CH AMBE R LAI N
U NI VE R SI TY
C O M P R E H E N S I V E C O U R S E E X A M I N AT I O N
Exam 2
NR 324 · Latest
Adult Health I
A 120-item comprehensive examination covering cardiovascular,
respiratory, fluid and electrolyte, gastrointestinal, renal,
endocrine, hematological, and perioperative nursing, with
detailed answer rationales aligned to the NCLEX-RN blueprint.
Course NR 324 — Adult Health I
Examination Exam 2 — Comprehensive
Total Questions 120 Multiple-Choice Items
Cognitive Mix 20% Recall · 50% Application · 30%
Analysis
Alignment NCLEX-RN Test Plan · QSEN
Competencies
2 0 2 0 2 7 AC A D E M I C Y E A R
,Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
EXAM 2 - NR324 / NR 324 (LATEST )
ADULT HEALTH I - CHAMBERLAIN UNIVERSITY
Comprehensive Course Examination | 120 Questions | Aligned with the Chamberlain University NR 324 Course Syllabus,
the NCLEX-RN Test Plan, QSEN Competencies, and Adult Health Nursing Standards (2026/2027 Edition)
Directions: Each question consists of a clinical stem followed by four options (A-D). Select the ONE best answer for
each item. The correct answer and a detailed rationale follow every question, so this examination also functions as a
study and remediation tool. Content is distributed across eight course sections, weighted to the NCLEX-RN blueprint
at approximately 20% recall, 50% application, and 30% analysis (prioritization, clinical reasoning, and critical
thinking). Special inclusions: 20 priority-setting items, 15 pharmacology items, and 10 laboratory value interpretation
items.
Section Questions Question Numbers
Cardiovascular Disorders 20 Q1-Q20
Respiratory Disorders 18 Q21-Q38
Fluid, Electrolyte, & Acid-Base Imbalances 15 Q39-Q53
Gastrointestinal Disorders 15 Q54-Q68
Renal & Genitourinary Disorders 15 Q69-Q83
Endocrine Disorders 15 Q84-Q98
Hematological Disorders 10 Q99-Q108
Perioperative Nursing 12 Q109-Q120
Section 1: Cardiovascular Disorders
20 Questions | Hypertension, Coronary Artery Disease, Angina, Myocardial Infarction, Heart Failure, Dysrhythmias, Valvular Disorders,
Peripheral Vascular Disease, DVT, Aneurysms, Shock, Cardiac Diagnostics, Interventions, and Medications
Q1. The nurse is providing discharge teaching to a 58-year-old client newly diagnosed with primary
hypertension (blood pressure 148/92 mm Hg) who will begin management with the DASH eating plan and
lifestyle modification. Which client statement indicates correct understanding of the teaching?
A. "I will check my blood pressure at home at the same time each day after resting quietly for 5 minutes."
[CORRECT]
B. "I can stop following the DASH eating plan once my blood pressure returns to the normal range."
C. "I should perform high-intensity aerobic exercise for 2 hours every day to lower my pressure quickly."
D. "I may add extra table salt to my food as long as I avoid salty snacks between meals."
Correct Answer: A
Rationale: Consistent home blood pressure monitoring after 5 minutes of quiet rest is a core component of the NR 324
Adult Health I hypertension management plan and supports early detection of worsening control (NCLEX-RN: Health
Promotion and Maintenance). The DASH plan is a lifelong pattern, not a temporary diet, so stopping it after improvement is
1
,Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
incorrect. Current guidelines recommend about 150 minutes of moderate-intensity activity per week, not 2 hours of
high-intensity exercise daily, and sodium restriction must include salt added during cooking and at the table, not just snacks.
Q2. A client with stable angina is being discharged with a new prescription for sublingual nitroglycerin. Which
client statement indicates a need for further teaching?
