NSG 3850 Exam 4 (Version A) – Galen
College of Nursing (U.S.) EXAM PRACTICE
250 QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A client with acute pulmonary edema is severely dyspneic and
coughing pink, frothy sputum. Which action should the nurse take
first?
A. Obtain a sputum culture
B. Place the client in high-Fowler's position
C. Encourage oral fluids
D. Place the client supine
Answer: B. Place the client in high-Fowler's position
Rationale: High-Fowler's positioning promotes lung expansion and
decreases venous return, helping reduce pulmonary congestion.
2. Which assessment finding is most characteristic of left-sided heart
failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion,
commonly producing crackles, dyspnea, and orthopnea.
,3. A client taking furosemide reports muscle weakness and
palpitations. Which laboratory value should the nurse assess first?
A. Sodium
B. Potassium
C. Calcium
D. Hemoglobin
Answer: B. Potassium
Rationale: Furosemide can cause potassium loss. Hypokalemia may
produce muscle weakness and dysrhythmias.
4. Which finding in a client with heart failure requires immediate
intervention?
A. 1+ ankle edema
B. Weight gain of 0.5 kg in one week
C. Oxygen saturation of 86%
D. Mild fatigue after activity
Answer: C. Oxygen saturation of 86%
Rationale: Significant hypoxemia indicates impaired oxygenation and
requires prompt intervention.
5. A client prescribed digoxin has an apical pulse of 52/min. What
should the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give an additional dose
D. Administer with an antacid
Answer: B. Hold the medication and notify the provider
,Rationale: Bradycardia can indicate excessive digoxin effect. Digoxin
is commonly withheld when the adult apical pulse is below 60/min.
6. Which finding is most concerning for digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Hypertension
D. Increased urination
Answer: B. Yellow-green visual disturbances
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations of digoxin toxicity.
7. A client with atrial fibrillation is prescribed warfarin. Which
laboratory test is used to monitor therapy?
A. aPTT
B. INR
C. Troponin
D. BNP
Answer: B. INR
Rationale: Warfarin therapy is monitored using PT/INR to evaluate
anticoagulation.
8. Which statement by a client taking warfarin indicates a need for
further teaching?
A. “I will report unusual bleeding.”
B. “I should keep my vitamin K intake relatively consistent.”
C. “I can take aspirin whenever I develop a headache.”
D. “I will attend regular INR appointments.”
Answer: C. “I can take aspirin whenever I develop a headache.”
, Rationale: Aspirin can increase bleeding risk when combined with
warfarin and should not be taken without appropriate guidance.
9. Which assessment finding is most consistent with right-sided heart
failure?
A. Pulmonary crackles
B. Pink frothy sputum
C. Jugular venous distention
D. Hemoptysis
Answer: C. Jugular venous distention
Rationale: Right-sided failure causes systemic venous congestion,
producing JVD, peripheral edema, hepatomegaly, and ascites.
10. A client with heart failure should be taught to monitor which
parameter daily?
A. Height
B. Weight
C. Visual acuity
D. Temperature only
Answer: B. Weight
Rationale: Daily weight monitoring can identify early fluid retention
before severe symptoms develop.
11. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation only
D. U waves
Answer: A. Peaked T waves
College of Nursing (U.S.) EXAM PRACTICE
250 QUESTIONS |ORIGINAL QUESTIONS &
ANSWERS |DETAILED RATIONALES
|HINTED COMPLETE EXAM PREP GRADED
A+*INSTANT DOWNLOAD PDF
1. A client with acute pulmonary edema is severely dyspneic and
coughing pink, frothy sputum. Which action should the nurse take
first?
A. Obtain a sputum culture
B. Place the client in high-Fowler's position
C. Encourage oral fluids
D. Place the client supine
Answer: B. Place the client in high-Fowler's position
Rationale: High-Fowler's positioning promotes lung expansion and
decreases venous return, helping reduce pulmonary congestion.
2. Which assessment finding is most characteristic of left-sided heart
failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Crackles in the lungs
D. Ascites
Answer: C. Crackles in the lungs
Rationale: Left-sided heart failure causes pulmonary congestion,
commonly producing crackles, dyspnea, and orthopnea.
,3. A client taking furosemide reports muscle weakness and
palpitations. Which laboratory value should the nurse assess first?
A. Sodium
B. Potassium
C. Calcium
D. Hemoglobin
Answer: B. Potassium
Rationale: Furosemide can cause potassium loss. Hypokalemia may
produce muscle weakness and dysrhythmias.
4. Which finding in a client with heart failure requires immediate
intervention?
A. 1+ ankle edema
B. Weight gain of 0.5 kg in one week
C. Oxygen saturation of 86%
D. Mild fatigue after activity
Answer: C. Oxygen saturation of 86%
Rationale: Significant hypoxemia indicates impaired oxygenation and
requires prompt intervention.
5. A client prescribed digoxin has an apical pulse of 52/min. What
should the nurse do?
A. Administer the medication
B. Hold the medication and notify the provider
C. Give an additional dose
D. Administer with an antacid
Answer: B. Hold the medication and notify the provider
,Rationale: Bradycardia can indicate excessive digoxin effect. Digoxin
is commonly withheld when the adult apical pulse is below 60/min.
6. Which finding is most concerning for digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Hypertension
D. Increased urination
Answer: B. Yellow-green visual disturbances
Rationale: Visual changes, nausea, vomiting, anorexia, and
dysrhythmias are classic manifestations of digoxin toxicity.
7. A client with atrial fibrillation is prescribed warfarin. Which
laboratory test is used to monitor therapy?
A. aPTT
B. INR
C. Troponin
D. BNP
Answer: B. INR
Rationale: Warfarin therapy is monitored using PT/INR to evaluate
anticoagulation.
8. Which statement by a client taking warfarin indicates a need for
further teaching?
A. “I will report unusual bleeding.”
B. “I should keep my vitamin K intake relatively consistent.”
C. “I can take aspirin whenever I develop a headache.”
D. “I will attend regular INR appointments.”
Answer: C. “I can take aspirin whenever I develop a headache.”
, Rationale: Aspirin can increase bleeding risk when combined with
warfarin and should not be taken without appropriate guidance.
9. Which assessment finding is most consistent with right-sided heart
failure?
A. Pulmonary crackles
B. Pink frothy sputum
C. Jugular venous distention
D. Hemoptysis
Answer: C. Jugular venous distention
Rationale: Right-sided failure causes systemic venous congestion,
producing JVD, peripheral edema, hepatomegaly, and ascites.
10. A client with heart failure should be taught to monitor which
parameter daily?
A. Height
B. Weight
C. Visual acuity
D. Temperature only
Answer: B. Weight
Rationale: Daily weight monitoring can identify early fluid retention
before severe symptoms develop.
11. Which ECG change is commonly associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation only
D. U waves
Answer: A. Peaked T waves
