NSG 3850 FINAL EXAM 4 2026-2027: Verified Practice
Questions with Correct Answers & Detailed Rationales |
Pathophysiology for Nurses II | Galen College of Nursing
| Guaranteed A+ Guide
Ace your NSG 3850 Final Exam 4 with this comprehensive 2026 test bank! Featuring 327+ high-
yield practice questions, this premium study guide covers all key topics including high -acuity
nursing, perfusion, metabolism, renal, and complex patient management. Each question
includes verified correct answers and detailed Rationales to boost your clinical reasoning.
Designed for nursing students at Galen and other top nursing schools, this A+ graded resource
is your ultimate key to exam success!
,Q1. A client with acute decompensated heart failure is receiving continuous IV furosemide.
Which assessment finding indicates the therapy is having the desired effect?
A) Increased jugular venous distension
B) Weight gain of 2 kg in 24 hours
C) Decreased crackles on lung auscultation
D) Blood pressure elevation to 150/90 mmHg
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis. A decrease
in pulmonary congestion, evidenced by fewer crackles, indicates a therapeutic response. Weight
gain and increased JVD suggest worsening fluid overload.
Q2. A client is 2 hours post-placement of a permanent pacemaker. The nurse notes the heart
rate is 48 bpm and the ECG shows pacing spikes with no subsequent QRS complexes. What is
the priority action?
A) Reposition the client to the left side
B) Administer atropine 0.5 mg IV push
C) Notify the healthcare provider immediately
D) Increase the pacemaker output settings
Rationale: Pacing spikes without capture indicate a failure to depolarize the myocardium, which
is a medical emergency. The provider must be notified immediately for possible pacemaker
malfunction or lead displacement.
Q3. A client with a history of myocardial infarction is prescribed aspirin 81 mg daily. The client
asks why this medication is needed. Which response by the nurse is most accurate?
A) "It will help lower your cholesterol levels."
B) "It prevents blood clots by thinning your blood."
C) "It inhibits platelet aggregation to reduce the risk of another heart attack."
D) "It will help reduce the workload on your heart."
Rationale: Aspirin irreversibly inhibits cyclooxygenase-1, reducing thromboxane A2 production
and preventing platelet aggregation. This reduces the risk of thrombus formation and
subsequent myocardial infarction.
Q4. A client with severe aortic stenosis is scheduled for valve replacement. The nurse
understands that this condition causes which primary pathophysiological change?
A) Left ventricular hypertrophy due to increased afterload
, B) Right ventricular failure due to increased preload
C) Decreased pulmonary vascular resistance
D) Increased cardiac output due to compensatory mechanisms
Rationale: Aortic stenosis increases left ventricular afterload because the left ventricle must
generate higher pressures to overcome the narrowed valve. This leads to concentric left
ventricular hypertrophy over time.
Q5. A nurse is caring for a client with unstable angina receiving IV nitroglycerin. Which adverse
effect requires the nurse to reduce the infusion rate?
A) Heart rate of 62 bpm
B) Systolic blood pressure of 88 mmHg
C) Respiratory rate of 18 breaths/min
D) Mild headache rated 3/10
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. A systolic
blood pressure below 90 mmHg or a drop of 30 mmHg from baseline warrants a reduction in the
infusion rate to prevent organ hypoperfusion.
Q6. A client with heart failure has an ejection fraction of 25%. The nurse interprets this finding
as:
A) Severely reduced left ventricular systolic function
B) Mildly impaired diastolic filling
C) Normal cardiac output for a resting adult
D) Hyperdynamic ventricular contraction
Rationale: Ejection fraction is the percentage of blood ejected from the left ventricle with each
contraction. A normal EF is 55-70%; 25% indicates severely reduced systolic function.
Q7. A client is prescribed carvedilol for heart failure. Which statement by the client indicates a
need for further teaching?
A) "I should not stop this medication abruptly."
B) "I will report any weight gain to my provider."
C) "I will take this medication when my blood pressure is elevated."
D) "This medication can cause dizziness when I stand up."
Rationale: Carvedilol is a beta-blocker that must be taken consistently, not as needed. Abrupt
withdrawal can cause rebound tachycardia and worsening heart failure. Dizziness and weight
gain are known effects that should be monitored.
