NUR 253 Exam 3 | Actual Test Questions and Answers | 2026
Update | 100% Correct - Galen Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Cardiovascular and Hematologic Disorders
Q1: A patient with a history of heart failure presents to the emergency department with an
acute exacerbation, reporting severe dyspnea at rest and a new cough. Which assessment
finding requires the most immediate nursing intervention?
A. Bilateral crackles auscultated at the lung bases
B. Oxygen saturation of 86% on room air [CORRECT]
C. Weight gain of 4 pounds over the past three days
D. Blood pressure of 142/88 mmHg
Correct Answer: B
Rationale: The best answer is an oxygen saturation of 86% because it indicates severe acute
hypoxemia that requires immediate supplemental oxygen and medical intervention to
prevent respiratory failure.
Q2: A patient reports crushing chest pain. Which electrocardiogram (ECG) finding most
strongly indicates an acute ST-elevation myocardial infarction (STEMI)?
A. Peaked T waves in the precordial leads
B. ST-segment elevation in two contiguous leads [CORRECT]
C. Prolonged PR interval greater than 0.20 seconds
D. Flattened T waves and prominent U waves
Correct Answer: B
Rationale: This choice is correct because ST-segment elevation in contiguous leads is the
hallmark diagnostic criterion for a STEMI, indicating full-thickness myocardial injury.
Q3: A patient with atrial fibrillation has been taking warfarin for three months. Which
international normalized ratio (INR) value indicates a therapeutic level?
A. 1.0
B. 2.5 [CORRECT]
C. 3.5
D. 4.5
Correct Answer: B
Rationale: The best answer is 2.5 because the standard therapeutic INR range for most
patients with atrial fibrillation is between 2.0 and 3.0 to prevent stroke.
Q4: A nurse is teaching a patient newly prescribed lisinopril for hypertension. Which
statement by the patient indicates effective teaching?
A. I will take this medication with my morning potassium supplement.
B. I should expect a persistent, dry cough while taking this drug. [CORRECT]
,C. I need to check my heart rate before taking each dose.
D. This medication will immediately lower my blood pressure to normal.
Correct Answer: B
Rationale: This matches the principle that ACE inhibitors like lisinopril commonly cause a
persistent, dry cough due to the accumulation of bradykinin in the lungs.
Q5: Which nursing intervention is most effective for preventing deep vein thrombosis (DVT)
in a postoperative patient on bed rest?
A. Placing a pillow under the patient's knees
B. Applying sequential compression devices (SCDs) while in bed [CORRECT]
C. Massaging the patient's lower legs twice daily
D. Encouraging the patient to keep their legs crossed
Correct Answer: B
Rationale: The best answer is applying SCDs because they promote venous return and
prevent blood stasis in the lower extremities, directly reducing the risk of clot formation.
Q6: A patient with iron deficiency anemia is prescribed an oral iron supplement. Which
instruction should the nurse include to maximize iron absorption?
A. Take the iron tablet with a glass of orange juice. [CORRECT]
B. Take the iron tablet with a glass of milk.
C. Take the iron tablet immediately after eating a high-fiber meal.
D. Take the iron tablet concurrently with an antacid.
Correct Answer: A
Rationale: This choice is correct because the ascorbic acid (vitamin C) in orange juice creates
an acidic environment that significantly enhances the gastrointestinal absorption of non-
heme iron.
Q7: A patient is admitted to the unit in a vaso-occlusive sickle cell crisis. Which intervention
should the nurse implement first?
A. Administer intravenous opioid analgesics as prescribed. [CORRECT]
B. Apply cold compresses to the affected joints.
C. Encourage the patient to perform deep breathing exercises.
D. Restrict oral fluid intake to prevent fluid overload.
Correct Answer: A
Rationale: The best answer is administering IV opioids because severe pain is the hallmark of
a vaso-occlusive crisis, and rapid pain relief is the immediate priority to reduce sympathetic
stress.
Q8: A nurse is providing dietary education to a patient with newly diagnosed heart failure.
Which food choice by the patient indicates a need for further teaching?
A. Baked chicken breast without skin
B. Steamed fresh broccoli florets
C. Canned vegetable soup [CORRECT]
D. Fresh apple slices
Correct Answer: C
Rationale: This choice is correct because canned soups are notoriously high in sodium,
which promotes fluid retention and exacerbates the symptoms of heart failure.
