NSG 3850 EXAM 4 LATEST 2026 UPDATE 100
QUESTIONS AND DETAILED VERIFIED ANSWERS
FROM ACTUAL EXAMS TEST GRADE A+
1. A nurse is caring for a client with acute respiratory distress syndrome (ARDS).
Which finding indicates improvement?
A. PaO₂ 55 mmHg
B. Decreased lung compliance
C. Increased PaO₂/FiO₂ ratio
D. Bilateral infiltrates on chest X-ray
Answer: C
Rationale: An increased PaO₂/FiO₂ ratio reflects improved oxygenation, indicating
recovery in ARDS.
2. A client with sepsis has a lactate level of 5 mmol/L. What is the priority
action?
A. Administer antibiotics
B. Begin fluid resuscitation
C. Administer vasopressors
D. Monitor urine output
Answer: B
Rationale: Elevated lactate indicates hypoperfusion; immediate fluid resuscitation
is the priority.
3. Which electrolyte imbalance is most likely with diabetic ketoacidosis (DKA)?
A. Hypercalcemia
B. Hypokalemia after treatment
,C. Hypernatremia
D. Hypophosphatemia initially
Answer: B
Rationale: Potassium shifts out of cells initially, but insulin therapy drives
potassium into cells, causing hypokalemia.
4. A client receiving heparin develops thrombocytopenia. What should the nurse
suspect?
A. DIC
B. HIT
C. TTP
D. Hemophilia
Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is characterized by low
platelets and increased clotting risk.
5. Which assessment finding requires immediate intervention in a client with
increased ICP?
A. Headache
B. Vomiting
C. Unequal pupils
D. Restlessness
Answer: C
Rationale: Unequal pupils indicate possible brain herniation, a life-threatening
emergency.
6. A nurse is caring for a client with a chest tube. Continuous bubbling in the
water seal chamber indicates:
A. Normal function
, B. Air leak
C. Tube obstruction
D. Lung expansion
Answer: B
Rationale: Continuous bubbling suggests an air leak in the system.
7. A client with heart failure is prescribed furosemide. Which lab value is most
concerning?
A. Sodium 140
B. Potassium 2.9
C. Calcium 9.0
D. Magnesium 2.0
Answer: B
Rationale: Hypokalemia (K⁺ <3.5) increases risk for dysrhythmias.
8. Which medication is used first-line for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Corticosteroids
D. Albuterol
Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylaxis due to rapid
reversal of airway constriction.
9. A client with COPD is on oxygen therapy. What is the priority concern?
A. Oxygen toxicity
B. Suppression of respiratory drive
C. Hyperthermia
D. Hypoglycemia
QUESTIONS AND DETAILED VERIFIED ANSWERS
FROM ACTUAL EXAMS TEST GRADE A+
1. A nurse is caring for a client with acute respiratory distress syndrome (ARDS).
Which finding indicates improvement?
A. PaO₂ 55 mmHg
B. Decreased lung compliance
C. Increased PaO₂/FiO₂ ratio
D. Bilateral infiltrates on chest X-ray
Answer: C
Rationale: An increased PaO₂/FiO₂ ratio reflects improved oxygenation, indicating
recovery in ARDS.
2. A client with sepsis has a lactate level of 5 mmol/L. What is the priority
action?
A. Administer antibiotics
B. Begin fluid resuscitation
C. Administer vasopressors
D. Monitor urine output
Answer: B
Rationale: Elevated lactate indicates hypoperfusion; immediate fluid resuscitation
is the priority.
3. Which electrolyte imbalance is most likely with diabetic ketoacidosis (DKA)?
A. Hypercalcemia
B. Hypokalemia after treatment
,C. Hypernatremia
D. Hypophosphatemia initially
Answer: B
Rationale: Potassium shifts out of cells initially, but insulin therapy drives
potassium into cells, causing hypokalemia.
4. A client receiving heparin develops thrombocytopenia. What should the nurse
suspect?
A. DIC
B. HIT
C. TTP
D. Hemophilia
Answer: B
Rationale: Heparin-induced thrombocytopenia (HIT) is characterized by low
platelets and increased clotting risk.
5. Which assessment finding requires immediate intervention in a client with
increased ICP?
A. Headache
B. Vomiting
C. Unequal pupils
D. Restlessness
Answer: C
Rationale: Unequal pupils indicate possible brain herniation, a life-threatening
emergency.
6. A nurse is caring for a client with a chest tube. Continuous bubbling in the
water seal chamber indicates:
A. Normal function
, B. Air leak
C. Tube obstruction
D. Lung expansion
Answer: B
Rationale: Continuous bubbling suggests an air leak in the system.
7. A client with heart failure is prescribed furosemide. Which lab value is most
concerning?
A. Sodium 140
B. Potassium 2.9
C. Calcium 9.0
D. Magnesium 2.0
Answer: B
Rationale: Hypokalemia (K⁺ <3.5) increases risk for dysrhythmias.
8. Which medication is used first-line for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Corticosteroids
D. Albuterol
Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylaxis due to rapid
reversal of airway constriction.
9. A client with COPD is on oxygen therapy. What is the priority concern?
A. Oxygen toxicity
B. Suppression of respiratory drive
C. Hyperthermia
D. Hypoglycemia
