NSG 3130 EXAM 4 PREP – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
• Medical-Surgical Nursing: Acute & Chronic Conditions
• Pharmacology & Safe Medication Administration
• Fluid, Electrolyte, & Acid-Base Balance
• Cardiovascular & Respiratory Disorders
• Neurological & Sensory Disorders
• Gastrointestinal & Renal Disorders
• Endocrine & Metabolic Disorders
• Perioperative & Pain Management Nursing
• Legal, Ethical, & Professional Standards in Nursing
• Patient Education & Health Promotion
Introduction
This comprehensive examination is designed to rigorously assess your mastery of core medical-surgical nursing
concepts as outlined in NSG 3130. The assessment evaluates your ability to apply foundational nursing theory,
synthesize pharmacological knowledge, and make critical clinical decisions in complex patient scenarios. You will
encounter a variety of multiple-choice questions that test your understanding of pathophysiology, nursing
interventions, and legal-ethical standards. This exam emphasizes real-world application, requiring you to prioritize
patient safety, interpret clinical data, and implement evidence-based care. Success on this exam reflects your readiness
to provide competent, holistic nursing care in diverse healthcare settings.
,SECTION ONE: QUESTIONS 1-100
1. A patient with heart failure is prescribed furosemide. Which of the following assessment findings would
indicate a therapeutic response to the medication?
A. Decreased blood pressure and heart rate
B. Increased urine output and decreased dyspnea
C. Weight gain and peripheral edema
D. Elevated serum potassium and decreased urine output
🟢B
🔴 Explanation: Furosemide is a loop diuretic used to reduce fluid volume overload in heart failure. A therapeutic
response is indicated by increased urine output (diuresis) leading to a reduction in pulmonary congestion and
dyspnea. Decreased blood pressure may be an effect, but the primary therapeutic goal is symptom management,
not a specific BP target.
2. A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. Which of the
following findings requires immediate intervention?
A. Constant bubbling in the suction control chamber
B. Gentle bubbling in the water-seal chamber with expiration
C. Absence of bubbling in the water-seal chamber with respiration
D. Continuous vigorous bubbling in the water-seal chamber
🟢D
🔴 Explanation: Continuous vigorous bubbling in the water-seal chamber indicates an air leak in the system, which
must be identified and corrected to prevent a pneumothorax. Gentle bubbling during expiration (B) is normal for a
,patient with an air leak, and a dry suction control chamber (A) is part of the system setup. The absence of bubbling
(C) is expected once the lung has re-expanded.
3. A patient is admitted with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following
serum laboratory results would the nurse expect to find?
A. Serum sodium 158 mEq/L, urine specific gravity 1.002
B. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg
C. Serum sodium 145 mEq/L, serum osmolality 290 mOsm/kg
D. Serum sodium 135 mEq/L, urine output 80 mL/hr
🟢B
🔴 Explanation: SIADH is characterized by excessive ADH release, leading to water retention, dilutional
hyponatremia (serum sodium <135 mEq/L), and concentrated urine with high osmolality (>300 mOsm/kg). Option B
reflects this pattern. Option A suggests diabetes insipidus (hypernatremia and dilute urine).
4. A nurse is preparing to administer an enteral feeding via a nasogastric tube. Which of the following actions is
most important to perform before initiating the feeding?
A. Verify the tube placement by aspirating gastric contents and checking pH.
B. Flush the tube with 100 mL of sterile water.
C. Position the patient in a supine position.
D. Check the volume of the residual feeding from the previous shift.
🟢A
🔴 Explanation: Confirming tube placement is the priority safety measure to prevent accidental pulmonary
instillation of feeding, which can lead to aspiration pneumonia. While flushing and checking residual are important,
, verifying correct placement in the stomach is the most critical intervention.
5. A patient is receiving a blood transfusion of packed red blood cells. Fifteen minutes after the start of the
infusion, the patient reports chills and lower back pain. What is the nurse's priority action?
A. Slow the infusion rate and monitor the patient closely.
B. Stop the transfusion and infuse normal saline with a new administration set.
C. Administer an antihistamine as a prescribed PRN medication.
D. Document the findings and continue the transfusion.
🟢B
🔴 Explanation: The patient is exhibiting classic signs of an acute hemolytic transfusion reaction. The immediate
priority is to stop the transfusion to prevent further complications and maintain IV access with normal saline using
new tubing. The blood bag and tubing must be returned to the blood bank for analysis.
