ATI MED SURG IMMUNE& INFECTION,ONCOLOGY
,CARDIOVASCULAR EXAM PACK | ALL PRACTICE Q&A
2026/2027 | A+ GRADED |COMPREHENSIVE EXAM
GUIDE 2026&2027
1. A client with heart failure reports a 2-kg (4.4-lb) weight gain over 48 hours. Which
action should the nurse take first?
A. Encourage increased oral fluid intake
B. Assess the client for manifestations of fluid overload
C. Instruct the client to increase sodium intake
D. Reassure the client that the weight change is expected
Answer: B
The rapid weight gain suggests fluid retention, a common indicator of worsening heart
failure. The nurse should assess for edema, dyspnea, lung sounds, and other manifestations of
fluid overload.
2. A nurse is assessing a client receiving chemotherapy who has an absolute neutrophil
count of 800/mm³. Which intervention is the priority?
A. Place the client on neutropenic precautions
B. Encourage raw fruits and vegetables
C. Administer an intramuscular injection
D. Limit oral hygiene
Answer: A
An ANC of 800/mm³ indicates significant neutropenia and increased infection risk. Protective
measures, including appropriate neutropenic precautions, help reduce exposure to infectious
organisms.
3. A client with infective endocarditis is receiving IV antibiotics. Which finding
requires immediate notification of the provider?
A. Temperature of 37.8°C (100°F)
B. Mild fatigue after ambulation
C. New onset of dyspnea and crackles
D. Decreased appetite
Answer: C
,New dyspnea and crackles can indicate heart failure related to valvular damage or worsening
cardiac function. This requires prompt evaluation.
4. A client taking warfarin for atrial fibrillation asks which laboratory test is used to
monitor therapeutic effectiveness. Which response is correct?
A. Troponin
B. aPTT
C. BNP
D. INR
Answer: D
Warfarin therapy is monitored primarily using the prothrombin time expressed as the INR.
5. A client with pneumonia becomes increasingly confused, hypotensive, and
tachycardic despite receiving IV fluids. Which complication should the nurse
suspect?
A. Septic shock
B. Stable angina
C. Chronic anemia
D. Pulmonary hypertension
Answer: A
Hypotension, tachycardia, and altered mental status in the setting of infection are concerning
for sepsis progressing to septic shock.
6. A client receiving doxorubicin reports increasing shortness of breath and fatigue.
Which assessment is most important?
A. Bowel sounds
B. Cardiac function
C. Visual acuity
D. Skin turgor
Answer: B
Doxorubicin can cause dose-related cardiotoxicity. New dyspnea and fatigue warrant
assessment for impaired cardiac function.
7. A client with systemic lupus erythematosus reports increased joint pain and fatigue
after prolonged sun exposure. Which teaching should the nurse reinforce?
A. Increase ultraviolet exposure gradually
B. Avoid all physical activity
C. Use sun protection and limit ultraviolet exposure
D. Discontinue prescribed medications during flares
,Answer: C
Ultraviolet exposure can trigger or worsen lupus manifestations. Protective clothing,
sunscreen, and avoidance of excessive sun exposure are appropriate measures.
8. A client with acute myocardial infarction reports severe chest pressure radiating to
the left arm. Which prescribed medication should the nurse anticipate
administering rapidly unless contraindicated?
A. Sublingual nitroglycerin
B. Oral potassium
C. Long-acting insulin
D. Ferrous sulfate
Answer: A
Nitroglycerin decreases myocardial oxygen demand and can relieve ischemic chest discomfort
when appropriate and when contraindications such as recent phosphodiesterase-5 inhibitor
use are absent.
9. A client with leukemia has a platelet count of 18,000/mm³. Which intervention is
appropriate?
A. Encourage vigorous flossing
B. Use an electric razor
C. Administer aspirin for headache
D. Encourage contact sports
Answer: B
Severe thrombocytopenia increases bleeding risk. An electric razor reduces the likelihood of
cuts compared with a traditional razor.
