NSG-300 Final Exam Prep 2026 | 200 Practice Questions with
Answers & Rationales | Nursing Study Guide
SECTION A: NURSING FUNDAMENTALS & PATIENT CARE (Questions 1–70)
1. A nurse is caring for a client who has a new diagnosis of diabetes mellitus. The client states, “I don’t
understand why I need to check my blood sugar so often.” Which response by the nurse is most
therapeutic?
A. “Tell me what concerns you have about checking your blood sugar.”
B. “You need to do it because your doctor ordered it.”
C. “It is important to keep your blood sugar under control to prevent complications.”
D. “Many diabetics check their sugar four times a day.”
Answer: A
Explanation: Open-ended questioning encourages expression of feelings and identifies specific concerns,
promoting therapeutic communication.
2. A nurse is preparing to administer a subcutaneous injection of heparin. Which technique is correct?
A. Insert the needle at a 45- to 90-degree angle without aspirating
B. Aspirate before injection to check for blood return
C. Massage the site after injection to distribute the medication
D. Use a 1-inch needle for all subcutaneous injections
Answer: A
Explanation: Heparin is given subcutaneously; do not aspirate or massage to avoid hematoma
formation.
3. A client with a history of falls has a new prescription for lorazepam. Which nursing action is most
important?
A. Implement fall precautions and monitor for sedation
B. Administer the medication with meals
C. Crush the medication for easier swallowing
,D. Give the medication only at bedtime
Answer: A
Explanation: Benzodiazepines increase fall risk; implement precautions and assess for sedation and
orthostatic hypotension.
4. A nurse is assessing a client’s peripheral IV site. The site is warm, edematous, and reddened along the
vein. What is the most appropriate intervention?
A. Discontinue the IV and restart in a different location
B. Apply a warm compress and continue the infusion
C. Flush the IV with 10 mL normal saline
D. Elevate the extremity and slow the infusion rate
Answer: A
Explanation: Signs indicate phlebitis; the IV must be removed to prevent further irritation or infection.
5. A nurse is teaching a client about using an incentive spirometer after surgery. Which instruction is
correct?
A. “Inhale slowly and deeply, then hold your breath for 3-5 seconds.”
B. “Exhale forcefully into the device to measure lung capacity.”
C. “Use the device every 4 hours while awake only.”
D. “Lie flat on your back while using the spirometer.”
Answer: A
Explanation: Sustained deep inhalation with breath hold promotes lung expansion and prevents
atelectasis.
6. A client is receiving a blood transfusion and reports chills and low back pain. Vital signs: BP 90/60, HR
120, temperature 101.2°F (38.4°C). What is the priority action?
A. Stop the transfusion and infuse normal saline through new tubing
B. Slow the transfusion rate and notify the provider
C. Administer acetaminophen and continue the transfusion
D. Obtain a urine sample for hemoglobin
,Answer: A
Explanation: Symptoms indicate acute hemolytic reaction; stop transfusion immediately, maintain IV
access with saline, and notify blood bank.
7. A nurse is calculating intake and output for a client over 8 hours. The client drank 240 mL water, 120
mL coffee, and 180 mL juice; received 500 mL IV fluids; urine output was 800 mL. What is the fluid
balance?
A. +240 mL
B. -240 mL
C. +500 mL
D. -800 mL
Answer: A
Explanation: Total intake = 240+120+180+500 = 1040 mL; output = 800 mL; positive balance of 240 mL.
8. A client with a nasogastric tube to low intermittent suction reports nausea and abdominal distention.
What should the nurse do first?
A. Check the patency of the NG tube
B. Irrigate the NG tube with 30 mL of air
C. Increase the suction pressure
D. Remove the NG tube and notify the provider
Answer: A
Explanation: Nausea and distention suggest tube obstruction; check for kinks or clots first.
9. A client with a new colostomy has a stoma that is dark purple and edematous. What should the nurse
do first?
A. Notify the surgeon immediately
B. Apply a cold compress to reduce edema
C. Gently massage the stoma to improve circulation
D. Document the finding as normal for a new stoma
Answer: A
, Explanation: Dark purple indicates ischemia or necrosis; this is a surgical emergency.
10. A nurse is caring for a client who is receiving a continuous enteral feeding via nasogastric tube.
Which finding indicates feeding intolerance?
A. Gastric residual volume of 300 mL
B. Bowel sounds present in all quadrants
C. Blood glucose of 110 mg/dL
D. Urine output of 1,500 mL in 24 hours
Answer: A
Explanation: High gastric residual (>250-500 mL) suggests delayed gastric emptying and aspiration risk.
11. A client is prescribed digoxin 0.25 mg daily. Which finding would prompt the nurse to withhold the
medication?
A. Apical pulse of 52 beats/min
B. Blood pressure of 110/70 mm Hg
C. Potassium level of 4.0 mEq/L
D. Respiratory rate of 18/min
Answer: A
Explanation: Digoxin is withheld for apical pulse <60 bpm in adults; hypokalemia also increases toxicity
risk but pulse is immediate concern.
12. A nurse is preparing to insert a nasogastric tube. Which action demonstrates correct infection
control?
A. Perform hand hygiene and apply clean gloves
B. Use sterile gloves and a sterile drape
C. Wear a face shield and sterile gown
D. Perform hand hygiene only
Answer: A
Explanation: NG tube insertion is a clean, not sterile, procedure; hand hygiene and clean gloves are
sufficient.
