NSG 3130 EXAM 4 FUNDAMENTAL
CONCEPTS AND SKILLS FOR NURSING
PRACTICE II 2026/2027 | PRACTICE
QUESTIONS & VERIFIED ANSWERS WITH
DETAILED RATIONALES | COMPLETE
NURSING EXAM STUDY GUIDE
NSG 3130 EXAM 4: FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING
PRACTICE II
2026/2027 |PRACTICE QUESTIONS & VERIFIED ANSWERS WITH DETAILED
RATIONALES | COMPLETE NURSING EXAM STUDY GUIDE
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to reinforce
mastery of fundamental nursing concepts, clinical skills, patient safety,
communication, and evidence-based nursing practice essential for NSG 3130.
• Utilize this material by reviewing questions systematically, attempting each
without referencing answers first, then reviewing detailed rationales to strengthen
understanding of correct and incorrect options—this active learning approach
enhances retention and clinical application.
QUESTIONS BEGIN
QUESTION 1
A 68-year-old patient admitted with pneumonia has a respiratory rate of 28
breaths per minute, uses accessory muscles, and reports shortness of breath.
Which nursing intervention is the priority?
A) Encourage fluid intake to 3000 mL daily
B) Position the patient supine to facilitate drainage
C) Elevate the head of the bed 45 degrees and administer oxygen as ordered
,D) Restrict patient communication to conserve energy
E) Perform chest physiotherapy every 2 hours
CORRECT ANSWER: C) Elevate the head of the bed 45 degrees and administer
oxygen as ordered
RATIONALE: Elevating the head of the bed (semi-Fowler's or high Fowler's position)
promotes optimal lung expansion and reduces work of breathing by using gravity
to assist ventilation. Administering oxygen as ordered addresses hypoxemia and
improves oxygen saturation. These interventions directly address respiratory
distress and are priorities in managing acute respiratory compromise. Supine
positioning (option B) would worsen breathing. Fluid restriction may be needed for
some respiratory conditions, not fluid encouragement (option A). Communication is
important for assessment and should not be restricted (option D).
QUESTION 2
During morning rounds, you notice your patient's IV site is red, warm, and
swollen. The patient reports pain at the insertion site. What is the most
appropriate action?
A) Apply a warm compress and monitor for 24 hours
B) Document findings and continue the current IV
C) Discontinue the IV, notify the physician, and assess for phlebitis or infection
D) Flush the IV line with normal saline to clear any blockage
E) Elevate the extremity above heart level
CORRECT ANSWER: C) Discontinue the IV, notify the physician, and assess for
phlebitis or infection
RATIONALE: Signs of redness, warmth, and swelling at an IV site indicate
inflammation or possible infection (phlebitis or infiltration). The standard of care
requires immediate discontinuation of the IV catheter to prevent further
complications such as systemic infection or abscess formation. The physician must
,be notified promptly for assessment and potential intervention. Continuing the IV
(option B) risks complications. Warm compresses (option A) may increase
inflammation in infectious phlebitis. These symptoms require action, not just
monitoring.
QUESTION 3
A patient in the immediate postoperative period demonstrates the following:
restlessness, increased heart rate of 120 bpm, respiratory rate of 28, and
blood pressure of 90/50 mmHg. Which complication should the nurse suspect?
A) Hyperventilation syndrome
B) Hypovolemic shock
C) Malignant hyperthermia
D) Medication side effect
E) Anxiety only
CORRECT ANSWER: B) Hypovolemic shock
RATIONALE: The patient demonstrates classic signs of hypovolemic shock:
hypotension (90/50), tachycardia (120 bpm), tachypnea (28), and restlessness (an
early sign of hypoxia and decreased cerebral perfusion). In the postoperative
period, hypovolemic shock may result from blood loss, inadequate fluid
replacement, or third-spacing of fluids. These vital signs indicate decreased
circulating blood volume and tissue perfusion. Malignant hyperthermia presents
with elevated temperature and muscle rigidity (not seen here). Anxiety alone would
not typically cause this degree of hypotension and multiple vital sign changes.
QUESTION 4
When obtaining a focused health history from a patient with chronic kidney
disease, which assessment finding would be most significant?
A) Patient reports nocturia 3-4 times per night
, B) Patient ate a high-sodium meal the previous evening
C) Patient has gained 5 pounds in 3 days without dietary changes
D) Patient completed dialysis 2 days ago
E) Patient ambulates independently without difficulty
CORRECT ANSWER: C) Patient has gained 5 pounds in 3 days without dietary
changes
RATIONALE: A weight gain of 5 pounds in 3 days without corresponding dietary or
activity changes indicates fluid retention, a critical concern in chronic kidney
disease. This represents approximately 2-2.5 liters of retained fluid and suggests
inadequate fluid removal or excessive fluid intake relative to kidney function. This
finding requires immediate intervention including possible medication adjustment
(diuretics) or dialysis modification. Nocturia (option A) is common in CKD but less
acute. Recent sodium intake and timing of dialysis are contextual but less
immediately concerning than acute fluid retention.
QUESTION 5
A 45-year-old patient with type 2 diabetes presents to the clinic with a blood
glucose of 380 mg/dL. The patient reports thirst, frequent urination, and
fatigue. Which pathophysiological process is occurring?