A. "I will sit or lie down before taking a tablet because the medication can make me dizzy."
B. "A headache after taking nitroglycerin is common and usually improves with continued use."
C. "I will call 911 if chest pain is not relieved 5 minutes after the first dose."
D. "I will keep my tablets in a clear plastic bottle in my car's glove box so they are easy to reach."
[CORRECT]
Correct Answer: D
Rationale: Nitroglycerin is volatile and degrades rapidly with exposure to light and heat, so tablets must be stored in the
original dark glass container away from heat sources such as a car glove box; potency loss leaves the client unprotected
during an anginal attack. Sitting down prevents orthostatic falls, headache is the most common adverse effect, and calling
emergency services when pain persists 5 minutes after the first dose reflects current resuscitation guidelines taught in the
NR 324 curriculum (NCLEX-RN: Pharmacological Therapies).
Q3. The nurse receives change-of-shift report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A 45-year-old with aortic stenosis scheduled for an echocardiogram this afternoon who reports mild
dizziness when walking to the bathroom
B. A 58-year-old reporting crushing substernal chest pain radiating to the left jaw, accompanied by
diaphoresis, that began 20 minutes ago [CORRECT]
C. A 70-year-old with chronic, controlled atrial fibrillation whose apical heart rate is 84 beats/min this
morning
D. A 66-year-old, 2 days postoperative coronary artery bypass graft surgery, requesting medication for
incisional pain rated 5/10
Correct Answer: B
Rationale: Crushing substernal pain radiating to the jaw with diaphoresis is the classic presentation of acute myocardial
infarction, and "time is muscle" demands immediate assessment, a 12-lead ECG within 10 minutes, and provider
notification. NCLEX-RN prioritization frameworks direct the nurse to the client with the most acute, unstable,
life-threatening physiological alteration first. Mild dizziness with a scheduled procedure, a stable chronic dysrhythmia, and
expected postoperative incisional pain are important but can wait until the unstable client is evaluated.
Q4. A client arrives at the emergency department with chest pain that began 1 hour ago. The 12-lead ECG
shows ST-segment elevation in leads II, III, and aVF. Which prescription should the nurse implement first?
A. Draw blood for serial cardiac biomarkers and a lipid profile
B. Obtain a detailed history of the pain, allergies, and family cardiac history
C. Prepare the client for immediate coronary artery bypass graft surgery
D. Administer chewable aspirin 325 mg as prescribed [CORRECT]
Correct Answer: D
Rationale: Chewed (not swallowed whole) aspirin 325 mg inhibits platelet aggregation and reduces mortality in
ST-elevation myocardial infarction, so it is administered as soon as the diagnosis is suspected. Leads II, III, and aVF indicate
an inferior infarction, for which nitrates and morphine are used cautiously because right ventricular involvement can cause
severe hypotension. Laboratory draws and history taking are completed in parallel but must never delay early antiplatelet
2
, Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
therapy; CABG is reserved for clients who are not candidates for percutaneous coronary intervention (NR 324 curriculum;
NCLEX-RN: Physiological Adaptation).
Q5. The nurse is teaching a client with hypertension and stable angina who is starting metoprolol succinate.
Which client statement indicates a need for further teaching?
A. "I will check my pulse and blood pressure before taking each dose."
B. "I should not stop this medication abruptly because my chest pain could get worse."
C. "If my resting pulse is below 60 beats per minute, I will hold the dose and notify my provider."
D. "This medication may cause weight gain, so I plan to cut all protein out of my diet." [CORRECT]
Correct Answer: D
Rationale: Beta blockers slow heart rate and blunt the compensatory response to activity, but they are not managed by
cutting protein from the diet, so this statement reflects a misunderstanding and an unsafe unplanned dietary change.
Checking pulse and blood pressure before each dose, never stopping beta blockers abruptly (rebound tachycardia,
hypertension, and worsening angina can occur), and holding the dose for bradycardia per provider parameters are all correct
NR 324 pharmacology standards (NCLEX-RN: Pharmacological Therapies).