10. A client receiving vancomycin develops flushing and erythema of the face and upper
torso during the infusion. Which action should the nurse take?
A. Increase the infusion rate
B. Stop all future antibiotic therapy
C. Slow the infusion and notify the provider as appropriate
D. Administer the next dose immediately
Answer: C
Rapid vancomycin infusion can cause a histamine-mediated reaction known as vancomycin
infusion reaction. Slowing the infusion is an important management measure.
11. A client with hypertension asks why lifestyle modification is recommended even
when antihypertensive medication is prescribed. Which explanation is appropriate?
A. Lifestyle changes can reduce cardiovascular risk and improve blood pressure control
, B. Medication becomes unnecessary for every client
C. Exercise permanently eliminates hypertension
D. Sodium intake has no relationship to blood pressure
Answer: A
Weight management, physical activity, dietary modification, and sodium reduction can
improve blood pressure control and reduce cardiovascular risk.
12. A client with a history of coronary artery disease develops crushing chest pain while
walking. Which assessment finding most strongly suggests myocardial ischemia?
A. Pain relieved by rest
B. Pain only after eating
C. Pain reproducible by pressing the chest
D. Pain lasting several seconds
Answer: A
Stable angina commonly occurs with exertion and improves with rest as myocardial oxygen
demand decreases.
13. A client with neutropenia has a temperature of 38.3°C (101°F). Which action is the
priority?
A. Recheck the temperature in 4 hours
B. Notify the provider promptly
C. Offer an ice bath
D. Encourage visitors to enter the room
Answer: B
Fever in a neutropenic client can indicate a life-threatening infection. Prompt evaluation and
antimicrobial therapy may be required.
14. A client taking an ACE inhibitor develops swelling of the lips and tongue. Which
action is the priority?
A. Administer the next scheduled dose
B. Encourage oral fluids
C. Assess and protect the airway
D. Place the client flat
Answer: C
Angioedema can rapidly compromise the airway. Airway assessment and emergency
management are priorities.
,CARDIOVASCULAR EXAM PACK | ALL PRACTICE Q&A
2026/2027 | A+ GRADED |COMPREHENSIVE EXAM
GUIDE 2026&2027
1. A client with heart failure reports a 2-kg (4.4-lb) weight gain over 48 hours. Which
action should the nurse take first?
A. Encourage increased oral fluid intake
B. Assess the client for manifestations of fluid overload
C. Instruct the client to increase sodium intake
D. Reassure the client that the weight change is expected
Answer: B
The rapid weight gain suggests fluid retention, a common indicator of worsening heart
failure. The nurse should assess for edema, dyspnea, lung sounds, and other manifestations of
fluid overload.
2. A nurse is assessing a client receiving chemotherapy who has an absolute neutrophil
count of 800/mm³. Which intervention is the priority?
A. Place the client on neutropenic precautions
B. Encourage raw fruits and vegetables
C. Administer an intramuscular injection
D. Limit oral hygiene
Answer: A
An ANC of 800/mm³ indicates significant neutropenia and increased infection risk. Protective
measures, including appropriate neutropenic precautions, help reduce exposure to infectious
organisms.
3. A client with infective endocarditis is receiving IV antibiotics. Which finding
requires immediate notification of the provider?
A. Temperature of 37.8°C (100°F)
B. Mild fatigue after ambulation
C. New onset of dyspnea and crackles
D. Decreased appetite
Answer: C
,New dyspnea and crackles can indicate heart failure related to valvular damage or worsening
cardiac function. This requires prompt evaluation.
4. A client taking warfarin for atrial fibrillation asks which laboratory test is used to
monitor therapeutic effectiveness. Which response is correct?
A. Troponin
B. aPTT
C. BNP
D. INR
Answer: D
Warfarin therapy is monitored primarily using the prothrombin time expressed as the INR.
5. A client with pneumonia becomes increasingly confused, hypotensive, and
tachycardic despite receiving IV fluids. Which complication should the nurse
suspect?
