,NSG 430 Exam 2 Adult Health Nursing II Questions And Answers
2026/2027 Grand canyon university
Q1. Which finding is most characteristic of acute decompensated
heart failure?
A) Acute pulmonary congestion with worsening dyspnea
B) Isolated bradycardia without respiratory changes
C) Increased urine output with improved exercise tolerance
D) Decreased preload accompanied by improved oxygenation
Correct Answer: A) Acute pulmonary congestion with worsening dyspnea
Rationale: Acute decompensated heart failure occurs when cardiac function
worsens enough to produce congestion and inadequate forward perfusion.
Pulmonary congestion commonly causes dyspnea and impaired oxygenation.
Q2. Which finding is most closely associated with right-sided heart
failure?
A) Bilateral crackles caused by pulmonary edema
B) Pink frothy sputum
C) Jugular venous distention and peripheral edema
D) Severe hemoptysis
Correct Answer: C) Jugular venous distention and peripheral edema
Rationale: Right-sided heart failure causes systemic venous congestion,
commonly producing jugular venous distention, dependent edema, weight
gain, and ascites.
Q3. Which assessment finding is most concerning in a client with
acute decompensated heart failure?
A) Mild ankle edema that is unchanged
B) Increasing dyspnea with crackles and falling oxygen saturation
C) Improved urine output
D) Stable blood pressure and respiratory rate
Correct Answer: B) Increasing dyspnea with crackles and falling oxygen
saturation
Rationale: Increasing respiratory distress and declining oxygenation
suggest worsening pulmonary congestion and possible pulmonary edema.
Q4. What is a major consequence of left-sided heart failure?
,A) Peripheral venous stasis without pulmonary effects
B) Increased renal filtration
C) Improved pulmonary circulation
D) Pulmonary congestion and impaired gas exchange
Correct Answer: D) Pulmonary congestion and impaired gas exchange
Rationale: Left ventricular dysfunction causes blood to back up into the
pulmonary circulation, producing pulmonary congestion, dyspnea, and
impaired gas exchange.
Q5. Which intervention is most appropriate for a client experiencing
acute pulmonary edema related to heart failure?
A) Place the client flat and encourage oral fluids.
B) Position the client upright and support oxygenation as prescribed.
C) Encourage ambulation to improve circulation.
D) Restrict all oxygen until laboratory studies return.
Correct Answer: B) Position the client upright and support oxygenation as
prescribed.
Rationale: Upright positioning reduces venous return and can improve lung
expansion, while oxygen and other prescribed therapies support gas
exchange.
Q6. Which medication class is commonly used to reduce fluid
overload in heart failure?
A) Diuretics
B) Antacids
C) Anticholinergics
D) Antitussives
Correct Answer: A) Diuretics
Rationale: Diuretics promote sodium and water excretion, reducing
intravascular and pulmonary congestion and helping relieve symptoms of
fluid overload.
Q7. A client receives furosemide 40 mg IV. The vial contains 10
mg/mL. How many milliliters should the nurse administer?
A) 2 mL
B) 3 mL
, C) 3.5 mL
D) 4 mL
Correct Answer: D) 4 mL
Rationale: The required volume is calculated as 40 mg ÷ 10 mg/mL = 4 mL.
Q8. Which finding best indicates that diuretic therapy for heart
failure is producing the desired effect?
A) Increasing crackles and weight gain
B) Decreased oxygen saturation
C) Reduced edema with improved breathing and urine output
D) Increasing jugular venous distention
Correct Answer: C) Reduced edema with improved breathing and urine
output
Rationale: Effective diuresis decreases fluid overload, which should improve
congestion, edema, respiratory symptoms, and urine output.
Q9. A client with heart failure has an echocardiogram showing
reduced left ventricular ejection fraction. Which type of heart failure
does this most strongly suggest?
A) HFrEF
B) HFpEF
C) Isolated right-sided failure
D) High-output failure
Correct Answer: A) HFrEF
Rationale: Heart failure with reduced ejection fraction reflects impaired
systolic contraction and decreased ventricular pumping ability.
Q10. Which finding is most consistent with HFpEF?
A) Severely reduced ventricular contraction as the defining feature
B) Impaired ventricular relaxation with relatively preserved ejection fraction
C) Complete absence of cardiac output
D) Primary pulmonary obstruction
Correct Answer: B) Impaired ventricular relaxation with relatively preserved
ejection fraction
Rationale: HFpEF is primarily associated with impaired ventricular filling and
relaxation despite a relatively preserved ejection fraction.
