NSG430 Exam 1 V3 | NSG 430 Adult Health
Nursing II | Grand Canyon University
This exam-style preparation material is designed to support students preparing for advanced
adult health nursing assessments involving acute illnesses, complex nursing care, and
multisystem disorders. The material emphasizes safe nursing interventions and critical thinking
in clinical settings.
The questions are structured to closely mirror actual course assessments while reinforcing
analytical reasoning and patient care decision-making skills. Detailed expert explanations are
included to improve comprehension and academic performance.
════════════════════════════════════
The Exam Covers:
• Adult respiratory emergencies
• Dysrhythmia management
• Hemodynamic monitoring
• Adult mobility and safety
• Nursing care planning
• Acute care nursing interventions
• Patient-centered communication
• Adult pharmacology review
════════════════════════════════════
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which clinical finding should the nurse anticipate during the physical
assessment?
A. Tachycardia and poor skin turgor
B. Decreased central venous pressure
C. Bilateral crackles and orthopnea
D. Flat neck veins while supine
,Correct Answer: C
Expert Explanation: An elevated PAWP of 22 mmHg indicates increased left-sided heart
pressures and fluid overload. This often results in pulmonary congestion, which manifests
as crackles upon auscultation and difficulty breathing when lying flat. The nurse must
monitor for worsening respiratory status and prepare for diuretic administration.
2. The nurse observes a patient’s monitor and notes a sudden onset of Ventricular
Fibrillation. After confirming the patient is pulseless, what is the nurse’s immediate priority
action?
A. Administer a 1 mg dose of Epinephrine IV push
B. Begin bag-mask ventilation with 100% oxygen
C. Prepare for emergency endotracheal intubation
D. Perform immediate unsynchronized defibrillation
Correct Answer: D
Expert Explanation: Ventricular fibrillation is a lethal rhythm that requires immediate
electrical therapy to restore a perfusing rhythm. Defibrillation is the most effective
treatment when performed quickly after the onset of the dysrhythmia. While CPR and
medications are important, they follow the delivery of the initial shock in the ACLS
protocol.
,3. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS) and is
being mechanically ventilated. The nurse notes the PEEP has been increased to 15 cm H2O.
Which complication should the nurse monitor for most closely?
A. Pneumothorax due to barotrauma
B. Increased cardiac output
C. Respiratory alkalosis
D. Decreased intracranial pressure
Correct Answer: A
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase the
risk of alveolar overdistension and barotrauma, which can lead to a pneumothorax.
Additionally, high PEEP can decrease venous return and cardiac output by increasing
intrathoracic pressure. The nurse must perform frequent lung assessments and monitor
hemodynamic stability during these settings.
4. The nurse is caring for a patient receiving an infusion of Norepinephrine for septic shock.
Which assessment finding indicates a therapeutic response to this medication?
A. Mean Arterial Pressure (MAP) of 70 mmHg
B. Heart rate of 115 beats per minute
C. Systemic Vascular Resistance (SVR) of 600 dynes/sec/cm5
D. Urine output of 15 mL per hour
, Correct Answer: A
Expert Explanation: The primary goal of Norepinephrine in shock is to maintain adequate
tissue perfusion, typically evidenced by a MAP of at least 65 mmHg. Norepinephrine is a
potent vasoconstrictor that increases SVR and blood pressure. A MAP of 70 mmHg suggests
that the medication is effectively supporting the patient’s hemodynamic status.
5. A patient’s cardiac monitor shows Supraventricular Tachycardia (SVT) with a heart rate of
190 bpm. The patient is alert but complains of palpitations and mild chest pressure. Which
intervention should the nurse implement first?
A. Instruct the patient to perform a Valsalva maneuver
B. Administer Adenosine 6 mg via rapid IV push
C. Prepare for immediate synchronized cardioversion
D. Obtain a stat 12-lead electrocardiogram
Correct Answer: A
Expert Explanation: For stable patients with SVT, vagal maneuvers such as the Valsalva
maneuver are the initial recommended intervention. These maneuvers can increase
parasympathetic tone and slow conduction through the AV node. If this fails,
pharmacological intervention with Adenosine is typically the next step.
6. The nurse is monitoring a patient with a Central Venous Pressure (CVP) of 2 mmHg. Which
clinical manifestation is most likely associated with this value?