Q6. A client with heart failure who takes furosemide and digoxin reports nausea, anorexia, and seeing
yellow-green halos around lights. Which assessment finding is most important for the nurse to report to the
provider?
A. Serum potassium level of 3.1 mEq/L [CORRECT]
B. Apical heart rate of 78 beats/min and regular
C. Serum sodium level of 138 mEq/L
D. Blood pressure of 118/72 mm Hg
Correct Answer: A
Rationale: Nausea, anorexia, and yellow-green visual halos are classic manifestations of digoxin toxicity, and hypokalemia
caused by loop diuretics potentiates digoxin toxicity even when the digoxin level is within therapeutic range. Reporting the
low potassium allows replacement therapy and dysrhythmia prevention, a high-risk Physiological Adaptation concept on the
NCLEX-RN. The heart rate, sodium, and blood pressure are within normal limits and do not explain the client's symptoms.
Q7. A client with chronic heart failure develops acute severe dyspnea; the nurse notes respirations of 34
breaths/min, SpO2 of 86%, bilateral crackles, and pink-tinged frothy sputum. Which action should the nurse
take first?
A. Insert an indwelling urinary catheter to monitor hourly urine output
B. Position the client upright with the legs dependent and administer prescribed oxygen [CORRECT]
C. Obtain a 12-lead ECG and call the provider with the results
D. Collect blood samples for BNP and serum electrolytes
Correct Answer: B
Rationale: These findings indicate acute pulmonary edema, and the immediate priority is supporting oxygenation: high
Fowler position with legs dependent decreases venous return to the overloaded pulmonary circulation while oxygen
addresses the hypoxemia. This follows the ABC priority framework emphasized throughout the NR 324 Adult Health I
course and the NCLEX-RN examination. Urine output monitoring, ECG, and laboratory studies are appropriate but are
secondary interventions that must never delay airway and breathing support.
3
U NI VE R SI TY
C O M P R E H E N S I V E C O U R S E E X A M I N AT I O N
Exam 2
NR 324 · Latest
Adult Health I
A 120-item comprehensive examination covering cardiovascular,
respiratory, fluid and electrolyte, gastrointestinal, renal,
endocrine, hematological, and perioperative nursing, with
detailed answer rationales aligned to the NCLEX-RN blueprint.
Course NR 324 — Adult Health I
Examination Exam 2 — Comprehensive
Total Questions 120 Multiple-Choice Items
Cognitive Mix 20% Recall · 50% Application · 30%
Analysis
Alignment NCLEX-RN Test Plan · QSEN
Competencies
2 0 2 0 2 7 AC A D E M I C Y E A R
,Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
EXAM 2 - NR324 / NR 324 (LATEST )
ADULT HEALTH I - CHAMBERLAIN UNIVERSITY
Comprehensive Course Examination | 120 Questions | Aligned with the Chamberlain University NR 324 Course Syllabus,
the NCLEX-RN Test Plan, QSEN Competencies, and Adult Health Nursing Standards (2026/2027 Edition)
Directions: Each question consists of a clinical stem followed by four options (A-D). Select the ONE best answer for
each item. The correct answer and a detailed rationale follow every question, so this examination also functions as a
study and remediation tool. Content is distributed across eight course sections, weighted to the NCLEX-RN blueprint
at approximately 20% recall, 50% application, and 30% analysis (prioritization, clinical reasoning, and critical
thinking). Special inclusions: 20 priority-setting items, 15 pharmacology items, and 10 laboratory value interpretation
items.