Questions with Correct Answers & Detailed Rationales |
Pathophysiology for Nurses II | Galen College of Nursing
| Guaranteed A+ Guide
Ace your NSG 3850 Final Exam 4 with this comprehensive 2026 test bank! Featuring 327+ high-
yield practice questions, this premium study guide covers all key topics including high -acuity
nursing, perfusion, metabolism, renal, and complex patient management. Each question
includes verified correct answers and detailed Rationales to boost your clinical reasoning.
Designed for nursing students at Galen and other top nursing schools, this A+ graded resource
is your ultimate key to exam success!
,Q1. A client with acute decompensated heart failure is receiving continuous IV furosemide.
Which assessment finding indicates the therapy is having the desired effect?
A) Increased jugular venous distension
B) Weight gain of 2 kg in 24 hours
C) Decreased crackles on lung auscultation
D) Blood pressure elevation to 150/90 mmHg
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis. A decrease
in pulmonary congestion, evidenced by fewer crackles, indicates a therapeutic response. Weight
gain and increased JVD suggest worsening fluid overload.
Q2. A client is 2 hours post-placement of a permanent pacemaker. The nurse notes the heart
rate is 48 bpm and the ECG shows pacing spikes with no subsequent QRS complexes. What is
the priority action?
A) Reposition the client to the left side
B) Administer atropine 0.5 mg IV push
C) Notify the healthcare provider immediately
D) Increase the pacemaker output settings
Rationale: Pacing spikes without capture indicate a failure to depolarize the myocardium, which
is a medical emergency. The provider must be notified immediately for possible pacemaker
malfunction or lead displacement.
Q3. A client with a history of myocardial infarction is prescribed aspirin 81 mg daily. The client
asks why this medication is needed. Which response by the nurse is most accurate?
A) "It will help lower your cholesterol levels."
B) "It prevents blood clots by thinning your blood."
C) "It inhibits platelet aggregation to reduce the risk of another heart attack."
D) "It will help reduce the workload on your heart."
Rationale: Aspirin irreversibly inhibits cyclooxygenase-1, reducing thromboxane A2 production
and preventing platelet aggregation. This reduces the risk of thrombus formation and
subsequent myocardial infarction.
Q4. A client with severe aortic stenosis is scheduled for valve replacement. The nurse
understands that this condition causes which primary pathophysiological change?
A) Left ventricular hypertrophy due to increased afterload
, B) Right ventricular failure due to increased preload
C) Decreased pulmonary vascular resistance
D) Increased cardiac output due to compensatory mechanisms
Rationale: Aortic stenosis increases left ventricular afterload because the left ventricle must
generate higher pressures to overcome the narrowed valve. This leads to concentric left
ventricular hypertrophy over time.
Q5. A nurse is caring for a client with unstable angina receiving IV nitroglycerin. Which adverse
effect requires the nurse to reduce the infusion rate?
A) Heart rate of 62 bpm
B) Systolic blood pressure of 88 mmHg
C) Respiratory rate of 18 breaths/min
D) Mild headache rated 3/10
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. A systolic
blood pressure below 90 mmHg or a drop of 30 mmHg from baseline warrants a reduction in the
infusion rate to prevent organ hypoperfusion.
Q6. A client with heart failure has an ejection fraction of 25%. The nurse interprets this finding
as:
A) Severely reduced left ventricular systolic function
B) Mildly impaired diastolic filling
C) Normal cardiac output for a resting adult
D) Hyperdynamic ventricular contraction
Rationale: Ejection fraction is the percentage of blood ejected from the left ventricle with each
contraction. A normal EF is 55-70%; 25% indicates severely reduced systolic function.
Q7. A client is prescribed carvedilol for heart failure. Which statement by the client indicates a
need for further teaching?
A) "I should not stop this medication abruptly."
B) "I will report any weight gain to my provider."
C) "I will take this medication when my blood pressure is elevated."
D) "This medication can cause dizziness when I stand up."
Rationale: Carvedilol is a beta-blocker that must be taken consistently, not as needed. Abrupt
withdrawal can cause rebound tachycardia and worsening heart failure. Dizziness and weight
gain are known effects that should be monitored.
