NUR 265 GALEN EXAM 3 2026/2027 | Medical-Surgical
Nursing | 100% Correct Answers | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular Disorders & Management (Q1-12)
Q1. A patient with heart failure is instructed to perform daily weights. Which finding
requires the nurse to notify the healthcare provider?
A. Weight gain of 0.5 lb in 3 days
B. Weight loss of 2 lbs in 1 week
C. Weight gain of 2-3 lbs in 2 days
D. Weight gain of 1 lb in 24 hours
Correct Answer: C. Weight gain of 2-3 lbs in 2 days [CORRECT]
Rationale: A weight gain of 2-3 pounds in 2 days or 3-5 pounds in a week indicates fluid
retention and possible decompensated heart failure requiring provider notification for
possible diuretic adjustment; smaller gains are expected variations and weight loss is
not a concern.
Q2. Which medication class is FIRST-LINE for reducing mortality in heart failure with
reduced ejection fraction (HFrEF)?
A. Loop diuretics
B. ACE inhibitors
C. Calcium channel blockers
D. Digoxin
Correct Answer: B. ACE inhibitors [CORRECT]
Rationale: ACE inhibitors (or ARBs/ARNI) are foundational therapy that block RAAS to
reduce mortality and morbidity in HFrEF; loop diuretics manage symptoms without
mortality benefit, digoxin improves symptoms only, and calcium channel blockers are
not first-line for HFrEF.
,Q3. A patient prescribed metoprolol has a heart rate of 58 beats/minute and blood
pressure 102/64 mmHg. Which action should the nurse take?
A. Give the dose as prescribed
B. Hold the dose and notify the provider
C. Check the potassium level before giving
D. Administer half the prescribed dose
Correct Answer: B. Hold the dose and notify the provider [CORRECT]
Rationale: Beta-blockers are typically held when the heart rate is <60 bpm to prevent
excessive bradycardia and reduced cardiac output; nurses must never independently
adjust doses or hold medications without notifying the provider.
Q4. A patient presents with chest pain unrelieved by nitroglycerin. The ECG shows
ST-segment elevation in leads V1-V4. Which intervention is the priority?
A. Administer morphine sulfate
B. Prepare for percutaneous coronary intervention
C. Start a heparin drip
D. Obtain serial cardiac enzymes
Correct Answer: B. Prepare for percutaneous coronary intervention [CORRECT]
Rationale: ST-elevation in anterior leads V1-V4 indicates an anterior STEMI requiring
emergent reperfusion via PCI within 90 minutes; while morphine, heparin, and enzymes
are important, restoring blood flow is the absolute priority to preserve myocardium.
Q5. A nurse is teaching a post-myocardial infarction patient about atorvastatin 80 mg
daily. Which statement best explains the purpose of this medication?
A. "It will dissolve any clots in your arteries."
B. "It stabilizes plaques and reduces future cardiac events."
C. "It lowers your blood pressure."
D. "It prevents abnormal heart rhythms."
Correct Answer: B. "It stabilizes plaques and reduces future cardiac events." [CORRECT]
, Rationale: High-intensity statins post-MI stabilize coronary plaques, reduce
inflammation, and lower LDL to prevent recurrent cardiac events; statins do not dissolve
clots, lower blood pressure, or treat dysrhythmias.
Q6. A patient on telemetry has an irregular rhythm with no discernible P waves,
fibrillatory waves, and a ventricular rate of 150. Which is the nurse's immediate priority?
A. Administer adenosine 6 mg IV push
B. Prepare for synchronized cardioversion
C. Assess for hemodynamic instability
D. Administer metoprolol orally
Correct Answer: C. Assess for hemodynamic instability [CORRECT]
Rationale: The rhythm is atrial fibrillation with rapid ventricular response; before
selecting treatment such as cardioversion, beta-blockers, or calcium channel blockers,
the nurse must first assess for hypotension, chest pain, or altered mental status that
would indicate instability.
Q7. Which ECG finding is characteristic of third-degree atrioventricular block?
A. Progressive PR interval prolongation
B. P waves and QRS complexes with no consistent relationship
C. Absent P waves with a sawtooth pattern
D. Wide QRS complexes at a regular rate of 150-250
Correct Answer: B. P waves and QRS complexes with no consistent relationship
[CORRECT]
Rationale: Third-degree AV block demonstrates complete atrioventricular dissociation
where P waves and QRS complexes occur independently without a fixed relationship;
progressive PR prolongation is Mobitz I, sawtooth pattern is atrial flutter, and wide
regular tachycardia is ventricular tachycardia.
Q8. A nurse is providing pre-procedure instructions for a stress echocardiogram. Which
instruction is essential?
