NSG 3500: Complex Adult Health
Nursing – Practice Exam with
questions and correct answers in bold
and rationale updated 2026
Topics: Cardiovascular, Respiratory, Neurological, Shock/Sepsis, Renal, Endocrine.
Section 1: Cardiovascular Disorders (Questions 1-20)
1. A patient is admitted with a suspected acute myocardial infarction (AMI). Which intervention
should the nurse perform first?
A. Administer sublingual nitroglycerin.
B. Obtain a 12-lead electrocardiogram (ECG).
C. Draw cardiac biomarker labs.
D. Start IV access.
Rationale: While all are important, the 12-lead ECG should be obtained within 10 minutes of arrival
to determine if the patient is a candidate for reperfusion therapy (PCI or fibrinolytics).
2. The nurse is caring for a patient with heart failure who is taking digoxin (Lanoxin). Which finding
would indicate digoxin toxicity?
A. Blood pressure of 140/90 mmHg.
B. Heart rate of 72 bpm.
C. Visual disturbances (yellow-green halos).
D. Increased urine output.
Rationale: Visual disturbances, nausea, vomiting, and bradycardia are classic signs of digoxin toxicity.
3. A patient with unstable angina is prescribed nitroglycerin. What instruction is most important for
the nurse to include?
,A. Take the medication with food.
B. Sit or lie down when taking the medication.
C. Expect a headache and ignore it.
D. Swallow the tablet whole.
Rationale: Nitroglycerin causes vasodilation and can lead to severe orthostatic hypotension; sitting
prevents falls.
4. Which dysrhythmia requires immediate defibrillation?
A. Atrial fibrillation.
B. Ventricular fibrillation.
C. Sinus tachycardia.
D. First-degree AV block.
Rationale: Ventricular fibrillation is a lethal dysrhythmia with no pulse; immediate defibrillation is
required for survival.
5. A patient returns from a cardiac catheterization via the right femoral artery. What is the priority
nursing assessment?
A. Check bowel sounds.
B. Assess the puncture site for bleeding and hematoma.
C. Encourage ambulation immediately.
D. Monitor urine color.
Rationale: Hemorrhage and hematoma formation at the access site are the most common and
dangerous complications post-cath.
6. The nurse hears a S3 heart sound in an older adult patient. What does this typically indicate?
A. Normal aging process.
B. Heart failure.
C. Hypertension.
D. Aortic stenosis.
, Rationale: An S3 in an adult usually indicates volume overload and ventricular failure.
7. A patient is diagnosed with peripheral artery disease (PAD). Which assessment finding is
expected?
A. Warm, flushed extremities.
B. Intermittent claudication.
C. Bounding pedal pulses.
D. Edema in the lower legs.
Rationale: Intermittent claudication (pain with walking that resolves with rest) is the hallmark
symptom of PAD.
8. Which laboratory value is most critical to monitor in a patient taking warfarin (Coumadin)?
A. Platelet count.
B. Hemoglobin.
C. INR.
D. Potassium.
Rationale: The International Normalized Ratio (INR) monitors the therapeutic effect of warfarin.
9. A patient with a deep vein thrombosis (DVT) suddenly complains of shortness of breath and chest
pain. What is the nurse's priority action?
A. Administer pain medication.
B. Elevate the head of the bed and notify the provider.
C. Massage the affected leg.
D. Encourage deep breathing.
Rationale: These are signs of a pulmonary embolism (PE), a life-threatening emergency.
10. What is the primary goal of therapy for a patient with hypertensive crisis?
A. Reduce BP to normal levels immediately.
Nursing – Practice Exam with
questions and correct answers in bold
and rationale updated 2026
Topics: Cardiovascular, Respiratory, Neurological, Shock/Sepsis, Renal, Endocrine.
Section 1: Cardiovascular Disorders (Questions 1-20)
1. A patient is admitted with a suspected acute myocardial infarction (AMI). Which intervention
should the nurse perform first?
A. Administer sublingual nitroglycerin.
B. Obtain a 12-lead electrocardiogram (ECG).
C. Draw cardiac biomarker labs.
D. Start IV access.
Rationale: While all are important, the 12-lead ECG should be obtained within 10 minutes of arrival
to determine if the patient is a candidate for reperfusion therapy (PCI or fibrinolytics).
2. The nurse is caring for a patient with heart failure who is taking digoxin (Lanoxin). Which finding
would indicate digoxin toxicity?
A. Blood pressure of 140/90 mmHg.
B. Heart rate of 72 bpm.
C. Visual disturbances (yellow-green halos).
D. Increased urine output.
Rationale: Visual disturbances, nausea, vomiting, and bradycardia are classic signs of digoxin toxicity.
3. A patient with unstable angina is prescribed nitroglycerin. What instruction is most important for
the nurse to include?
,A. Take the medication with food.
B. Sit or lie down when taking the medication.
C. Expect a headache and ignore it.
D. Swallow the tablet whole.
Rationale: Nitroglycerin causes vasodilation and can lead to severe orthostatic hypotension; sitting
prevents falls.
4. Which dysrhythmia requires immediate defibrillation?
A. Atrial fibrillation.
B. Ventricular fibrillation.
C. Sinus tachycardia.
D. First-degree AV block.
Rationale: Ventricular fibrillation is a lethal dysrhythmia with no pulse; immediate defibrillation is
required for survival.
5. A patient returns from a cardiac catheterization via the right femoral artery. What is the priority
nursing assessment?
A. Check bowel sounds.
B. Assess the puncture site for bleeding and hematoma.
C. Encourage ambulation immediately.
D. Monitor urine color.
Rationale: Hemorrhage and hematoma formation at the access site are the most common and
dangerous complications post-cath.
6. The nurse hears a S3 heart sound in an older adult patient. What does this typically indicate?
A. Normal aging process.
B. Heart failure.
C. Hypertension.
D. Aortic stenosis.
, Rationale: An S3 in an adult usually indicates volume overload and ventricular failure.
7. A patient is diagnosed with peripheral artery disease (PAD). Which assessment finding is
expected?
A. Warm, flushed extremities.
B. Intermittent claudication.
C. Bounding pedal pulses.
D. Edema in the lower legs.
Rationale: Intermittent claudication (pain with walking that resolves with rest) is the hallmark
symptom of PAD.
8. Which laboratory value is most critical to monitor in a patient taking warfarin (Coumadin)?
A. Platelet count.
B. Hemoglobin.
C. INR.
D. Potassium.
Rationale: The International Normalized Ratio (INR) monitors the therapeutic effect of warfarin.
9. A patient with a deep vein thrombosis (DVT) suddenly complains of shortness of breath and chest
pain. What is the nurse's priority action?
A. Administer pain medication.
B. Elevate the head of the bed and notify the provider.
C. Massage the affected leg.
D. Encourage deep breathing.
Rationale: These are signs of a pulmonary embolism (PE), a life-threatening emergency.
10. What is the primary goal of therapy for a patient with hypertensive crisis?
A. Reduce BP to normal levels immediately.
