,NSG3130/NSG 3130 Exam 4 | Fundamental Concepts & Skills for
Nursing Practice II | Galen College | Q & A | 2026/2027 Edition (PDF)
1. While auscultating a patient's lung fields, the nurse hears fine crackles at the lung bases. This finding is
most consistent with which condition?
A) Asthma
B) Pulmonary fibrosis
C) Fluid in the alveoli, such as pulmonary edema
D) Atelectasis
Correct Answer: Fluid in the alveoli, such as pulmonary edema
Rationale: Fine crackles (rales) are produced by air passing through fluid-filled airways and are
characteristic of pulmonary edema or early heart failure. Asthma typically presents with wheezing, while
atelectasis may present with diminished breath sounds.
2. To perform an accurate assessment of jugular venous pressure (JVP) in a patient with suspected heart
failure, the nurse should position the patient in which way?
A) Supine with the head of the bed flat
B) High-Fowler's with the patient's head turned to the right
C) Semi-Fowler's (30-45 degrees) and observe the neck for pulsations
D) Prone with the patient's chin tucked
Correct Answer: Semi-Fowler's (30-45 degrees) and observe the neck for pulsations
Rationale: JVP is best assessed with the patient reclining at 30-45 degrees, with the head slightly rotated
away from the side being examined, allowing visualization of the internal jugular vein pulsations.
3. Upon cardiac auscultation, the nurse hears an S3 heart sound. In an adult patient, an S3 is most likely
associated with which condition?
A) Fluid volume deficit
B) Heart failure or volume overload
,C) Aortic stenosis
D) Pericardial friction rub
Correct Answer: Heart failure or volume overload
Rationale: An S3 (ventricular gallop) occurs during rapid ventricular filling and is an early sign of heart
failure or volume overload. In children it can be normal, but in adults it is pathologic.
4. A patient with a history of chronic obstructive pulmonary disease (COPD) admits to smoking one pack
of cigarettes per day for the last 40 years. When developing a plan of care, which intervention should
the nurse prioritize for patient education?
A) Pursed-lip breathing technique
B) Smoking cessation strategies
C) High-flow oxygen therapy
D) Increased fluid intake
Correct Answer: Smoking cessation strategies
Rationale: Smoking cessation is the single most important intervention for patients with COPD, as it
slows disease progression and improves outcomes. While pursed-lip breathing and other interventions
are helpful, addressing the underlying cause is the priority.
5. A patient with left-sided heart failure presents with crackles in the lung fields. Which nursing
intervention is most appropriate to improve the patient's breathing?
A) Place the patient in a supine position
B) Encourage the patient to cough and deep breathe
C) Position the patient with three pillows for support
D) Restrict all oral fluid intake
Correct Answer: Position the patient with three pillows for support
, Rationale: Elevating the head of the bed with multiple pillows (orthopneic position) helps reduce venous
return to the heart and decreases pulmonary congestion, making breathing easier for patients with left-
sided heart failure.
6. A patient on 4 liters of oxygen per minute via nasal cannula has an oxygen saturation of 88%. What is
the nurse's priority action?
A) Increase the oxygen to 6 liters per minute
B) Place the patient in semi-Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory effort
Correct Answer: Place the patient in semi-Fowler's position
Rationale: Positioning the patient in semi-Fowler's position promotes optimal lung expansion and can
improve oxygenation. While reassessment and notification may be needed, positioning is an immediate,
non-invasive intervention.
7. A patient has just returned from a femoral cardiac catheterization. Which assessment should the
nurse prioritize?
A) Monitoring intake and output
B) Performing neurovascular checks with vital signs
C) Assessing bowel sounds
D) Evaluating mental status
Correct Answer: Performing neurovascular checks with vital signs
Rationale: After femoral cardiac catheterization, the patient is at risk for bleeding, hematoma, and
vascular compromise. Neurovascular checks of the affected extremity, along with vital signs, are
essential to detect complications early.
