1
NUR417 / NUR 417 Final Exam Care of Adult II
Concordia St. Paul Actual Exam 2026/2027 | Complete
Exam-Style Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Cardiovascular Disorders | Q1 – Q10
Section 2 | Respiratory Disorders | Q11 – Q20
Section 3 | Renal and Endocrine Disorders | Q21 – Q30
Section 4 | Neurological and Musculoskeletal Disorders | Q31 – Q40
Section 5 | Multisystem and Critical Care Concepts | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
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SECTION 1: CARDIOVASCULAR DISORDERS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old female with atrial fibrillation has been on digoxin 0.25 mg daily for two years. She
presents with nausea, anorexia, and reports seeing yellow halos around lights. Her heart rate is 52
beats per minute and her serum digoxin level is 2.8 ng/mL. What is the nurse's best response?
A. Administer the next dose as scheduled and obtain a stat magnesium level
B. Hold the next dose and notify the provider to check potassium and renal function ✓
CORRECT
C. Reduce the dose by half and continue the medication to maintain rate control
D. Switch to intravenous digoxin for more reliable absorption
Correct Answer: B
Rationale: Digoxin toxicity is confirmed by elevated serum levels accompanied by
gastrointestinal and visual symptoms; holding the dose and assessing potassium and renal
function is essential because hypokalemia and reduced clearance exacerbate toxicity. Continuing
,2
or reducing the dose can worsen bradycardia and precipitate dangerous arrhythmias. Intravenous
administration does not resolve toxicity and increases the risk of hypotension.
Question 2 of 50
A 65-year-old female is postoperative day 3 following an uncomplicated myocardial infarction.
She reports sudden onset of sharp, pleuritic chest pain that worsens when she lies flat.
Auscultation reveals a friction rub along the left sternal border, and the 12-lead ECG shows
diffuse ST-segment elevation. Which intervention should the nurse anticipate?
A. Administer thrombolytics immediately to treat recurrent infarction
B. Administer high-dose aspirin and colchicine per provider order ✓ CORRECT
C. Prepare the patient for emergent cardiac catheterization
D. Increase the heparin infusion to prevent coronary reocclusion
Correct Answer: B
Rationale: Post-myocardial infarction pericarditis is treated with high-dose aspirin and colchicine
to reduce inflammation; thrombolytics and catheterization address coronary occlusion, not
pericardial inflammation. Increasing heparin could worsen bleeding into the pericardial space
and precipitate tamponade. Diffuse ST elevation with a friction rub distinguishes pericarditis
from recurrent STEMI.
Question 3 of 50
A 58-year-old male had a dual-chamber pacemaker implanted two weeks ago. He calls the clinic
reporting that his left arm is swollen, warm, and painful near the generator site, and his
temperature is 38.3°C. Which instruction should the nurse provide?
A. Apply warm compresses to the area and schedule a routine follow-up visit in one week
B. Start oral cephalexin from his home antibiotic supply and monitor for 48 hours
C. Advise him to proceed to the emergency department immediately for evaluation ✓ CORRECT
D. Instruct him to take ibuprofen and elevate the arm above heart level
Correct Answer: C
Rationale: Fever and localized swelling near a pacemaker generator strongly suggest device
infection or pocket hematoma with infection, requiring urgent in-person assessment and possible
device extraction. Outpatient antibiotics and conservative measures delay definitive care and risk
sepsis or endocarditis. Generator infections rarely resolve without hardware removal and
prolonged intravenous antibiotics.
, 3
Question 4 of 50
An 81-year-old female with atrial fibrillation on warfarin presents to the emergency department
after slipping in her kitchen and striking her forehead on a cabinet. She is alert and oriented with
no neurologic deficits, and her INR is 3.5. Which action should the nurse prioritize?
A. Reverse the warfarin effect immediately with 10 mg of intravenous vitamin K
B. Discharge the patient to home observation with family monitoring for 24 hours
C. Administer fresh frozen plasma prophylactically to normalize the INR
D. Obtain a noncontrast head CT scan to rule out intracranial bleeding ✓ CORRECT
Correct Answer: D
Rationale: Anticoagulated elderly patients with even minor head trauma require prompt
noncontrast head CT to rule out intracranial hemorrhage because delayed bleeds are common and
can be asymptomatic initially. Immediate reversal without imaging is unnecessary if no bleed is
present and can lead to thrombotic complications. Discharging without imaging places the
patient at significant risk for delayed epidural or subdural hematoma.
Question 5 of 50
A 49-year-old male with hypertrophic cardiomyopathy experienced a syncopal episode while
running on a treadmill. His father died suddenly at age 42 from an undiagnosed cardiac
condition. During discharge teaching, which recommendation is most important for the nurse to
emphasize?
A. Avoid competitive athletics and strenuous exercise permanently ✓ CORRECT
B. Light jogging is acceptable provided he carries a rescue inhaler
C. Beta-blocker therapy will eliminate the risk of sudden death during exertion
D. Swimming is a safe alternative because water supports cardiac workload
Correct Answer: A
Rationale: Hypertrophic cardiomyopathy with exercise-induced syncope and family history of
sudden death carries high risk for ventricular arrhythmias; guidelines recommend restriction
from competitive sports and strenuous exertion. Beta-blockers reduce symptoms but do not
eliminate sudden death risk during intense exercise. Swimming and jogging can still trigger
arrhythmias and should be approached cautiously under cardiology guidance.
