NUR355: EXAM 3 UPDATED ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular System
Respiratory System
Renal and Urinary System
Neurological System
Endocrine System
Gastrointestinal System
Hematologic System
Shock and Sepsis
Fluid and Electrolyte Balance
Introduction
This comprehensive assessment evaluates the knowledge and
clinical judgment required for NUR355 Exam 3. The examination
covers medical-surgical nursing concepts including cardiovascular,
respiratory, renal, neurological, endocrine, and gastrointestinal
disorders. Questions incorporate both theoretical foundations and
scenario-based decision-making that mirror real-world clinical
situations. Emphasis is placed on prioritization, evidence-based
practice, and the application of the nursing process during acute
and chronic health disruptions. Candidates must demonstrate
mastery of pathophysiology, assessment findings, nursing
interventions, and patient education standards expected of
baccalaureate-prepared nurses.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a patient who is 24 hours post-myocardial
infarction and suddenly develops a heart rate of 120 bpm and
crackles in the lung bases. Which complication should the nurse
suspect first?
A. Pericarditis
B. Pulmonary embolism
C. Acute left-sided heart failure
D. Recurrent myocardial infarction
🟢 C. Acute left-sided heart failure
🔴 RATIONALE: The development of crackles and tachycardia
post-myocardial infarction is a classic indicator of acute left-sided
heart failure. When the damaged myocardium cannot pump
blood effectively, pulmonary congestion develops, and
tachycardia serves as a compensatory mechanism to maintain
cardiac output .
Question 2
Which assessment finding should the nurse prioritize for a patient
admitted with an acute exacerbation of Chronic Obstructive
Pulmonary Disease (COPD)?
A. Productive cough with thick green sputum
B. Clubbing of the fingernails
C. Pursed-lip breathing during rest
D. Increased use of accessory muscles
,🟢 D. Increased use of accessory muscles
🔴 RATIONALE: The use of accessory muscles indicates a
significant increase in the work of breathing and impending
respiratory failure. While clubbing and pursed-lip breathing are
common chronic findings, they do not indicate acute distress.
Prioritizing the work of breathing follows the ABC framework for
emergency nursing care .
Question 3
A patient with Type 1 Diabetes Mellitus presents to the ED with a
blood glucose of 550 mg/dL and Kussmaul respirations. What is
the nurse's immediate priority intervention?
A. Administering subcutaneous insulin
B. Providing a carbohydrate-rich snack
C. Starting an IV infusion of 0.9% Normal Saline
D. Assessing for signs of hypoglycemia
🟢 C. Starting an IV infusion of 0.9% Normal Saline
🔴 RATIONALE: In Diabetic Ketoacidosis (DKA), the patient is
severely dehydrated due to osmotic diuresis caused by
hyperglycemia. Rehydrating the patient with isotonic fluids is the
first step to restore circulatory volume and stabilize blood
pressure. Insulin therapy follows or accompanies fluid
resuscitation .
Question 4
, A nurse is reviewing the lab results of a patient with Chronic
Kidney Disease (CKD) and notes a potassium level of 6.5 mEq/L.
Which action is most critical?
A. Checking the patient's blood pressure
B. Obtaining a 12-lead Electrocardiogram (ECG)
C. Encouraging a low-potassium diet
D. Administering a scheduled dose of Lisinopril
🟢 B. Obtaining a 12-lead Electrocardiogram (ECG)
🔴 RATIONALE: Hyperkalemia at levels above 6.0 mEq/L poses a
severe risk for lethal cardiac arrhythmias. An ECG must be
performed immediately to look for peaked T-waves, widened QRS
complexes, or loss of P-waves. Lisinopril should be held as it can
further increase potassium levels .
Question 5
Which clinical manifestation should a nurse monitor for in a
patient with suspected Hyperthyroidism (Graves' Disease)?
A. Weight gain and bradycardia
B. Cold intolerance and dry skin
C. Exophthalmos and tremors
D. Periorbital edema and thick tongue
🟢 C. Exophthalmos and tremors
🔴 RATIONALE: Hyperthyroidism results in a hypermetabolic state
characterized by heat intolerance, weight loss, and tremors.
Exophthalmos, or bulging eyes, is a specific autoimmune
manifestation found in Graves' disease .