Section Questions Question Numbers
Cardiovascular Disorders 20 Q1-Q20
Respiratory Disorders 18 Q21-Q38
Fluid, Electrolyte, & Acid-Base Imbalances 15 Q39-Q53
Gastrointestinal Disorders 15 Q54-Q68
Renal & Genitourinary Disorders 15 Q69-Q83
Endocrine Disorders 15 Q84-Q98
Hematological Disorders 10 Q99-Q108
Perioperative Nursing 12 Q109-Q120
Section 1: Cardiovascular Disorders
20 Questions | Hypertension, Coronary Artery Disease, Angina, Myocardial Infarction, Heart Failure, Dysrhythmias, Valvular Disorders,
Peripheral Vascular Disease, DVT, Aneurysms, Shock, Cardiac Diagnostics, Interventions, and Medications
Q1. The nurse is providing discharge teaching to a 58-year-old client newly diagnosed with primary
hypertension (blood pressure 148/92 mm Hg) who will begin management with the DASH eating plan and
lifestyle modification. Which client statement indicates correct understanding of the teaching?
A. "I will check my blood pressure at home at the same time each day after resting quietly for 5 minutes."
[CORRECT]
B. "I can stop following the DASH eating plan once my blood pressure returns to the normal range."
C. "I should perform high-intensity aerobic exercise for 2 hours every day to lower my pressure quickly."
D. "I may add extra table salt to my food as long as I avoid salty snacks between meals."
Correct Answer: A
Rationale: Consistent home blood pressure monitoring after 5 minutes of quiet rest is a core component of the NR 324
Adult Health I hypertension management plan and supports early detection of worsening control (NCLEX-RN: Health
Promotion and Maintenance). The DASH plan is a lifelong pattern, not a temporary diet, so stopping it after improvement is
1
,Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
incorrect. Current guidelines recommend about 150 minutes of moderate-intensity activity per week, not 2 hours of
high-intensity exercise daily, and sodium restriction must include salt added during cooking and at the table, not just snacks.
Q2. A client with stable angina is being discharged with a new prescription for sublingual nitroglycerin. Which
client statement indicates a need for further teaching?
A. "I will sit or lie down before taking a tablet because the medication can make me dizzy."
B. "A headache after taking nitroglycerin is common and usually improves with continued use."
C. "I will call 911 if chest pain is not relieved 5 minutes after the first dose."
D. "I will keep my tablets in a clear plastic bottle in my car's glove box so they are easy to reach."
[CORRECT]
Correct Answer: D
Rationale: Nitroglycerin is volatile and degrades rapidly with exposure to light and heat, so tablets must be stored in the
original dark glass container away from heat sources such as a car glove box; potency loss leaves the client unprotected
during an anginal attack. Sitting down prevents orthostatic falls, headache is the most common adverse effect, and calling
emergency services when pain persists 5 minutes after the first dose reflects current resuscitation guidelines taught in the
NR 324 curriculum (NCLEX-RN: Pharmacological Therapies).
Q3. The nurse receives change-of-shift report on four clients on a medical-surgical unit. Which client should the
nurse assess first?
A. A 45-year-old with aortic stenosis scheduled for an echocardiogram this afternoon who reports mild
dizziness when walking to the bathroom
B. A 58-year-old reporting crushing substernal chest pain radiating to the left jaw, accompanied by
diaphoresis, that began 20 minutes ago [CORRECT]
C. A 70-year-old with chronic, controlled atrial fibrillation whose apical heart rate is 84 beats/min this
morning
D. A 66-year-old, 2 days postoperative coronary artery bypass graft surgery, requesting medication for
incisional pain rated 5/10
Correct Answer: B
Rationale: Crushing substernal pain radiating to the jaw with diaphoresis is the classic presentation of acute myocardial
infarction, and "time is muscle" demands immediate assessment, a 12-lead ECG within 10 minutes, and provider
notification. NCLEX-RN prioritization frameworks direct the nurse to the client with the most acute, unstable,
life-threatening physiological alteration first. Mild dizziness with a scheduled procedure, a stable chronic dysrhythmia, and
expected postoperative incisional pain are important but can wait until the unstable client is evaluated.
Q4. A client arrives at the emergency department with chest pain that began 1 hour ago. The 12-lead ECG
shows ST-segment elevation in leads II, III, and aVF. Which prescription should the nurse implement first?
