NR 324 – ADULT HEALTH I COMPREHENSIVE HIGH-DIFFICULTY PRACTICE
EXAMINATION
100 QUESTIIONS WITH DETAILED ANSEWERS
2026/2027 NR 324 – ADULT HEALTH I
,Major Content Areas:
• Cardiovascular Disorders
• Respiratory Disorders
• Fluid & Electrolyte Imbalances
• Acid-Base Balance
• Renal Disorders
• Endocrine Disorders
• Gastrointestinal Disorders
• Hematologic Disorders
• Shock & Emergency Nursing
• Perioperative Care
• Clinical Judgment
• Prioritization & Patient Safety
Prepared as an Original Nursing Exam-Preparation Resource
2026 Edition
EXAM INSTRUCTIONS
1. Read each question carefully.
2. Select the single best answer unless otherwise indicated.
3. Apply the principles of priority nursing care, patient safety, clinical
judgment, and the nursing process.
4. Pay close attention to changes in vital signs, laboratory results, and clinical
deterioration.
5. Review the rationale after each question to reinforce learning.
,SECTION I: CARDIOVASCULAR NURSING
Question 1
A client with acute pulmonary edema is sitting upright, severely dyspneic, and
producing pink, frothy sputum. Which action should the nurse take first?
A. Place the client in a supine position
B. Apply prescribed supplemental oxygen and maintain an upright position
C. Encourage oral fluid intake
D. Obtain the client's daily weight
Correct Answer: B
Rationale: The immediate priority is to improve oxygenation. Sitting upright
promotes lung expansion and may reduce venous return to the heart. Supplemental
oxygen helps correct hypoxemia. Pulmonary edema is a potentially life-threatening
manifestation of acute heart failure and requires rapid intervention.
Question 2
A client with heart failure reports gaining 2.5 kg (5.5 lb) in four days and
experiencing increasing difficulty breathing when lying flat. Which interpretation
is most appropriate?
A. The client is experiencing expected age-related changes
B. The client is likely experiencing fluid retention and worsening heart failure
C. The client is becoming dehydrated
D. The client's cardiac function is improving
Correct Answer: B
Rationale: Rapid weight gain is a sensitive indicator of fluid retention in clients
with heart failure. Orthopnea indicates worsening pulmonary congestion. The
nurse should assess lung sounds, oxygenation, edema, urine output, and
cardiovascular status and promptly communicate the deterioration.
, Question 3
A client receiving IV furosemide has a potassium level of 2.8 mEq/L. Which
action should the nurse take?
A. Administer the medication as prescribed without further assessment
B. Notify the provider and anticipate potassium replacement
C. Encourage the client to restrict dietary potassium
D. Encourage vigorous ambulation
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause potassium loss. A
potassium level of 2.8 mEq/L represents significant hypokalemia and increases the
risk of potentially dangerous cardiac dysrhythmias. The nurse should notify the
provider and anticipate replacement and cardiac monitoring.
Question 4
A client with a history of myocardial infarction reports new crushing chest pain
radiating to the left arm. Which action should the nurse take first?
A. Obtain a complete dietary history
B. Assess vital signs and initiate immediate cardiac assessment
C. Encourage the client to ambulate
D. Offer a high-fat snack
Correct Answer: B
Rationale: New crushing chest pain with radiation is concerning for acute
coronary syndrome. The nurse should immediately assess the client's airway,
breathing, circulation, vital signs, oxygenation, and cardiac rhythm while
activating the appropriate emergency response according to facility protocol.
EXAMINATION
100 QUESTIIONS WITH DETAILED ANSEWERS
2026/2027 NR 324 – ADULT HEALTH I
,Major Content Areas:
• Cardiovascular Disorders
• Respiratory Disorders
• Fluid & Electrolyte Imbalances
• Acid-Base Balance
• Renal Disorders
• Endocrine Disorders
• Gastrointestinal Disorders
• Hematologic Disorders
• Shock & Emergency Nursing
• Perioperative Care
• Clinical Judgment
• Prioritization & Patient Safety
Prepared as an Original Nursing Exam-Preparation Resource
2026 Edition
EXAM INSTRUCTIONS
1. Read each question carefully.
2. Select the single best answer unless otherwise indicated.
3. Apply the principles of priority nursing care, patient safety, clinical
judgment, and the nursing process.
4. Pay close attention to changes in vital signs, laboratory results, and clinical
deterioration.
5. Review the rationale after each question to reinforce learning.
,SECTION I: CARDIOVASCULAR NURSING
Question 1
A client with acute pulmonary edema is sitting upright, severely dyspneic, and
producing pink, frothy sputum. Which action should the nurse take first?
A. Place the client in a supine position
B. Apply prescribed supplemental oxygen and maintain an upright position
C. Encourage oral fluid intake
D. Obtain the client's daily weight
Correct Answer: B
Rationale: The immediate priority is to improve oxygenation. Sitting upright
promotes lung expansion and may reduce venous return to the heart. Supplemental
oxygen helps correct hypoxemia. Pulmonary edema is a potentially life-threatening
manifestation of acute heart failure and requires rapid intervention.
Question 2
A client with heart failure reports gaining 2.5 kg (5.5 lb) in four days and
experiencing increasing difficulty breathing when lying flat. Which interpretation
is most appropriate?
A. The client is experiencing expected age-related changes
B. The client is likely experiencing fluid retention and worsening heart failure
C. The client is becoming dehydrated
D. The client's cardiac function is improving
Correct Answer: B
Rationale: Rapid weight gain is a sensitive indicator of fluid retention in clients
with heart failure. Orthopnea indicates worsening pulmonary congestion. The
nurse should assess lung sounds, oxygenation, edema, urine output, and
cardiovascular status and promptly communicate the deterioration.
, Question 3
A client receiving IV furosemide has a potassium level of 2.8 mEq/L. Which
action should the nurse take?
A. Administer the medication as prescribed without further assessment
B. Notify the provider and anticipate potassium replacement
C. Encourage the client to restrict dietary potassium
D. Encourage vigorous ambulation
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause potassium loss. A
potassium level of 2.8 mEq/L represents significant hypokalemia and increases the
risk of potentially dangerous cardiac dysrhythmias. The nurse should notify the
provider and anticipate replacement and cardiac monitoring.
Question 4
A client with a history of myocardial infarction reports new crushing chest pain
radiating to the left arm. Which action should the nurse take first?
A. Obtain a complete dietary history
B. Assess vital signs and initiate immediate cardiac assessment
C. Encourage the client to ambulate
D. Offer a high-fat snack
Correct Answer: B
Rationale: New crushing chest pain with radiation is concerning for acute
coronary syndrome. The nurse should immediately assess the client's airway,
breathing, circulation, vital signs, oxygenation, and cardiac rhythm while
activating the appropriate emergency response according to facility protocol.
