NSG 430 EXAM 2
ADULT HEALTH EXAM
QUESTIONS AND
VERIFIED ANSWERS
WITH RATIONALES
EXAM SPECIFICATIONS
Time Allocation: 2 Hours
Total Questions: 75 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: 75% Required to Pass
Core Focus: Cardiovascular, Respiratory, Endocrine, Neuro, GI
NSG 430 Exam 2 Adult Health Exam Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
NSG 430 Exam 2 Adult Health validates competency in medical-surgical nursing for adult patients.
Covers cardiovascular, respiratory, endocrine, neurological, and gastrointestinal disorders per current
nursing standards and NCLEX-RN blueprint.
CONTENT DISTRIBUTION
• Cardiovascular (25%) — Heart failure, MI, hypertension, arrhythmias, medications, diagnostics
• Respiratory (25%) — COPD, pneumonia, asthma, ABGs, oxygen therapy, mechanical ventilation
• Endocrine (20%) — Diabetes, DKA, HHS, thyroid disorders, adrenal insufficiency, SIADH
• Neurological & GI (30%) — Stroke, seizures, increased ICP, GI bleeding, pancreatitis, liver
disease
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes detailed rationale with pathophysiology and nursing interventions. Requires
75% to pass.
STUDY STRATEGY
Master pathophysiology and clinical manifestations. Know priority nursing interventions and
assessments. Understand medication mechanisms and side effects. Practice ABG interpretation.
Review lab values: electrolytes, glucose, cardiac enzymes, coagulation. Study priority questions
using ABCs and Maslow.
CURRICULUM ALIGNMENT
Questions reflect current standards: AACN Essentials, NCLEX-RN Test Plan, evidence-based
practice guidelines, and medical-surgical nursing textbooks.
NSG 430 Exam 2 Adult Health Exam Page 2
, SECTION I: Cardiovascular
1. Heart failure with reduced ejection fraction (HFrEF) EF is:
A. >50%
✓ B. ≤40%
C. 45-49%
D. 100%
Rationale: HFrEF: Ejection fraction ≤40%. HFpEF (preserved): EF ≥50%. HFmrEF (mid-range): 41-49%.
HFrEF = systolic dysfunction, heart cannot pump effectively. Symptoms: dyspnea, orthopnea, PND, edema,
fatigue, S3 gallop. Treatment: ACE inhibitors/ARBs, beta-blockers, diuretics, aldosterone antagonists,
SGLT2 inhibitors.
2. Myocardial infarction priority intervention:
A. Administer pain med
✓ B. MONA: Morphine, Oxygen, Nitroglycerin, Aspirin; 12-lead ECG, reperfusion
C. Ambulate patient
D. NPO only
Rationale: MI priority: MONA - Morphine (pain, preload reduction), Oxygen (if <90% or dyspneic),
Nitroglycerin (vasodilation, preload/afterload), Aspirin 325mg chewed (antiplatelet). Immediate 12-lead ECG
within 10 min. Reperfusion: PCI within 90 min or thrombolytics within 30 min. Troponin elevated. STEMI vs
NSTEMI. Time is muscle.
3. Hypertensive crisis BP reading:
A. 120/80
✓ B. >180/120 with or without target organ damage
C. 140/90
D. 90/60
Rationale: Hypertensive crisis: BP >180/120 mmHg. Hypertensive emergency: >180/120 WITH target organ
damage (stroke, MI, HF, renal failure, encephalopathy) - requires IV meds, ICU, gradual reduction 25% first
hour. Hypertensive urgency: >180/120 WITHOUT organ damage - oral meds, reduce over 24-48 hours.
Rapid drop causes stroke/MI.
4. Atrial fibrillation highest risk:
A. Bradycardia
✓ B. Stroke from thromboembolism
C. Hypertension
D. Hypoglycemia
Rationale: A-fib: Irregular irregular rhythm, no P waves, chaotic atrial activity. Blood stasis in atria forms
clots, risk of stroke. CHA2DS2-VASc score determines anticoagulation need. Treatment: Rate control
(beta-blockers, CCB), rhythm control (cardioversion, amiodarone), anticoagulation (warfarin, DOACs).
Symptoms: palpitations, fatigue, dyspnea.
