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NRSG 3420 EXAM 2 (NORTHEASTERN) LATEST 2026/
2027 TEST BANK| NRSG 3420 NURSING CARE OF
ADULTS 2 EXAM 2 REVIEW WITH COMPLETE REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
A client with atrial fibrillation takes digoxin and warfarin. The client
reports anorexia, nausea, blurred yellow vision, and increasing fatigue.
Laboratory results show potassium 3.0 mEq/L and creatinine 2.3 mg/dL.
Which factor most increases the risk of the suspected medication
complication?
A. Chronic anticoagulant use
B. Hypokalemia and impaired renal clearance
C. Atrial fibrillation itself
D. Increased dietary vitamin K - Correct Answer - B. Hypokalemia and
impaired renal clearance
Digoxin is primarily renally cleared, and hypokalemia increases
myocardial sensitivity to digoxin. The symptoms strongly suggest
digoxin toxicity.
A client with severe aortic stenosis reports increasing exertional dyspnea
and two episodes of syncope. Assessment reveals BP 94/58 mm Hg and
a harsh systolic murmur radiating to the carotids. Which new finding
would be most concerning?
A. Mild ankle edema
B. Heart rate of 88/min
C. Chest pain occurring at rest
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D. Respiratory rate of 20/min - Correct Answer - C. Chest pain
occurring at rest
Aortic stenosis can cause angina, syncope, and heart failure. New
ischemic chest pain at rest suggests significant myocardial oxygen-
supply imbalance and possible acute deterioration.
Correct Answer – C. Right coronary artery (RCA).
ST-segment elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, which is most commonly caused by RCA
occlusion. The hypotension and bradycardia also support possible right-
ventricular involvement.
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A client with acute coronary syndrome receives aspirin, heparin, and a
beta blocker. Thirty minutes later, the client becomes pale and
diaphoretic. BP is 76/44 mm Hg, HR 48/min, and the cardiac monitor
shows inferior ST-segment elevation. Which complication should the
nurse suspect?
A. Right ventricular involvement causing preload dependence
B. Uncomplicated medication-related fatigue
C. Chronic left-sided heart failure
D. Hypervolemia from the heparin infusion - Correct Answer - A. Right
ventricular involvement causing preload dependence
Inferior MI can involve the right ventricle, causing hypotension and
bradycardia because cardiac output becomes highly dependent on
adequate preload. Vasodilators and excessive preload reduction can
worsen the situation.
A client with a history of heart failure presents with orthopnea and
pulmonary crackles. BNP is markedly elevated. The client is taking
lisinopril, spironolactone, and furosemide. Laboratory results show
potassium 5.8 mEq/L and creatinine 2.7 mg/dL. Which prescribed
medication requires the closest scrutiny?
A. Furosemide
B. Spironolactone
C. Acetaminophen
D. Pantoprazole - Correct Answer - B. Spironolactone
Spironolactone can increase potassium, particularly when renal function
is impaired. Hyperkalemia at 5.8 mEq/L requires prompt reassessment.
A client with new-onset atrial fibrillation has a ventricular rate of
168/min. BP is 78/44 mm Hg, the client reports chest pressure, and the
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level of consciousness is declining. Which intervention should the nurse
anticipate?
A. Oral anticoagulation only
B. Synchronized cardioversion
C. Routine outpatient Holter monitoring
D. Increased oral fluid intake - Correct Answer - B. Synchronized
cardioversion
Atrial fibrillation accompanied by hypotension, ischemic symptoms, and
altered consciousness represents hemodynamic instability. Synchronized
cardioversion is indicated for unstable tachyarrhythmia.
Correct Answer - A. Placement of a chest tube
pg. 4
NRSG 3420 EXAM 2 (NORTHEASTERN) LATEST 2026/
2027 TEST BANK| NRSG 3420 NURSING CARE OF
ADULTS 2 EXAM 2 REVIEW WITH COMPLETE REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+
A client with atrial fibrillation takes digoxin and warfarin. The client
reports anorexia, nausea, blurred yellow vision, and increasing fatigue.
Laboratory results show potassium 3.0 mEq/L and creatinine 2.3 mg/dL.
Which factor most increases the risk of the suspected medication
complication?
A. Chronic anticoagulant use
B. Hypokalemia and impaired renal clearance
C. Atrial fibrillation itself
D. Increased dietary vitamin K - Correct Answer - B. Hypokalemia and
impaired renal clearance
Digoxin is primarily renally cleared, and hypokalemia increases
myocardial sensitivity to digoxin. The symptoms strongly suggest
digoxin toxicity.
A client with severe aortic stenosis reports increasing exertional dyspnea
and two episodes of syncope. Assessment reveals BP 94/58 mm Hg and
a harsh systolic murmur radiating to the carotids. Which new finding
would be most concerning?
A. Mild ankle edema
B. Heart rate of 88/min
C. Chest pain occurring at rest
pg. 1
,2|Page
D. Respiratory rate of 20/min - Correct Answer - C. Chest pain
occurring at rest
Aortic stenosis can cause angina, syncope, and heart failure. New
ischemic chest pain at rest suggests significant myocardial oxygen-
supply imbalance and possible acute deterioration.
Correct Answer – C. Right coronary artery (RCA).
ST-segment elevation in leads II, III, and aVF indicates an inferior
myocardial infarction, which is most commonly caused by RCA
occlusion. The hypotension and bradycardia also support possible right-
ventricular involvement.
pg. 2
,3|Page
A client with acute coronary syndrome receives aspirin, heparin, and a
beta blocker. Thirty minutes later, the client becomes pale and
diaphoretic. BP is 76/44 mm Hg, HR 48/min, and the cardiac monitor
shows inferior ST-segment elevation. Which complication should the
nurse suspect?
A. Right ventricular involvement causing preload dependence
B. Uncomplicated medication-related fatigue
C. Chronic left-sided heart failure
D. Hypervolemia from the heparin infusion - Correct Answer - A. Right
ventricular involvement causing preload dependence
Inferior MI can involve the right ventricle, causing hypotension and
bradycardia because cardiac output becomes highly dependent on
adequate preload. Vasodilators and excessive preload reduction can
worsen the situation.
A client with a history of heart failure presents with orthopnea and
pulmonary crackles. BNP is markedly elevated. The client is taking
lisinopril, spironolactone, and furosemide. Laboratory results show
potassium 5.8 mEq/L and creatinine 2.7 mg/dL. Which prescribed
medication requires the closest scrutiny?
A. Furosemide
B. Spironolactone
C. Acetaminophen
D. Pantoprazole - Correct Answer - B. Spironolactone
Spironolactone can increase potassium, particularly when renal function
is impaired. Hyperkalemia at 5.8 mEq/L requires prompt reassessment.
A client with new-onset atrial fibrillation has a ventricular rate of
168/min. BP is 78/44 mm Hg, the client reports chest pressure, and the
pg. 3
, 4|Page
level of consciousness is declining. Which intervention should the nurse
anticipate?
A. Oral anticoagulation only
B. Synchronized cardioversion
C. Routine outpatient Holter monitoring
D. Increased oral fluid intake - Correct Answer - B. Synchronized
cardioversion
Atrial fibrillation accompanied by hypotension, ischemic symptoms, and
altered consciousness represents hemodynamic instability. Synchronized
cardioversion is indicated for unstable tachyarrhythmia.
Correct Answer - A. Placement of a chest tube
pg. 4
