SOUTH COLLEGE NSG 2610 AH2 EXAM 2/ NSG 2610 AH2 ACTUAL EXAM
2 LATEST 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
APPROVED QUESTIONSAND CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES (100% CORRECT VERIFIED SOLUTIONS)
CURRENTLY UPDATED VERSION 2026 EDITION |GUARANTEED
SUCCESS A+
1. A patient with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding indicates the medication is having the desired effect?
A. Decreased jugular venous distention
B. Increased blood pressure from 90/60 to 110/70
C. Crackles auscultated in the lung bases
D. Weight gain of 2 kg in 24 hours
CORRECT ANSWER: A
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
diuresis. Decreased jugular venous distention indicates reduced central venous
pressure, a sign of effective volume reduction. Option B is less specific and may
not be desired in all heart failure patients. Option C indicates worsening
pulmonary congestion. Option D indicates fluid retention, not diuresis.
2. A nurse is caring for a patient with acute respiratory distress syndrome
(ARDS). Which ventilator setting adjustment would the provider most likely
prescribe to improve oxygenation?
A. Decrease positive end-expiratory pressure (PEEP) to 5 cm H₂O
B. Increase FiOS₂ to 80%
C. Switch to pressure support ventilation
D. Decrease tidal volume to 4 mL/kg
CORRECT ANSWER: B
*Rationale: In ARDS, increasing FiOS₂ is a direct intervention to improve arterial
oxygenation. PEEP is typically increased, not decreased, to recruit alveoli.
Pressure support is not primarily for oxygenation. Low tidal volumes (6 mL/kg)
are lung-protective but do not directly raise Paso₂ as much as increasing FiO₂. *
, 3. Which finding is the earliest sign of increased intracranial pressure (ICP) in
a patient with a traumatic brain injury?
A. Pupil dilation unilaterally
B. Decorticate posturing
C. Change in level of consciousness
D. Widening pulse pressure
CORRECT ANSWER: C
Rationale: Altered level of consciousness (lethargy, confusion) is the most sensitive
and earliest indicator of rising ICP. Pupil changes and posturing occur later.
Widening pulse pressure is a late sign (Cushing’s triad).
4. A patient with status asthmatics is receiving continuous albuterol
nebulization. Which assessment finding requires immediate intervention?
A. Heart rate of 120 beats/min
B. Respiratory rate of 28 breaths/min
C. Wheezing that is no longer audible
D. Tremors in both hands
CORRECT ANSWER: C
Rationale: Absence of wheezing in severe asthma may indicate "silent chest" due
to severe airflow limitation, a sign of impending respiratory failure. Tachycardia
and tremors are expected side effects of beta-agonists. Tachypnea is common but
not as critical as silent chest.
5. A patient post-cardiac arrest has a Glasgow Coma Scale (GCS) score of 6.
Which intervention is priority?
A. Administer IV phenytoin for seizure prophylaxis
B. Initiate targeted temperature management (TTM)
C. Obtain a stat CT scan of the head
D. Prepare for emergency craniotomy
CORRECT ANSWER: B
*Rationale: Post-cardiac arrest, TTM (32–36°C) reduces brain damage and
improves neurological outcomes. Seizure prophylaxis is not routinely given. CT
may be done but not before temperature management. Craniotomy is not indicated
without specific lesion. *
, 6. Which laboratory value in a patient with diabetic ketoacidosis (DKA)
indicates a need to transition from IV insulin to subcutaneous insulin?
A. Serum glucose 210 mg/ld.
B. Serum bicarbonate 20 me/L
C. Venous pH 7.35
D. Anion gap closed to 10 me/L
CORRECT ANSWER: D
*Rationale: Transition to subcutaneous insulin is safe when the anion gap is
normalized (≤12 me/L), indicating resolution of ketosis. Glucose can be >200
mg/ld. if anion gap is closed. Bicarbonate and pH improve but lag behind anion
gap closure. *
7. A nurse is assessing a patient with acute pancreatitis. Which finding
suggests a complication of necrotizing pancreatitis?
A. Cullen’s sign
B. Elevated serum lipase
C. Hypoactive bowel sounds
D. Amylase three times normal
CORRECT ANSWER: A
Rationale: Cullen’s sign (periumbilical ecchymosis) indicates retroperitoneal
bleeding from pancreatic necrosis. Elevated lipase/amylase indicates acute
inflammation but not necrosis. Hypoactive bowel sounds are common in
pancreatitis but nonspecific.