A. Jugular venous distention
Nursing II | Grand Canyon University
This exam-style preparation material is designed to support students preparing for advanced
adult health nursing assessments involving acute illnesses, complex nursing care, and
multisystem disorders. The material emphasizes safe nursing interventions and critical thinking
in clinical settings.
The questions are structured to closely mirror actual course assessments while reinforcing
analytical reasoning and patient care decision-making skills. Detailed expert explanations are
included to improve comprehension and academic performance.
════════════════════════════════════
The Exam Covers:
• Adult respiratory emergencies
• Dysrhythmia management
• Hemodynamic monitoring
• Adult mobility and safety
• Nursing care planning
• Acute care nursing interventions
• Patient-centered communication
• Adult pharmacology review
════════════════════════════════════
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which clinical finding should the nurse anticipate during the physical
assessment?
A. Tachycardia and poor skin turgor
B. Decreased central venous pressure
C. Bilateral crackles and orthopnea
D. Flat neck veins while supine
,Correct Answer: C
Expert Explanation: An elevated PAWP of 22 mmHg indicates increased left-sided heart
pressures and fluid overload. This often results in pulmonary congestion, which manifests
as crackles upon auscultation and difficulty breathing when lying flat. The nurse must
monitor for worsening respiratory status and prepare for diuretic administration.
2. The nurse observes a patient’s monitor and notes a sudden onset of Ventricular
Fibrillation. After confirming the patient is pulseless, what is the nurse’s immediate priority
action?
A. Administer a 1 mg dose of Epinephrine IV push
B. Begin bag-mask ventilation with 100% oxygen
C. Prepare for emergency endotracheal intubation
D. Perform immediate unsynchronized defibrillation
Correct Answer: D
Expert Explanation: Ventricular fibrillation is a lethal rhythm that requires immediate
electrical therapy to restore a perfusing rhythm. Defibrillation is the most effective
treatment when performed quickly after the onset of the dysrhythmia. While CPR and
medications are important, they follow the delivery of the initial shock in the ACLS
protocol.
,3. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS) and is
being mechanically ventilated. The nurse notes the PEEP has been increased to 15 cm H2O.
Which complication should the nurse monitor for most closely?
A. Pneumothorax due to barotrauma
B. Increased cardiac output
C. Respiratory alkalosis
D. Decreased intracranial pressure
Correct Answer: A
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase the
risk of alveolar overdistension and barotrauma, which can lead to a pneumothorax.
Additionally, high PEEP can decrease venous return and cardiac output by increasing
intrathoracic pressure. The nurse must perform frequent lung assessments and monitor
hemodynamic stability during these settings.
4. The nurse is caring for a patient receiving an infusion of Norepinephrine for septic shock.
Which assessment finding indicates a therapeutic response to this medication?
A. Mean Arterial Pressure (MAP) of 70 mmHg
B. Heart rate of 115 beats per minute
C. Systemic Vascular Resistance (SVR) of 600 dynes/sec/cm5
D. Urine output of 15 mL per hour
, Correct Answer: A
Expert Explanation: The primary goal of Norepinephrine in shock is to maintain adequate
tissue perfusion, typically evidenced by a MAP of at least 65 mmHg. Norepinephrine is a
potent vasoconstrictor that increases SVR and blood pressure. A MAP of 70 mmHg suggests
that the medication is effectively supporting the patient’s hemodynamic status.
5. A patient’s cardiac monitor shows Supraventricular Tachycardia (SVT) with a heart rate of
190 bpm. The patient is alert but complains of palpitations and mild chest pressure. Which
intervention should the nurse implement first?
A. Instruct the patient to perform a Valsalva maneuver
B. Administer Adenosine 6 mg via rapid IV push
C. Prepare for immediate synchronized cardioversion
D. Obtain a stat 12-lead electrocardiogram
Correct Answer: A
Expert Explanation: For stable patients with SVT, vagal maneuvers such as the Valsalva
maneuver are the initial recommended intervention. These maneuvers can increase
parasympathetic tone and slow conduction through the AV node. If this fails,
pharmacological intervention with Adenosine is typically the next step.
6. The nurse is monitoring a patient with a Central Venous Pressure (CVP) of 2 mmHg. Which
clinical manifestation is most likely associated with this value?
A. Jugular venous distention
