Chamberlain
UniversityNR-325:
Adult Health
IIComprehensive
Exam
Instructions: Read each question carefully and select the best answer. The correct
answer is bolded and followed by a rationale.
Section 1: Cardiovascular Disorders
1. A patient with acute myocardial infarction reports crushing chest pain. The
nurse understands the priority intervention is:
a. Obtain a dietary history
b. Assess pain after 8 hours
c. Ensure immediate cardiac assessment and oxygenation
d. Encourage ambulation
Rationale: Acute myocardial infarction is a medical emergency requiring rapid
assessment, oxygenation, ECG monitoring, and interventions to restore myocardial
perfusion .
,2. Which laboratory value is most specific for myocardial injury?
a. Hemoglobin
b. Troponin
c. Platelet count
d. Creatine kinase
Rationale: Troponin is highly sensitive and specific for cardiac muscle injury .
3. A patient with left-sided heart failure is most likely to exhibit:
a. Ascites
b. Jugular venous distention
c. Pulmonary crackles
d. Peripheral edema only
Rationale: Left ventricular failure causes pulmonary congestion and crackles .
4. Which finding is characteristic of right-sided heart failure?
a. Pulmonary crackles
b. Orthopnea
c. Jugular venous distention and peripheral edema
d. Hemoptysis
Rationale: Right-sided failure causes systemic venous congestion resulting in edema
and JVD .
5. A patient with atrial fibrillation is at greatest risk for:
a. Fractures
b. Hyperthyroidism
c. Embolic stroke
d. Bradycardia
Rationale: Blood pooling in the atria increases thrombus formation and embolic stroke
risk .
6. The nurse identifies which rhythm as life-threatening?
a. Normal sinus rhythm
b. Sinus bradycardia
,c. Ventricular fibrillation
d. Sinus tachycardia
Rationale: Ventricular fibrillation results in no effective cardiac output and requires
immediate defibrillation .
7. Cardiogenic shock results from:
a. Severe pump failure of the heart
b. Allergic reaction
c. Spinal cord injury
d. Severe hemorrhage
Rationale: Cardiogenic shock is caused by severe pump failure, resulting in inadequate
cardiac output and tissue perfusion .
8. A client with hypertension is started on lisinopril. Which adverse effect requires
immediate discontinuation?
a. Dry cough
b. Angioedema of the tongue
c. Hyperkalemia
d. Dizziness with standing
Rationale: Angioedema (lip/tongue/larynx swelling) is life-threatening and requires
immediate discontinuation of the ACE inhibitor and administration of epinephrine .
9. Which medication is most appropriate for acute chest pain due to myocardial
infarction?
a. Furosemide
b. Atenolol
c. Nitroglycerin
d. Warfarin
Rationale: Nitroglycerin dilates coronary arteries and reduces myocardial oxygen
demand, relieving ischemic chest pain .
10. A client with COPD has an SpO2 of 88% on 2L nasal cannula. ABG: pH 7.32,
PaCO2 68, HCO3 30. What is the priority intervention?
a. Increase O2 to 4L
b. Prepare for intubation
, c. Administer sodium bicarbonate
d. Maintain current O2 and assess for hypoventilation
Rationale: This represents compensated respiratory acidosis with mild hypoxemia.
Increasing O2 may remove hypoxic drive and worsen acidosis. Maintain current O2 and
monitor .
Section 2: Respiratory Disorders
11. A patient with COPD is receiving oxygen at 4 L/min via nasal cannula. The
nurse should monitor for which complication?
a. Respiratory acidosis
b. Metabolic acidosis
c. Hypoventilation
d. Pulmonary embolism
Rationale: High oxygen flow in COPD can suppress hypoxic drive, leading to
hypoventilation and CO2 retention .
12. A client with status asthmaticus is on continuous albuterol nebulizer. The nurse
notes a heart rate of 140 and tremors. The nurse should:
a. Continue the medication as ordered
b. Hold the medication and notify the provider
c. Increase the dose
d. Administer a beta-blocker
Rationale: Tachycardia and tremors are adverse effects of beta-agonists indicating
toxicity. The medication should be held and the provider notified .
13. A client with pneumonia has pleuritic chest pain. The nurse should instruct the
client to:
a. Take shallow breaths to reduce pain
b. Splint the chest when coughing
c. Lie on the unaffected side
d. Avoid deep breathing exercises
UniversityNR-325:
Adult Health
IIComprehensive
Exam
Instructions: Read each question carefully and select the best answer. The correct
answer is bolded and followed by a rationale.
