ATI Swift River Med Surg Medical Surgical
Nursing Study Guide Practice Questions
2026/ 2027
Section 1: Cardiovascular Disorders
Question 1
A nurse is caring for a client who has left-sided heart failure. Which of the following
manifestations should the nurse expect?
A. Pedal edema
B. Neck vein distention
C. Daytime oliguria
D. Enlarged liver
Correct Answer: C
C. Daytime oliguria
Rationale: Left-sided heart failure causes decreased cardiac output, leading to decreased
renal perfusion and oliguria during the day when the client is active. Pedal edema, neck vein
distention, and enlarged liver are manifestations of right-sided heart failure .
Question 2
A client with acute anterior-wall ST-elevation MI is receiving alteplase (tPA). Which findings
require the nurse to stop the infusion? (Select all that apply.)
A. Sudden severe headache
B. IV site ecchymosis 2 cm
C. Blood pressure 180/100 mmHg
D. Gross blood in Foley catheter
E. Epistaxis lasting 5 min
Correct Answer: A, D
A. Sudden severe headache
D. Gross blood in Foley catheter
, Rationale: Sudden severe headache is a hallmark of intracranial bleed, an absolute
contraindication. Gross blood in the Foley catheter indicates genitourinary bleeding, which may
be major. IV site ecchymosis is minor oozing; apply pressure. Hypertension should be treated
but does not require stopping the infusion if no bleeding occurs. Minor epistaxis can be
managed with packing/nasal spray .
Question 3
A client with hypertensive crisis (BP 220/130) is started on nicardipine 5 mg/hr IV. Two minutes
after initiation the BP is 218/128. What is the nurse's best action?
A. Increase drip to 7.5 mg/hr
B. Notify provider immediately
C. Recheck BP in 5 min using same cuff
D. Place client in Trendelenburg
Correct Answer: C
C. Recheck BP in 5 min using same cuff
Rationale: Rapid-acting vasodilators require 5-15 minutes for full effect. The nurse should
recheck per protocol before titrating. Trendelenburg worsens cerebral perfusion and is
contraindicated in hypertensive crisis .
Question 4
A client is discharged on warfarin 5 mg daily. Which statement indicates correct understanding?
A. "I will take aspirin if I have chest pain."
B. "I should eat a spinach salad every day."
C. "I will check my INR every month."
D. "I will use an electric razor."
Correct Answer: D
D. "I will use an electric razor."
Rationale: An electric razor prevents bleeding injury. Daily spinach (vitamin K) would
destabilize INR; aspirin increases bleeding risk; INR is checked more frequently initially, then
weekly to monthly once stable .
,Question 5
The monitor shows PR 0.28 s, regular RR, QRS 0.08 s. The nurse interprets this as:
A. First-degree AV block
B. Second-degree AV block Type I
C. Second-degree AV block Type II
D. Third-degree AV block
Correct Answer: A
A. First-degree AV block
Rationale: A PR interval greater than 0.20 seconds with a regular rhythm and normal QRS
indicates first-degree AV block. This is characterized by prolonged AV conduction time .
Question 6
A nurse is teaching a client about a low-sodium diet. Which statement by the client indicates a
need for further teaching?
A. "I will avoid canned soups and frozen dinners."
B. "I can use lemon juice instead of salt to flavor my food."
C. "I will eat fresh fruits and vegetables."
D. "I can drink tomato juice every morning."
Correct Answer: D
D. "I can drink tomato juice every morning."
Rationale: Tomato juice is often high in sodium unless labeled "low sodium." The other
statements reflect appropriate dietary modifications for a low-sodium diet .
Question 7
A nurse is assessing a client who has heart failure and is taking furosemide. Which of the
following findings indicates a therapeutic response to the medication?
A. Weight gain of 2 kg in 24 hours
B. Decreased urine output
, C. Clear lung sounds bilaterally
D. Increased peripheral edema
Correct Answer: C
C. Clear lung sounds bilaterally
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart failure. Clear
lung sounds indicate a reduction in pulmonary congestion, which is a therapeutic response .
Question 8
A nurse is caring for a client who has a new prescription for warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of the medication?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
B. INR
Rationale: Warfarin is an anticoagulant that affects the extrinsic pathway. The INR is the
standard laboratory test used to monitor warfarin therapy and adjust dosage .
Question 9
A client with a suspected pulmonary embolism suddenly develops severe dyspnea, tachypnea,
and a loud systolic murmur at the left sternal border. The nurse suspects:
A. Myocardial infarction
B. Cardiac tamponade
C. Acute right ventricular failure
D. Papillary muscle rupture
Correct Answer: C
C. Acute right ventricular failure
Nursing Study Guide Practice Questions
2026/ 2027
Section 1: Cardiovascular Disorders
Question 1
A nurse is caring for a client who has left-sided heart failure. Which of the following
manifestations should the nurse expect?