, Q9: A patient just returned to the unit following the insertion of a permanent transvenous
pacemaker. Which nursing action is appropriate for the first 24 hours?
A. Encouraging active range of motion of the right arm
B. Keeping the head of the bed flat at all times
C. Restricting shoulder movement on the insertion side [CORRECT]
D. Applying a heating pad to the insertion site for comfort
Correct Answer: C
Rationale: The best answer is restricting shoulder movement to prevent dislodgement of the
newly implanted pacemaker leads before they have securely scarred into the myocardial
tissue.
Q10: A patient reports chest pain that radiates to the left arm. Which characteristic most
strongly suggests stable angina rather than a myocardial infarction?
A. The pain is described as a tearing sensation.
B. The pain is completely relieved by rest and nitroglycerin. [CORRECT]
C. The pain persists for more than 30 minutes continuously.
D. The pain is accompanied by profound nausea and diaphoresis.
Correct Answer: B
Rationale: This matches the principle that stable angina is predictable and typically resolves
with rest or nitroglycerin, whereas myocardial infarction pain is prolonged and unrelieved
by these measures.
Q11: A patient taking digoxin for heart failure reports nausea, vomiting, and seeing yellow
halos around lights. What is the nurse's priority action?
A. Administer the next scheduled dose of digoxin.
B. Hold the medication and notify the healthcare provider. [CORRECT]
C. Encourage the patient to eat a potassium-rich banana.
D. Document the findings as expected side effects of the medication.
Correct Answer: B
Rationale: The best answer is holding the medication because visual disturbances and
gastrointestinal distress are classic early signs of digoxin toxicity, requiring immediate
medical evaluation and a serum level check.
Q12: A patient with peripheral arterial disease (PAD) reports pain in the calves when walking
that resolves with rest. How should the nurse document this finding?
A. Rest pain
B. Intermittent claudication [CORRECT]
C. Raynaud's phenomenon
D. Deep vein thrombosis
Correct Answer: B
Rationale: This choice is correct because intermittent claudication is the classic symptom of
PAD, characterized by muscle pain during exertion that is reliably relieved by resting.
Q13: Which hematocrit value falls within the normal reference range for an adult male?
A. 35%
B. 45% [CORRECT]
Update | 100% Correct - Galen Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Cardiovascular and Hematologic Disorders
Q1: A patient with a history of heart failure presents to the emergency department with an
acute exacerbation, reporting severe dyspnea at rest and a new cough. Which assessment
finding requires the most immediate nursing intervention?
A. Bilateral crackles auscultated at the lung bases
B. Oxygen saturation of 86% on room air [CORRECT]
C. Weight gain of 4 pounds over the past three days
D. Blood pressure of 142/88 mmHg
Correct Answer: B
Rationale: The best answer is an oxygen saturation of 86% because it indicates severe acute
hypoxemia that requires immediate supplemental oxygen and medical intervention to
prevent respiratory failure.
Q2: A patient reports crushing chest pain. Which electrocardiogram (ECG) finding most
strongly indicates an acute ST-elevation myocardial infarction (STEMI)?
A. Peaked T waves in the precordial leads
B. ST-segment elevation in two contiguous leads [CORRECT]
C. Prolonged PR interval greater than 0.20 seconds
D. Flattened T waves and prominent U waves
Correct Answer: B
Rationale: This choice is correct because ST-segment elevation in contiguous leads is the
hallmark diagnostic criterion for a STEMI, indicating full-thickness myocardial injury.
Q3: A patient with atrial fibrillation has been taking warfarin for three months. Which
international normalized ratio (INR) value indicates a therapeutic level?
A. 1.0
B. 2.5 [CORRECT]
C. 3.5
D. 4.5
Correct Answer: B
Rationale: The best answer is 2.5 because the standard therapeutic INR range for most
patients with atrial fibrillation is between 2.0 and 3.0 to prevent stroke.
Q4: A nurse is teaching a patient newly prescribed lisinopril for hypertension. Which
statement by the patient indicates effective teaching?
A. I will take this medication with my morning potassium supplement.
B. I should expect a persistent, dry cough while taking this drug. [CORRECT]
,C. I need to check my heart rate before taking each dose.
D. This medication will immediately lower my blood pressure to normal.
Correct Answer: B
Rationale: This matches the principle that ACE inhibitors like lisinopril commonly cause a
persistent, dry cough due to the accumulation of bradykinin in the lungs.
