NUR 355 ACUTE & CHRONIC HEALTH
DISRUPTIONS IN ADULTS I – FINAL EXAM 5
| 75 QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
Q1: A client with left-sided heart failure is admitted with dyspnea and crackles in the lung
bases. Which assessment finding is most consistent with left-sided heart failure?
A. Jugular venous distention
B. Peripheral edema in the ankles
C. Productive cough with frothy pink sputum [CORRECT]
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, producing crackles,
dyspnea, orthopnea, and frothy pink sputum. Jugular venous distention, peripheral edema,
and hepatomegaly are classic signs of right-sided heart failure due to systemic venous
congestion.
Q2: The nurse is teaching a client with heart failure about daily weights. Which statement by
the client indicates understanding?
A. “I will weigh myself once a week in the evening.”
B. “A weight gain of 2 kg in one day means I need more fluid.”
C. “I will weigh myself every morning after voiding and before eating.” [CORRECT]
D. “Weight loss of 1 kg means I have lost muscle mass.”
Correct Answer: C
Rationale: Daily weights are the most sensitive indicator of fluid status in heart failure; 1 kg
equals approximately 1 L of fluid. Weights should be obtained at the same time each morning
after voiding and before breakfast, using the same scale and similar clothing.
Q3: A client’s BNP level is reported as 850 pg/mL. The nurse interprets this finding as most
indicative of which condition?
,A. Acute myocardial infarction
B. Heart failure [CORRECT]
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: BNP greater than 100 pg/mL is a sensitive marker of ventricular stretch and heart
failure. While other conditions may mildly elevate BNP, a level of 850 pg/mL strongly supports
the diagnosis of heart failure and guides treatment decisions.
Q4: A client with acute coronary syndrome reports chest pain that is unrelieved by three
doses of sublingual nitroglycerin. Which laboratory value is most useful in confirming
myocardial infarction?
A. Elevated BNP
B. Elevated troponin [CORRECT]
C. Decreased potassium
D. Elevated D-dimer
Correct Answer: B
Rationale: Troponin is the most specific and sensitive biomarker for myocardial injury and
remains elevated for days after MI. BNP reflects heart failure, D-dimer suggests thrombosis,
and potassium changes are nonspecific.
Q5: The nurse is caring for a client in atrial fibrillation with a rapid ventricular response.
Which medication is most appropriate to prevent thromboembolic complications?
A. Amiodarone
B. Digoxin
C. Warfarin [CORRECT]
D. Metoprolol
Correct Answer: C
Rationale: Atrial fibrillation predisposes to atrial thrombus formation and embolic stroke;
anticoagulation with warfarin (or a DOAC) is indicated for stroke prevention. Rate-control or
rhythm-control agents do not address the thrombotic risk.
, Q6: Which finding is most characteristic of right-sided heart failure?
A. Crackles in the lung bases
B. Orthopnea
C. Dependent peripheral edema [CORRECT]
D. Productive cough with frothy sputum
Correct Answer: C
Rationale: Right-sided heart failure causes systemic venous congestion, resulting in peripheral
edema, jugular venous distention, and hepatomegaly. Pulmonary symptoms are hallmark of
left-sided failure.
Q7: A client with hypertension is prescribed lisinopril. Which statement by the client indicates
the need for further teaching?
A. “I will rise slowly from a sitting position.”
B. “I will have my blood pressure checked regularly.”
C. “I can stop the medication once my blood pressure is normal.” [CORRECT]
D. “I will report a persistent dry cough to my provider.”
Correct Answer: C
Rationale: Antihypertensive therapy is usually lifelong; abrupt discontinuation can cause
rebound hypertension. Clients must understand the need for continued therapy even when
readings are normal.
Q8: The nurse prioritizes which intervention for a client with acute decompensated heart
failure and pulmonary edema?
A. Administer a loop diuretic as prescribed [CORRECT]
B. Encourage ambulation in the hallway
C. Restrict fluid to 3 L per day
D. Obtain a 12-lead ECG in 2 hours
Correct Answer: A
DISRUPTIONS IN ADULTS I – FINAL EXAM 5
| 75 QUESTIONS AND ANSWERS | 2026
UPDATE | WITH COMPLETE SOLUTIONS.
