NSG430 Exam 3 V3 | NSG 430 Adult Health
Nursing II | Grand Canyon University
1. A nurse is caring for a client with Parkinson’s disease who is experiencing a ‘wearing-off’
phenomenon with levodopa-carbidopa. Which intervention is most appropriate?
A. Advise the client to take the medication with a high-protein meal.
B. Discuss the potential for adding a dopamine agonist to the regimen.
C. Instruct the client to stop the medication immediately.
D. Suggest increasing the time interval between doses.
Answer: B
Rationale: The ‘wearing-off’ phenomenon occurs when the therapeutic effects of levodopa
decrease before the next dose is due. Adding a dopamine agonist or changing the dosing
frequency can help maintain more stable blood levels. High-protein meals should be
avoided as they can interfere with the absorption of levodopa.
2. When assessing a client in Buck’s traction, which finding requires immediate nursing
intervention?
A. The weights are hanging freely off the floor.
B. The skin under the boot is intact and warm.
C. The client reports a pain level of 3 out of 10.
,D. The client’s heel is touching the bed surface.
Answer: D
Rationale: The heel should not rest on the bed surface to prevent the development of
pressure ulcers. Weights must always hang freely to provide the necessary tension for
immobilization and spasm reduction. Constant assessment of the skin and neurovascular
status is critical for patients in skin traction.
3. A client with multiple myeloma is at risk for hypercalcemia. Which nursing action is a
priority?
A. Restrict fluid intake to 1 liter per day.
B. Monitor for signs of metabolic alkalosis.
C. Administer calcium supplements as prescribed.
D. Encourage weight-bearing exercises and hydration.
Answer: D
Rationale: Multiple myeloma causes bone destruction, leading to the release of calcium
into the bloodstream. Hydration helps the kidneys excrete excess calcium, and weight-
bearing exercise helps keep calcium in the bones. Restricting fluids or giving calcium
supplements would worsen the condition significantly.
4. Which neurovascular assessment finding is an early sign of compartment syndrome?
A. Paresthesia or ‘pins and needles’ sensation.
, B. Absence of a distal pulse.
C. Cold, cyanotic skin distal to the injury.
D. Paralysis of the affected limb.
Answer: A
Rationale: Paresthesia is often one of the first signs of compartment syndrome due to
nerve compression. Pulselessness and paralysis are late signs and usually indicate
permanent damage is occurring. Nurses must perform frequent neurovascular checks to
identify these changes before they progress to irreversible ischemia.
5. A client is undergoing a bone marrow aspiration. Which post-procedure instruction is most
important?
A. Maintain strict bed rest for 24 hours.
B. Apply a pressure dressing and monitor for bleeding.
C. Avoid taking any fluids for 4 hours.
D. Keep the site open to air to promote healing.
Answer: B
Rationale: Bone marrow aspiration involves a needle entering the bone, which carries a
high risk of bleeding, especially in hematologic patients. A pressure dressing is applied to
the site to promote hemostasis. The nurse must monitor the site frequently for hematoma
formation or active bleeding.
Nursing II | Grand Canyon University
1. A nurse is caring for a client with Parkinson’s disease who is experiencing a ‘wearing-off’
phenomenon with levodopa-carbidopa. Which intervention is most appropriate?
A. Advise the client to take the medication with a high-protein meal.
B. Discuss the potential for adding a dopamine agonist to the regimen.
C. Instruct the client to stop the medication immediately.
D. Suggest increasing the time interval between doses.
Answer: B
Rationale: The ‘wearing-off’ phenomenon occurs when the therapeutic effects of levodopa
decrease before the next dose is due. Adding a dopamine agonist or changing the dosing
frequency can help maintain more stable blood levels. High-protein meals should be
avoided as they can interfere with the absorption of levodopa.
2. When assessing a client in Buck’s traction, which finding requires immediate nursing
intervention?
A. The weights are hanging freely off the floor.
B. The skin under the boot is intact and warm.
C. The client reports a pain level of 3 out of 10.
,D. The client’s heel is touching the bed surface.
Answer: D
Rationale: The heel should not rest on the bed surface to prevent the development of
pressure ulcers. Weights must always hang freely to provide the necessary tension for
immobilization and spasm reduction. Constant assessment of the skin and neurovascular
status is critical for patients in skin traction.
3. A client with multiple myeloma is at risk for hypercalcemia. Which nursing action is a
priority?
A. Restrict fluid intake to 1 liter per day.
B. Monitor for signs of metabolic alkalosis.
C. Administer calcium supplements as prescribed.
D. Encourage weight-bearing exercises and hydration.
Answer: D
Rationale: Multiple myeloma causes bone destruction, leading to the release of calcium
into the bloodstream. Hydration helps the kidneys excrete excess calcium, and weight-
bearing exercise helps keep calcium in the bones. Restricting fluids or giving calcium
supplements would worsen the condition significantly.
4. Which neurovascular assessment finding is an early sign of compartment syndrome?
A. Paresthesia or ‘pins and needles’ sensation.
, B. Absence of a distal pulse.
C. Cold, cyanotic skin distal to the injury.
D. Paralysis of the affected limb.
Answer: A
Rationale: Paresthesia is often one of the first signs of compartment syndrome due to
nerve compression. Pulselessness and paralysis are late signs and usually indicate
permanent damage is occurring. Nurses must perform frequent neurovascular checks to
identify these changes before they progress to irreversible ischemia.
5. A client is undergoing a bone marrow aspiration. Which post-procedure instruction is most
important?
A. Maintain strict bed rest for 24 hours.
B. Apply a pressure dressing and monitor for bleeding.
C. Avoid taking any fluids for 4 hours.
D. Keep the site open to air to promote healing.
Answer: B
Rationale: Bone marrow aspiration involves a needle entering the bone, which carries a
high risk of bleeding, especially in hematologic patients. A pressure dressing is applied to
the site to promote hemostasis. The nurse must monitor the site frequently for hematoma
formation or active bleeding.
