,NU 189 EXAM 4 Medical-Surgical Nursing II Questions And Answers
2026/2027 Galen College
Q1. A client with acute pericarditis reports severe chest pain. Which
position should the nurse recommend?
A) Supine with the legs elevated
B) Sitting upright and leaning forward
C) Prone with the head turned
D) Trendelenburg position
Correct Answer: B) Sitting upright and leaning forward
Rationale: Sitting upright and leaning forward can reduce pressure and
irritation on the inflamed pericardium and commonly decreases pericardial
chest pain.
Q2. Which finding is most characteristic of acute pericarditis?
A) Chest pain that improves when leaning forward
B) Painless bilateral leg edema
C) Chest pain relieved by eating
D) Severe abdominal distention
Correct Answer: A) Chest pain that improves when leaning forward
Rationale: Pericardial inflammation produces sharp positional chest pain that
often worsens when lying flat and improves when sitting forward.
Q3. Which assessment finding is associated with cardiac
tamponade?
A) Hypertension, bounding pulses, and crackles
B) Hypotension, muffled heart sounds, and jugular venous distention
C) Bradycardia, warm skin, and increased urine output
D) Hyperthermia, wheezing, and hypertension
Correct Answer: B) Hypotension, muffled heart sounds, and jugular venous
distention
Rationale: Cardiac tamponade restricts ventricular filling and can produce
Beck's triad of hypotension, muffled heart sounds, and jugular venous
distention.
Q4. A client with cardiac tamponade is becoming hypotensive.
Which intervention should the nurse anticipate?
, A) Pericardiocentesis
B) Thoracentesis
C) Hemodialysis
D) Bronchoscopy
Correct Answer: A) Pericardiocentesis
Rationale: Pericardiocentesis removes excess fluid from the pericardial space
and relieves pressure on the heart.
Q5. Which condition can cause obstructive shock?
A) Cardiac tamponade
B) Iron-deficiency anemia
C) Hypothyroidism
D) Osteoarthritis
Correct Answer: A) Cardiac tamponade
Rationale: Cardiac tamponade mechanically prevents adequate cardiac filling
and reduces cardiac output, producing obstructive shock.
Q6. Which additional condition can cause obstructive shock?
A) Massive pulmonary embolism
B) Type 2 diabetes mellitus
C) Rheumatoid arthritis
D) Cataracts
Correct Answer: A) Massive pulmonary embolism
Rationale: A massive pulmonary embolism obstructs pulmonary circulation
and can severely impair right-heart output.
Q7. A client with stable angina reports chest discomfort while
walking. Which initial intervention is appropriate?
A) Encourage the client to continue exercising
B) Stop the activity and have the client rest
C) Place the client prone
D) Give a high-fat snack
Correct Answer: B) Stop the activity and have the client rest
Rationale: Stable angina is commonly triggered by exertion and improves
with rest because myocardial oxygen demand decreases.
2026/2027 Galen College
Q1. A client with acute pericarditis reports severe chest pain. Which
position should the nurse recommend?
A) Supine with the legs elevated
B) Sitting upright and leaning forward
C) Prone with the head turned
D) Trendelenburg position
Correct Answer: B) Sitting upright and leaning forward
Rationale: Sitting upright and leaning forward can reduce pressure and
irritation on the inflamed pericardium and commonly decreases pericardial
chest pain.
Q2. Which finding is most characteristic of acute pericarditis?
A) Chest pain that improves when leaning forward
B) Painless bilateral leg edema
C) Chest pain relieved by eating
D) Severe abdominal distention
Correct Answer: A) Chest pain that improves when leaning forward
Rationale: Pericardial inflammation produces sharp positional chest pain that
often worsens when lying flat and improves when sitting forward.
Q3. Which assessment finding is associated with cardiac
tamponade?
A) Hypertension, bounding pulses, and crackles
B) Hypotension, muffled heart sounds, and jugular venous distention
C) Bradycardia, warm skin, and increased urine output
D) Hyperthermia, wheezing, and hypertension
Correct Answer: B) Hypotension, muffled heart sounds, and jugular venous
distention
Rationale: Cardiac tamponade restricts ventricular filling and can produce
Beck's triad of hypotension, muffled heart sounds, and jugular venous
distention.
Q4. A client with cardiac tamponade is becoming hypotensive.
Which intervention should the nurse anticipate?
, A) Pericardiocentesis
B) Thoracentesis
C) Hemodialysis
D) Bronchoscopy
Correct Answer: A) Pericardiocentesis
Rationale: Pericardiocentesis removes excess fluid from the pericardial space
and relieves pressure on the heart.
Q5. Which condition can cause obstructive shock?
A) Cardiac tamponade
B) Iron-deficiency anemia
C) Hypothyroidism
D) Osteoarthritis
Correct Answer: A) Cardiac tamponade
Rationale: Cardiac tamponade mechanically prevents adequate cardiac filling
and reduces cardiac output, producing obstructive shock.
Q6. Which additional condition can cause obstructive shock?
A) Massive pulmonary embolism
B) Type 2 diabetes mellitus
C) Rheumatoid arthritis
D) Cataracts
Correct Answer: A) Massive pulmonary embolism
Rationale: A massive pulmonary embolism obstructs pulmonary circulation
and can severely impair right-heart output.
Q7. A client with stable angina reports chest discomfort while
walking. Which initial intervention is appropriate?
A) Encourage the client to continue exercising
B) Stop the activity and have the client rest
C) Place the client prone
D) Give a high-fat snack
Correct Answer: B) Stop the activity and have the client rest
Rationale: Stable angina is commonly triggered by exertion and improves
with rest because myocardial oxygen demand decreases.
