Walden NURS 3040 Adult Health
Nursing Final Exam Practice Examination
2026–2027 Comprehensive Question
Practice Test with Answers & Rationales
Free Pdf Access
NURS 3040 Adult Health Nursing Final
Practice Examination
1. Heart Failure
A patient with left-sided heart failure suddenly develops severe dyspnea, bilateral crackles, and
pink frothy sputum. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the patient in high-Fowler's position and administer oxygen as prescribed
C. Place the patient flat
D. Encourage ambulation
Answer: B
Rationale: The findings indicate acute pulmonary edema. Upright positioning improves lung
expansion and decreases venous return, while oxygen supports gas exchange.
2. Acute Myocardial Infarction
Which finding is most concerning in a patient experiencing an acute myocardial infarction?
A. Mild nausea
B. Occasional fatigue
C. New-onset ventricular tachycardia
D. Heart rate of 78/min
Answer: C
,Rationale: Ventricular tachycardia can significantly reduce cardiac output and may progress to
ventricular fibrillation and cardiac arrest.
3. Nitroglycerin
A patient taking sublingual nitroglycerin reports that chest pain remains severe after the first
dose. What should the nurse do?
A. Tell the patient to wait several hours
B. Have the patient take aspirin only
C. Activate emergency evaluation according to protocol
D. Encourage exercise
Answer: C
Rationale: Persistent chest pain despite initial nitroglycerin may indicate ongoing myocardial
ischemia and requires urgent evaluation.
4. Hypertension
Which patient requires the most immediate assessment?
A. BP 138/84 mmHg with no symptoms
B. BP 150/90 mmHg with mild headache
C. BP 226/124 mmHg with confusion and visual changes
D. BP 142/88 mmHg after exercise
Answer: C
Rationale: Severe hypertension accompanied by neurologic symptoms suggests possible
hypertensive emergency with target-organ injury.
5. ACE Inhibitor
A patient taking lisinopril develops swelling of the lips and tongue. What is the priority action?
A. Give the next dose with food
B. Hold the medication and obtain emergency assistance
C. Encourage increased fluid intake
D. Document the finding as expected
Answer: B
Rationale: Facial and tongue swelling can represent ACE-inhibitor-associated angioedema,
which can rapidly compromise the airway.
,6. Dysrhythmia
Which ECG finding is most consistent with atrial fibrillation?
A. Regular rhythm with identical P waves
B. Irregularly irregular rhythm with absent distinct P waves
C. Wide QRS complexes at 30/min
D. Regular rhythm with sawtooth waves
Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular ventricular rhythm and
no consistent P waves.
7. Bradycardia
A patient has a heart rate of 38/min, dizziness, and hypotension. What is the priority?
A. Encourage ambulation
B. Prepare for emergency treatment of symptomatic bradycardia
C. Give oral fluids
D. Reassess in 4 hours
Answer: B
Rationale: Bradycardia accompanied by hypotension and dizziness indicates inadequate cardiac
output and requires prompt intervention.
8. Peripheral Arterial Disease
Which finding is characteristic of peripheral arterial disease?
A. Warm legs with bilateral edema
B. Brown pigmentation around the ankles
C. Intermittent claudication and diminished peripheral pulses
D. Bounding pedal pulses
Answer: C
Rationale: Arterial insufficiency commonly causes diminished pulses, cool extremities, and pain
with activity that improves with rest.
9. Venous Insufficiency
Which finding is most consistent with chronic venous insufficiency?
A. Dependent edema and brown skin discoloration
B. Absent pulses and severe ischemic pain
, C. Pale foot with elevation
D. Sudden unilateral chest pain
Answer: A
Rationale: Venous hypertension commonly causes dependent edema, stasis changes, and brown
pigmentation from hemosiderin deposition.
10. Deep Vein Thrombosis
A patient has unilateral calf swelling, warmth, and pain. Which action should the nurse avoid?
A. Notify the healthcare provider
B. Massage the affected calf
C. Assess the extremity
D. Monitor respiratory status
Answer: B
Rationale: Massage could dislodge a thrombus and potentially cause a pulmonary embolism.
11. Pulmonary Embolism
Which finding suggests pulmonary embolism?
A. Gradual ankle edema
B. Sudden dyspnea, pleuritic chest pain, and tachycardia
C. Chronic productive cough
D. Bradycardia after sleeping
Answer: B
Rationale: Sudden respiratory distress, pleuritic chest pain, tachycardia, and hypoxemia are
classic concerning findings for pulmonary embolism.
12. Heparin
Which laboratory test is commonly used to monitor unfractionated heparin therapy?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Serum sodium
Answer: B
Rationale: The activated partial thromboplastin time is commonly used to monitor
unfractionated heparin.
