NUR 254 EXAM 2 | 50 Questions and
Well Detailed Answers Plus Rationales |
2026 Update | 100% Correct-Galen
College of Nursing
1. A patient with heart failure has crackles, jugular venous distention, and 3+ peripheral
edema. Which medication is the priority?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces fluid overload and preload,
improving symptoms of congestion.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles and
dyspnea.
3. A patient taking digoxin reports nausea and yellow-green vision. What is the nurse’s
priority action?
A. Administer an antiemetic
B. Check serum digoxin level
C. Give potassium supplement
D. Hold the beta blocker
,Answer: B
Rationale: Visual changes and GI symptoms are classic signs of digoxin toxicity and require
immediate level monitoring.
4. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Low potassium enhances digoxin’s effects, increasing the risk of toxicity.
5. Which medication class reduces afterload in patients with heart failure?
A. Diuretics
B. ACE inhibitors
C. Antiarrhythmics
D. Calcium channel blockers
Answer: B
Rationale: ACE inhibitors decrease systemic vascular resistance, lowering afterload and
improving cardiac output.
6. Which symptom is most concerning in a patient experiencing an acute myocardial
infarction?
A. Mild chest discomfort
B. Diaphoresis and nausea
C. Fatigue
D. Anxiety
Answer: B
Rationale: Diaphoresis and nausea are classic signs of acute MI and indicate sympathetic
activation.
7. Which intervention should be performed first for a patient with suspected MI?
A. Administer morphine
B. Obtain a 12-lead ECG
, C. Give aspirin
D. Start IV fluids
Answer: C
Rationale: Aspirin should be given immediately to inhibit platelet aggregation unless
contraindicated.
8. Which medication decreases heart rate and myocardial oxygen demand after an MI?
A. Nitroglycerin
B. Beta blocker
C. Diuretic
D. ACE inhibitor
Answer: B
Rationale: Beta blockers reduce heart rate and contractility, decreasing oxygen demand.
9. A patient receiving nitroglycerin complains of headache. What is the best response?
A. Stop the medication
B. Administer acetaminophen
C. Reduce the dose immediately
D. Notify the provider
Answer: B
Rationale: Headache is a common side effect of nitroglycerin due to vasodilation and is
treated with mild analgesics.
10. Which lab value is most important before administering heparin?
A. Platelet count
B. INR
C. Hemoglobin
D. Potassium
Answer: A
Rationale: Heparin can cause thrombocytopenia; platelets must be monitored.
11. Which assessment finding indicates decreased cardiac output?
A. Bounding peripheral pulses
B. Increased urine output
C. Altered mental status
D. Warm, flushed skin
Well Detailed Answers Plus Rationales |
2026 Update | 100% Correct-Galen
College of Nursing
1. A patient with heart failure has crackles, jugular venous distention, and 3+ peripheral
edema. Which medication is the priority?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Answer: B
Rationale: Furosemide is a loop diuretic that rapidly reduces fluid overload and preload,
improving symptoms of congestion.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Ascites
B. Peripheral edema
C. Pulmonary crackles
D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles and
dyspnea.
3. A patient taking digoxin reports nausea and yellow-green vision. What is the nurse’s
priority action?
A. Administer an antiemetic
B. Check serum digoxin level
C. Give potassium supplement
D. Hold the beta blocker
,Answer: B
Rationale: Visual changes and GI symptoms are classic signs of digoxin toxicity and require
immediate level monitoring.
4. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Low potassium enhances digoxin’s effects, increasing the risk of toxicity.
5. Which medication class reduces afterload in patients with heart failure?
A. Diuretics
B. ACE inhibitors
C. Antiarrhythmics
D. Calcium channel blockers
Answer: B
Rationale: ACE inhibitors decrease systemic vascular resistance, lowering afterload and
improving cardiac output.
6. Which symptom is most concerning in a patient experiencing an acute myocardial
infarction?
A. Mild chest discomfort
B. Diaphoresis and nausea
C. Fatigue
D. Anxiety
Answer: B
Rationale: Diaphoresis and nausea are classic signs of acute MI and indicate sympathetic
activation.
7. Which intervention should be performed first for a patient with suspected MI?
A. Administer morphine
B. Obtain a 12-lead ECG
, C. Give aspirin
D. Start IV fluids
Answer: C
Rationale: Aspirin should be given immediately to inhibit platelet aggregation unless
contraindicated.
8. Which medication decreases heart rate and myocardial oxygen demand after an MI?
A. Nitroglycerin
B. Beta blocker
C. Diuretic
D. ACE inhibitor
Answer: B
Rationale: Beta blockers reduce heart rate and contractility, decreasing oxygen demand.
9. A patient receiving nitroglycerin complains of headache. What is the best response?
A. Stop the medication
B. Administer acetaminophen
C. Reduce the dose immediately
D. Notify the provider
Answer: B
Rationale: Headache is a common side effect of nitroglycerin due to vasodilation and is
treated with mild analgesics.
10. Which lab value is most important before administering heparin?
A. Platelet count
B. INR
C. Hemoglobin
D. Potassium
Answer: A
Rationale: Heparin can cause thrombocytopenia; platelets must be monitored.
11. Which assessment finding indicates decreased cardiac output?
A. Bounding peripheral pulses
B. Increased urine output
C. Altered mental status
D. Warm, flushed skin
