NSG430 Exam 1 V2 | NSG 430 Adult Health
Nursing II | Grand Canyon University
This study guide is intended to provide comprehensive preparation for adult health nursing
assessments related to acute care management, medical-surgical nursing, and patient-
centered care planning. The content reflects practical nursing concepts frequently tested in
nursing school examinations.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disease processes, nursing interventions, and clinical prioritization strategies. Detailed
expert explanations support deeper understanding and practical nursing application.
════════════════════════════════════
The Exam Covers:
• Pulmonary nursing management
• Cardiac monitoring concepts
• Hypertension and heart failure
• Oxygenation and perfusion
• Adult patient education
• Pain management strategies
• Nursing documentation standards
• Prioritization and delegation
════════════════════════════════════
1. A nurse is caring for a patient with an exacerbation of COPD. The patient’s arterial blood
gas (ABG) results are: pH 7.30, PaCO2 58 mmHg, and HCO3 26 mEq/L. Which acid-base
imbalance is the patient experiencing?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
,Correct Answer: D
Expert Explanation: The pH of 7.30 indicates acidosis, while the PaCO2 of 58 mmHg
indicates a respiratory cause. The bicarbonate level is within a normal range, suggesting
that the kidneys have not yet compensated for the respiratory failure. This clinical picture
is classic for acute respiratory failure secondary to COPD exacerbation.
2. A client is diagnosed with right-sided heart failure. Which assessment finding should the
nurse prioritize as a primary indicator of this condition?
A. Crackles in the lung bases
B. Orthopnea
C. Frothy pink sputum
D. Jugular Venous Distention (JVD)
Correct Answer: D
Expert Explanation: Right-sided heart failure causes blood to back up into the systemic
circulation, leading to symptoms like JVD, peripheral edema, and hepatomegaly. Crackles
and frothy pink sputum are associated with left-sided heart failure due to pulmonary
congestion. Monitoring for JVD helps the nurse evaluate the severity of fluid volume excess
in the venous system.
3. Which clinical manifestation is considered an early sign of hypoxia in a patient with
pneumonia?
A. Cyanosis of the lips
,B. Restlessness and agitation
C. Bradycardia
D. Clubbing of the fingers
Correct Answer: B
Expert Explanation: Restlessness and agitation are early neurologic signs that the brain is
not receiving enough oxygen. Cyanosis and bradycardia are typically late signs indicating
severe respiratory distress and impending failure. Recognizing early behavioral changes
allows the nurse to intervene before the patient’s condition deteriorates further.
4. The nurse is educating a patient about the side effects of Lisinopril for hypertension. Which
symptom should the nurse instruct the patient to report immediately to the healthcare
provider?
A. Swelling of the tongue or lips
B. Occasional dry cough
C. Slight dizziness when standing up
D. Increased urinary frequency
Correct Answer: A
Expert Explanation: Swelling of the tongue or lips indicates angioedema, a life-threatening
adverse effect of ACE inhibitors that can obstruct the airway. While a dry cough is a
common side effect, it is not an emergency like angioedema. Dizziness is a common initial
, response to blood pressure medication but requires monitoring rather than immediate
emergency intervention.
5. A nurse is reviewing a cardiac rhythm strip and notes the absence of P waves and a highly
irregular QRS rhythm. Which rhythm does this represent?
A. Sinus Bradycardia
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree Heart Block
Correct Answer: B
Expert Explanation: Atrial fibrillation is characterized by the absence of discernible P
waves and an ‘irregularly irregular’ ventricular response. This occurs due to chaotic
electrical activity in the atria, which leads to a loss of atrial kick and risk of thrombus
formation. Proper identification is critical for initiating appropriate anticoagulation and
rate control therapies.
6. When delegating tasks to an Unlicensed Assistive Personnel (UAP), which task is most
appropriate for the nurse to assign?
