NUR 2502 / NUR2502 FINAL EXAM – EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027
Q&A | INSTANT DOWNLOAD PDF
1. A client with heart failure reports increasing shortness of breath when lying flat.
Which additional finding most strongly suggests worsening fluid congestion?
A. Dry mucous membranes
B. Weight loss of 2 kg in 3 days
C. New bilateral crackles in the lung bases
D. Increased urine output
Rationale: New bibasilar crackles indicate pulmonary fluid accumulation, a common
manifestation of worsening heart failure. Rapid weight gain would also suggest fluid retention,
whereas weight loss and increased urine output do not support worsening congestion.
2. A client with left-sided heart failure is being assessed during a routine visit. Which
finding requires the most immediate follow-up?
A. Oxygen saturation of 88% on room air
B. Mild ankle edema at the end of the day
C. Fatigue after walking several blocks
D. A 1-kg weight gain over one week
Rationale: An oxygen saturation of 88% indicates significant hypoxemia and may reflect
pulmonary congestion. The other findings can occur with chronic heart failure but are less
immediately threatening.
3. A client prescribed furosemide for heart failure should be monitored most closely
for which electrolyte abnormality?
A. Hypermagnesemia
B. Hypernatremia
C. Hypercalcemia
D. Hypokalemia
,Rationale: Furosemide is a loop diuretic that increases urinary potassium loss. Hypokalemia
can contribute to muscle weakness and potentially dangerous cardiac dysrhythmias.
4. A client taking digoxin reports nausea, poor appetite, and seeing yellow-green
halos around lights. How should the nurse interpret these findings?
A. Expected therapeutic effects
B. Possible digoxin toxicity
C. Evidence of improved cardiac output
D. Expected effects of potassium replacement
Rationale: Gastrointestinal symptoms and visual disturbances such as yellow or green halos are
classic warning signs of digoxin toxicity. The nurse should withhold further doses as appropriate
and notify the provider.
5. Before administering digoxin, which assessment is most important?
A. Respiratory depth
B. Bowel sounds
C. Apical heart rate
D. Peripheral temperature
Rationale: Digoxin can decrease heart rate and cause bradycardia. The apical pulse should be
assessed before administration according to prescribed parameters.
6. A client with acute pulmonary edema is severely dyspneic and producing pink,
frothy sputum. Which position should the nurse use initially?
A. Supine with legs elevated
B. Prone with the head turned
C. Flat with the knees flexed
D. High-Fowler position with the legs dependent
Rationale: High-Fowler positioning improves lung expansion, while allowing the legs to remain
dependent can reduce venous return and cardiac workload. Supine positioning can worsen
pulmonary congestion.
, 7. A client experiencing stable angina asks why nitroglycerin is prescribed. Which
explanation is most accurate?
A. It decreases myocardial oxygen demand and improves coronary blood flow.
B. It increases the heart's need for oxygen.
C. It permanently removes atherosclerotic plaques.
D. It increases blood volume returning to the heart.
Rationale: Nitroglycerin primarily causes vasodilation, reducing preload and myocardial
oxygen demand while improving coronary perfusion. It does not remove atherosclerotic plaques.
8. A client reports crushing substernal chest pressure accompanied by diaphoresis
and nausea. What is the priority nursing action?
A. Encourage the client to walk to relieve the discomfort.
B. Provide a meal to prevent hypoglycemia.
C. Assess the client promptly and activate the appropriate emergency response.
D. Ask the client to return for an appointment tomorrow.
Rationale: Crushing chest pressure with autonomic symptoms is concerning for acute coronary
syndrome. Prompt assessment and emergency management are required to limit myocardial
injury.
9. Which laboratory marker is particularly useful when evaluating suspected
myocardial injury?
A. Serum albumin
B. Cardiac troponin
C. Serum bilirubin
D. Hemoglobin A1c
Rationale: Cardiac troponins are highly sensitive and specific markers of myocardial injury. The
other laboratory values evaluate different physiologic conditions.
10. A client has a new prescription for an angiotensin-converting enzyme inhibitor.
Which adverse effect should the nurse emphasize when providing teaching?
, A. Orange discoloration of urine
B. Severe constipation
C. Increased appetite
D. Persistent dry cough
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors because of
increased bradykinin activity. Angioedema is another serious reaction requiring immediate
attention.
11. A client receiving an ACE inhibitor develops swelling of the lips and tongue. What
is the priority response?
A. Treat the finding as a potential airway emergency.
B. Document it as an expected mild effect.
C. Encourage the client to drink additional fluids.
D. Administer the next dose with food.
Rationale: Lip and tongue swelling can indicate ACE-inhibitor-associated angioedema, which
may rapidly compromise the airway. Immediate evaluation and emergency management are
necessary.
12. A client with peripheral arterial disease reports calf pain when walking that
resolves with rest. This symptom is known as:
A. Orthopnea
B. Venous stasis
C. Intermittent claudication
D. Dependent edema
Rationale: Intermittent claudication is exertional muscle pain caused by inadequate arterial
blood flow and typically improves when the activity stops.
13. Which assessment finding is more characteristic of chronic venous insufficiency
than peripheral arterial disease?