Answers & Rationales | Nursing Study Guide
SECTION A: NURSING FUNDAMENTALS & PATIENT CARE (Questions 1–70)
1. A nurse is caring for a client who has a new diagnosis of diabetes mellitus. The client states, “I don’t
understand why I need to check my blood sugar so often.” Which response by the nurse is most
therapeutic?
A. “Tell me what concerns you have about checking your blood sugar.”
B. “You need to do it because your doctor ordered it.”
C. “It is important to keep your blood sugar under control to prevent complications.”
D. “Many diabetics check their sugar four times a day.”
Answer: A
Explanation: Open-ended questioning encourages expression of feelings and identifies specific concerns,
promoting therapeutic communication.
2. A nurse is preparing to administer a subcutaneous injection of heparin. Which technique is correct?
A. Insert the needle at a 45- to 90-degree angle without aspirating
B. Aspirate before injection to check for blood return
C. Massage the site after injection to distribute the medication
D. Use a 1-inch needle for all subcutaneous injections
Answer: A
Explanation: Heparin is given subcutaneously; do not aspirate or massage to avoid hematoma
formation.
3. A client with a history of falls has a new prescription for lorazepam. Which nursing action is most
important?
A. Implement fall precautions and monitor for sedation
B. Administer the medication with meals
C. Crush the medication for easier swallowing
,D. Give the medication only at bedtime
Answer: A
Explanation: Benzodiazepines increase fall risk; implement precautions and assess for sedation and
orthostatic hypotension.
4. A nurse is assessing a client’s peripheral IV site. The site is warm, edematous, and reddened along the
vein. What is the most appropriate intervention?
A. Discontinue the IV and restart in a different location
B. Apply a warm compress and continue the infusion
C. Flush the IV with 10 mL normal saline
D. Elevate the extremity and slow the infusion rate
Answer: A
Explanation: Signs indicate phlebitis; the IV must be removed to prevent further irritation or infection.
5. A nurse is teaching a client about using an incentive spirometer after surgery. Which instruction is
correct?
A. “Inhale slowly and deeply, then hold your breath for 3-5 seconds.”
B. “Exhale forcefully into the device to measure lung capacity.”
C. “Use the device every 4 hours while awake only.”
D. “Lie flat on your back while using the spirometer.”
Answer: A
Explanation: Sustained deep inhalation with breath hold promotes lung expansion and prevents
atelectasis.
6. A client is receiving a blood transfusion and reports chills and low back pain. Vital signs: BP 90/60, HR
120, temperature 101.2°F (38.4°C). What is the priority action?
A. Stop the transfusion and infuse normal saline through new tubing
B. Slow the transfusion rate and notify the provider
C. Administer acetaminophen and continue the transfusion
D. Obtain a urine sample for hemoglobin
,Answer: A
Explanation: Symptoms indicate acute hemolytic reaction; stop transfusion immediately, maintain IV
access with saline, and notify blood bank.
7. A nurse is calculating intake and output for a client over 8 hours. The client drank 240 mL water, 120
mL coffee, and 180 mL juice; received 500 mL IV fluids; urine output was 800 mL. What is the fluid
balance?
A. +240 mL
B. -240 mL
C. +500 mL
D. -800 mL
Answer: A
Explanation: Total intake = 240+120+180+500 = 1040 mL; output = 800 mL; positive balance of 240 mL.
8. A client with a nasogastric tube to low intermittent suction reports nausea and abdominal distention.
What should the nurse do first?
A. Check the patency of the NG tube
B. Irrigate the NG tube with 30 mL of air
C. Increase the suction pressure
D. Remove the NG tube and notify the provider
Answer: A
Explanation: Nausea and distention suggest tube obstruction; check for kinks or clots first.
9. A client with a new colostomy has a stoma that is dark purple and edematous. What should the nurse
do first?
A. Notify the surgeon immediately
B. Apply a cold compress to reduce edema
C. Gently massage the stoma to improve circulation
D. Document the finding as normal for a new stoma
Answer: A
, Explanation: Dark purple indicates ischemia or necrosis; this is a surgical emergency.
10. A nurse is caring for a client who is receiving a continuous enteral feeding via nasogastric tube.
Which finding indicates feeding intolerance?
A. Gastric residual volume of 300 mL
B. Bowel sounds present in all quadrants
C. Blood glucose of 110 mg/dL
D. Urine output of 1,500 mL in 24 hours
Answer: A
Explanation: High gastric residual (>250-500 mL) suggests delayed gastric emptying and aspiration risk.
11. A client is prescribed digoxin 0.25 mg daily. Which finding would prompt the nurse to withhold the
medication?
A. Apical pulse of 52 beats/min
B. Blood pressure of 110/70 mm Hg
C. Potassium level of 4.0 mEq/L
D. Respiratory rate of 18/min
Answer: A
Explanation: Digoxin is withheld for apical pulse <60 bpm in adults; hypokalemia also increases toxicity
risk but pulse is immediate concern.
12. A nurse is preparing to insert a nasogastric tube. Which action demonstrates correct infection
control?
A. Perform hand hygiene and apply clean gloves
B. Use sterile gloves and a sterile drape
C. Wear a face shield and sterile gown
D. Perform hand hygiene only
Answer: A
Explanation: NG tube insertion is a clean, not sterile, procedure; hand hygiene and clean gloves are
sufficient.
