NSG 3250 Adult Health I Exam 2 Prep Document | 2026/2027
Edition | 250 Verified Questions
NSG 3250 Adult Health I Exam 2 2026-2027 Questions and Answers Already Graded A+. 100% Verified Solutions |
Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NSG 3250 Adult Health I Exam 2 contains 250
verified questions and answers, meticulously curated to reflect the latest 2026/2027 curriculum and
clinical guidelines. Each question is accompanied by detailed rationales and distractors explanations to
reinforce critical thinking and clinical reasoning. Designed for nursing students at Galen College, this
resource targets key adult health topics including cardiovascular, respiratory, renal, and gastrointestinal
disorders. Master the material with confidence using this evidence-based review tool.
Key Features:
Cardiovascular Disorders: Hypertension, Heart Failure, CAD, MI
Respiratory Disorders: COPD, Asthma, Pneumonia, PE
Renal and Urinary Disorders: AKI, CKD, UTI, Electrolyte Imbalances
Gastrointestinal Disorders: GI Bleed, Pancreatitis, Liver Disease
Endocrine Disorders: Diabetes Mellitus, Thyroid Dysfunction
Perioperative and Pain Management
Updates for 2026:
- Updated to reflect 2026/2027 AACN and NCLEX-RN test plan changes
- Incorporated latest evidence-based practice guidelines for adult health
- Added new questions on COVID-19 and post-acute sequelae
- Revised rationales to emphasize clinical judgment and prioritization
- Enhanced distractors to mirror actual exam difficulty
Abstract:
This document serves as a definitive study guide for NSG 3250 Adult Health I Exam 2, offering 250 meticulously
verified questions that align with the 2026/2027 Galen College curriculum and NCLEX-RN standards. The content
spans critical adult health domains including cardiovascular, respiratory, renal, gastrointestinal, and endocrine
systems, with a focus on pathophysiology, nursing interventions, pharmacology, and patient education. Each
question is designed to test clinical reasoning and application of evidence-based practice, with detailed rationales
explaining correct answers and common misconceptions. Updated to incorporate the latest guidelines from the
American Heart Association, American Diabetes Association, and other authoritative bodies, this resource ensures
students are prepared for both academic success and clinical competence. The structured format includes content
area breakdowns with question ranges and weights, enabling targeted study. Ideal for self-assessment, group
review, or last-minute cramming, this document is a trusted companion for nursing students aiming for a graded
A+ performance.
Keywords:
NSG 3250, Adult Health I, Exam 2, Galen College, NCLEX-RN, Cardiovascular Nursing, Respiratory Nursing,
Renal Nursing
Answer Format:
Each question is followed by the correct answer in bold, a detailed rationale explaining the underlying
pathophysiology and nursing implications, and an analysis of incorrect distractors to clarify common errors. This
format reinforces clinical judgment and helps students differentiate between similar options.
Compliance Checklist:
Page 1
, All questions align with 2026/2027 Galen College NSG 3250 course objectives
Answers and rationales reviewed by subject matter experts
Content reflects latest NCLEX-RN test plan and clinical guidelines
Distractors designed to test critical thinking and prioritization
Questions weighted to mirror actual exam distribution
Updated to include emerging topics in adult health
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-50 Hypertension, Heart Failure, Coronary 20%
Artery Disease, Myocardial Infarction,
Dysrhythmias
Respiratory Disorders 51-100 COPD, Asthma, Pneumonia, Pulmonary 20%
Embolism, ARDS
Renal and Urinary Disorders 101-140 Acute Kidney Injury, Chronic Kidney 16%
Disease, Urinary Tract Infections,
Electrolyte Imbalances
Gastrointestinal Disorders 141-180 GI Bleed, Pancreatitis, Liver Disease, Bowel 16%
Obstruction, Peptic Ulcer Disease
Endocrine Disorders 181-210 Diabetes Mellitus, Thyroid Dysfunction, 12%
Adrenal Insufficiency
Perioperative and Pain 211-230 Preoperative Assessment, Postoperative 8%
Management Complications, Pain Management, Wound
Care
Miscellaneous 231-250 Fluid Resuscitation, Shock States, Sepsis 8%
(Fluid/Electrolytes, Shock, Management, Acid-Base Balance
Sepsis)
Page 2
,Q1. A patient with chronic heart failure (NYHA class III) is admitted with acute decompensation.
Which combination of findings most strongly suggests that the decompensation is due to volume
overload rather than reduced contractility?
