Exam 2 NSG 4100 – Advanced Medical-Surgical
Nursing: ACTUAL Questions and Verified Answers
(2026 Edition) Instant Pdf Download
Introduction
Welcome to the NSG 4100 Exam 2 Comprehensive Practice Question Set, designed for nursing
students preparing for advanced medical-surgical nursing assessments in 2026. This collection
contains 120 rigorously crafted questions in mixed formats—including multiple-choice
questions (MCQs), select-all-that-apply (SATA), and short-answer questions—aligned with core
nursing competencies, evidence-based practices, and current clinical guidelines.
The content covers high-yield topics frequently tested in Exam 2, such as:
Cardiovascular Disorders: Heart failure, myocardial infarction, dysrhythmias,
hypertension, and shock.
Respiratory Disorders: COPD, asthma, pneumonia, ventilator care, and oxygen
management.
Endocrine and Metabolic Disorders: Diabetes mellitus, DKA, hypoglycemia, hyper- and
hypokalemia, and thyroid disorders.
Renal and Fluid-Electrolyte Imbalances: Acute kidney injury, chronic kidney disease,
hyperphosphatemia, and fluid volume imbalances.
Infection Control and Sepsis Management: Identification, early intervention, and
implementation of infection precautions.
Gastrointestinal and Pancreatic Disorders: Acute pancreatitis, nutrition, and pain
management.
Patient Safety and Quality Care: Fall prevention, pressure injury prevention, aspiration
precautions, DVT prevention, and monitoring for adverse effects of medications.
1. A nurse is caring for a patient with heart failure who reports new-onset shortness
of breath. Which assessment finding is most concerning?
A. Mild ankle edema
B. Crackles in the lungs
C. Slight weight gain
D. Fatigue with exertion
,Answer: B. Crackles in the lungs
Rationale: Crackles indicate fluid accumulation in the lungs, suggesting worsening heart
failure and pulmonary congestion, which is an urgent concern.
2. SATA: The nurse is teaching a patient with hypertension about lifestyle
modifications. Which statements indicate understanding?
A. “I should reduce sodium in my diet.”
B. “I can skip my medications if I feel fine.”
C. “Regular exercise helps control blood pressure.”
D. “Stress management can lower my BP.”
E. “Alcohol has no effect on blood pressure.”
Answer: A, C, D
Rationale: Reducing sodium, exercising regularly, and managing stress all help lower blood
pressure. Skipping medications or drinking alcohol excessively can worsen hypertension.
3. A patient is prescribed furosemide 40 mg IV for fluid overload. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss,
increasing the risk of arrhythmias.
4. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 85% on room air. What is the nurse’s priority action?
A. Administer oxygen as prescribed
B. Encourage coughing and deep breathing
,C. Place the patient in a supine position
D. Notify the healthcare provider after 1 hour
Answer: A. Administer oxygen as prescribed
Rationale: Oxygen saturation below 90% requires immediate intervention with
supplemental oxygen. Positioning and coughing are supportive measures.
5. A nurse is assessing a patient with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with DKA?
A. Serum glucose 180 mg/dL
B. Serum pH 7.28
C. Serum potassium 3.0 mEq/L
D. BUN 10 mg/dL
Answer: B. Serum pH 7.28
Rationale: DKA causes metabolic acidosis, reflected by a low pH. Hyperglycemia and
electrolyte imbalances may also occur.
6. SATA: Which patients are at increased risk for pressure injuries?
A. Elderly patient with limited mobility
B. Patient on high-dose corticosteroids
C. Patient who ambulates independently
D. Patient with incontinence
E. Patient with obesity
Answer: A, B, D, E
Rationale: Limited mobility, corticosteroid use, incontinence, and obesity increase pressure
injury risk. Ambulation protects skin integrity.
7. A nurse is reviewing a patient’s medication list. Which drug class is most likely to
cause orthostatic hypotension?
, A. Beta-blockers
B. ACE inhibitors
C. Diuretics
D. Calcium channel blockers
Answer: A. Beta-blockers
Rationale: Beta-blockers can reduce sympathetic tone, leading to orthostatic hypotension,
especially in older adults.
8. Short Answer: Describe three interventions a nurse can implement to prevent falls
in hospitalized older adults.
Answer:
1. Keep the bed in a low position with brakes locked
2. Ensure adequate lighting and clear pathways
3. Use assistive devices (walker, cane) as needed
Rationale: These interventions reduce environmental hazards and support safe
mobility.
9. A patient with COPD is using pursed-lip breathing. Which statement indicates
proper technique?
A. “I breathe in slowly through my mouth.”
B. “I exhale quickly through my nose.”
C. “I inhale through my nose and exhale through pursed lips.”
D. “I hold my breath for 10 seconds before exhaling.”
Answer: C. “I inhale through my nose and exhale through pursed lips.”
Rationale: Pursed-lip breathing prolongs exhalation, helps remove trapped air, and reduces
dyspnea.