Section 1: Cardiovascular Disorders
1. A patient with acute myocardial infarction reports crushing chest pain. The
nurse understands the priority intervention is:
a. Obtain a dietary history
b. Assess pain after 8 hours
c. Ensure immediate cardiac assessment and oxygenation
d. Encourage ambulation
Rationale: Acute myocardial infarction is a medical emergency requiring rapid
assessment, oxygenation, ECG monitoring, and interventions to restore myocardial
perfusion .
,2. Which laboratory value is most specific for myocardial injury?
a. Hemoglobin
b. Troponin
c. Platelet count
d. Creatine kinase
Rationale: Troponin is highly sensitive and specific for cardiac muscle injury .
3. A patient with left-sided heart failure is most likely to exhibit:
a. Ascites
b. Jugular venous distention
c. Pulmonary crackles
d. Peripheral edema only
Rationale: Left ventricular failure causes pulmonary congestion and crackles .
4. Which finding is characteristic of right-sided heart failure?
a. Pulmonary crackles
b. Orthopnea
c. Jugular venous distention and peripheral edema
d. Hemoptysis
Rationale: Right-sided failure causes systemic venous congestion resulting in edema
and JVD .
5. A patient with atrial fibrillation is at greatest risk for:
a. Fractures
b. Hyperthyroidism
c. Embolic stroke
d. Bradycardia
Rationale: Blood pooling in the atria increases thrombus formation and embolic stroke
risk .
6. The nurse identifies which rhythm as life-threatening?
a. Normal sinus rhythm
b. Sinus bradycardia
,c. Ventricular fibrillation
d. Sinus tachycardia
Rationale: Ventricular fibrillation results in no effective cardiac output and requires
immediate defibrillation .
7. Cardiogenic shock results from:
a. Severe pump failure of the heart
b. Allergic reaction
c. Spinal cord injury
d. Severe hemorrhage
Rationale: Cardiogenic shock is caused by severe pump failure, resulting in inadequate
cardiac output and tissue perfusion .
8. A client with hypertension is started on lisinopril. Which adverse effect requires
immediate discontinuation?
a. Dry cough
b. Angioedema of the tongue
c. Hyperkalemia
d. Dizziness with standing
Rationale: Angioedema (lip/tongue/larynx swelling) is life-threatening and requires
immediate discontinuation of the ACE inhibitor and administration of epinephrine .
9. Which medication is most appropriate for acute chest pain due to myocardial
infarction?
a. Furosemide
b. Atenolol
c. Nitroglycerin
d. Warfarin
Rationale: Nitroglycerin dilates coronary arteries and reduces myocardial oxygen
demand, relieving ischemic chest pain .
10. A client with COPD has an SpO2 of 88% on 2L nasal cannula. ABG: pH 7.32,
PaCO2 68, HCO3 30. What is the priority intervention?
a. Increase O2 to 4L
b. Prepare for intubation
, c. Administer sodium bicarbonate
d. Maintain current O2 and assess for hypoventilation
Rationale: This represents compensated respiratory acidosis with mild hypoxemia.
Increasing O2 may remove hypoxic drive and worsen acidosis. Maintain current O2 and
monitor .
Section 2: Respiratory Disorders
11. A patient with COPD is receiving oxygen at 4 L/min via nasal cannula. The
nurse should monitor for which complication?
a. Respiratory acidosis
b. Metabolic acidosis
c. Hypoventilation
d. Pulmonary embolism
Rationale: High oxygen flow in COPD can suppress hypoxic drive, leading to
hypoventilation and CO2 retention .
12. A client with status asthmaticus is on continuous albuterol nebulizer. The nurse
notes a heart rate of 140 and tremors. The nurse should:
a. Continue the medication as ordered
b. Hold the medication and notify the provider
c. Increase the dose
d. Administer a beta-blocker
Rationale: Tachycardia and tremors are adverse effects of beta-agonists indicating
toxicity. The medication should be held and the provider notified .
13. A client with pneumonia has pleuritic chest pain. The nurse should instruct the
client to:
a. Take shallow breaths to reduce pain
b. Splint the chest when coughing
c. Lie on the unaffected side
d. Avoid deep breathing exercises