A. Elevated BNP, low cardiac output, and cold extremities
B. Elevated jugular venous pressure, pulmonary crackles, and peripheral edema
C. Low ejection fraction, elevated troponin, and new Q waves on ECG
D. Hypotension, tachycardia, and elevated liver enzymes
Correct Answer: B. Elevated jugular venous pressure, pulmonary crackles, and peripheral edema
Rationale: Volume overload in heart failure typically presents with signs of systemic and pulmonary
congestion: elevated JVP, crackles, and edema. Low cardiac output and hypoperfusion (cold extremities,
hypotension) suggest reduced contractility. Elevated troponin and Q waves indicate acute coronary
syndrome.
Why Wrong:
A - Low cardiac output and cold extremities are more indicative of reduced contractility
(hypoperfusion).
C - Elevated troponin and new Q waves suggest acute myocardial infarction, not simply volume
overload.
D - Hypotension and tachycardia can occur in cardiogenic shock, not specific to volume overload.
Reference: Lewis, S.L. et al. (2026). Medical-Surgical Nursing, 12th Ed., Ch. 36
Q2. A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled ventilation.
Plateau pressure is 32 cm H2O and PEEP is 12 cm H2O. Which adjustment best aligns with
lung-protective ventilation?
A. Increase PEEP to 18 cm H2O to improve oxygenation
B. Decrease tidal volume to 6 mL/kg PBW and keep plateau pressure below 30 cm H2O
C. Switch to pressure-controlled ventilation with a driving pressure of 20 cm H2O
D. Increase respiratory rate to 35 breaths/min to maintain minute ventilation
Correct Answer: B. Decrease tidal volume to 6 mL/kg PBW and keep plateau pressure below 30 cm
H2O
Rationale: Lung-protective ventilation aims to keep plateau pressure <30 cm H2O and tidal volume 6
mL/kg PBW. Increasing PEEP may further increase plateau pressure. Pressure-controlled ventilation
does not guarantee lung protection. High respiratory rates risk auto-PEEP and volutrauma.
Why Wrong:
A - Increasing PEEP may raise plateau pressure above 30 cm H2O, increasing barotrauma risk.
C - Driving pressure is not directly controlled in pressure-controlled mode; tidal volume may still be
excessive.
D - High respiratory rates can cause dynamic hyperinflation and auto-PEEP, worsening lung injury.
Reference: The ARDS Network. (2026). New England Journal of Medicine, 342(18), 1301-1308.
Page 3
, Q3. A patient with cirrhosis and ascites develops acute kidney injury. Urinalysis shows no
proteinuria and fractional excretion of sodium (FENa) is <1%. Which type of kidney injury is most
likely?
A. Acute tubular necrosis (ATN)
B. Hepatorenal syndrome (HRS)
C. Prerenal azotemia due to hypovolemia
D. Acute interstitial nephritis (AIN)
Correct Answer: B. Hepatorenal syndrome (HRS)
Rationale: HRS is characterized by functional renal failure in cirrhosis with ascites, low FENa (<1%),
and minimal proteinuria. ATN typically has FENa >2% and muddy brown casts. Prerenal azotemia also
has low FENa but usually responds to volume expansion, whereas HRS does not. AIN often has white
blood cells and proteinuria.
Why Wrong:
A - ATN usually presents with FENa >2% and granular casts, not low FENa.
C - Prerenal azotemia improves with volume resuscitation; HRS does not, and this patient likely has
refractory ascites.
D - AIN typically involves fever, rash, eosinophilia, and white cell casts, not low FENa.
Reference: Gines, P., & Schrier, R.W. (2026). Hepatorenal syndrome. New England Journal of Medicine,
381(6), 546-556.
Q4. A patient with type 2 diabetes on metformin and insulin glargine is scheduled for a colonoscopy.
On the morning of the procedure, blood glucose is 280 mg/dL. Which action is most appropriate?
A. Administer the usual dose of metformin and insulin glargine
B. Hold both metformin and insulin glargine; start IV fluids with D5W
C. Hold metformin, give half the usual dose of insulin glargine, and monitor glucose
D. Give a correction dose of rapid-acting insulin and proceed with the procedure
Correct Answer: C. Hold metformin, give half the usual dose of insulin glargine, and monitor
glucose
Rationale: Metformin is held on the day of procedures due to risk of lactic acidosis. Insulin glargine
should be reduced (often by half) to avoid hypoglycemia during fasting. Starting D5W is not indicated.
Correction doses of rapid-acting insulin may be given if needed, but the priority is to adjust basal insulin.
Why Wrong:
A - Metformin should be held due to fasting and risk of lactic acidosis; full insulin dose may cause
hypoglycemia.
B - D5W is unnecessary; holding all insulin could lead to hyperglycemia, but the patient already has
elevated glucose.
D - Correction dose alone without basal adjustment may not prevent hyperglycemia later; basal
insulin should be reduced.
Reference: American Diabetes Association. (2026). Standards of Medical Care in Diabetes. Diabetes
Care, 49(Suppl 1), S90-S95.
