NRSG 110 Exam 2 V3 | NRSG 110 Medical Surgical
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 2) | Ivy Tech
1. A nurse is caring for a client with left-sided heart failure. Which clinical manifestation
should the nurse expect to observe during the physical assessment?
A. Dependent edema
B. Jugular vein distention
C. Hepatomegaly
D. Dyspnea and crackles
Correct Answer: D
Explanation: Left-sided heart failure results in pulmonary congestion because the left
ventricle cannot effectively pump blood into the systemic circulation. This leads to
symptoms such as dyspnea, orthopnea, and crackles upon auscultation of the lungs. The
other options, such as dependent edema and JVD, are characteristic of right-sided heart
failure.
2. A client is prescribed lisinopril for the management of hypertension. Which side effect is a
common reason for patients to discontinue this medication?
A. Hypokalemia
B. Dry, nonproductive cough
,C. Weight gain
D. Tachycardia
Correct Answer: B
Explanation: ACE inhibitors like lisinopril prevent the breakdown of bradykinin, which
can lead to a persistent, dry cough in some patients. This side effect is often distressing
enough that patients may need to switch to an Angiotensin II Receptor Blocker (ARB).
Unlike diuretics, ACE inhibitors are more likely to cause hyperkalemia rather than
hypokalemia.
3. The nurse is calculating the cardiac output for a client with a stroke volume of 70 mL and a
heart rate of 80 beats per minute. What is the client’s cardiac output?
A. 5.6 L/min
B. 4.2 L/min
C. 150 mL/min
D. 7.0 L/min
Correct Answer: A
Explanation: Cardiac output is determined by multiplying the stroke volume by the heart
rate (CO = SV x HR). In this case, 70 mL multiplied by 80 bpm equals 5,600 mL, which
converts to 5.6 liters per minute. Understanding this formula is crucial for assessing a
client’s hemodynamic stability and perfusion status.
, 4. A client presents to the emergency department with substernal chest pain radiating to the
left arm. Which diagnostic test is the most specific indicator of myocardial injury?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. C-reactive protein
D. B-type natriuretic peptide (BNP)
E. Troponin I and T
Correct Answer: E
Explanation: Troponins are proteins found in cardiac muscle and are released into the
bloodstream when myocardial damage occurs. They are highly specific to cardiac tissue
and remain elevated longer than other markers like CK-MB. While BNP is used for heart
failure, Troponin is the gold standard for diagnosing a myocardial infarction.
5. Which cardiac rhythm is characterized by the absence of P waves and an irregularly
irregular QRS complex?
A. Sinus bradycardia
B. First-degree heart block
C. Ventricular tachycardia
D. Atrial fibrillation
Correct Answer: D
Nursing II | Actual Q&A with Rationale (NRSG110
Exam 2) | Ivy Tech
1. A nurse is caring for a client with left-sided heart failure. Which clinical manifestation
should the nurse expect to observe during the physical assessment?
A. Dependent edema
B. Jugular vein distention
C. Hepatomegaly
D. Dyspnea and crackles
Correct Answer: D
Explanation: Left-sided heart failure results in pulmonary congestion because the left
ventricle cannot effectively pump blood into the systemic circulation. This leads to
symptoms such as dyspnea, orthopnea, and crackles upon auscultation of the lungs. The
other options, such as dependent edema and JVD, are characteristic of right-sided heart
failure.
2. A client is prescribed lisinopril for the management of hypertension. Which side effect is a
common reason for patients to discontinue this medication?
A. Hypokalemia
B. Dry, nonproductive cough
,C. Weight gain
D. Tachycardia
Correct Answer: B
Explanation: ACE inhibitors like lisinopril prevent the breakdown of bradykinin, which
can lead to a persistent, dry cough in some patients. This side effect is often distressing
enough that patients may need to switch to an Angiotensin II Receptor Blocker (ARB).
Unlike diuretics, ACE inhibitors are more likely to cause hyperkalemia rather than
hypokalemia.
3. The nurse is calculating the cardiac output for a client with a stroke volume of 70 mL and a
heart rate of 80 beats per minute. What is the client’s cardiac output?
A. 5.6 L/min
B. 4.2 L/min
C. 150 mL/min
D. 7.0 L/min
Correct Answer: A
Explanation: Cardiac output is determined by multiplying the stroke volume by the heart
rate (CO = SV x HR). In this case, 70 mL multiplied by 80 bpm equals 5,600 mL, which
converts to 5.6 liters per minute. Understanding this formula is crucial for assessing a
client’s hemodynamic stability and perfusion status.
, 4. A client presents to the emergency department with substernal chest pain radiating to the
left arm. Which diagnostic test is the most specific indicator of myocardial injury?
A. Creatine kinase (CK-MB)
B. Myoglobin
C. C-reactive protein
D. B-type natriuretic peptide (BNP)
E. Troponin I and T
Correct Answer: E
Explanation: Troponins are proteins found in cardiac muscle and are released into the
bloodstream when myocardial damage occurs. They are highly specific to cardiac tissue
and remain elevated longer than other markers like CK-MB. While BNP is used for heart
failure, Troponin is the gold standard for diagnosing a myocardial infarction.
5. Which cardiac rhythm is characterized by the absence of P waves and an irregularly
irregular QRS complex?
A. Sinus bradycardia
B. First-degree heart block
C. Ventricular tachycardia
D. Atrial fibrillation
Correct Answer: D