A. Draw blood for serial cardiac biomarkers and a lipid profile
B. Obtain a detailed history of the pain, allergies, and family cardiac history
C. Prepare the client for immediate coronary artery bypass graft surgery
D. Administer chewable aspirin 325 mg as prescribed [CORRECT]
Correct Answer: D
Rationale: Chewed (not swallowed whole) aspirin 325 mg inhibits platelet aggregation and reduces mortality in
ST-elevation myocardial infarction, so it is administered as soon as the diagnosis is suspected. Leads II, III, and aVF indicate
an inferior infarction, for which nitrates and morphine are used cautiously because right ventricular involvement can cause
severe hypotension. Laboratory draws and history taking are completed in parallel but must never delay early antiplatelet
2
, Exam 2 - NR324 (Latest 2026/2027): Adult Health I - Chamberlain
therapy; CABG is reserved for clients who are not candidates for percutaneous coronary intervention (NR 324 curriculum;
NCLEX-RN: Physiological Adaptation).
Q5. The nurse is teaching a client with hypertension and stable angina who is starting metoprolol succinate.
Which client statement indicates a need for further teaching?
A. "I will check my pulse and blood pressure before taking each dose."
B. "I should not stop this medication abruptly because my chest pain could get worse."
C. "If my resting pulse is below 60 beats per minute, I will hold the dose and notify my provider."
D. "This medication may cause weight gain, so I plan to cut all protein out of my diet." [CORRECT]
Correct Answer: D
Rationale: Beta blockers slow heart rate and blunt the compensatory response to activity, but they are not managed by
cutting protein from the diet, so this statement reflects a misunderstanding and an unsafe unplanned dietary change.
Checking pulse and blood pressure before each dose, never stopping beta blockers abruptly (rebound tachycardia,
hypertension, and worsening angina can occur), and holding the dose for bradycardia per provider parameters are all correct
NR 324 pharmacology standards (NCLEX-RN: Pharmacological Therapies).
Q6. A client with heart failure who takes furosemide and digoxin reports nausea, anorexia, and seeing
yellow-green halos around lights. Which assessment finding is most important for the nurse to report to the
provider?
A. Serum potassium level of 3.1 mEq/L [CORRECT]
B. Apical heart rate of 78 beats/min and regular
C. Serum sodium level of 138 mEq/L
D. Blood pressure of 118/72 mm Hg
Correct Answer: A
Rationale: Nausea, anorexia, and yellow-green visual halos are classic manifestations of digoxin toxicity, and hypokalemia
caused by loop diuretics potentiates digoxin toxicity even when the digoxin level is within therapeutic range. Reporting the
low potassium allows replacement therapy and dysrhythmia prevention, a high-risk Physiological Adaptation concept on the
NCLEX-RN. The heart rate, sodium, and blood pressure are within normal limits and do not explain the client's symptoms.
Q7. A client with chronic heart failure develops acute severe dyspnea; the nurse notes respirations of 34
breaths/min, SpO2 of 86%, bilateral crackles, and pink-tinged frothy sputum. Which action should the nurse
take first?
A. Insert an indwelling urinary catheter to monitor hourly urine output
B. Position the client upright with the legs dependent and administer prescribed oxygen [CORRECT]
C. Obtain a 12-lead ECG and call the provider with the results
D. Collect blood samples for BNP and serum electrolytes
Correct Answer: B
Rationale: These findings indicate acute pulmonary edema, and the immediate priority is supporting oxygenation: high
Fowler position with legs dependent decreases venous return to the overloaded pulmonary circulation while oxygen
addresses the hypoxemia. This follows the ABC priority framework emphasized throughout the NR 324 Adult Health I
course and the NCLEX-RN examination. Urine output monitoring, ECG, and laboratory studies are appropriate but are
secondary interventions that must never delay airway and breathing support.
3