2026/2027 Grand canyon university
Q1. Which finding is most characteristic of acute decompensated
heart failure?
A) Acute pulmonary congestion with worsening dyspnea
B) Isolated bradycardia without respiratory changes
C) Increased urine output with improved exercise tolerance
D) Decreased preload accompanied by improved oxygenation
Correct Answer: A) Acute pulmonary congestion with worsening dyspnea
Rationale: Acute decompensated heart failure occurs when cardiac function
worsens enough to produce congestion and inadequate forward perfusion.
Pulmonary congestion commonly causes dyspnea and impaired oxygenation.
Q2. Which finding is most closely associated with right-sided heart
failure?
A) Bilateral crackles caused by pulmonary edema
B) Pink frothy sputum
C) Jugular venous distention and peripheral edema
D) Severe hemoptysis
Correct Answer: C) Jugular venous distention and peripheral edema
Rationale: Right-sided heart failure causes systemic venous congestion,
commonly producing jugular venous distention, dependent edema, weight
gain, and ascites.
Q3. Which assessment finding is most concerning in a client with
acute decompensated heart failure?
A) Mild ankle edema that is unchanged
B) Increasing dyspnea with crackles and falling oxygen saturation
C) Improved urine output
D) Stable blood pressure and respiratory rate
Correct Answer: B) Increasing dyspnea with crackles and falling oxygen
saturation
Rationale: Increasing respiratory distress and declining oxygenation
suggest worsening pulmonary congestion and possible pulmonary edema.
Q4. What is a major consequence of left-sided heart failure?
,A) Peripheral venous stasis without pulmonary effects
B) Increased renal filtration
C) Improved pulmonary circulation
D) Pulmonary congestion and impaired gas exchange
Correct Answer: D) Pulmonary congestion and impaired gas exchange
Rationale: Left ventricular dysfunction causes blood to back up into the
pulmonary circulation, producing pulmonary congestion, dyspnea, and
impaired gas exchange.
Q5. Which intervention is most appropriate for a client experiencing
acute pulmonary edema related to heart failure?
A) Place the client flat and encourage oral fluids.
B) Position the client upright and support oxygenation as prescribed.
C) Encourage ambulation to improve circulation.
D) Restrict all oxygen until laboratory studies return.
Correct Answer: B) Position the client upright and support oxygenation as
prescribed.
Rationale: Upright positioning reduces venous return and can improve lung
expansion, while oxygen and other prescribed therapies support gas
exchange.
Q6. Which medication class is commonly used to reduce fluid
overload in heart failure?
A) Diuretics
B) Antacids
C) Anticholinergics
D) Antitussives
Correct Answer: A) Diuretics
Rationale: Diuretics promote sodium and water excretion, reducing
intravascular and pulmonary congestion and helping relieve symptoms of
fluid overload.
Q7. A client receives furosemide 40 mg IV. The vial contains 10
mg/mL. How many milliliters should the nurse administer?
A) 2 mL
B) 3 mL
, C) 3.5 mL
D) 4 mL
Correct Answer: D) 4 mL
Rationale: The required volume is calculated as 40 mg ÷ 10 mg/mL = 4 mL.
Q8. Which finding best indicates that diuretic therapy for heart
failure is producing the desired effect?
A) Increasing crackles and weight gain
B) Decreased oxygen saturation
C) Reduced edema with improved breathing and urine output
D) Increasing jugular venous distention
Correct Answer: C) Reduced edema with improved breathing and urine
output
Rationale: Effective diuresis decreases fluid overload, which should improve
congestion, edema, respiratory symptoms, and urine output.
Q9. A client with heart failure has an echocardiogram showing
reduced left ventricular ejection fraction. Which type of heart failure
does this most strongly suggest?
A) HFrEF
B) HFpEF
C) Isolated right-sided failure
D) High-output failure
Correct Answer: A) HFrEF
Rationale: Heart failure with reduced ejection fraction reflects impaired
systolic contraction and decreased ventricular pumping ability.
Q10. Which finding is most consistent with HFpEF?
A) Severely reduced ventricular contraction as the defining feature
B) Impaired ventricular relaxation with relatively preserved ejection fraction
C) Complete absence of cardiac output
D) Primary pulmonary obstruction
Correct Answer: B) Impaired ventricular relaxation with relatively preserved
ejection fraction
Rationale: HFpEF is primarily associated with impaired ventricular filling and
relaxation despite a relatively preserved ejection fraction.
