,NR 324 Adult Health I Exam 2 | Chamberlain
College of Nursing | Latest 2026/2027 Update
(PDF)
1. A nurse is preparing a client for a cardiac catheterization. Which pre-procedure nursing action is the
priority?
A) Administer the client's morning dose of metformin
B) Assess the client for allergy to shellfish or iodine
C) Encourage the client to drink 2 liters of fluid
D) Apply a warming blanket to the client
Correct Answer: Assess the client for allergy to shellfish or iodine
Rationale: Cardiac catheterization uses iodine-based contrast media, and clients with shellfish or
iodine allergies may be at risk for an allergic reaction. The provider should be notified, and
premedication with antihistamines or corticosteroids may be ordered. Metformin is typically held 48
hours before and after the procedure to prevent lactic acidosis, fluids may be restricted, and warming
blankets are not a priority.
2. A client asks the nurse what an echocardiogram will evaluate. Which response by the nurse is most
accurate?
A) "This test evaluates the electrical activity of your heart."
B) "This test uses sound waves to create images of your heart's structure and function."
C) "This test measures the amount of oxygen in your blood."
D) "This test evaluates your heart's response to exercise."
Correct Answer: "This test uses sound waves to create images of your heart's structure and function."
Rationale: An echocardiogram uses ultrasound (sound waves) to visualize the heart's chambers,
valves, and wall motion, assessing structural and functional abnormalities. Electrical activity is
evaluated with an ECG, oxygen levels with ABGs, and exercise response with a stress test.
,3. A nurse is assessing a client's jugular venous pressure (JVP). Which technique is correct?
A) Elevate the head of the bed to 30-45 degrees and observe the neck
B) Elevate the head of the bed to 90 degrees and observe the neck
C) Have the client lie flat and observe the neck
D) Have the client turn their head to the side and observe the neck
Correct Answer: Elevate the head of the bed to 30-45 degrees and observe the neck
Rationale: JVP is best assessed with the head of the bed elevated to 30-45 degrees. The client should
be positioned so the sternal angle is at approximately 45 degrees, and the internal jugular vein
pulsations are observed. Elevating to 90 degrees or lying flat does not allow accurate visualization,
and turning the head can obscure the pulsations.
4. A client with a suspected myocardial infarction has a 12-lead ECG showing ST-segment elevation.
Which action should the nurse take first?
A) Administer sublingual nitroglycerin
B) Notify the healthcare provider immediately
C) Administer aspirin 325 mg chewed
D) Obtain a serum troponin level
Correct Answer: Notify the healthcare provider immediately
Rationale: ST-segment elevation indicates acute myocardial injury (STEMI) and requires immediate
reperfusion therapy. The nurse should notify the provider without delay to activate the cardiac
catheterization lab or administer thrombolytics. While aspirin, nitroglycerin, and troponin are
important, notification is the priority to initiate definitive treatment.
5. A nurse is assessing a client with left-sided heart failure. Which finding should the nurse expect?
A) Peripheral edema and jugular venous distention
B) Pulmonary congestion and orthopnea
, C) Hepatomegaly and ascites
D) Weight gain and dependent edema
Correct Answer: Pulmonary congestion and orthopnea
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation, leading to
pulmonary congestion, orthopnea, paroxysmal nocturnal dyspnea, and crackles. Peripheral edema,
JVD, hepatomegaly, and ascites are signs of right-sided heart failure.
6. A client is prescribed furosemide (Lasix) for heart failure. Which laboratory value should the nurse
monitor most closely?
A) Blood glucose
B) Serum potassium
C) Liver function tests
D) Platelet count
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia. The nurse
should monitor serum potassium levels and assess for signs of hypokalemia such as muscle weakness
and cardiac arrhythmias. Blood glucose, liver function, and platelet count are not directly affected by
furosemide.
7. A nurse is teaching a client about nitroglycerin administration for angina. Which statement by the
client indicates correct understanding?
A) "I should swallow the tablet with a full glass of water."
B) "I should take one tablet every 5 minutes, up to three doses, and call 911 if pain persists."
C) "I should take two tablets at the same time for severe pain."
D) "I should take the medication only if the pain lasts longer than 30 minutes."
Correct Answer: "I should take one tablet every 5 minutes, up to three doses, and call 911 if pain
persists."
