Walden NURS 3040 Adult Health
Nursing Midterm Exam Practice
Examination 2026–2027 Comprehensive
Question Practice Test with Answers &
Rationales Free Pdf Access
NURS 3040 Adult Health Nursing
Midterm Practice Examination 2026–2027
1. A client with heart failure suddenly develops severe dyspnea and pink, frothy sputum.
Which condition should the nurse suspect?
A. Stable angina
B. Pulmonary edema
C. Pneumothorax
D. Chronic bronchitis
Answer: B
Rationale: Acute pulmonary edema can occur with severe left-sided heart failure and causes
acute dyspnea, crackles, hypoxemia, and potentially pink, frothy sputum. This is an emergency
requiring rapid intervention.
2. Which assessment finding is most concerning in a client with chest pain?
A. Pain rated 2/10
B. Heart rate of 82/min
C. New ST-segment changes on ECG
D. Respiratory rate of 16/min
Answer: C
,Rationale: New ST-segment changes may indicate myocardial ischemia or infarction and
require immediate evaluation and treatment.
3. A client with suspected myocardial infarction reports crushing substernal chest pain.
What is the priority nursing action?
A. Encourage ambulation
B. Obtain or assist with an immediate ECG according to protocol
C. Give a large meal
D. Place the client in Trendelenburg position
Answer: B
Rationale: Rapid ECG assessment is essential in suspected acute coronary syndrome because it
helps identify ischemia or infarction and guides urgent treatment.
4. Which symptom is most characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver
D. Dependent peripheral edema only
Answer: A
Rationale: Left ventricular failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion, crackles, dyspnea, and orthopnea.
5. Which finding is commonly associated with right-sided heart failure?
A. Pulmonary edema only
B. Peripheral edema
C. Hemoptysis
D. Hyperventilation only
Answer: B
Rationale: Right-sided heart failure causes systemic venous congestion, which can produce
dependent edema, jugular venous distention, hepatomegaly, and ascites.
6. A client taking furosemide should be monitored closely for which electrolyte
abnormality?
A. Hyperkalemia
B. Hypokalemia
,C. Hypermagnesemia
D. Hypernatremia
Answer: B
Rationale: Furosemide is a loop diuretic that increases urinary sodium and potassium loss.
Hypokalemia can contribute to weakness and cardiac dysrhythmias.
7. Which assessment finding in a client receiving digoxin requires immediate attention?
A. Mild hunger
B. Yellow-green visual disturbances
C. Increased appetite
D. Dry skin
Answer: B
Rationale: Visual disturbances, nausea, vomiting, and dysrhythmias can occur with digoxin
toxicity. Yellow or green vision changes are a classic warning sign.
8. A client with COPD is receiving oxygen. Which principle is important?
A. Oxygen should always be withheld
B. Oxygen should be administered as prescribed while monitoring respiratory status
C. Oxygen should always be set at the highest flow rate
D. Oxygen is contraindicated in all COPD clients
Answer: B
Rationale: COPD clients may require supplemental oxygen. The nurse should administer the
prescribed amount and monitor oxygenation and respiratory status.
9. Which position generally facilitates breathing in a client experiencing severe dyspnea?
A. Supine
B. High-Fowler's
C. Prone
D. Trendelenburg
Answer: B
Rationale: High-Fowler's positioning promotes lung expansion and can reduce the work of
breathing.
10. Which finding is most suggestive of hypoxemia?
, A. Oxygen saturation of 98%
B. Restlessness and confusion
C. Warm, dry skin only
D. Heart rate of 60/min in an asymptomatic client
Answer: B
Rationale: Early hypoxemia may cause restlessness, anxiety, difficulty concentrating, and
confusion. Worsening hypoxemia can lead to cyanosis and decreased level of consciousness.
11. Which assessment finding is expected in a client experiencing an asthma exacerbation?
A. Expiratory wheezing
B. Bradycardia with no respiratory symptoms
C. Absent cough in every case
D. Increased bowel sounds
Answer: A
Rationale: Bronchoconstriction commonly causes wheezing, prolonged expiration, cough,
dyspnea, and chest tightness.
12. A client with asthma has severe respiratory distress and suddenly develops a “silent
chest.” What does this finding indicate?
A. Improvement
B. Severe airflow obstruction
C. Normal lung function
D. Resolution of bronchospasm
Answer: B
Rationale: A silent chest in severe asthma can indicate critically reduced airflow and impending
respiratory failure. It is an emergency finding.
13. Which intervention is appropriate for a client with pneumonia?
A. Encourage appropriate hydration if not contraindicated
B. Keep the client completely immobile
C. Avoid coughing
D. Restrict all fluids regardless of condition
Answer: A
Rationale: Adequate hydration, when clinically appropriate, can help maintain thinner
respiratory secretions and facilitate airway clearance.