8. A patient with septic shock has a mean arterial pressure (MAP) of 55 mm
Hg despite fluid resuscitation. Which medication does the nurse anticipate?
A. Dopamine at 5 mcg/kg/min
B. Norepinephrine continuous infusion
C. Dobutamine at 10 mcg/kg/min
D. Nitroprusside infusion
CORRECT ANSWER: B
*Rationale: Norepinephrine is first-line vasopressor in septic shock to achieve
MAP ≥65 mm Hg. Dopamine is second-line. Dobutamine is for cardiogenic shock.
Nitroprusside is a vasodilator and would worsen hypotension. *
, 9. Which electrocardiogram (ECG) finding is most consistent with
hyperkalemia?
A. Peaked T waves
B. Prolonged PR interval
C. Widened QRS complex
D. Absent P waves
CORRECT ANSWER: A
Rationale: Peaked, narrow-based T waves are the earliest ECG sign of
hyperkalemia. PR prolongation, widened QRS, and absent P waves occur with
more severe hyperkalemia.
10. A patient with cirrhosis develops asterisks and confusion. Which dietary
modification is most important?
A. Low-sodium diet
B. High-protein diet
C. Low-protein diet
D. Fluid restriction to 1.5 L/day
CORRECT ANSWER: C
Rationale: Asterisks and confusion indicate hepatic encephalopathy. Protein
restriction (temporary) reduces ammonia production. Low sodium is for ascites.
High protein may worsen encephalopathy. Fluid restriction is not primary for
encephalopathy.
11. A patient in cardiogenic shock has a pulmonary artery catheter. Which
finding indicates reduced cardiac output?
A. Cardiac index 1.8 L/min/m²
B. Pulmonary artery wedge pressure (PAWP) 8 mm Hg
C. Mixed venous oxygen saturation (So₂) 70%
D. Systemic vascular resistance (SVR) 800 dynes·sec/cm⁵
CORRECT ANSWER: A
*Rationale: Normal cardiac index is 2.5–4.0 L/min/m²; 1.8 indicates low output.
Low PAWP suggests hypovolemia, not cardiogenic shock. Low So₂ (<60%)
indicates low output or high extraction. Low SVR occurs in distributive shock. *
12. Which intervention is priority for a patient with a tension pneumothorax?
2 LATEST 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
APPROVED QUESTIONSAND CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES (100% CORRECT VERIFIED SOLUTIONS)
CURRENTLY UPDATED VERSION 2026 EDITION |GUARANTEED
SUCCESS A+
1. A patient with heart failure is prescribed furosemide 40 mg IV push. Which
assessment finding indicates the medication is having the desired effect?
A. Decreased jugular venous distention
B. Increased blood pressure from 90/60 to 110/70
C. Crackles auscultated in the lung bases
D. Weight gain of 2 kg in 24 hours
CORRECT ANSWER: A
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
diuresis. Decreased jugular venous distention indicates reduced central venous
pressure, a sign of effective volume reduction. Option B is less specific and may
not be desired in all heart failure patients. Option C indicates worsening
pulmonary congestion. Option D indicates fluid retention, not diuresis.
2. A nurse is caring for a patient with acute respiratory distress syndrome
(ARDS). Which ventilator setting adjustment would the provider most likely
prescribe to improve oxygenation?
A. Decrease positive end-expiratory pressure (PEEP) to 5 cm H₂O
B. Increase FiOS₂ to 80%
C. Switch to pressure support ventilation
D. Decrease tidal volume to 4 mL/kg
CORRECT ANSWER: B
*Rationale: In ARDS, increasing FiOS₂ is a direct intervention to improve arterial
oxygenation. PEEP is typically increased, not decreased, to recruit alveoli.
Pressure support is not primarily for oxygenation. Low tidal volumes (6 mL/kg)
are lung-protective but do not directly raise Paso₂ as much as increasing FiO₂. *
, 3. Which finding is the earliest sign of increased intracranial pressure (ICP) in
a patient with a traumatic brain injury?
A. Pupil dilation unilaterally
B. Decorticate posturing
C. Change in level of consciousness
D. Widening pulse pressure
CORRECT ANSWER: C
Rationale: Altered level of consciousness (lethargy, confusion) is the most sensitive
and earliest indicator of rising ICP. Pupil changes and posturing occur later.
Widening pulse pressure is a late sign (Cushing’s triad).
4. A patient with status asthmatics is receiving continuous albuterol
nebulization. Which assessment finding requires immediate intervention?