Nursing Practice II | Galen College | Q & A | 2026/2027 Edition (PDF)
1. While auscultating a patient's lung fields, the nurse hears fine crackles at the lung bases. This finding is
most consistent with which condition?
A) Asthma
B) Pulmonary fibrosis
C) Fluid in the alveoli, such as pulmonary edema
D) Atelectasis
Correct Answer: Fluid in the alveoli, such as pulmonary edema
Rationale: Fine crackles (rales) are produced by air passing through fluid-filled airways and are
characteristic of pulmonary edema or early heart failure. Asthma typically presents with wheezing, while
atelectasis may present with diminished breath sounds.
2. To perform an accurate assessment of jugular venous pressure (JVP) in a patient with suspected heart
failure, the nurse should position the patient in which way?
A) Supine with the head of the bed flat
B) High-Fowler's with the patient's head turned to the right
C) Semi-Fowler's (30-45 degrees) and observe the neck for pulsations
D) Prone with the patient's chin tucked
Correct Answer: Semi-Fowler's (30-45 degrees) and observe the neck for pulsations
Rationale: JVP is best assessed with the patient reclining at 30-45 degrees, with the head slightly rotated
away from the side being examined, allowing visualization of the internal jugular vein pulsations.
3. Upon cardiac auscultation, the nurse hears an S3 heart sound. In an adult patient, an S3 is most likely
associated with which condition?
A) Fluid volume deficit
B) Heart failure or volume overload
,C) Aortic stenosis
D) Pericardial friction rub
Correct Answer: Heart failure or volume overload
Rationale: An S3 (ventricular gallop) occurs during rapid ventricular filling and is an early sign of heart
failure or volume overload. In children it can be normal, but in adults it is pathologic.
4. A patient with a history of chronic obstructive pulmonary disease (COPD) admits to smoking one pack
of cigarettes per day for the last 40 years. When developing a plan of care, which intervention should
the nurse prioritize for patient education?
A) Pursed-lip breathing technique
B) Smoking cessation strategies
C) High-flow oxygen therapy
D) Increased fluid intake
Correct Answer: Smoking cessation strategies
Rationale: Smoking cessation is the single most important intervention for patients with COPD, as it
slows disease progression and improves outcomes. While pursed-lip breathing and other interventions
are helpful, addressing the underlying cause is the priority.
5. A patient with left-sided heart failure presents with crackles in the lung fields. Which nursing
intervention is most appropriate to improve the patient's breathing?
A) Place the patient in a supine position
B) Encourage the patient to cough and deep breathe
C) Position the patient with three pillows for support
D) Restrict all oral fluid intake
Correct Answer: Position the patient with three pillows for support
, Rationale: Elevating the head of the bed with multiple pillows (orthopneic position) helps reduce venous
return to the heart and decreases pulmonary congestion, making breathing easier for patients with left-
sided heart failure.
6. A patient on 4 liters of oxygen per minute via nasal cannula has an oxygen saturation of 88%. What is
the nurse's priority action?
A) Increase the oxygen to 6 liters per minute
B) Place the patient in semi-Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory effort
Correct Answer: Place the patient in semi-Fowler's position
Rationale: Positioning the patient in semi-Fowler's position promotes optimal lung expansion and can
improve oxygenation. While reassessment and notification may be needed, positioning is an immediate,
non-invasive intervention.
7. A patient has just returned from a femoral cardiac catheterization. Which assessment should the
nurse prioritize?
A) Monitoring intake and output
B) Performing neurovascular checks with vital signs
C) Assessing bowel sounds
D) Evaluating mental status
Correct Answer: Performing neurovascular checks with vital signs
Rationale: After femoral cardiac catheterization, the patient is at risk for bleeding, hematoma, and
vascular compromise. Neurovascular checks of the affected extremity, along with vital signs, are
essential to detect complications early.
