NUR 282 | Advanced Clinical / Transition Nursing | Exam 2 Study
Guide 2026 |Galen College
1. A nurse is caring for a client with left-sided heart failure. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Peripheral edema and weight gain
B. Dyspnea and crackles in the lungs
C. Jugular venous distention (JVD)
D. Hepatomegaly and splenomegaly
Answer: B
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary symptoms like dyspnea, crackles, and orthopnea. Right-sided failure typically
results in systemic congestion like edema and JVD.
2. Which cardiac rhythm is characterized by a ‘sawtooth’ appearance of P waves
and requires monitoring for thromboembolism?
A. Atrial Fibrillation
B. Atrial Flutter
C. Ventricular Tachycardia
D. Sinus Bradycardia
Answer: B
Rationale: Atrial Flutter is recognized by the sawtooth pattern (F-waves). Both Atrial
Fibrillation and Atrial Flutter carry a high risk of clot formation due to blood stasis in the
atria.
,3. A client is in Ventricular Fibrillation (VF). What is the priority nursing action?
A. Immediate defibrillation
B. Perform synchronized cardioversion
C. Administer IV Adenosine
D. Assess the client’s blood pressure
Answer: A
Rationale: Ventricular Fibrillation is a lethal rhythm where the heart is not pumping.
Immediate defibrillation is the most effective treatment. Synchronized cardioversion is for
rhythms with a pulse.
4. A client with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse prepare to administer to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Furosemide
D. Epoetin Alfa
Answer: B
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
cardiac membrane and prevent life-threatening arrhythmias, though it does not lower the
potassium level itself.
5. When assessing a client with a new Arteriovenous (AV) fistula for dialysis,
which finding indicates the fistula is patent?
A. Absence of a pulse distal to the site
B. Pitting edema in the affected extremity
C. Presence of a thrill and bruit
D. Redness and warmth at the incision
Answer: C
, Rationale: A functioning AV fistula should have a palpable thrill (vibration) and an audible
bruit (whooshing sound), indicating adequate blood flow.
6. Which set of vital signs is most indicative of Cushing’s Triad in a patient with
increased intracranial pressure (ICP)?
A. BP 180/100, HR 110, tachypnea
B. BP 90/60, HR 120, rapid shallow respirations
C. BP 120/80, HR 80, regular respirations
D. BP 160/60, HR 50, irregular respirations
Answer: D
Rationale: Cushing’s Triad consists of widening pulse pressure (high systolic/low
diastolic), bradycardia, and irregular respirations. It is a late sign of increased ICP.
7. A client is diagnosed with Septic Shock. Which of the following is a primary
clinical indicator of the ‘hyperdynamic’ (early) phase?
A. Warm, flushed skin
B. Hypotension and bradycardia
C. Cool, clammy skin
D. Oliguria
Answer: A
Rationale: In early (warm) septic shock, peripheral vasodilation leads to warm, flushed
skin and a high cardiac output despite the underlying infection.
8. What is the primary goal of PEEP (Positive End-Expiratory Pressure) for a
patient on a mechanical ventilator?
A. To increase the fraction of inspired oxygen (FiO2)
B. To decrease the risk of barotrauma
C. To prevent alveolar collapse and improve oxygenation
D. To increase the patient’s respiratory rate
Answer: C
Guide 2026 |Galen College
1. A nurse is caring for a client with left-sided heart failure. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Peripheral edema and weight gain
B. Dyspnea and crackles in the lungs
C. Jugular venous distention (JVD)
D. Hepatomegaly and splenomegaly
Answer: B
Rationale: Left-sided heart failure causes blood to back up into the lungs, leading to
pulmonary symptoms like dyspnea, crackles, and orthopnea. Right-sided failure typically
results in systemic congestion like edema and JVD.
2. Which cardiac rhythm is characterized by a ‘sawtooth’ appearance of P waves
and requires monitoring for thromboembolism?
A. Atrial Fibrillation
B. Atrial Flutter
C. Ventricular Tachycardia
D. Sinus Bradycardia
Answer: B
Rationale: Atrial Flutter is recognized by the sawtooth pattern (F-waves). Both Atrial
Fibrillation and Atrial Flutter carry a high risk of clot formation due to blood stasis in the
atria.
,3. A client is in Ventricular Fibrillation (VF). What is the priority nursing action?
A. Immediate defibrillation
B. Perform synchronized cardioversion
C. Administer IV Adenosine
D. Assess the client’s blood pressure
Answer: A
Rationale: Ventricular Fibrillation is a lethal rhythm where the heart is not pumping.
Immediate defibrillation is the most effective treatment. Synchronized cardioversion is for
rhythms with a pulse.
4. A client with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse prepare to administer to protect the
heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Furosemide
D. Epoetin Alfa
Answer: B
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
cardiac membrane and prevent life-threatening arrhythmias, though it does not lower the
potassium level itself.
5. When assessing a client with a new Arteriovenous (AV) fistula for dialysis,
which finding indicates the fistula is patent?
A. Absence of a pulse distal to the site
B. Pitting edema in the affected extremity
C. Presence of a thrill and bruit
D. Redness and warmth at the incision
Answer: C
, Rationale: A functioning AV fistula should have a palpable thrill (vibration) and an audible
bruit (whooshing sound), indicating adequate blood flow.
6. Which set of vital signs is most indicative of Cushing’s Triad in a patient with
increased intracranial pressure (ICP)?
A. BP 180/100, HR 110, tachypnea
B. BP 90/60, HR 120, rapid shallow respirations
C. BP 120/80, HR 80, regular respirations
D. BP 160/60, HR 50, irregular respirations
Answer: D
Rationale: Cushing’s Triad consists of widening pulse pressure (high systolic/low
diastolic), bradycardia, and irregular respirations. It is a late sign of increased ICP.
7. A client is diagnosed with Septic Shock. Which of the following is a primary
clinical indicator of the ‘hyperdynamic’ (early) phase?
A. Warm, flushed skin
B. Hypotension and bradycardia
C. Cool, clammy skin
D. Oliguria
Answer: A
Rationale: In early (warm) septic shock, peripheral vasodilation leads to warm, flushed
skin and a high cardiac output despite the underlying infection.
8. What is the primary goal of PEEP (Positive End-Expiratory Pressure) for a
patient on a mechanical ventilator?
A. To increase the fraction of inspired oxygen (FiO2)
B. To decrease the risk of barotrauma
C. To prevent alveolar collapse and improve oxygenation
D. To increase the patient’s respiratory rate
Answer: C