A. Pedal edema
B. Neck vein distention
C. Daytime oliguria
D. Enlarged liver
Correct Answer: C
C. Daytime oliguria
Rationale: Left-sided heart failure causes decreased cardiac output, leading to decreased
renal perfusion and oliguria during the day when the client is active. Pedal edema, neck vein
distention, and enlarged liver are manifestations of right-sided heart failure .
Question 2
A client with acute anterior-wall ST-elevation MI is receiving alteplase (tPA). Which findings
require the nurse to stop the infusion? (Select all that apply.)
A. Sudden severe headache
B. IV site ecchymosis 2 cm
C. Blood pressure 180/100 mmHg
D. Gross blood in Foley catheter
E. Epistaxis lasting 5 min
Correct Answer: A, D
A. Sudden severe headache
D. Gross blood in Foley catheter
, Rationale: Sudden severe headache is a hallmark of intracranial bleed, an absolute
contraindication. Gross blood in the Foley catheter indicates genitourinary bleeding, which may
be major. IV site ecchymosis is minor oozing; apply pressure. Hypertension should be treated
but does not require stopping the infusion if no bleeding occurs. Minor epistaxis can be
managed with packing/nasal spray .
Question 3
A client with hypertensive crisis (BP 220/130) is started on nicardipine 5 mg/hr IV. Two minutes
after initiation the BP is 218/128. What is the nurse's best action?
A. Increase drip to 7.5 mg/hr
B. Notify provider immediately
C. Recheck BP in 5 min using same cuff
D. Place client in Trendelenburg
Correct Answer: C
C. Recheck BP in 5 min using same cuff
Rationale: Rapid-acting vasodilators require 5-15 minutes for full effect. The nurse should
recheck per protocol before titrating. Trendelenburg worsens cerebral perfusion and is
contraindicated in hypertensive crisis .
Question 4
A client is discharged on warfarin 5 mg daily. Which statement indicates correct understanding?
A. "I will take aspirin if I have chest pain."
B. "I should eat a spinach salad every day."
C. "I will check my INR every month."
D. "I will use an electric razor."
Correct Answer: D
D. "I will use an electric razor."
Rationale: An electric razor prevents bleeding injury. Daily spinach (vitamin K) would
destabilize INR; aspirin increases bleeding risk; INR is checked more frequently initially, then
weekly to monthly once stable .
,Question 5
The monitor shows PR 0.28 s, regular RR, QRS 0.08 s. The nurse interprets this as:
A. First-degree AV block
B. Second-degree AV block Type I
C. Second-degree AV block Type II
D. Third-degree AV block
Correct Answer: A
A. First-degree AV block
Rationale: A PR interval greater than 0.20 seconds with a regular rhythm and normal QRS
indicates first-degree AV block. This is characterized by prolonged AV conduction time .
Question 6
A nurse is teaching a client about a low-sodium diet. Which statement by the client indicates a
need for further teaching?
A. "I will avoid canned soups and frozen dinners."
B. "I can use lemon juice instead of salt to flavor my food."
C. "I will eat fresh fruits and vegetables."
D. "I can drink tomato juice every morning."
Correct Answer: D
D. "I can drink tomato juice every morning."
Rationale: Tomato juice is often high in sodium unless labeled "low sodium." The other
statements reflect appropriate dietary modifications for a low-sodium diet .
Question 7
A nurse is assessing a client who has heart failure and is taking furosemide. Which of the
following findings indicates a therapeutic response to the medication?
A. Weight gain of 2 kg in 24 hours
B. Decreased urine output
, C. Clear lung sounds bilaterally
D. Increased peripheral edema
Correct Answer: C
C. Clear lung sounds bilaterally
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart failure. Clear
lung sounds indicate a reduction in pulmonary congestion, which is a therapeutic response .
Question 8
A nurse is caring for a client who has a new prescription for warfarin. Which laboratory value
should the nurse monitor to evaluate the effectiveness of the medication?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
B. INR
Rationale: Warfarin is an anticoagulant that affects the extrinsic pathway. The INR is the
standard laboratory test used to monitor warfarin therapy and adjust dosage .
Question 9
A client with a suspected pulmonary embolism suddenly develops severe dyspnea, tachypnea,
and a loud systolic murmur at the left sternal border. The nurse suspects:
A. Myocardial infarction
B. Cardiac tamponade
C. Acute right ventricular failure
D. Papillary muscle rupture
Correct Answer: C
C. Acute right ventricular failure