College of Nursing | Latest 2026/2027 Update
(PDF)
1. A nurse is preparing a client for a cardiac catheterization. Which pre-procedure nursing action is the
priority?
A) Administer the client's morning dose of metformin
B) Assess the client for allergy to shellfish or iodine
C) Encourage the client to drink 2 liters of fluid
D) Apply a warming blanket to the client
Correct Answer: Assess the client for allergy to shellfish or iodine
Rationale: Cardiac catheterization uses iodine-based contrast media, and clients with shellfish or
iodine allergies may be at risk for an allergic reaction. The provider should be notified, and
premedication with antihistamines or corticosteroids may be ordered. Metformin is typically held 48
hours before and after the procedure to prevent lactic acidosis, fluids may be restricted, and warming
blankets are not a priority.
2. A client asks the nurse what an echocardiogram will evaluate. Which response by the nurse is most
accurate?
A) "This test evaluates the electrical activity of your heart."
B) "This test uses sound waves to create images of your heart's structure and function."
C) "This test measures the amount of oxygen in your blood."
D) "This test evaluates your heart's response to exercise."
Correct Answer: "This test uses sound waves to create images of your heart's structure and function."
Rationale: An echocardiogram uses ultrasound (sound waves) to visualize the heart's chambers,
valves, and wall motion, assessing structural and functional abnormalities. Electrical activity is
evaluated with an ECG, oxygen levels with ABGs, and exercise response with a stress test.
,3. A nurse is assessing a client's jugular venous pressure (JVP). Which technique is correct?
A) Elevate the head of the bed to 30-45 degrees and observe the neck
B) Elevate the head of the bed to 90 degrees and observe the neck
C) Have the client lie flat and observe the neck
D) Have the client turn their head to the side and observe the neck
Correct Answer: Elevate the head of the bed to 30-45 degrees and observe the neck
Rationale: JVP is best assessed with the head of the bed elevated to 30-45 degrees. The client should
be positioned so the sternal angle is at approximately 45 degrees, and the internal jugular vein
pulsations are observed. Elevating to 90 degrees or lying flat does not allow accurate visualization,
and turning the head can obscure the pulsations.
4. A client with a suspected myocardial infarction has a 12-lead ECG showing ST-segment elevation.
Which action should the nurse take first?
A) Administer sublingual nitroglycerin
B) Notify the healthcare provider immediately
C) Administer aspirin 325 mg chewed
D) Obtain a serum troponin level
Correct Answer: Notify the healthcare provider immediately
Rationale: ST-segment elevation indicates acute myocardial injury (STEMI) and requires immediate
reperfusion therapy. The nurse should notify the provider without delay to activate the cardiac
catheterization lab or administer thrombolytics. While aspirin, nitroglycerin, and troponin are
important, notification is the priority to initiate definitive treatment.
5. A nurse is assessing a client with left-sided heart failure. Which finding should the nurse expect?
A) Peripheral edema and jugular venous distention
B) Pulmonary congestion and orthopnea
, C) Hepatomegaly and ascites
D) Weight gain and dependent edema
Correct Answer: Pulmonary congestion and orthopnea
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation, leading to
pulmonary congestion, orthopnea, paroxysmal nocturnal dyspnea, and crackles. Peripheral edema,
JVD, hepatomegaly, and ascites are signs of right-sided heart failure.
6. A client is prescribed furosemide (Lasix) for heart failure. Which laboratory value should the nurse
monitor most closely?
A) Blood glucose
B) Serum potassium
C) Liver function tests
D) Platelet count
Correct Answer: Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia. The nurse
should monitor serum potassium levels and assess for signs of hypokalemia such as muscle weakness
and cardiac arrhythmias. Blood glucose, liver function, and platelet count are not directly affected by
furosemide.
7. A nurse is teaching a client about nitroglycerin administration for angina. Which statement by the
client indicates correct understanding?
A) "I should swallow the tablet with a full glass of water."
B) "I should take one tablet every 5 minutes, up to three doses, and call 911 if pain persists."
C) "I should take two tablets at the same time for severe pain."
D) "I should take the medication only if the pain lasts longer than 30 minutes."
Correct Answer: "I should take one tablet every 5 minutes, up to three doses, and call 911 if pain
persists."