Nursing | 100% Correct Answers | Pass Guaranteed - A+
Graded
Section 1: Cardiovascular Disorders & Management (Q1-12)
Q1. A patient with heart failure is instructed to perform daily weights. Which finding
requires the nurse to notify the healthcare provider?
A. Weight gain of 0.5 lb in 3 days
B. Weight loss of 2 lbs in 1 week
C. Weight gain of 2-3 lbs in 2 days
D. Weight gain of 1 lb in 24 hours
Correct Answer: C. Weight gain of 2-3 lbs in 2 days [CORRECT]
Rationale: A weight gain of 2-3 pounds in 2 days or 3-5 pounds in a week indicates fluid
retention and possible decompensated heart failure requiring provider notification for
possible diuretic adjustment; smaller gains are expected variations and weight loss is
not a concern.
Q2. Which medication class is FIRST-LINE for reducing mortality in heart failure with
reduced ejection fraction (HFrEF)?
A. Loop diuretics
B. ACE inhibitors
C. Calcium channel blockers
D. Digoxin
Correct Answer: B. ACE inhibitors [CORRECT]
Rationale: ACE inhibitors (or ARBs/ARNI) are foundational therapy that block RAAS to
reduce mortality and morbidity in HFrEF; loop diuretics manage symptoms without
mortality benefit, digoxin improves symptoms only, and calcium channel blockers are
not first-line for HFrEF.
,Q3. A patient prescribed metoprolol has a heart rate of 58 beats/minute and blood
pressure 102/64 mmHg. Which action should the nurse take?
A. Give the dose as prescribed
B. Hold the dose and notify the provider
C. Check the potassium level before giving
D. Administer half the prescribed dose
Correct Answer: B. Hold the dose and notify the provider [CORRECT]
Rationale: Beta-blockers are typically held when the heart rate is <60 bpm to prevent
excessive bradycardia and reduced cardiac output; nurses must never independently
adjust doses or hold medications without notifying the provider.
Q4. A patient presents with chest pain unrelieved by nitroglycerin. The ECG shows
ST-segment elevation in leads V1-V4. Which intervention is the priority?
A. Administer morphine sulfate
B. Prepare for percutaneous coronary intervention
C. Start a heparin drip
D. Obtain serial cardiac enzymes
Correct Answer: B. Prepare for percutaneous coronary intervention [CORRECT]
Rationale: ST-elevation in anterior leads V1-V4 indicates an anterior STEMI requiring
emergent reperfusion via PCI within 90 minutes; while morphine, heparin, and enzymes
are important, restoring blood flow is the absolute priority to preserve myocardium.
Q5. A nurse is teaching a post-myocardial infarction patient about atorvastatin 80 mg
daily. Which statement best explains the purpose of this medication?
A. "It will dissolve any clots in your arteries."
B. "It stabilizes plaques and reduces future cardiac events."
C. "It lowers your blood pressure."
D. "It prevents abnormal heart rhythms."
Correct Answer: B. "It stabilizes plaques and reduces future cardiac events." [CORRECT]
, Rationale: High-intensity statins post-MI stabilize coronary plaques, reduce
inflammation, and lower LDL to prevent recurrent cardiac events; statins do not dissolve
clots, lower blood pressure, or treat dysrhythmias.
Q6. A patient on telemetry has an irregular rhythm with no discernible P waves,
fibrillatory waves, and a ventricular rate of 150. Which is the nurse's immediate priority?
A. Administer adenosine 6 mg IV push
B. Prepare for synchronized cardioversion
C. Assess for hemodynamic instability
D. Administer metoprolol orally
Correct Answer: C. Assess for hemodynamic instability [CORRECT]
Rationale: The rhythm is atrial fibrillation with rapid ventricular response; before
selecting treatment such as cardioversion, beta-blockers, or calcium channel blockers,
the nurse must first assess for hypotension, chest pain, or altered mental status that
would indicate instability.
Q7. Which ECG finding is characteristic of third-degree atrioventricular block?
A. Progressive PR interval prolongation
B. P waves and QRS complexes with no consistent relationship
C. Absent P waves with a sawtooth pattern
D. Wide QRS complexes at a regular rate of 150-250
Correct Answer: B. P waves and QRS complexes with no consistent relationship
[CORRECT]
Rationale: Third-degree AV block demonstrates complete atrioventricular dissociation
where P waves and QRS complexes occur independently without a fixed relationship;
progressive PR prolongation is Mobitz I, sawtooth pattern is atrial flutter, and wide
regular tachycardia is ventricular tachycardia.
Q8. A nurse is providing pre-procedure instructions for a stress echocardiogram. Which
instruction is essential?
