NURS FPX 4015 – FULL 2025 TEST BANK (70
BIG Questions, Answer-s, Rationales &
Rotations)
(Holistic Pathophysiology + Pharmacology + Assessment)
ROTATION 1 — CARDIOVASCULAR (Q1–Q10)
1. A 62-year-old male presents with sudden-onset chest pressure radiating to his
left arm, diaphoresis, and nausea. ECG shows ST-segment elevation in leads II,
III, aVF. Which immediate intervention has the highest priority?
A. Administer nitroglycerin SL
B. Obtain troponin levels
C. Prepare for percutaneous coronary intervention (PCI)
D. Start IV morphine
Answer-: C
Rationale:
STEMI in inferior leads requires rapid reperfusion, and PCI within 90 minutes is
the priority. Nitroglycerin and morphine may help symptoms but do not treat the
cause. Troponins confirm diagnosis but should not delay PCI.
2. A patient with heart failure reports worsening dyspnea, pink frothy sputum,
and crackles in both lower lobes. What medication should be administered first?
A. Metoprolol
B. Furosemide IV
C. Spironolactone
D. Enalapril PO
,Answer-: B
Rationale:
Pink frothy sputum = acute pulmonary edema → immediate diuresis with IV
furosemide to reduce preload and fluid volume.
3. A client taking warfarin has an INR of 6.2 with minor gum bleeding. The nurse
expects the provider to order:
A. Fresh frozen plasma
B. Vitamin K oral
C. Heparin infusion
D. Platelet transfusion
Answer-: B
Rationale:
INR > 6 with mild bleeding → oral vitamin K is appropriate. IV vitamin K or FFP is
for life-threatening bleeding.
4. During a cardiovascular assessment, the nurse notes a displaced apical
impulse at the 6th intercostal space, midaxillary line. This finding is most
consistent with:
A. Right-sided heart failure
B. Left ventricular hypertrophy
C. Pericarditis
D. Aortic stenosis
Answer-: B
Rationale:
A displaced PMI indicates enlarged left ventricle.
5. A client with chronic hypertension is prescribed lisinopril. Which adverse
effect requires immediate intervention?
, A. Dry cough
B. Elevated potassium
C. Angioedema
D. Dizziness
Answer-: C
Rationale:
Angioedema is a medical emergency → airway risk.
6. A patient on digoxin has nausea, bradycardia (HR 48), and sees yellow halos.
Priority action?
A. Give next dose
B. Check digoxin level
C. Administer atropine
D. Give IV fluids
Answer-: B
Rationale:
Classic signs of digoxin toxicity → confirm with a level before treating.
7. A client develops hypotension and muffled heart sounds after chest trauma.
What is suspected?
A. Pulmonary embolism
B. Tension pneumothorax
C. Cardiac tamponade
D. Hemothorax
Answer-: C
8. Which finding in a client taking carvedilol requires urgent follow-up?
A. Fatigue
B. Wheezing
BIG Questions, Answer-s, Rationales &
Rotations)
(Holistic Pathophysiology + Pharmacology + Assessment)
ROTATION 1 — CARDIOVASCULAR (Q1–Q10)
1. A 62-year-old male presents with sudden-onset chest pressure radiating to his
left arm, diaphoresis, and nausea. ECG shows ST-segment elevation in leads II,
III, aVF. Which immediate intervention has the highest priority?
A. Administer nitroglycerin SL
B. Obtain troponin levels
C. Prepare for percutaneous coronary intervention (PCI)
D. Start IV morphine
Answer-: C
Rationale:
STEMI in inferior leads requires rapid reperfusion, and PCI within 90 minutes is
the priority. Nitroglycerin and morphine may help symptoms but do not treat the
cause. Troponins confirm diagnosis but should not delay PCI.
2. A patient with heart failure reports worsening dyspnea, pink frothy sputum,
and crackles in both lower lobes. What medication should be administered first?
A. Metoprolol
B. Furosemide IV
C. Spironolactone
D. Enalapril PO
,Answer-: B
Rationale:
Pink frothy sputum = acute pulmonary edema → immediate diuresis with IV
furosemide to reduce preload and fluid volume.
3. A client taking warfarin has an INR of 6.2 with minor gum bleeding. The nurse
expects the provider to order:
A. Fresh frozen plasma
B. Vitamin K oral
C. Heparin infusion
D. Platelet transfusion
Answer-: B
Rationale:
INR > 6 with mild bleeding → oral vitamin K is appropriate. IV vitamin K or FFP is
for life-threatening bleeding.
4. During a cardiovascular assessment, the nurse notes a displaced apical
impulse at the 6th intercostal space, midaxillary line. This finding is most
consistent with:
A. Right-sided heart failure
B. Left ventricular hypertrophy
C. Pericarditis
D. Aortic stenosis
Answer-: B
Rationale:
A displaced PMI indicates enlarged left ventricle.
5. A client with chronic hypertension is prescribed lisinopril. Which adverse
effect requires immediate intervention?
, A. Dry cough
B. Elevated potassium
C. Angioedema
D. Dizziness
Answer-: C
Rationale:
Angioedema is a medical emergency → airway risk.
6. A patient on digoxin has nausea, bradycardia (HR 48), and sees yellow halos.
Priority action?
A. Give next dose
B. Check digoxin level
C. Administer atropine
D. Give IV fluids
Answer-: B
Rationale:
Classic signs of digoxin toxicity → confirm with a level before treating.
7. A client develops hypotension and muffled heart sounds after chest trauma.
What is suspected?
A. Pulmonary embolism
B. Tension pneumothorax
C. Cardiac tamponade
D. Hemothorax
Answer-: C
8. Which finding in a client taking carvedilol requires urgent follow-up?
A. Fatigue
B. Wheezing