10. SATA: Which patients require contact precautions?
Nursing: ACTUAL Questions and Verified Answers
(2026 Edition) Instant Pdf Download
Introduction
Welcome to the NSG 4100 Exam 2 Comprehensive Practice Question Set, designed for nursing
students preparing for advanced medical-surgical nursing assessments in 2026. This collection
contains 120 rigorously crafted questions in mixed formats—including multiple-choice
questions (MCQs), select-all-that-apply (SATA), and short-answer questions—aligned with core
nursing competencies, evidence-based practices, and current clinical guidelines.
The content covers high-yield topics frequently tested in Exam 2, such as:
Cardiovascular Disorders: Heart failure, myocardial infarction, dysrhythmias,
hypertension, and shock.
Respiratory Disorders: COPD, asthma, pneumonia, ventilator care, and oxygen
management.
Endocrine and Metabolic Disorders: Diabetes mellitus, DKA, hypoglycemia, hyper- and
hypokalemia, and thyroid disorders.
Renal and Fluid-Electrolyte Imbalances: Acute kidney injury, chronic kidney disease,
hyperphosphatemia, and fluid volume imbalances.
Infection Control and Sepsis Management: Identification, early intervention, and
implementation of infection precautions.
Gastrointestinal and Pancreatic Disorders: Acute pancreatitis, nutrition, and pain
management.
Patient Safety and Quality Care: Fall prevention, pressure injury prevention, aspiration
precautions, DVT prevention, and monitoring for adverse effects of medications.
1. A nurse is caring for a patient with heart failure who reports new-onset shortness
of breath. Which assessment finding is most concerning?
A. Mild ankle edema
B. Crackles in the lungs
C. Slight weight gain
D. Fatigue with exertion
,Answer: B. Crackles in the lungs
Rationale: Crackles indicate fluid accumulation in the lungs, suggesting worsening heart
failure and pulmonary congestion, which is an urgent concern.
2. SATA: The nurse is teaching a patient with hypertension about lifestyle
modifications. Which statements indicate understanding?
A. “I should reduce sodium in my diet.”
B. “I can skip my medications if I feel fine.”
C. “Regular exercise helps control blood pressure.”
D. “Stress management can lower my BP.”
E. “Alcohol has no effect on blood pressure.”
Answer: A, C, D
Rationale: Reducing sodium, exercising regularly, and managing stress all help lower blood
pressure. Skipping medications or drinking alcohol excessively can worsen hypertension.
3. A patient is prescribed furosemide 40 mg IV for fluid overload. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss,
increasing the risk of arrhythmias.
4. A patient with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 85% on room air. What is the nurse’s priority action?
A. Administer oxygen as prescribed
B. Encourage coughing and deep breathing
,C. Place the patient in a supine position
D. Notify the healthcare provider after 1 hour
Answer: A. Administer oxygen as prescribed
Rationale: Oxygen saturation below 90% requires immediate intervention with
supplemental oxygen. Positioning and coughing are supportive measures.
5. A nurse is assessing a patient with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with DKA?
A. Serum glucose 180 mg/dL
B. Serum pH 7.28
C. Serum potassium 3.0 mEq/L
D. BUN 10 mg/dL
Answer: B. Serum pH 7.28
Rationale: DKA causes metabolic acidosis, reflected by a low pH. Hyperglycemia and
electrolyte imbalances may also occur.
6. SATA: Which patients are at increased risk for pressure injuries?
A. Elderly patient with limited mobility
B. Patient on high-dose corticosteroids
C. Patient who ambulates independently
D. Patient with incontinence
E. Patient with obesity
Answer: A, B, D, E
Rationale: Limited mobility, corticosteroid use, incontinence, and obesity increase pressure
injury risk. Ambulation protects skin integrity.
7. A nurse is reviewing a patient’s medication list. Which drug class is most likely to
cause orthostatic hypotension?
, A. Beta-blockers
B. ACE inhibitors
C. Diuretics
D. Calcium channel blockers
Answer: A. Beta-blockers
Rationale: Beta-blockers can reduce sympathetic tone, leading to orthostatic hypotension,
especially in older adults.
8. Short Answer: Describe three interventions a nurse can implement to prevent falls
in hospitalized older adults.
Answer:
1. Keep the bed in a low position with brakes locked
2. Ensure adequate lighting and clear pathways
3. Use assistive devices (walker, cane) as needed
Rationale: These interventions reduce environmental hazards and support safe
mobility.
9. A patient with COPD is using pursed-lip breathing. Which statement indicates
proper technique?
A. “I breathe in slowly through my mouth.”
B. “I exhale quickly through my nose.”
C. “I inhale through my nose and exhale through pursed lips.”
D. “I hold my breath for 10 seconds before exhaling.”
Answer: C. “I inhale through my nose and exhale through pursed lips.”
Rationale: Pursed-lip breathing prolongs exhalation, helps remove trapped air, and reduces
dyspnea.
10. SATA: Which patients require contact precautions?