Q1: A client with left-sided heart failure is admitted with dyspnea and crackles in the lung
bases. Which assessment finding is most consistent with left-sided heart failure?
A. Jugular venous distention
B. Peripheral edema in the ankles
C. Productive cough with frothy pink sputum [CORRECT]
D. Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, producing crackles,
dyspnea, orthopnea, and frothy pink sputum. Jugular venous distention, peripheral edema,
and hepatomegaly are classic signs of right-sided heart failure due to systemic venous
congestion.
Q2: The nurse is teaching a client with heart failure about daily weights. Which statement by
the client indicates understanding?
A. “I will weigh myself once a week in the evening.”
B. “A weight gain of 2 kg in one day means I need more fluid.”
C. “I will weigh myself every morning after voiding and before eating.” [CORRECT]
D. “Weight loss of 1 kg means I have lost muscle mass.”
Correct Answer: C
Rationale: Daily weights are the most sensitive indicator of fluid status in heart failure; 1 kg
equals approximately 1 L of fluid. Weights should be obtained at the same time each morning
after voiding and before breakfast, using the same scale and similar clothing.
Q3: A client’s BNP level is reported as 850 pg/mL. The nurse interprets this finding as most
indicative of which condition?
,A. Acute myocardial infarction
B. Heart failure [CORRECT]
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: BNP greater than 100 pg/mL is a sensitive marker of ventricular stretch and heart
failure. While other conditions may mildly elevate BNP, a level of 850 pg/mL strongly supports
the diagnosis of heart failure and guides treatment decisions.
Q4: A client with acute coronary syndrome reports chest pain that is unrelieved by three
doses of sublingual nitroglycerin. Which laboratory value is most useful in confirming
myocardial infarction?
A. Elevated BNP
B. Elevated troponin [CORRECT]
C. Decreased potassium
D. Elevated D-dimer
Correct Answer: B
Rationale: Troponin is the most specific and sensitive biomarker for myocardial injury and
remains elevated for days after MI. BNP reflects heart failure, D-dimer suggests thrombosis,
and potassium changes are nonspecific.
Q5: The nurse is caring for a client in atrial fibrillation with a rapid ventricular response.
Which medication is most appropriate to prevent thromboembolic complications?
A. Amiodarone
B. Digoxin
C. Warfarin [CORRECT]
D. Metoprolol
Correct Answer: C
Rationale: Atrial fibrillation predisposes to atrial thrombus formation and embolic stroke;
anticoagulation with warfarin (or a DOAC) is indicated for stroke prevention. Rate-control or
rhythm-control agents do not address the thrombotic risk.
, Q6: Which finding is most characteristic of right-sided heart failure?
A. Crackles in the lung bases
B. Orthopnea
C. Dependent peripheral edema [CORRECT]
D. Productive cough with frothy sputum
Correct Answer: C
Rationale: Right-sided heart failure causes systemic venous congestion, resulting in peripheral
edema, jugular venous distention, and hepatomegaly. Pulmonary symptoms are hallmark of
left-sided failure.
Q7: A client with hypertension is prescribed lisinopril. Which statement by the client indicates
the need for further teaching?
A. “I will rise slowly from a sitting position.”
B. “I will have my blood pressure checked regularly.”
C. “I can stop the medication once my blood pressure is normal.” [CORRECT]
D. “I will report a persistent dry cough to my provider.”
Correct Answer: C
Rationale: Antihypertensive therapy is usually lifelong; abrupt discontinuation can cause
rebound hypertension. Clients must understand the need for continued therapy even when
readings are normal.
Q8: The nurse prioritizes which intervention for a client with acute decompensated heart
failure and pulmonary edema?
A. Administer a loop diuretic as prescribed [CORRECT]
B. Encourage ambulation in the hallway
C. Restrict fluid to 3 L per day
D. Obtain a 12-lead ECG in 2 hours
Correct Answer: A
