Comprehensive Nursing (NSG) EXAM with
Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Advanced Pathophysiology and Disease Management
2. Acute Medical-Surgical Nursing Interventions
3. Geriatric Nursing and Age-Related Considerations
4. Community and Public Health Nursing Strategies
5. Professional Nursing Concepts, Ethics, and Leadership
6. Pharmacological Therapies and Pharmacokinetics
1. An 82-year-old patient with a history of heart failure and chronic kidney disease presents with
acute delirium and severe peripheral edema. The physician orders an aggressive dose of
intravenous furosemide. Considering the patient's comorbidities and age, which of the following
assessments is the most critical priority for the nurse to perform within the first hour of
administration?
A. Assess the patient's orientation to person, place, and time to monitor for worsening delirium.
B. Monitor strict urine output and assess blood pressure for orthostatic changes or
profound hypotension.
C. Auscultate lung sounds to determine if pulmonary edema is resolving.
D. Check the patient's capillary refill time to evaluate peripheral perfusion.
CORRECT ANSWER : B
Rationale: While assessing fluid status and respiratory function is important, an elderly patient
with chronic kidney disease is at extreme risk for rapid fluid depletion and resulting
hypoperfusion or acute kidney injury when receiving aggressive loop diuretics. Monitoring urine
, output and blood pressure addresses the immediate, life-threatening risk of profound
hypovolemia and hemodynamic instability, making it the highest priority. Options A, C, and D
are important but secondary to maintaining hemodynamic stability.
2. A community health nurse is designing a secondary prevention program for a population with a
high incidence of type 2 diabetes. Which intervention represents the most appropriate secondary
prevention strategy?
A. Providing cooking classes focused on low-glycemic meals for families with a history of
diabetes.
B. Establishing an accessible clinic for routine hemoglobin A1c screening and early referral.
C. Initiating a mobile health unit that conducts targeted blood glucose screenings for high-
risk, asymptomatic adults.
D. Developing a community support group for individuals experiencing diabetic neuropathy.
CORRECT ANSWER : C
Rationale: Secondary prevention focuses on the early detection and treatment of a disease in
asymptomatic individuals to halt its progression. A mobile unit conducting targeted blood
glucose screenings for high-risk populations fits this definition perfectly. Option A is primary
prevention (preventing onset). Option B combines screening with treatment structure but Option
C is the purest form of targeted secondary prevention. Option D is tertiary prevention (managing
complications).
3. A patient is recovering in the ICU following a coronary artery bypass graft (CABG). The nurse
notes sudden muffled heart sounds, jugular venous distention, and a drop in blood pressure with
a narrowed pulse pressure. What is the nurse's immediate action based on these findings?
A. Administer a fluid bolus to increase cardiac preload and improve cardiac output.
B. Increase the oxygen delivery via high-flow nasal cannula and prepare for intubation.
C. Notify the provider immediately and prepare for an emergency pericardiocentesis.
D. Administer prescribed intravenous loop diuretics to decrease cardiac workload.
CORRECT ANSWER : C
Rationale: Muffled heart sounds, jugular venous distention, and narrowed pulse pressure are
classic signs of Beck's triad, indicating cardiac tamponade, a life-threatening complication of
cardiac surgery. This requires immediate medical intervention to remove fluid from the
pericardial sac (pericardiocentesis). Administering fluids (A) or diuretics (D) will not resolve the
Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Advanced Pathophysiology and Disease Management
2. Acute Medical-Surgical Nursing Interventions
3. Geriatric Nursing and Age-Related Considerations
4. Community and Public Health Nursing Strategies
5. Professional Nursing Concepts, Ethics, and Leadership
6. Pharmacological Therapies and Pharmacokinetics
1. An 82-year-old patient with a history of heart failure and chronic kidney disease presents with
acute delirium and severe peripheral edema. The physician orders an aggressive dose of
intravenous furosemide. Considering the patient's comorbidities and age, which of the following
assessments is the most critical priority for the nurse to perform within the first hour of
administration?
A. Assess the patient's orientation to person, place, and time to monitor for worsening delirium.
B. Monitor strict urine output and assess blood pressure for orthostatic changes or
profound hypotension.
C. Auscultate lung sounds to determine if pulmonary edema is resolving.
D. Check the patient's capillary refill time to evaluate peripheral perfusion.
CORRECT ANSWER : B
Rationale: While assessing fluid status and respiratory function is important, an elderly patient
with chronic kidney disease is at extreme risk for rapid fluid depletion and resulting
hypoperfusion or acute kidney injury when receiving aggressive loop diuretics. Monitoring urine
, output and blood pressure addresses the immediate, life-threatening risk of profound
hypovolemia and hemodynamic instability, making it the highest priority. Options A, C, and D
are important but secondary to maintaining hemodynamic stability.
2. A community health nurse is designing a secondary prevention program for a population with a
high incidence of type 2 diabetes. Which intervention represents the most appropriate secondary
prevention strategy?
A. Providing cooking classes focused on low-glycemic meals for families with a history of
diabetes.
B. Establishing an accessible clinic for routine hemoglobin A1c screening and early referral.
C. Initiating a mobile health unit that conducts targeted blood glucose screenings for high-
risk, asymptomatic adults.
D. Developing a community support group for individuals experiencing diabetic neuropathy.
CORRECT ANSWER : C
Rationale: Secondary prevention focuses on the early detection and treatment of a disease in
asymptomatic individuals to halt its progression. A mobile unit conducting targeted blood
glucose screenings for high-risk populations fits this definition perfectly. Option A is primary
prevention (preventing onset). Option B combines screening with treatment structure but Option
C is the purest form of targeted secondary prevention. Option D is tertiary prevention (managing
complications).
3. A patient is recovering in the ICU following a coronary artery bypass graft (CABG). The nurse
notes sudden muffled heart sounds, jugular venous distention, and a drop in blood pressure with
a narrowed pulse pressure. What is the nurse's immediate action based on these findings?
A. Administer a fluid bolus to increase cardiac preload and improve cardiac output.
B. Increase the oxygen delivery via high-flow nasal cannula and prepare for intubation.
C. Notify the provider immediately and prepare for an emergency pericardiocentesis.
D. Administer prescribed intravenous loop diuretics to decrease cardiac workload.
CORRECT ANSWER : C
Rationale: Muffled heart sounds, jugular venous distention, and narrowed pulse pressure are
classic signs of Beck's triad, indicating cardiac tamponade, a life-threatening complication of
cardiac surgery. This requires immediate medical intervention to remove fluid from the
pericardial sac (pericardiocentesis). Administering fluids (A) or diuretics (D) will not resolve the