A) Hyperglycemia leading to osmotic diuresis and dehydration
B) Hypoglycemia causing sympathetic nervous system stimulation
C) Diabetic ketoacidosis with metabolic acidosis
D) Hyperosmolar hyperglycemic state with coma
E) Hypoglycemic unawareness
CORRECT ANSWER: A) Hyperglycemia leading to osmotic diuresis and
dehydration
RATIONALE: When blood glucose exceeds the renal threshold (approximately 180
mg/dL), glucose spills into the urine. This increases the osmotic pressure in the
CONCEPTS AND SKILLS FOR NURSING
PRACTICE II 2026/2027 | PRACTICE
QUESTIONS & VERIFIED ANSWERS WITH
DETAILED RATIONALES | COMPLETE
NURSING EXAM STUDY GUIDE
NSG 3130 EXAM 4: FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING
PRACTICE II
2026/2027 |PRACTICE QUESTIONS & VERIFIED ANSWERS WITH DETAILED
RATIONALES | COMPLETE NURSING EXAM STUDY GUIDE
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to reinforce
mastery of fundamental nursing concepts, clinical skills, patient safety,
communication, and evidence-based nursing practice essential for NSG 3130.
• Utilize this material by reviewing questions systematically, attempting each
without referencing answers first, then reviewing detailed rationales to strengthen
understanding of correct and incorrect options—this active learning approach
enhances retention and clinical application.
QUESTIONS BEGIN
QUESTION 1
A 68-year-old patient admitted with pneumonia has a respiratory rate of 28
breaths per minute, uses accessory muscles, and reports shortness of breath.
Which nursing intervention is the priority?
A) Encourage fluid intake to 3000 mL daily
B) Position the patient supine to facilitate drainage
C) Elevate the head of the bed 45 degrees and administer oxygen as ordered
,D) Restrict patient communication to conserve energy
E) Perform chest physiotherapy every 2 hours
CORRECT ANSWER: C) Elevate the head of the bed 45 degrees and administer
oxygen as ordered
RATIONALE: Elevating the head of the bed (semi-Fowler's or high Fowler's position)
promotes optimal lung expansion and reduces work of breathing by using gravity
to assist ventilation. Administering oxygen as ordered addresses hypoxemia and
improves oxygen saturation. These interventions directly address respiratory
distress and are priorities in managing acute respiratory compromise. Supine
positioning (option B) would worsen breathing. Fluid restriction may be needed for
some respiratory conditions, not fluid encouragement (option A). Communication is
important for assessment and should not be restricted (option D).
QUESTION 2
During morning rounds, you notice your patient's IV site is red, warm, and
swollen. The patient reports pain at the insertion site. What is the most
appropriate action?
A) Apply a warm compress and monitor for 24 hours
B) Document findings and continue the current IV
C) Discontinue the IV, notify the physician, and assess for phlebitis or infection
D) Flush the IV line with normal saline to clear any blockage
E) Elevate the extremity above heart level
CORRECT ANSWER: C) Discontinue the IV, notify the physician, and assess for
phlebitis or infection
RATIONALE: Signs of redness, warmth, and swelling at an IV site indicate
inflammation or possible infection (phlebitis or infiltration). The standard of care
requires immediate discontinuation of the IV catheter to prevent further
complications such as systemic infection or abscess formation. The physician must
,be notified promptly for assessment and potential intervention. Continuing the IV
(option B) risks complications. Warm compresses (option A) may increase
inflammation in infectious phlebitis. These symptoms require action, not just
monitoring.
QUESTION 3
A patient in the immediate postoperative period demonstrates the following:
restlessness, increased heart rate of 120 bpm, respiratory rate of 28, and
blood pressure of 90/50 mmHg. Which complication should the nurse suspect?
A) Hyperventilation syndrome
B) Hypovolemic shock
C) Malignant hyperthermia
D) Medication side effect
E) Anxiety only
CORRECT ANSWER: B) Hypovolemic shock
RATIONALE: The patient demonstrates classic signs of hypovolemic shock:
hypotension (90/50), tachycardia (120 bpm), tachypnea (28), and restlessness (an
early sign of hypoxia and decreased cerebral perfusion). In the postoperative
period, hypovolemic shock may result from blood loss, inadequate fluid
replacement, or third-spacing of fluids. These vital signs indicate decreased
circulating blood volume and tissue perfusion. Malignant hyperthermia presents
with elevated temperature and muscle rigidity (not seen here). Anxiety alone would
not typically cause this degree of hypotension and multiple vital sign changes.
QUESTION 4
When obtaining a focused health history from a patient with chronic kidney
disease, which assessment finding would be most significant?
A) Patient reports nocturia 3-4 times per night
, B) Patient ate a high-sodium meal the previous evening
C) Patient has gained 5 pounds in 3 days without dietary changes
D) Patient completed dialysis 2 days ago
E) Patient ambulates independently without difficulty
CORRECT ANSWER: C) Patient has gained 5 pounds in 3 days without dietary
changes
RATIONALE: A weight gain of 5 pounds in 3 days without corresponding dietary or
activity changes indicates fluid retention, a critical concern in chronic kidney
disease. This represents approximately 2-2.5 liters of retained fluid and suggests
inadequate fluid removal or excessive fluid intake relative to kidney function. This
finding requires immediate intervention including possible medication adjustment
(diuretics) or dialysis modification. Nocturia (option A) is common in CKD but less
acute. Recent sodium intake and timing of dialysis are contextual but less
immediately concerning than acute fluid retention.
QUESTION 5
A 45-year-old patient with type 2 diabetes presents to the clinic with a blood
glucose of 380 mg/dL. The patient reports thirst, frequent urination, and
fatigue. Which pathophysiological process is occurring?
A) Hyperglycemia leading to osmotic diuresis and dehydration
B) Hypoglycemia causing sympathetic nervous system stimulation
C) Diabetic ketoacidosis with metabolic acidosis
D) Hyperosmolar hyperglycemic state with coma
E) Hypoglycemic unawareness
CORRECT ANSWER: A) Hyperglycemia leading to osmotic diuresis and
dehydration
RATIONALE: When blood glucose exceeds the renal threshold (approximately 180
mg/dL), glucose spills into the urine. This increases the osmotic pressure in the