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular System
Respiratory System
Renal and Urinary System
Neurological System
Endocrine System
Gastrointestinal System
Hematologic System
Shock and Sepsis
Fluid and Electrolyte Balance
Introduction
This comprehensive assessment evaluates the knowledge and
clinical judgment required for NUR355 Exam 3. The examination
covers medical-surgical nursing concepts including cardiovascular,
respiratory, renal, neurological, endocrine, and gastrointestinal
disorders. Questions incorporate both theoretical foundations and
scenario-based decision-making that mirror real-world clinical
situations. Emphasis is placed on prioritization, evidence-based
practice, and the application of the nursing process during acute
and chronic health disruptions. Candidates must demonstrate
mastery of pathophysiology, assessment findings, nursing
interventions, and patient education standards expected of
baccalaureate-prepared nurses.
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is caring for a patient who is 24 hours post-myocardial
infarction and suddenly develops a heart rate of 120 bpm and
crackles in the lung bases. Which complication should the nurse
suspect first?
A. Pericarditis
B. Pulmonary embolism
C. Acute left-sided heart failure
D. Recurrent myocardial infarction
🟢 C. Acute left-sided heart failure
🔴 RATIONALE: The development of crackles and tachycardia
post-myocardial infarction is a classic indicator of acute left-sided
heart failure. When the damaged myocardium cannot pump
blood effectively, pulmonary congestion develops, and
tachycardia serves as a compensatory mechanism to maintain
cardiac output .
Question 2
Which assessment finding should the nurse prioritize for a patient
admitted with an acute exacerbation of Chronic Obstructive
Pulmonary Disease (COPD)?
A. Productive cough with thick green sputum
B. Clubbing of the fingernails
C. Pursed-lip breathing during rest
D. Increased use of accessory muscles
,🟢 D. Increased use of accessory muscles
🔴 RATIONALE: The use of accessory muscles indicates a
significant increase in the work of breathing and impending
respiratory failure. While clubbing and pursed-lip breathing are
common chronic findings, they do not indicate acute distress.
Prioritizing the work of breathing follows the ABC framework for
emergency nursing care .
Question 3
A patient with Type 1 Diabetes Mellitus presents to the ED with a
blood glucose of 550 mg/dL and Kussmaul respirations. What is
the nurse's immediate priority intervention?
A. Administering subcutaneous insulin
B. Providing a carbohydrate-rich snack
C. Starting an IV infusion of 0.9% Normal Saline
D. Assessing for signs of hypoglycemia
🟢 C. Starting an IV infusion of 0.9% Normal Saline
🔴 RATIONALE: In Diabetic Ketoacidosis (DKA), the patient is
severely dehydrated due to osmotic diuresis caused by
hyperglycemia. Rehydrating the patient with isotonic fluids is the
first step to restore circulatory volume and stabilize blood
pressure. Insulin therapy follows or accompanies fluid
resuscitation .
Question 4
, A nurse is reviewing the lab results of a patient with Chronic
Kidney Disease (CKD) and notes a potassium level of 6.5 mEq/L.
Which action is most critical?
A. Checking the patient's blood pressure
B. Obtaining a 12-lead Electrocardiogram (ECG)
C. Encouraging a low-potassium diet
D. Administering a scheduled dose of Lisinopril
🟢 B. Obtaining a 12-lead Electrocardiogram (ECG)
🔴 RATIONALE: Hyperkalemia at levels above 6.0 mEq/L poses a
severe risk for lethal cardiac arrhythmias. An ECG must be
performed immediately to look for peaked T-waves, widened QRS
complexes, or loss of P-waves. Lisinopril should be held as it can
further increase potassium levels .
Question 5
Which clinical manifestation should a nurse monitor for in a
patient with suspected Hyperthyroidism (Graves' Disease)?
A. Weight gain and bradycardia
B. Cold intolerance and dry skin
C. Exophthalmos and tremors
D. Periorbital edema and thick tongue
🟢 C. Exophthalmos and tremors
🔴 RATIONALE: Hyperthyroidism results in a hypermetabolic state
characterized by heat intolerance, weight loss, and tremors.
Exophthalmos, or bulging eyes, is a specific autoimmune
manifestation found in Graves' disease .