Nursing Midterm Exam Practice
Examination 2026–2027 Comprehensive
Question Practice Test with Answers &
Rationales Free Pdf Access
NURS 3040 Adult Health Nursing
Midterm Practice Examination 2026–2027
1. A client with heart failure suddenly develops severe dyspnea and pink, frothy sputum.
Which condition should the nurse suspect?
A. Stable angina
B. Pulmonary edema
C. Pneumothorax
D. Chronic bronchitis
Answer: B
Rationale: Acute pulmonary edema can occur with severe left-sided heart failure and causes
acute dyspnea, crackles, hypoxemia, and potentially pink, frothy sputum. This is an emergency
requiring rapid intervention.
2. Which assessment finding is most concerning in a client with chest pain?
A. Pain rated 2/10
B. Heart rate of 82/min
C. New ST-segment changes on ECG
D. Respiratory rate of 16/min
Answer: C
,Rationale: New ST-segment changes may indicate myocardial ischemia or infarction and
require immediate evaluation and treatment.
3. A client with suspected myocardial infarction reports crushing substernal chest pain.
What is the priority nursing action?
A. Encourage ambulation
B. Obtain or assist with an immediate ECG according to protocol
C. Give a large meal
D. Place the client in Trendelenburg position
Answer: B
Rationale: Rapid ECG assessment is essential in suspected acute coronary syndrome because it
helps identify ischemia or infarction and guides urgent treatment.
4. Which symptom is most characteristic of left-sided heart failure?
A. Pulmonary crackles
B. Ascites only
C. Enlarged liver
D. Dependent peripheral edema only
Answer: A
Rationale: Left ventricular failure causes blood to back up into the pulmonary circulation,
producing pulmonary congestion, crackles, dyspnea, and orthopnea.
5. Which finding is commonly associated with right-sided heart failure?
A. Pulmonary edema only
B. Peripheral edema
C. Hemoptysis
D. Hyperventilation only
Answer: B
Rationale: Right-sided heart failure causes systemic venous congestion, which can produce
dependent edema, jugular venous distention, hepatomegaly, and ascites.
6. A client taking furosemide should be monitored closely for which electrolyte
abnormality?
A. Hyperkalemia
B. Hypokalemia
,C. Hypermagnesemia
D. Hypernatremia
Answer: B
Rationale: Furosemide is a loop diuretic that increases urinary sodium and potassium loss.
Hypokalemia can contribute to weakness and cardiac dysrhythmias.
7. Which assessment finding in a client receiving digoxin requires immediate attention?
A. Mild hunger
B. Yellow-green visual disturbances
C. Increased appetite
D. Dry skin
Answer: B
Rationale: Visual disturbances, nausea, vomiting, and dysrhythmias can occur with digoxin
toxicity. Yellow or green vision changes are a classic warning sign.
8. A client with COPD is receiving oxygen. Which principle is important?
A. Oxygen should always be withheld
B. Oxygen should be administered as prescribed while monitoring respiratory status
C. Oxygen should always be set at the highest flow rate
D. Oxygen is contraindicated in all COPD clients
Answer: B
Rationale: COPD clients may require supplemental oxygen. The nurse should administer the
prescribed amount and monitor oxygenation and respiratory status.
9. Which position generally facilitates breathing in a client experiencing severe dyspnea?
A. Supine
B. High-Fowler's
C. Prone
D. Trendelenburg
Answer: B
Rationale: High-Fowler's positioning promotes lung expansion and can reduce the work of
breathing.
10. Which finding is most suggestive of hypoxemia?
, A. Oxygen saturation of 98%
B. Restlessness and confusion
C. Warm, dry skin only
D. Heart rate of 60/min in an asymptomatic client
Answer: B
Rationale: Early hypoxemia may cause restlessness, anxiety, difficulty concentrating, and
confusion. Worsening hypoxemia can lead to cyanosis and decreased level of consciousness.
11. Which assessment finding is expected in a client experiencing an asthma exacerbation?
A. Expiratory wheezing
B. Bradycardia with no respiratory symptoms
C. Absent cough in every case
D. Increased bowel sounds
Answer: A
Rationale: Bronchoconstriction commonly causes wheezing, prolonged expiration, cough,
dyspnea, and chest tightness.
12. A client with asthma has severe respiratory distress and suddenly develops a “silent
chest.” What does this finding indicate?
A. Improvement
B. Severe airflow obstruction
C. Normal lung function
D. Resolution of bronchospasm
Answer: B
Rationale: A silent chest in severe asthma can indicate critically reduced airflow and impending
respiratory failure. It is an emergency finding.
13. Which intervention is appropriate for a client with pneumonia?
A. Encourage appropriate hydration if not contraindicated
B. Keep the client completely immobile
C. Avoid coughing
D. Restrict all fluids regardless of condition
Answer: A
Rationale: Adequate hydration, when clinically appropriate, can help maintain thinner
respiratory secretions and facilitate airway clearance.
