https://www.stuvia.com/user/performance
MED SURG 2 FINAL EXAM Complete Original Study Guide &
EXAM Questions with Answers and Rationales
Section 1: Cardiovascular Disorders (Questions)
1. A nurse is assessing a client with left-sided heart failure.
Which finding is most expected?
A. Dependent edema
B. Jugular vein distention
C. Crackles in the lung bases
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure causes pulmonary
congestion, leading to crackles, dyspnea, and orthopnea.
Dependent edema, JVD, and hepatomegaly are signs of
right-sided heart failure.
2. A client is receiving nitroglycerin sublingual for chest pain.
The nurse should instruct the client to:
A. Swallow the tablet with water
B. Take one tablet every 5 minutes, up to 3 tablets, and call
,https://www.stuvia.com/user/performance
911 if pain persists
C. Lie flat after taking the medication
D. Expect a rapid heart rate and headache, which are signs
of allergy
Answer: B
Rationale: Sublingual nitroglycerin is given every 5
minutes up to 3 doses; if pain is unrelieved, emergency
services are needed. The tablet dissolves under the
tongue, not swallowed.
3. Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
Answer: B
Rationale: Troponin I and T are highly specific to cardiac
muscle and rise 3-12 hours after MI, remaining elevated
,https://www.stuvia.com/user/performance
for up to 2 weeks. CK-MB is less specific; BNP is for heart
failure.
4. A client with atrial fibrillation is at highest risk for which
complication?
A. Myocardial infarction
B. Stroke
C. Pulmonary embolism
D. Pericarditis
Answer: B
Rationale: Atrial fibrillation causes ineffective atrial
contraction, leading to blood stasis in the atria and clot
formation. Emboli can travel to the brain causing stroke.
5. The nurse is auscultating heart sounds. An S3 heart sound
is most likely indicative of:
A. Hypertension
B. Heart failure
C. Aortic stenosis
D. Mitral valve prolapse
Answer: B
, https://www.stuvia.com/user/performance
Rationale: An S3 (ventricular gallop) is an early diastolic
sound associated with volume overload and decreased
ventricular compliance, commonly heard in heart failure.
6. Which client should the nurse see first?
A. A client with stable angina who reports pain 4/10 after
walking
B. A client with heart failure who has gained 2 lb in 2 days
C. A client with new onset of chest pain unrelieved by rest
D. A client with hypertension whose BP is 150/90
Answer: C
Rationale: Unstable angina or possible MI is an
emergency. The client with new chest pain unrelieved by
rest needs immediate assessment and intervention.
7. A client is prescribed warfarin. The nurse should monitor
which laboratory value?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
MED SURG 2 FINAL EXAM Complete Original Study Guide &
EXAM Questions with Answers and Rationales
Section 1: Cardiovascular Disorders (Questions)
1. A nurse is assessing a client with left-sided heart failure.
Which finding is most expected?
A. Dependent edema
B. Jugular vein distention
C. Crackles in the lung bases
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure causes pulmonary
congestion, leading to crackles, dyspnea, and orthopnea.
Dependent edema, JVD, and hepatomegaly are signs of
right-sided heart failure.
2. A client is receiving nitroglycerin sublingual for chest pain.
The nurse should instruct the client to:
A. Swallow the tablet with water
B. Take one tablet every 5 minutes, up to 3 tablets, and call
,https://www.stuvia.com/user/performance
911 if pain persists
C. Lie flat after taking the medication
D. Expect a rapid heart rate and headache, which are signs
of allergy
Answer: B
Rationale: Sublingual nitroglycerin is given every 5
minutes up to 3 doses; if pain is unrelieved, emergency
services are needed. The tablet dissolves under the
tongue, not swallowed.
3. Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
Answer: B
Rationale: Troponin I and T are highly specific to cardiac
muscle and rise 3-12 hours after MI, remaining elevated
,https://www.stuvia.com/user/performance
for up to 2 weeks. CK-MB is less specific; BNP is for heart
failure.
4. A client with atrial fibrillation is at highest risk for which
complication?
A. Myocardial infarction
B. Stroke
C. Pulmonary embolism
D. Pericarditis
Answer: B
Rationale: Atrial fibrillation causes ineffective atrial
contraction, leading to blood stasis in the atria and clot
formation. Emboli can travel to the brain causing stroke.
5. The nurse is auscultating heart sounds. An S3 heart sound
is most likely indicative of:
A. Hypertension
B. Heart failure
C. Aortic stenosis
D. Mitral valve prolapse
Answer: B
, https://www.stuvia.com/user/performance
Rationale: An S3 (ventricular gallop) is an early diastolic
sound associated with volume overload and decreased
ventricular compliance, commonly heard in heart failure.
6. Which client should the nurse see first?
A. A client with stable angina who reports pain 4/10 after
walking
B. A client with heart failure who has gained 2 lb in 2 days
C. A client with new onset of chest pain unrelieved by rest
D. A client with hypertension whose BP is 150/90
Answer: C
Rationale: Unstable angina or possible MI is an
emergency. The client with new chest pain unrelieved by
rest needs immediate assessment and intervention.
7. A client is prescribed warfarin. The nurse should monitor
which laboratory value?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
