NU 185 Exam 3 - Medical-Surgical Nursing II Practice Quiz 2026/2027 UPDATE – Galen
1. A patient with left-sided heart failure is experiencing worsening dyspnea and crackles in
the lung bases. Which pathophysiological mechanism is responsible for these symptoms?
A. Increased systemic vascular resistance
B. Backup of blood into the pulmonary circulation
C. Peripheral venous congestion
D. Decreased renal perfusion causing fluid retention
Answer: B
Rationale: Left-sided heart failure causes the left ventricle to fail as a pump, leading to a
backup of blood into the left atrium and pulmonary veins, causing pulmonary edema and
respiratory symptoms.
2. A nurse is assessing a client with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Orthopnea
B. Wheezing and pink frothy sputum
C. Jugular venous distention
D. Paroxysmal nocturnal dyspnea
,Answer: C
Rationale: Right-sided heart failure causes blood to back up into the systemic venous
system, resulting in JVD, peripheral edema, and hepatomegaly.
3. A patient taking Digoxin for heart failure reports blurred vision and seeing yellow-green
halos. What is the priority nursing action?
A. Administer the next dose as scheduled
B. Assess the apical pulse and notify the provider
C. Encourage the patient to eat a banana
D. Document this as a common side effect
Answer: B
Rationale: Visual changes like yellow-green halos are classic signs of Digoxin toxicity. The
nurse must assess the patient and hold the medication until serum levels are checked.
4. Which laboratory value is the most specific indicator for acute myocardial infarction (MI)?
A. Troponin I
B. Myoglobin
C. B-type Natriuretic Peptide (BNP)
D. Creatine Kinase (CK-MB)
Answer: A
, Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated for
longer periods, making them the gold standard for diagnosing an MI.
5. A patient is admitted with a potassium level of 6.8 mEq/L. Which EKG change is the nurse
most likely to observe?
A. Prominent U waves
B. Shortened PR interval
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (high potassium) typically causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest if untreated.
6. A client presents with Peripheral Arterial Disease (PAD) and reports pain while walking that
is relieved by rest. How should the nurse document this finding?
A. Rest pain
B. Intermittent claudication
C. Venous insufficiency
D. Paresthesia
Answer: B
1. A patient with left-sided heart failure is experiencing worsening dyspnea and crackles in
the lung bases. Which pathophysiological mechanism is responsible for these symptoms?
A. Increased systemic vascular resistance
B. Backup of blood into the pulmonary circulation
C. Peripheral venous congestion
D. Decreased renal perfusion causing fluid retention
Answer: B
Rationale: Left-sided heart failure causes the left ventricle to fail as a pump, leading to a
backup of blood into the left atrium and pulmonary veins, causing pulmonary edema and
respiratory symptoms.
2. A nurse is assessing a client with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Orthopnea
B. Wheezing and pink frothy sputum
C. Jugular venous distention
D. Paroxysmal nocturnal dyspnea
,Answer: C
Rationale: Right-sided heart failure causes blood to back up into the systemic venous
system, resulting in JVD, peripheral edema, and hepatomegaly.
3. A patient taking Digoxin for heart failure reports blurred vision and seeing yellow-green
halos. What is the priority nursing action?
A. Administer the next dose as scheduled
B. Assess the apical pulse and notify the provider
C. Encourage the patient to eat a banana
D. Document this as a common side effect
Answer: B
Rationale: Visual changes like yellow-green halos are classic signs of Digoxin toxicity. The
nurse must assess the patient and hold the medication until serum levels are checked.
4. Which laboratory value is the most specific indicator for acute myocardial infarction (MI)?
A. Troponin I
B. Myoglobin
C. B-type Natriuretic Peptide (BNP)
D. Creatine Kinase (CK-MB)
Answer: A
, Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated for
longer periods, making them the gold standard for diagnosing an MI.
5. A patient is admitted with a potassium level of 6.8 mEq/L. Which EKG change is the nurse
most likely to observe?
A. Prominent U waves
B. Shortened PR interval
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (high potassium) typically causes peaked T waves, widened QRS
complexes, and potentially cardiac arrest if untreated.
6. A client presents with Peripheral Arterial Disease (PAD) and reports pain while walking that
is relieved by rest. How should the nurse document this finding?
A. Rest pain
B. Intermittent claudication
C. Venous insufficiency
D. Paresthesia
Answer: B