A. Septic shock
B. Stable angina
C. Chronic anemia
D. Pulmonary hypertension
Answer: A
Hypotension, tachycardia, and altered mental status in the setting of infection are concerning
for sepsis progressing to septic shock.
6. A client receiving doxorubicin reports increasing shortness of breath and fatigue.
Which assessment is most important?
A. Bowel sounds
B. Cardiac function
C. Visual acuity
D. Skin turgor
Answer: B
Doxorubicin can cause dose-related cardiotoxicity. New dyspnea and fatigue warrant
assessment for impaired cardiac function.
7. A client with systemic lupus erythematosus reports increased joint pain and fatigue
after prolonged sun exposure. Which teaching should the nurse reinforce?
A. Increase ultraviolet exposure gradually
B. Avoid all physical activity
C. Use sun protection and limit ultraviolet exposure
D. Discontinue prescribed medications during flares
,Answer: C
Ultraviolet exposure can trigger or worsen lupus manifestations. Protective clothing,
sunscreen, and avoidance of excessive sun exposure are appropriate measures.
8. A client with acute myocardial infarction reports severe chest pressure radiating to
the left arm. Which prescribed medication should the nurse anticipate
administering rapidly unless contraindicated?
A. Sublingual nitroglycerin
B. Oral potassium
C. Long-acting insulin
D. Ferrous sulfate
Answer: A
Nitroglycerin decreases myocardial oxygen demand and can relieve ischemic chest discomfort
when appropriate and when contraindications such as recent phosphodiesterase-5 inhibitor
use are absent.
9. A client with leukemia has a platelet count of 18,000/mm³. Which intervention is
appropriate?
A. Encourage vigorous flossing
B. Use an electric razor
C. Administer aspirin for headache
D. Encourage contact sports
Answer: B
Severe thrombocytopenia increases bleeding risk. An electric razor reduces the likelihood of
cuts compared with a traditional razor.
10. A client receiving vancomycin develops flushing and erythema of the face and upper
torso during the infusion. Which action should the nurse take?
A. Increase the infusion rate
B. Stop all future antibiotic therapy
C. Slow the infusion and notify the provider as appropriate
D. Administer the next dose immediately
Answer: C
Rapid vancomycin infusion can cause a histamine-mediated reaction known as vancomycin
infusion reaction. Slowing the infusion is an important management measure.
11. A client with hypertension asks why lifestyle modification is recommended even
when antihypertensive medication is prescribed. Which explanation is appropriate?
A. Lifestyle changes can reduce cardiovascular risk and improve blood pressure control
, B. Medication becomes unnecessary for every client
C. Exercise permanently eliminates hypertension
D. Sodium intake has no relationship to blood pressure
Answer: A
Weight management, physical activity, dietary modification, and sodium reduction can
improve blood pressure control and reduce cardiovascular risk.
12. A client with a history of coronary artery disease develops crushing chest pain while
walking. Which assessment finding most strongly suggests myocardial ischemia?
A. Pain relieved by rest
B. Pain only after eating
C. Pain reproducible by pressing the chest
D. Pain lasting several seconds
Answer: A
Stable angina commonly occurs with exertion and improves with rest as myocardial oxygen
demand decreases.
13. A client with neutropenia has a temperature of 38.3°C (101°F). Which action is the
priority?
A. Recheck the temperature in 4 hours
B. Notify the provider promptly
C. Offer an ice bath
D. Encourage visitors to enter the room
Answer: B
Fever in a neutropenic client can indicate a life-threatening infection. Prompt evaluation and
antimicrobial therapy may be required.
14. A client taking an ACE inhibitor develops swelling of the lips and tongue. Which
action is the priority?
A. Administer the next scheduled dose
B. Encourage oral fluids
C. Assess and protect the airway
D. Place the client flat
Answer: C
Angioedema can rapidly compromise the airway. Airway assessment and emergency
management are priorities.