5. Digoxin toxicity signs:
NSG 430 Exam 2 Adult Health Exam Page 3
ADULT HEALTH EXAM
QUESTIONS AND
VERIFIED ANSWERS
WITH RATIONALES
EXAM SPECIFICATIONS
Time Allocation: 2 Hours
Total Questions: 75 Questions
Question Format: Multiple Choice with Rationales
Minimum Competency: 75% Required to Pass
Core Focus: Cardiovascular, Respiratory, Endocrine, Neuro, GI
NSG 430 Exam 2 Adult Health Exam Page 1
, Exam Overview & Content Outline
EXAM PURPOSE
NSG 430 Exam 2 Adult Health validates competency in medical-surgical nursing for adult patients.
Covers cardiovascular, respiratory, endocrine, neurological, and gastrointestinal disorders per current
nursing standards and NCLEX-RN blueprint.
CONTENT DISTRIBUTION
• Cardiovascular (25%) — Heart failure, MI, hypertension, arrhythmias, medications, diagnostics
• Respiratory (25%) — COPD, pneumonia, asthma, ABGs, oxygen therapy, mechanical ventilation
• Endocrine (20%) — Diabetes, DKA, HHS, thyroid disorders, adrenal insufficiency, SIADH
• Neurological & GI (30%) — Stroke, seizures, increased ICP, GI bleeding, pancreatitis, liver
disease
QUESTION FORMAT & SCORING
Each item presents four options. Correct answers are highlighted in green with checkmark (✓).
Every question includes detailed rationale with pathophysiology and nursing interventions. Requires
75% to pass.
STUDY STRATEGY
Master pathophysiology and clinical manifestations. Know priority nursing interventions and
assessments. Understand medication mechanisms and side effects. Practice ABG interpretation.
Review lab values: electrolytes, glucose, cardiac enzymes, coagulation. Study priority questions
using ABCs and Maslow.
CURRICULUM ALIGNMENT
Questions reflect current standards: AACN Essentials, NCLEX-RN Test Plan, evidence-based
practice guidelines, and medical-surgical nursing textbooks.
NSG 430 Exam 2 Adult Health Exam Page 2
, SECTION I: Cardiovascular
1. Heart failure with reduced ejection fraction (HFrEF) EF is:
A. >50%
✓ B. ≤40%
C. 45-49%
D. 100%
Rationale: HFrEF: Ejection fraction ≤40%. HFpEF (preserved): EF ≥50%. HFmrEF (mid-range): 41-49%.
HFrEF = systolic dysfunction, heart cannot pump effectively. Symptoms: dyspnea, orthopnea, PND, edema,
fatigue, S3 gallop. Treatment: ACE inhibitors/ARBs, beta-blockers, diuretics, aldosterone antagonists,
SGLT2 inhibitors.
2. Myocardial infarction priority intervention:
A. Administer pain med
✓ B. MONA: Morphine, Oxygen, Nitroglycerin, Aspirin; 12-lead ECG, reperfusion
C. Ambulate patient
D. NPO only
Rationale: MI priority: MONA - Morphine (pain, preload reduction), Oxygen (if <90% or dyspneic),
Nitroglycerin (vasodilation, preload/afterload), Aspirin 325mg chewed (antiplatelet). Immediate 12-lead ECG
within 10 min. Reperfusion: PCI within 90 min or thrombolytics within 30 min. Troponin elevated. STEMI vs
NSTEMI. Time is muscle.
3. Hypertensive crisis BP reading:
A. 120/80
✓ B. >180/120 with or without target organ damage
C. 140/90
D. 90/60
Rationale: Hypertensive crisis: BP >180/120 mmHg. Hypertensive emergency: >180/120 WITH target organ
damage (stroke, MI, HF, renal failure, encephalopathy) - requires IV meds, ICU, gradual reduction 25% first
hour. Hypertensive urgency: >180/120 WITHOUT organ damage - oral meds, reduce over 24-48 hours.
Rapid drop causes stroke/MI.
4. Atrial fibrillation highest risk:
A. Bradycardia
✓ B. Stroke from thromboembolism
C. Hypertension
D. Hypoglycemia
Rationale: A-fib: Irregular irregular rhythm, no P waves, chaotic atrial activity. Blood stasis in atria forms
clots, risk of stroke. CHA2DS2-VASc score determines anticoagulation need. Treatment: Rate control
(beta-blockers, CCB), rhythm control (cardioversion, amiodarone), anticoagulation (warfarin, DOACs).
Symptoms: palpitations, fatigue, dyspnea.
5. Digoxin toxicity signs:
NSG 430 Exam 2 Adult Health Exam Page 3
