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NUR 176 EXAM 3 COMPREHENSIVE QUESTIONS AND CORRECT
ANSWERS LATEST EDITION 2026
SECTION 1: CARDIOVASCULAR DISORDERS — MYOCARDIAL INFARCTION & HEART FAILURE
(Questions 1–40)
1. A patient presents to the ER with cool clammy skin, shortness of breath, indigestion, and
chest pain. What should the nurse do?
A) Administer antibiotics
B) Start the MONA protocol and connect to a heart monitor
C) Administer oral pain medication
D) Encourage deep breathing
Answer: B
Rationale: These are classic signs of myocardial infarction. The MONA protocol (Morphine,
Oxygen, Nitrates, Aspirin) should be initiated immediately along with cardiac monitoring .
2. What is the purpose of aspirin in the treatment of an MI?
A) To relieve pain
B) Anti-platelet to help keep the blood thin to prevent clots from forming
C) To decrease heart rate
D) To increase blood pressure
Answer: B
Rationale: Aspirin is given as an anti-platelet to prevent further clot formation. It should be
chewed for rapid absorption when given for acute MI .
3. What are the signs and symptoms of left-sided heart failure?
A) Ascites, JVD, peripheral edema
B) Pulmonary congestion, crackles, dyspnea, cough, frothy blood-tinged sputum, confusion
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C) Hypertension and tachycardia
D) Weight gain and anorexia
Answer: B
Rationale: Left-sided heart failure affects the lungs. Signs include pulmonary congestion,
crackles, dyspnea, cough with frothy blood-tinged sputum (pulmonary edema), confusion,
increased respirations, restlessness, and orthopnea .
4. What are the signs and symptoms of right-sided heart failure?
A) Pulmonary congestion and crackles
B) Ascites, liver/spleen enlargement, JVD, edema in feet/ankles, abdominal distention
C) Frothy sputum and cough
D) Dyspnea and orthopnea
Answer: B
Rationale: Right-sided heart failure affects the body's venous system. Signs include ascites,
liver/spleen enlargement (hepatomegaly), JVD, edema in the feet and ankles (pitting edema),
and abdominal distention .
5. What diagnostic tests are used to diagnose heart failure?
A) CBC and BUN
B) BNP (lab) and Chest X-ray
C) EKG and Echocardiogram
D) Cardiac enzymes and stress test
Answer: B
Rationale: Diagnostic tests for heart failure include BNP (B-type Natriuretic Peptide) which is
elevated in heart failure, and Chest X-ray which evaluates pulmonary congestion and
cardiomegaly. Normal BNP is less than 100 pg/mL .
6. A patient has dyspnea, pink frothy sputum, and pulmonary edema. What is the priority
nursing intervention?
A) Place the patient in supine position
B) Position the patient in high Fowler's and give oxygen therapy
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C) Administer oral fluids
D) Encourage the patient to cough
Answer: B
Rationale: High Fowler's position reduces venous return and pulmonary congestion. Oxygen
therapy is essential for hypoxemia .
7. What is malignant hypertension?
A) Mild high blood pressure
B) Severe and rapid high blood pressure that can damage internal organs
C) Normal blood pressure
D) Low blood pressure
Answer: B
Rationale: Malignant hypertension is severe and rapid high blood pressure that can damage
internal organs. Signs include severe headache, blurred vision, epistaxis, and diastolic BP > 120
mmHg .
8. What is the normal range for cardiac output?
A) 2-4 L/min
B) 4-8 L/min
C) 8-12 L/min
D) 12-16 L/min
Answer: B
Rationale: Normal cardiac output is 4-8 L/min .
9. What factors affect cardiac output?
A) Heart rate, arrhythmias, blood volume, contractility, medications, cardiac disease
B) Only heart rate
C) Only blood volume
D) Only medications
Answer: A
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Rationale: Cardiac output is affected by heart rate, arrhythmias, blood volume, contractility,
medications, and cardiac disease .
10. What is preload?
A) Pressure ventricle must overcome to eject blood
B) Amount of blood remaining in ventricle at end of diastole
C) Heart rate
D) Contractility
Answer: B
Rationale: Preload is the amount of blood remaining in the ventricle at end of diastole .
11. What is afterload?
A) Amount of blood remaining in ventricle at end of diastole
B) Pressure ventricle must overcome to eject blood
C) Heart rate
D) Contractility
Answer: B
Rationale: Afterload is the pressure the ventricle must overcome to eject blood. It is
determined by pressure in the arterial system, decreased with vasodilation, and increased with
vasoconstriction .
12. What is the effect of vasodilation on afterload?
A) Increases afterload
B) Decreases afterload
C) No effect
D) Doubles afterload
Answer: B
Rationale: Vasodilation decreases afterload .