Question 6 of 50
NUR417 / NUR 417 Final Exam Care of Adult II
Concordia St. Paul Actual Exam 2026/2027 | Complete
Exam-Style Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Cardiovascular Disorders | Q1 – Q10
Section 2 | Respiratory Disorders | Q11 – Q20
Section 3 | Renal and Endocrine Disorders | Q21 – Q30
Section 4 | Neurological and Musculoskeletal Disorders | Q31 – Q40
Section 5 | Multisystem and Critical Care Concepts | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: CARDIOVASCULAR DISORDERS Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old female with atrial fibrillation has been on digoxin 0.25 mg daily for two years. She
presents with nausea, anorexia, and reports seeing yellow halos around lights. Her heart rate is 52
beats per minute and her serum digoxin level is 2.8 ng/mL. What is the nurse's best response?
A. Administer the next dose as scheduled and obtain a stat magnesium level
B. Hold the next dose and notify the provider to check potassium and renal function ✓
CORRECT
C. Reduce the dose by half and continue the medication to maintain rate control
D. Switch to intravenous digoxin for more reliable absorption
Correct Answer: B
Rationale: Digoxin toxicity is confirmed by elevated serum levels accompanied by
gastrointestinal and visual symptoms; holding the dose and assessing potassium and renal
function is essential because hypokalemia and reduced clearance exacerbate toxicity. Continuing
,2
or reducing the dose can worsen bradycardia and precipitate dangerous arrhythmias. Intravenous
administration does not resolve toxicity and increases the risk of hypotension.
Question 2 of 50
A 65-year-old female is postoperative day 3 following an uncomplicated myocardial infarction.
She reports sudden onset of sharp, pleuritic chest pain that worsens when she lies flat.
Auscultation reveals a friction rub along the left sternal border, and the 12-lead ECG shows
diffuse ST-segment elevation. Which intervention should the nurse anticipate?
A. Administer thrombolytics immediately to treat recurrent infarction
B. Administer high-dose aspirin and colchicine per provider order ✓ CORRECT
C. Prepare the patient for emergent cardiac catheterization
D. Increase the heparin infusion to prevent coronary reocclusion
Correct Answer: B
Rationale: Post-myocardial infarction pericarditis is treated with high-dose aspirin and colchicine
to reduce inflammation; thrombolytics and catheterization address coronary occlusion, not
pericardial inflammation. Increasing heparin could worsen bleeding into the pericardial space
and precipitate tamponade. Diffuse ST elevation with a friction rub distinguishes pericarditis
from recurrent STEMI.
Question 3 of 50
A 58-year-old male had a dual-chamber pacemaker implanted two weeks ago. He calls the clinic
reporting that his left arm is swollen, warm, and painful near the generator site, and his
temperature is 38.3°C. Which instruction should the nurse provide?
A. Apply warm compresses to the area and schedule a routine follow-up visit in one week
B. Start oral cephalexin from his home antibiotic supply and monitor for 48 hours
C. Advise him to proceed to the emergency department immediately for evaluation ✓ CORRECT
D. Instruct him to take ibuprofen and elevate the arm above heart level
Correct Answer: C
Rationale: Fever and localized swelling near a pacemaker generator strongly suggest device
infection or pocket hematoma with infection, requiring urgent in-person assessment and possible
device extraction. Outpatient antibiotics and conservative measures delay definitive care and risk
sepsis or endocarditis. Generator infections rarely resolve without hardware removal and
prolonged intravenous antibiotics.
, 3
Question 4 of 50
An 81-year-old female with atrial fibrillation on warfarin presents to the emergency department
after slipping in her kitchen and striking her forehead on a cabinet. She is alert and oriented with
no neurologic deficits, and her INR is 3.5. Which action should the nurse prioritize?
A. Reverse the warfarin effect immediately with 10 mg of intravenous vitamin K
B. Discharge the patient to home observation with family monitoring for 24 hours
C. Administer fresh frozen plasma prophylactically to normalize the INR
D. Obtain a noncontrast head CT scan to rule out intracranial bleeding ✓ CORRECT
Correct Answer: D
Rationale: Anticoagulated elderly patients with even minor head trauma require prompt
noncontrast head CT to rule out intracranial hemorrhage because delayed bleeds are common and
can be asymptomatic initially. Immediate reversal without imaging is unnecessary if no bleed is
present and can lead to thrombotic complications. Discharging without imaging places the
patient at significant risk for delayed epidural or subdural hematoma.
Question 5 of 50
A 49-year-old male with hypertrophic cardiomyopathy experienced a syncopal episode while
running on a treadmill. His father died suddenly at age 42 from an undiagnosed cardiac
condition. During discharge teaching, which recommendation is most important for the nurse to
emphasize?
A. Avoid competitive athletics and strenuous exercise permanently ✓ CORRECT
B. Light jogging is acceptable provided he carries a rescue inhaler
C. Beta-blocker therapy will eliminate the risk of sudden death during exertion
D. Swimming is a safe alternative because water supports cardiac workload
Correct Answer: A
Rationale: Hypertrophic cardiomyopathy with exercise-induced syncope and family history of
sudden death carries high risk for ventricular arrhythmias; guidelines recommend restriction
from competitive sports and strenuous exertion. Beta-blockers reduce symptoms but do not
eliminate sudden death risk during intense exercise. Swimming and jogging can still trigger
arrhythmias and should be approached cautiously under cardiology guidance.
Question 6 of 50