A. Heart rate of 120 beats/min
B. Respiratory rate of 28 breaths/min
C. Wheezing that is no longer audible
D. Tremors in both hands
CORRECT ANSWER: C
Rationale: Absence of wheezing in severe asthma may indicate "silent chest" due
to severe airflow limitation, a sign of impending respiratory failure. Tachycardia
and tremors are expected side effects of beta-agonists. Tachypnea is common but
not as critical as silent chest.
5. A patient post-cardiac arrest has a Glasgow Coma Scale (GCS) score of 6.
Which intervention is priority?
A. Administer IV phenytoin for seizure prophylaxis
B. Initiate targeted temperature management (TTM)
C. Obtain a stat CT scan of the head
D. Prepare for emergency craniotomy
CORRECT ANSWER: B
*Rationale: Post-cardiac arrest, TTM (32–36°C) reduces brain damage and
improves neurological outcomes. Seizure prophylaxis is not routinely given. CT
may be done but not before temperature management. Craniotomy is not indicated
without specific lesion. *
, 6. Which laboratory value in a patient with diabetic ketoacidosis (DKA)
indicates a need to transition from IV insulin to subcutaneous insulin?
A. Serum glucose 210 mg/ld.
B. Serum bicarbonate 20 me/L
C. Venous pH 7.35
D. Anion gap closed to 10 me/L
CORRECT ANSWER: D
*Rationale: Transition to subcutaneous insulin is safe when the anion gap is
normalized (≤12 me/L), indicating resolution of ketosis. Glucose can be >200
mg/ld. if anion gap is closed. Bicarbonate and pH improve but lag behind anion
gap closure. *
7. A nurse is assessing a patient with acute pancreatitis. Which finding
suggests a complication of necrotizing pancreatitis?
A. Cullen’s sign
B. Elevated serum lipase
C. Hypoactive bowel sounds
D. Amylase three times normal
CORRECT ANSWER: A
Rationale: Cullen’s sign (periumbilical ecchymosis) indicates retroperitoneal
bleeding from pancreatic necrosis. Elevated lipase/amylase indicates acute
inflammation but not necrosis. Hypoactive bowel sounds are common in
pancreatitis but nonspecific.
8. A patient with septic shock has a mean arterial pressure (MAP) of 55 mm
Hg despite fluid resuscitation. Which medication does the nurse anticipate?
A. Dopamine at 5 mcg/kg/min
B. Norepinephrine continuous infusion
C. Dobutamine at 10 mcg/kg/min
D. Nitroprusside infusion
CORRECT ANSWER: B
*Rationale: Norepinephrine is first-line vasopressor in septic shock to achieve
MAP ≥65 mm Hg. Dopamine is second-line. Dobutamine is for cardiogenic shock.
Nitroprusside is a vasodilator and would worsen hypotension. *
, 9. Which electrocardiogram (ECG) finding is most consistent with
hyperkalemia?
A. Peaked T waves
B. Prolonged PR interval
C. Widened QRS complex
D. Absent P waves
CORRECT ANSWER: A
Rationale: Peaked, narrow-based T waves are the earliest ECG sign of
hyperkalemia. PR prolongation, widened QRS, and absent P waves occur with
more severe hyperkalemia.
10. A patient with cirrhosis develops asterisks and confusion. Which dietary
modification is most important?
A. Low-sodium diet
B. High-protein diet
C. Low-protein diet
D. Fluid restriction to 1.5 L/day
CORRECT ANSWER: C
Rationale: Asterisks and confusion indicate hepatic encephalopathy. Protein
restriction (temporary) reduces ammonia production. Low sodium is for ascites.
High protein may worsen encephalopathy. Fluid restriction is not primary for
encephalopathy.
11. A patient in cardiogenic shock has a pulmonary artery catheter. Which
finding indicates reduced cardiac output?
A. Cardiac index 1.8 L/min/m²
B. Pulmonary artery wedge pressure (PAWP) 8 mm Hg
C. Mixed venous oxygen saturation (So₂) 70%
D. Systemic vascular resistance (SVR) 800 dynes·sec/cm⁵
CORRECT ANSWER: A
*Rationale: Normal cardiac index is 2.5–4.0 L/min/m²; 1.8 indicates low output.
Low PAWP suggests hypovolemia, not cardiogenic shock. Low So₂ (<60%)
indicates low output or high extraction. Low SVR occurs in distributive shock. *
12. Which intervention is priority for a patient with a tension pneumothorax?
