NSG430 Exam 4 V2 | NSG 430 Adult Health
Nursing II | Grand Canyon University
This study guide is intended to help students strengthen their understanding of critical illness
management, advanced adult nursing care, and complex psychosocial issues affecting adult
patients and families. The content reflects practical nursing concepts frequently tested in adult
health nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing nursing
prioritization, therapeutic communication, and emergency nursing management skills. Detailed
expert explanations are included to support concept mastery and exam preparedness.
════════════════════════════════════
The Exam Covers:
• Respiratory failure management
• Emergency cardiovascular care
• Intensive care nursing assessment
• Adult trauma care
• Palliative and hospice nursing
• Family coping and support systems
• Ethical and legal nursing issues
• Crisis intervention nursing care
════════════════════════════════════
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is not responding to
conventional oxygen therapy. Which position should the nurse anticipate placing the patient
in to improve oxygenation?
A. High-Fowler’s position
B. Trendelenburg position
C. Prone position
D. Left lateral recumbent position
,Correct Answer: C
Expert Explanation: Prone positioning is utilized in ARDS to improve oxygenation by
recruiting collapsed alveoli in the dorsal lung regions. It helps redistribute blood flow to
better-ventilated areas, reducing intrapulmonary shunting. This intervention is often used
for patients with a PaO2/FiO2 ratio of less than 150.
2. A nurse is caring for a patient in the ICU who has a sudden drop in cardiac output and
increased systemic vascular resistance. Which type of shock is most likely occurring?
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Anaphylactic shock
Correct Answer: C
Expert Explanation: Cardiogenic shock is characterized by a decrease in cardiac output
due to pump failure, which triggers a compensatory increase in systemic vascular
resistance. In contrast, distributive shocks like septic or anaphylactic shock usually involve
a decrease in systemic vascular resistance. Recognizing these hemodynamic patterns is
essential for selecting the correct vasopressor or inotropic support.
3. During the primary survey of a trauma patient, which action should the nurse perform
first?
A. Assess the patient’s level of consciousness
, B. Check for a patent airway while maintaining cervical spine stabilization
C. Apply high-flow oxygen via a non-rebreather mask
D. Obtain a full set of vital signs and oxygen saturation
Correct Answer: B
Expert Explanation: The standard trauma assessment follows the ABCDE sequence, where
‘A’ stands for airway maintenance with cervical spine protection. Airway obstruction is the
most immediate threat to life and must be cleared before assessing breathing or
circulation. Stabilizing the spine prevents secondary neurological injury during airway
maneuvers.
4. A patient is admitted with a suspected tension pneumothorax. What is the immediate
priority intervention the nurse should prepare for?
A. Chest X-ray to confirm the diagnosis
B. Administration of a bolus of intravenous fluids
C. Endotracheal intubation and mechanical ventilation
D. Needle decompression at the second intercostal space
Correct Answer: D
Expert Explanation: Tension pneumothorax is a life-threatening emergency that requires
immediate needle decompression to release trapped air. Waiting for a chest X-ray can
Nursing II | Grand Canyon University
This study guide is intended to help students strengthen their understanding of critical illness
management, advanced adult nursing care, and complex psychosocial issues affecting adult
patients and families. The content reflects practical nursing concepts frequently tested in adult
health nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing nursing
prioritization, therapeutic communication, and emergency nursing management skills. Detailed
expert explanations are included to support concept mastery and exam preparedness.
════════════════════════════════════
The Exam Covers:
• Respiratory failure management
• Emergency cardiovascular care
• Intensive care nursing assessment
• Adult trauma care
• Palliative and hospice nursing
• Family coping and support systems
• Ethical and legal nursing issues
• Crisis intervention nursing care
════════════════════════════════════
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is not responding to
conventional oxygen therapy. Which position should the nurse anticipate placing the patient
in to improve oxygenation?
A. High-Fowler’s position
B. Trendelenburg position
C. Prone position
D. Left lateral recumbent position
,Correct Answer: C
Expert Explanation: Prone positioning is utilized in ARDS to improve oxygenation by
recruiting collapsed alveoli in the dorsal lung regions. It helps redistribute blood flow to
better-ventilated areas, reducing intrapulmonary shunting. This intervention is often used
for patients with a PaO2/FiO2 ratio of less than 150.
2. A nurse is caring for a patient in the ICU who has a sudden drop in cardiac output and
increased systemic vascular resistance. Which type of shock is most likely occurring?
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Anaphylactic shock
Correct Answer: C
Expert Explanation: Cardiogenic shock is characterized by a decrease in cardiac output
due to pump failure, which triggers a compensatory increase in systemic vascular
resistance. In contrast, distributive shocks like septic or anaphylactic shock usually involve
a decrease in systemic vascular resistance. Recognizing these hemodynamic patterns is
essential for selecting the correct vasopressor or inotropic support.
3. During the primary survey of a trauma patient, which action should the nurse perform
first?
A. Assess the patient’s level of consciousness
, B. Check for a patent airway while maintaining cervical spine stabilization
C. Apply high-flow oxygen via a non-rebreather mask
D. Obtain a full set of vital signs and oxygen saturation
Correct Answer: B
Expert Explanation: The standard trauma assessment follows the ABCDE sequence, where
‘A’ stands for airway maintenance with cervical spine protection. Airway obstruction is the
most immediate threat to life and must be cleared before assessing breathing or
circulation. Stabilizing the spine prevents secondary neurological injury during airway
maneuvers.
4. A patient is admitted with a suspected tension pneumothorax. What is the immediate
priority intervention the nurse should prepare for?
A. Chest X-ray to confirm the diagnosis
B. Administration of a bolus of intravenous fluids
C. Endotracheal intubation and mechanical ventilation
D. Needle decompression at the second intercostal space
Correct Answer: D
Expert Explanation: Tension pneumothorax is a life-threatening emergency that requires
immediate needle decompression to release trapped air. Waiting for a chest X-ray can