A. Cool, pale extremities
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALE | 2027
Q&A | INSTANT DOWNLOAD PDF
1. A client with heart failure reports increasing shortness of breath when lying flat.
Which additional finding most strongly suggests worsening fluid congestion?
A. Dry mucous membranes
B. Weight loss of 2 kg in 3 days
C. New bilateral crackles in the lung bases
D. Increased urine output
Rationale: New bibasilar crackles indicate pulmonary fluid accumulation, a common
manifestation of worsening heart failure. Rapid weight gain would also suggest fluid retention,
whereas weight loss and increased urine output do not support worsening congestion.
2. A client with left-sided heart failure is being assessed during a routine visit. Which
finding requires the most immediate follow-up?
A. Oxygen saturation of 88% on room air
B. Mild ankle edema at the end of the day
C. Fatigue after walking several blocks
D. A 1-kg weight gain over one week
Rationale: An oxygen saturation of 88% indicates significant hypoxemia and may reflect
pulmonary congestion. The other findings can occur with chronic heart failure but are less
immediately threatening.
3. A client prescribed furosemide for heart failure should be monitored most closely
for which electrolyte abnormality?
A. Hypermagnesemia
B. Hypernatremia
C. Hypercalcemia
D. Hypokalemia
,Rationale: Furosemide is a loop diuretic that increases urinary potassium loss. Hypokalemia
can contribute to muscle weakness and potentially dangerous cardiac dysrhythmias.
4. A client taking digoxin reports nausea, poor appetite, and seeing yellow-green
halos around lights. How should the nurse interpret these findings?
A. Expected therapeutic effects
B. Possible digoxin toxicity
C. Evidence of improved cardiac output
D. Expected effects of potassium replacement
Rationale: Gastrointestinal symptoms and visual disturbances such as yellow or green halos are
classic warning signs of digoxin toxicity. The nurse should withhold further doses as appropriate
and notify the provider.
5. Before administering digoxin, which assessment is most important?
A. Respiratory depth
B. Bowel sounds
C. Apical heart rate
D. Peripheral temperature
Rationale: Digoxin can decrease heart rate and cause bradycardia. The apical pulse should be
assessed before administration according to prescribed parameters.
6. A client with acute pulmonary edema is severely dyspneic and producing pink,
frothy sputum. Which position should the nurse use initially?
A. Supine with legs elevated
B. Prone with the head turned
C. Flat with the knees flexed
D. High-Fowler position with the legs dependent
Rationale: High-Fowler positioning improves lung expansion, while allowing the legs to remain
dependent can reduce venous return and cardiac workload. Supine positioning can worsen
pulmonary congestion.
, 7. A client experiencing stable angina asks why nitroglycerin is prescribed. Which
explanation is most accurate?
A. It decreases myocardial oxygen demand and improves coronary blood flow.
B. It increases the heart's need for oxygen.
C. It permanently removes atherosclerotic plaques.
D. It increases blood volume returning to the heart.
Rationale: Nitroglycerin primarily causes vasodilation, reducing preload and myocardial
oxygen demand while improving coronary perfusion. It does not remove atherosclerotic plaques.
8. A client reports crushing substernal chest pressure accompanied by diaphoresis
and nausea. What is the priority nursing action?
A. Encourage the client to walk to relieve the discomfort.
B. Provide a meal to prevent hypoglycemia.
C. Assess the client promptly and activate the appropriate emergency response.
D. Ask the client to return for an appointment tomorrow.
Rationale: Crushing chest pressure with autonomic symptoms is concerning for acute coronary
syndrome. Prompt assessment and emergency management are required to limit myocardial
injury.
9. Which laboratory marker is particularly useful when evaluating suspected
myocardial injury?
A. Serum albumin
B. Cardiac troponin
C. Serum bilirubin
D. Hemoglobin A1c
Rationale: Cardiac troponins are highly sensitive and specific markers of myocardial injury. The
other laboratory values evaluate different physiologic conditions.
10. A client has a new prescription for an angiotensin-converting enzyme inhibitor.
Which adverse effect should the nurse emphasize when providing teaching?
, A. Orange discoloration of urine
B. Severe constipation
C. Increased appetite
D. Persistent dry cough
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors because of
increased bradykinin activity. Angioedema is another serious reaction requiring immediate
attention.
11. A client receiving an ACE inhibitor develops swelling of the lips and tongue. What
is the priority response?
A. Treat the finding as a potential airway emergency.
B. Document it as an expected mild effect.
C. Encourage the client to drink additional fluids.
D. Administer the next dose with food.
Rationale: Lip and tongue swelling can indicate ACE-inhibitor-associated angioedema, which
may rapidly compromise the airway. Immediate evaluation and emergency management are
necessary.
12. A client with peripheral arterial disease reports calf pain when walking that
resolves with rest. This symptom is known as:
A. Orthopnea
B. Venous stasis
C. Intermittent claudication
D. Dependent edema
Rationale: Intermittent claudication is exertional muscle pain caused by inadequate arterial
blood flow and typically improves when the activity stops.
13. Which assessment finding is more characteristic of chronic venous insufficiency
than peripheral arterial disease?
A. Cool, pale extremities