13. What is the effect of vasoconstriction on afterload?
A) Decreases afterload
B) Increases afterload
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NUR 176 EXAM 3 COMPREHENSIVE QUESTIONS AND CORRECT
ANSWERS LATEST EDITION 2026
SECTION 1: CARDIOVASCULAR DISORDERS — MYOCARDIAL INFARCTION & HEART FAILURE
(Questions 1–40)
1. A patient presents to the ER with cool clammy skin, shortness of breath, indigestion, and
chest pain. What should the nurse do?
A) Administer antibiotics
B) Start the MONA protocol and connect to a heart monitor
C) Administer oral pain medication
D) Encourage deep breathing
Answer: B
Rationale: These are classic signs of myocardial infarction. The MONA protocol (Morphine,
Oxygen, Nitrates, Aspirin) should be initiated immediately along with cardiac monitoring .
2. What is the purpose of aspirin in the treatment of an MI?
A) To relieve pain
B) Anti-platelet to help keep the blood thin to prevent clots from forming
C) To decrease heart rate
D) To increase blood pressure
Answer: B
Rationale: Aspirin is given as an anti-platelet to prevent further clot formation. It should be
chewed for rapid absorption when given for acute MI .
3. What are the signs and symptoms of left-sided heart failure?
A) Ascites, JVD, peripheral edema
B) Pulmonary congestion, crackles, dyspnea, cough, frothy blood-tinged sputum, confusion
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C) Hypertension and tachycardia
D) Weight gain and anorexia
Answer: B
Rationale: Left-sided heart failure affects the lungs. Signs include pulmonary congestion,
crackles, dyspnea, cough with frothy blood-tinged sputum (pulmonary edema), confusion,
increased respirations, restlessness, and orthopnea .
4. What are the signs and symptoms of right-sided heart failure?
A) Pulmonary congestion and crackles
B) Ascites, liver/spleen enlargement, JVD, edema in feet/ankles, abdominal distention
C) Frothy sputum and cough
D) Dyspnea and orthopnea
Answer: B
Rationale: Right-sided heart failure affects the body's venous system. Signs include ascites,
liver/spleen enlargement (hepatomegaly), JVD, edema in the feet and ankles (pitting edema),
and abdominal distention .
5. What diagnostic tests are used to diagnose heart failure?
A) CBC and BUN
B) BNP (lab) and Chest X-ray
C) EKG and Echocardiogram
D) Cardiac enzymes and stress test
Answer: B
Rationale: Diagnostic tests for heart failure include BNP (B-type Natriuretic Peptide) which is
elevated in heart failure, and Chest X-ray which evaluates pulmonary congestion and
cardiomegaly. Normal BNP is less than 100 pg/mL .
6. A patient has dyspnea, pink frothy sputum, and pulmonary edema. What is the priority
nursing intervention?
A) Place the patient in supine position
B) Position the patient in high Fowler's and give oxygen therapy
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C) Administer oral fluids
D) Encourage the patient to cough
Answer: B
Rationale: High Fowler's position reduces venous return and pulmonary congestion. Oxygen
therapy is essential for hypoxemia .
7. What is malignant hypertension?
A) Mild high blood pressure
B) Severe and rapid high blood pressure that can damage internal organs
C) Normal blood pressure
D) Low blood pressure
Answer: B
Rationale: Malignant hypertension is severe and rapid high blood pressure that can damage
internal organs. Signs include severe headache, blurred vision, epistaxis, and diastolic BP > 120
mmHg .
8. What is the normal range for cardiac output?
A) 2-4 L/min
B) 4-8 L/min
C) 8-12 L/min
D) 12-16 L/min
Answer: B
Rationale: Normal cardiac output is 4-8 L/min .
9. What factors affect cardiac output?
A) Heart rate, arrhythmias, blood volume, contractility, medications, cardiac disease
B) Only heart rate
C) Only blood volume
D) Only medications
Answer: A
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Rationale: Cardiac output is affected by heart rate, arrhythmias, blood volume, contractility,
medications, and cardiac disease .
10. What is preload?
A) Pressure ventricle must overcome to eject blood
B) Amount of blood remaining in ventricle at end of diastole
C) Heart rate
D) Contractility
Answer: B
Rationale: Preload is the amount of blood remaining in the ventricle at end of diastole .
11. What is afterload?
A) Amount of blood remaining in ventricle at end of diastole
B) Pressure ventricle must overcome to eject blood
C) Heart rate
D) Contractility
Answer: B
Rationale: Afterload is the pressure the ventricle must overcome to eject blood. It is
determined by pressure in the arterial system, decreased with vasodilation, and increased with
vasoconstriction .
12. What is the effect of vasodilation on afterload?
A) Increases afterload
B) Decreases afterload
C) No effect
D) Doubles afterload
Answer: B
Rationale: Vasodilation decreases afterload .
13. What is the effect of vasoconstriction on afterload?
A) Decreases afterload
B) Increases afterload
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