NSG430 Final Exam V3 | NSG 430 Adult
Health Nursing II | Grand Canyon
University
This comprehensive final exam preparation material is designed to strengthen understanding of
advanced adult nursing concepts, critical care management, and complex medical-surgical
nursing interventions. The content focuses on integrating nursing knowledge into real-world
adult clinical scenarios.
The questions are structured to closely mirror actual nursing final exams while reinforcing
analytical reasoning, prioritization, and nursing intervention strategies. Detailed expert
explanations are included to support concept mastery and academic success.
════════════════════════════════════
The Exam Covers:
• Multisystem adult disorders
• Advanced nursing assessment
• Adult emergency and trauma care
• Critical care pharmacology
• Complex patient management
• Comprehensive nursing interventions
• Patient-centered nursing care
• Final adult health nursing review
════════════════════════════════════
1. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS). Which
clinical manifestation is most characteristic of the condition?
A. Hyperventilation leading to respiratory alkalosis
B. Pink frothy sputum and crackles
C. Hypoxemia that is unresponsive to supplemental oxygen
D. Increased lung compliance and ease of ventilation
,Correct Answer: C
Expert Explanation: Refractory hypoxemia is the hallmark sign of ARDS, where the
patient’s PaO2 does not improve significantly despite increasing the fraction of inspired
oxygen. This occurs due to intrapulmonary shunting where blood flows past non-
ventilated, fluid-filled alveoli. The nurse should anticipate interventions such as mechanical
ventilation with high PEEP.
2. A patient in the ICU is being treated for septic shock. Which of the following findings would
indicate that the patient is progressing toward Multiple Organ Dysfunction Syndrome
(MODS)?
A. Serum creatinine level of 1.2 mg/dL
B. Urine output of 45 mL/hr
C. Platelet count of 80,000/mm3 and elevated AST levels
D. Mean arterial pressure (MAP) of 70 mmHg
Correct Answer: C
Expert Explanation: MODS involves the failure of two or more organ systems in an acutely
ill patient. A decrease in platelet count (thrombocytopenia) and elevated liver enzymes
(AST/ALT) suggest hepatic and hematologic dysfunction. The nurse must monitor for
systemic inflammatory response symptoms to prevent further decline.
, 3. When calculating fluid resuscitation using the Parkland formula for a 70kg patient with 40%
total body surface area (TBSA) burns, how much fluid should be administered in the first 8
hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Expert Explanation: The Parkland formula is 4 mL x kg x % TBSA. For this patient, the
total 24-hour volume is 4 x 70 x 40 = 11,200 mL. Half of this volume (5,600 mL) must be
administered within the first 8 hours post-injury.
4. A patient with a T4 spinal cord injury suddenly reports a severe throbbing headache and
has a blood pressure of 210/110 mmHg. What is the priority nursing action?
A. Administer an ordered antihypertensive medication
B. Check the patient for bladder distention or fecal impaction
C. Lower the head of the bed to a flat position
D. Notify the healthcare provider immediately
Correct Answer: B
Health Nursing II | Grand Canyon
University
This comprehensive final exam preparation material is designed to strengthen understanding of
advanced adult nursing concepts, critical care management, and complex medical-surgical
nursing interventions. The content focuses on integrating nursing knowledge into real-world
adult clinical scenarios.
The questions are structured to closely mirror actual nursing final exams while reinforcing
analytical reasoning, prioritization, and nursing intervention strategies. Detailed expert
explanations are included to support concept mastery and academic success.
════════════════════════════════════
The Exam Covers:
• Multisystem adult disorders
• Advanced nursing assessment
• Adult emergency and trauma care
• Critical care pharmacology
• Complex patient management
• Comprehensive nursing interventions
• Patient-centered nursing care
• Final adult health nursing review
════════════════════════════════════
1. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS). Which
clinical manifestation is most characteristic of the condition?
A. Hyperventilation leading to respiratory alkalosis
B. Pink frothy sputum and crackles
C. Hypoxemia that is unresponsive to supplemental oxygen
D. Increased lung compliance and ease of ventilation
,Correct Answer: C
Expert Explanation: Refractory hypoxemia is the hallmark sign of ARDS, where the
patient’s PaO2 does not improve significantly despite increasing the fraction of inspired
oxygen. This occurs due to intrapulmonary shunting where blood flows past non-
ventilated, fluid-filled alveoli. The nurse should anticipate interventions such as mechanical
ventilation with high PEEP.
2. A patient in the ICU is being treated for septic shock. Which of the following findings would
indicate that the patient is progressing toward Multiple Organ Dysfunction Syndrome
(MODS)?
A. Serum creatinine level of 1.2 mg/dL
B. Urine output of 45 mL/hr
C. Platelet count of 80,000/mm3 and elevated AST levels
D. Mean arterial pressure (MAP) of 70 mmHg
Correct Answer: C
Expert Explanation: MODS involves the failure of two or more organ systems in an acutely
ill patient. A decrease in platelet count (thrombocytopenia) and elevated liver enzymes
(AST/ALT) suggest hepatic and hematologic dysfunction. The nurse must monitor for
systemic inflammatory response symptoms to prevent further decline.
, 3. When calculating fluid resuscitation using the Parkland formula for a 70kg patient with 40%
total body surface area (TBSA) burns, how much fluid should be administered in the first 8
hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Expert Explanation: The Parkland formula is 4 mL x kg x % TBSA. For this patient, the
total 24-hour volume is 4 x 70 x 40 = 11,200 mL. Half of this volume (5,600 mL) must be
administered within the first 8 hours post-injury.
4. A patient with a T4 spinal cord injury suddenly reports a severe throbbing headache and
has a blood pressure of 210/110 mmHg. What is the priority nursing action?
A. Administer an ordered antihypertensive medication
B. Check the patient for bladder distention or fecal impaction
C. Lower the head of the bed to a flat position
D. Notify the healthcare provider immediately
Correct Answer: B