Q5: Which nursing intervention is most effective for preventing deep vein thrombosis (DVT)
in a postoperative patient on bed rest?
A. Placing a pillow under the patient's knees
B. Applying sequential compression devices (SCDs) while in bed [CORRECT]
C. Massaging the patient's lower legs twice daily
D. Encouraging the patient to keep their legs crossed
Correct Answer: B
Rationale: The best answer is applying SCDs because they promote venous return and
prevent blood stasis in the lower extremities, directly reducing the risk of clot formation.
Q6: A patient with iron deficiency anemia is prescribed an oral iron supplement. Which
instruction should the nurse include to maximize iron absorption?
A. Take the iron tablet with a glass of orange juice. [CORRECT]
B. Take the iron tablet with a glass of milk.
C. Take the iron tablet immediately after eating a high-fiber meal.
D. Take the iron tablet concurrently with an antacid.
Correct Answer: A
Rationale: This choice is correct because the ascorbic acid (vitamin C) in orange juice creates
an acidic environment that significantly enhances the gastrointestinal absorption of non-
heme iron.
Q7: A patient is admitted to the unit in a vaso-occlusive sickle cell crisis. Which intervention
should the nurse implement first?
A. Administer intravenous opioid analgesics as prescribed. [CORRECT]
B. Apply cold compresses to the affected joints.
C. Encourage the patient to perform deep breathing exercises.
D. Restrict oral fluid intake to prevent fluid overload.
Correct Answer: A
Rationale: The best answer is administering IV opioids because severe pain is the hallmark of
a vaso-occlusive crisis, and rapid pain relief is the immediate priority to reduce sympathetic
stress.
Q8: A nurse is providing dietary education to a patient with newly diagnosed heart failure.
Which food choice by the patient indicates a need for further teaching?
A. Baked chicken breast without skin
B. Steamed fresh broccoli florets
C. Canned vegetable soup [CORRECT]
D. Fresh apple slices
Correct Answer: C
Rationale: This choice is correct because canned soups are notoriously high in sodium,
which promotes fluid retention and exacerbates the symptoms of heart failure.
, Q9: A patient just returned to the unit following the insertion of a permanent transvenous
pacemaker. Which nursing action is appropriate for the first 24 hours?
A. Encouraging active range of motion of the right arm
B. Keeping the head of the bed flat at all times
C. Restricting shoulder movement on the insertion side [CORRECT]
D. Applying a heating pad to the insertion site for comfort
Correct Answer: C
Rationale: The best answer is restricting shoulder movement to prevent dislodgement of the
newly implanted pacemaker leads before they have securely scarred into the myocardial
tissue.
Q10: A patient reports chest pain that radiates to the left arm. Which characteristic most
strongly suggests stable angina rather than a myocardial infarction?
A. The pain is described as a tearing sensation.
B. The pain is completely relieved by rest and nitroglycerin. [CORRECT]
C. The pain persists for more than 30 minutes continuously.
D. The pain is accompanied by profound nausea and diaphoresis.
Correct Answer: B
Rationale: This matches the principle that stable angina is predictable and typically resolves
with rest or nitroglycerin, whereas myocardial infarction pain is prolonged and unrelieved
by these measures.
Q11: A patient taking digoxin for heart failure reports nausea, vomiting, and seeing yellow
halos around lights. What is the nurse's priority action?
A. Administer the next scheduled dose of digoxin.
B. Hold the medication and notify the healthcare provider. [CORRECT]
C. Encourage the patient to eat a potassium-rich banana.
D. Document the findings as expected side effects of the medication.
Correct Answer: B
Rationale: The best answer is holding the medication because visual disturbances and
gastrointestinal distress are classic early signs of digoxin toxicity, requiring immediate
medical evaluation and a serum level check.
Q12: A patient with peripheral arterial disease (PAD) reports pain in the calves when walking
that resolves with rest. How should the nurse document this finding?
A. Rest pain
B. Intermittent claudication [CORRECT]
C. Raynaud's phenomenon
D. Deep vein thrombosis
Correct Answer: B
Rationale: This choice is correct because intermittent claudication is the classic symptom of
PAD, characterized by muscle pain during exertion that is reliably relieved by resting.
Q13: Which hematocrit value falls within the normal reference range for an adult male?
A. 35%
B. 45% [CORRECT]