Nursing Final Exam Practice Examination
2026–2027 Comprehensive Question
Practice Test with Answers & Rationales
Free Pdf Access
NURS 3040 Adult Health Nursing Final
Practice Examination
1. Heart Failure
A patient with left-sided heart failure suddenly develops severe dyspnea, bilateral crackles, and
pink frothy sputum. What is the nurse's priority action?
A. Encourage oral fluids
B. Place the patient in high-Fowler's position and administer oxygen as prescribed
C. Place the patient flat
D. Encourage ambulation
Answer: B
Rationale: The findings indicate acute pulmonary edema. Upright positioning improves lung
expansion and decreases venous return, while oxygen supports gas exchange.
2. Acute Myocardial Infarction
Which finding is most concerning in a patient experiencing an acute myocardial infarction?
A. Mild nausea
B. Occasional fatigue
C. New-onset ventricular tachycardia
D. Heart rate of 78/min
Answer: C
,Rationale: Ventricular tachycardia can significantly reduce cardiac output and may progress to
ventricular fibrillation and cardiac arrest.
3. Nitroglycerin
A patient taking sublingual nitroglycerin reports that chest pain remains severe after the first
dose. What should the nurse do?
A. Tell the patient to wait several hours
B. Have the patient take aspirin only
C. Activate emergency evaluation according to protocol
D. Encourage exercise
Answer: C
Rationale: Persistent chest pain despite initial nitroglycerin may indicate ongoing myocardial
ischemia and requires urgent evaluation.
4. Hypertension
Which patient requires the most immediate assessment?
A. BP 138/84 mmHg with no symptoms
B. BP 150/90 mmHg with mild headache
C. BP 226/124 mmHg with confusion and visual changes
D. BP 142/88 mmHg after exercise
Answer: C
Rationale: Severe hypertension accompanied by neurologic symptoms suggests possible
hypertensive emergency with target-organ injury.
5. ACE Inhibitor
A patient taking lisinopril develops swelling of the lips and tongue. What is the priority action?
A. Give the next dose with food
B. Hold the medication and obtain emergency assistance
C. Encourage increased fluid intake
D. Document the finding as expected
Answer: B
Rationale: Facial and tongue swelling can represent ACE-inhibitor-associated angioedema,
which can rapidly compromise the airway.
,6. Dysrhythmia
Which ECG finding is most consistent with atrial fibrillation?
A. Regular rhythm with identical P waves
B. Irregularly irregular rhythm with absent distinct P waves
C. Wide QRS complexes at 30/min
D. Regular rhythm with sawtooth waves
Answer: B
Rationale: Atrial fibrillation classically produces an irregularly irregular ventricular rhythm and
no consistent P waves.
7. Bradycardia
A patient has a heart rate of 38/min, dizziness, and hypotension. What is the priority?
A. Encourage ambulation
B. Prepare for emergency treatment of symptomatic bradycardia
C. Give oral fluids
D. Reassess in 4 hours
Answer: B
Rationale: Bradycardia accompanied by hypotension and dizziness indicates inadequate cardiac
output and requires prompt intervention.
8. Peripheral Arterial Disease
Which finding is characteristic of peripheral arterial disease?
A. Warm legs with bilateral edema
B. Brown pigmentation around the ankles
C. Intermittent claudication and diminished peripheral pulses
D. Bounding pedal pulses
Answer: C
Rationale: Arterial insufficiency commonly causes diminished pulses, cool extremities, and pain
with activity that improves with rest.
9. Venous Insufficiency
Which finding is most consistent with chronic venous insufficiency?
A. Dependent edema and brown skin discoloration
B. Absent pulses and severe ischemic pain
, C. Pale foot with elevation
D. Sudden unilateral chest pain
Answer: A
Rationale: Venous hypertension commonly causes dependent edema, stasis changes, and brown
pigmentation from hemosiderin deposition.
10. Deep Vein Thrombosis
A patient has unilateral calf swelling, warmth, and pain. Which action should the nurse avoid?
A. Notify the healthcare provider
B. Massage the affected calf
C. Assess the extremity
D. Monitor respiratory status
Answer: B
Rationale: Massage could dislodge a thrombus and potentially cause a pulmonary embolism.
11. Pulmonary Embolism
Which finding suggests pulmonary embolism?
A. Gradual ankle edema
B. Sudden dyspnea, pleuritic chest pain, and tachycardia
C. Chronic productive cough
D. Bradycardia after sleeping
Answer: B
Rationale: Sudden respiratory distress, pleuritic chest pain, tachycardia, and hypoxemia are
classic concerning findings for pulmonary embolism.
12. Heparin
Which laboratory test is commonly used to monitor unfractionated heparin therapy?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Serum sodium
Answer: B
Rationale: The activated partial thromboplastin time is commonly used to monitor
unfractionated heparin.
