D. Hair loss
Correct Answer: C — Sternal wound dehiscence
Rationale: Load limits protect bone healing. The other outcomes are unrelated to precautions.

Question 11. A new murmur with fever after dental work suggests:
A. Infective endocarditis
B. Benign flow murmur always
C. Mitral stenosis regression
D. Aortic dissection onset
Correct Answer: A — Infective endocarditis
Rationale: Bacteremia seeds valves. Regression and benign labels delay cultures.

Question 12. Hypertensive emergency management uses intravenous agents to lower pressure:
A. Instantly to normal within minutes
B. Only after symptoms vanish alone
C. Never in emergency settings
D. Controlled gradually within defined limits
Correct Answer: D — Controlled gradually within defined limits
Rationale: Rapid drops cause perfusion injury. Guided titration protects organs.