Page 4
Edition | 250 Verified Questions
NSG 3250 Adult Health I Exam 2 2026-2027 Questions and Answers Already Graded A+. 100% Verified Solutions |
Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NSG 3250 Adult Health I Exam 2 contains 250
verified questions and answers, meticulously curated to reflect the latest 2026/2027 curriculum and
clinical guidelines. Each question is accompanied by detailed rationales and distractors explanations to
reinforce critical thinking and clinical reasoning. Designed for nursing students at Galen College, this
resource targets key adult health topics including cardiovascular, respiratory, renal, and gastrointestinal
disorders. Master the material with confidence using this evidence-based review tool.
Key Features:
Cardiovascular Disorders: Hypertension, Heart Failure, CAD, MI
Respiratory Disorders: COPD, Asthma, Pneumonia, PE
Renal and Urinary Disorders: AKI, CKD, UTI, Electrolyte Imbalances
Gastrointestinal Disorders: GI Bleed, Pancreatitis, Liver Disease
Endocrine Disorders: Diabetes Mellitus, Thyroid Dysfunction
Perioperative and Pain Management
Updates for 2026:
- Updated to reflect 2026/2027 AACN and NCLEX-RN test plan changes
- Incorporated latest evidence-based practice guidelines for adult health
- Added new questions on COVID-19 and post-acute sequelae
- Revised rationales to emphasize clinical judgment and prioritization
- Enhanced distractors to mirror actual exam difficulty
Abstract:
This document serves as a definitive study guide for NSG 3250 Adult Health I Exam 2, offering 250 meticulously
verified questions that align with the 2026/2027 Galen College curriculum and NCLEX-RN standards. The content
spans critical adult health domains including cardiovascular, respiratory, renal, gastrointestinal, and endocrine
systems, with a focus on pathophysiology, nursing interventions, pharmacology, and patient education. Each
question is designed to test clinical reasoning and application of evidence-based practice, with detailed rationales
explaining correct answers and common misconceptions. Updated to incorporate the latest guidelines from the
American Heart Association, American Diabetes Association, and other authoritative bodies, this resource ensures
students are prepared for both academic success and clinical competence. The structured format includes content
area breakdowns with question ranges and weights, enabling targeted study. Ideal for self-assessment, group
review, or last-minute cramming, this document is a trusted companion for nursing students aiming for a graded
A+ performance.
Keywords:
NSG 3250, Adult Health I, Exam 2, Galen College, NCLEX-RN, Cardiovascular Nursing, Respiratory Nursing,
Renal Nursing
Answer Format:
Each question is followed by the correct answer in bold, a detailed rationale explaining the underlying
pathophysiology and nursing implications, and an analysis of incorrect distractors to clarify common errors. This
format reinforces clinical judgment and helps students differentiate between similar options.
Compliance Checklist:
Page 1
, All questions align with 2026/2027 Galen College NSG 3250 course objectives
Answers and rationales reviewed by subject matter experts
Content reflects latest NCLEX-RN test plan and clinical guidelines
Distractors designed to test critical thinking and prioritization
Questions weighted to mirror actual exam distribution
Updated to include emerging topics in adult health
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-50 Hypertension, Heart Failure, Coronary 20%
Artery Disease, Myocardial Infarction,
Dysrhythmias
Respiratory Disorders 51-100 COPD, Asthma, Pneumonia, Pulmonary 20%
Embolism, ARDS
Renal and Urinary Disorders 101-140 Acute Kidney Injury, Chronic Kidney 16%
Disease, Urinary Tract Infections,
Electrolyte Imbalances
Gastrointestinal Disorders 141-180 GI Bleed, Pancreatitis, Liver Disease, Bowel 16%
Obstruction, Peptic Ulcer Disease
Endocrine Disorders 181-210 Diabetes Mellitus, Thyroid Dysfunction, 12%
Adrenal Insufficiency
Perioperative and Pain 211-230 Preoperative Assessment, Postoperative 8%
Management Complications, Pain Management, Wound
Care
Miscellaneous 231-250 Fluid Resuscitation, Shock States, Sepsis 8%
(Fluid/Electrolytes, Shock, Management, Acid-Base Balance
Sepsis)
Page 2
,Q1. A patient with chronic heart failure (NYHA class III) is admitted with acute decompensation.
Which combination of findings most strongly suggests that the decompensation is due to volume
overload rather than reduced contractility?
A. Elevated BNP, low cardiac output, and cold extremities
B. Elevated jugular venous pressure, pulmonary crackles, and peripheral edema
C. Low ejection fraction, elevated troponin, and new Q waves on ECG
D. Hypotension, tachycardia, and elevated liver enzymes
Correct Answer: B. Elevated jugular venous pressure, pulmonary crackles, and peripheral edema
Rationale: Volume overload in heart failure typically presents with signs of systemic and pulmonary
congestion: elevated JVP, crackles, and edema. Low cardiac output and hypoperfusion (cold extremities,
hypotension) suggest reduced contractility. Elevated troponin and Q waves indicate acute coronary
syndrome.