A. Assessing a patient’s breath sounds after a breathing treatment
B. Feeding a stable patient with a history of dysphagia
C. Assisting a stable patient with ambulation to the bathroom
Nursing II | Grand Canyon University
This study guide is intended to provide comprehensive preparation for adult health nursing
assessments related to acute care management, medical-surgical nursing, and patient-
centered care planning. The content reflects practical nursing concepts frequently tested in
nursing school examinations.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disease processes, nursing interventions, and clinical prioritization strategies. Detailed
expert explanations support deeper understanding and practical nursing application.
════════════════════════════════════
The Exam Covers:
• Pulmonary nursing management
• Cardiac monitoring concepts
• Hypertension and heart failure
• Oxygenation and perfusion
• Adult patient education
• Pain management strategies
• Nursing documentation standards
• Prioritization and delegation
════════════════════════════════════
1. A nurse is caring for a patient with an exacerbation of COPD. The patient’s arterial blood
gas (ABG) results are: pH 7.30, PaCO2 58 mmHg, and HCO3 26 mEq/L. Which acid-base
imbalance is the patient experiencing?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
,Correct Answer: D
Expert Explanation: The pH of 7.30 indicates acidosis, while the PaCO2 of 58 mmHg
indicates a respiratory cause. The bicarbonate level is within a normal range, suggesting
that the kidneys have not yet compensated for the respiratory failure. This clinical picture
is classic for acute respiratory failure secondary to COPD exacerbation.
2. A client is diagnosed with right-sided heart failure. Which assessment finding should the
nurse prioritize as a primary indicator of this condition?
A. Crackles in the lung bases
B. Orthopnea
C. Frothy pink sputum
D. Jugular Venous Distention (JVD)
Correct Answer: D
Expert Explanation: Right-sided heart failure causes blood to back up into the systemic
circulation, leading to symptoms like JVD, peripheral edema, and hepatomegaly. Crackles
and frothy pink sputum are associated with left-sided heart failure due to pulmonary
congestion. Monitoring for JVD helps the nurse evaluate the severity of fluid volume excess
in the venous system.
3. Which clinical manifestation is considered an early sign of hypoxia in a patient with
pneumonia?
A. Cyanosis of the lips
,B. Restlessness and agitation
C. Bradycardia
D. Clubbing of the fingers
Correct Answer: B
Expert Explanation: Restlessness and agitation are early neurologic signs that the brain is
not receiving enough oxygen. Cyanosis and bradycardia are typically late signs indicating
severe respiratory distress and impending failure. Recognizing early behavioral changes
allows the nurse to intervene before the patient’s condition deteriorates further.
4. The nurse is educating a patient about the side effects of Lisinopril for hypertension. Which
symptom should the nurse instruct the patient to report immediately to the healthcare
provider?
A. Swelling of the tongue or lips
B. Occasional dry cough
C. Slight dizziness when standing up
D. Increased urinary frequency
Correct Answer: A
Expert Explanation: Swelling of the tongue or lips indicates angioedema, a life-threatening
adverse effect of ACE inhibitors that can obstruct the airway. While a dry cough is a
common side effect, it is not an emergency like angioedema. Dizziness is a common initial
, response to blood pressure medication but requires monitoring rather than immediate
emergency intervention.
5. A nurse is reviewing a cardiac rhythm strip and notes the absence of P waves and a highly
irregular QRS rhythm. Which rhythm does this represent?
A. Sinus Bradycardia
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. First-degree Heart Block
Correct Answer: B
Expert Explanation: Atrial fibrillation is characterized by the absence of discernible P
waves and an ‘irregularly irregular’ ventricular response. This occurs due to chaotic
electrical activity in the atria, which leads to a loss of atrial kick and risk of thrombus
formation. Proper identification is critical for initiating appropriate anticoagulation and
rate control therapies.
6. When delegating tasks to an Unlicensed Assistive Personnel (UAP), which task is most
appropriate for the nurse to assign?
A. Assessing a patient’s breath sounds after a breathing treatment
B. Feeding a stable patient with a history of dysphagia
C. Assisting a stable patient with ambulation to the bathroom