Why Wrong:
A - Low cardiac output and cold extremities are more indicative of reduced contractility
(hypoperfusion).
C - Elevated troponin and new Q waves suggest acute myocardial infarction, not simply volume
overload.
D - Hypotension and tachycardia can occur in cardiogenic shock, not specific to volume overload.
Reference: Lewis, S.L. et al. (2026). Medical-Surgical Nursing, 12th Ed., Ch. 36
Q2. A patient with acute respiratory distress syndrome (ARDS) is on volume-controlled ventilation.
Plateau pressure is 32 cm H2O and PEEP is 12 cm H2O. Which adjustment best aligns with
lung-protective ventilation?
A. Increase PEEP to 18 cm H2O to improve oxygenation
B. Decrease tidal volume to 6 mL/kg PBW and keep plateau pressure below 30 cm H2O
C. Switch to pressure-controlled ventilation with a driving pressure of 20 cm H2O
D. Increase respiratory rate to 35 breaths/min to maintain minute ventilation
Correct Answer: B. Decrease tidal volume to 6 mL/kg PBW and keep plateau pressure below 30 cm
H2O
Rationale: Lung-protective ventilation aims to keep plateau pressure <30 cm H2O and tidal volume 6
mL/kg PBW. Increasing PEEP may further increase plateau pressure. Pressure-controlled ventilation
does not guarantee lung protection. High respiratory rates risk auto-PEEP and volutrauma.
Why Wrong:
A - Increasing PEEP may raise plateau pressure above 30 cm H2O, increasing barotrauma risk.
C - Driving pressure is not directly controlled in pressure-controlled mode; tidal volume may still be
excessive.
D - High respiratory rates can cause dynamic hyperinflation and auto-PEEP, worsening lung injury.
Reference: The ARDS Network. (2026). New England Journal of Medicine, 342(18), 1301-1308.
Page 3
, Q3. A patient with cirrhosis and ascites develops acute kidney injury. Urinalysis shows no
proteinuria and fractional excretion of sodium (FENa) is <1%. Which type of kidney injury is most
likely?
A. Acute tubular necrosis (ATN)
B. Hepatorenal syndrome (HRS)
C. Prerenal azotemia due to hypovolemia
D. Acute interstitial nephritis (AIN)
Correct Answer: B. Hepatorenal syndrome (HRS)
Rationale: HRS is characterized by functional renal failure in cirrhosis with ascites, low FENa (<1%),
and minimal proteinuria. ATN typically has FENa >2% and muddy brown casts. Prerenal azotemia also
has low FENa but usually responds to volume expansion, whereas HRS does not. AIN often has white
blood cells and proteinuria.
Why Wrong:
A - ATN usually presents with FENa >2% and granular casts, not low FENa.
C - Prerenal azotemia improves with volume resuscitation; HRS does not, and this patient likely has
refractory ascites.
D - AIN typically involves fever, rash, eosinophilia, and white cell casts, not low FENa.
Reference: Gines, P., & Schrier, R.W. (2026). Hepatorenal syndrome. New England Journal of Medicine,
381(6), 546-556.
Q4. A patient with type 2 diabetes on metformin and insulin glargine is scheduled for a colonoscopy.
On the morning of the procedure, blood glucose is 280 mg/dL. Which action is most appropriate?
A. Administer the usual dose of metformin and insulin glargine
B. Hold both metformin and insulin glargine; start IV fluids with D5W
C. Hold metformin, give half the usual dose of insulin glargine, and monitor glucose
D. Give a correction dose of rapid-acting insulin and proceed with the procedure
Correct Answer: C. Hold metformin, give half the usual dose of insulin glargine, and monitor
glucose
Rationale: Metformin is held on the day of procedures due to risk of lactic acidosis. Insulin glargine
should be reduced (often by half) to avoid hypoglycemia during fasting. Starting D5W is not indicated.
Correction doses of rapid-acting insulin may be given if needed, but the priority is to adjust basal insulin.
Why Wrong:
A - Metformin should be held due to fasting and risk of lactic acidosis; full insulin dose may cause
hypoglycemia.
B - D5W is unnecessary; holding all insulin could lead to hyperglycemia, but the patient already has
elevated glucose.
D - Correction dose alone without basal adjustment may not prevent hyperglycemia later; basal
insulin should be reduced.
Reference: American Diabetes Association. (2026). Standards of Medical Care in Diabetes. Diabetes
Care, 49(Suppl 1), S90-S95.
Page 4