6. A nurse is assessing a patient who has a history of chronic obstructive pulmonary disease (COPD). Which of
the following arterial blood gas (ABG) values indicates a state of uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L
B. pH 7.45, PaCO2 40 mm Hg, HCO3- 26 mEq/L
C. pH 7.35, PaCO2 60 mm Hg, HCO3- 32 mEq/L
D. pH 7.48, PaCO2 30 mm Hg, HCO3- 22 mEq/L
🟢A
🔴 Explanation: Uncompensated respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2
(>45 mm Hg) with a normal bicarbonate level. Option A fits this profile. Option C shows partially compensated
respiratory acidosis because the bicarbonate is elevated, attempting to compensate.
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
• Medical-Surgical Nursing: Acute & Chronic Conditions
• Pharmacology & Safe Medication Administration
• Fluid, Electrolyte, & Acid-Base Balance
• Cardiovascular & Respiratory Disorders
• Neurological & Sensory Disorders
• Gastrointestinal & Renal Disorders
• Endocrine & Metabolic Disorders
• Perioperative & Pain Management Nursing
• Legal, Ethical, & Professional Standards in Nursing
• Patient Education & Health Promotion
Introduction
This comprehensive examination is designed to rigorously assess your mastery of core medical-surgical nursing
concepts as outlined in NSG 3130. The assessment evaluates your ability to apply foundational nursing theory,
synthesize pharmacological knowledge, and make critical clinical decisions in complex patient scenarios. You will
encounter a variety of multiple-choice questions that test your understanding of pathophysiology, nursing
interventions, and legal-ethical standards. This exam emphasizes real-world application, requiring you to prioritize
patient safety, interpret clinical data, and implement evidence-based care. Success on this exam reflects your readiness
to provide competent, holistic nursing care in diverse healthcare settings.
,SECTION ONE: QUESTIONS 1-100
1. A patient with heart failure is prescribed furosemide. Which of the following assessment findings would
indicate a therapeutic response to the medication?
A. Decreased blood pressure and heart rate
B. Increased urine output and decreased dyspnea
C. Weight gain and peripheral edema
D. Elevated serum potassium and decreased urine output
🟢B
🔴 Explanation: Furosemide is a loop diuretic used to reduce fluid volume overload in heart failure. A therapeutic
response is indicated by increased urine output (diuresis) leading to a reduction in pulmonary congestion and
dyspnea. Decreased blood pressure may be an effect, but the primary therapeutic goal is symptom management,
not a specific BP target.
2. A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. Which of the
following findings requires immediate intervention?
A. Constant bubbling in the suction control chamber
B. Gentle bubbling in the water-seal chamber with expiration
C. Absence of bubbling in the water-seal chamber with respiration
D. Continuous vigorous bubbling in the water-seal chamber
🟢D
🔴 Explanation: Continuous vigorous bubbling in the water-seal chamber indicates an air leak in the system, which
must be identified and corrected to prevent a pneumothorax. Gentle bubbling during expiration (B) is normal for a
,patient with an air leak, and a dry suction control chamber (A) is part of the system setup. The absence of bubbling
(C) is expected once the lung has re-expanded.
3. A patient is admitted with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following
serum laboratory results would the nurse expect to find?
A. Serum sodium 158 mEq/L, urine specific gravity 1.002
B. Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg
C. Serum sodium 145 mEq/L, serum osmolality 290 mOsm/kg
D. Serum sodium 135 mEq/L, urine output 80 mL/hr
🟢B
🔴 Explanation: SIADH is characterized by excessive ADH release, leading to water retention, dilutional
hyponatremia (serum sodium <135 mEq/L), and concentrated urine with high osmolality (>300 mOsm/kg). Option B
reflects this pattern. Option A suggests diabetes insipidus (hypernatremia and dilute urine).
4. A nurse is preparing to administer an enteral feeding via a nasogastric tube. Which of the following actions is
most important to perform before initiating the feeding?
A. Verify the tube placement by aspirating gastric contents and checking pH.
B. Flush the tube with 100 mL of sterile water.
C. Position the patient in a supine position.
D. Check the volume of the residual feeding from the previous shift.
🟢A
🔴 Explanation: Confirming tube placement is the priority safety measure to prevent accidental pulmonary
instillation of feeding, which can lead to aspiration pneumonia. While flushing and checking residual are important,
, verifying correct placement in the stomach is the most critical intervention.
5. A patient is receiving a blood transfusion of packed red blood cells. Fifteen minutes after the start of the
infusion, the patient reports chills and lower back pain. What is the nurse's priority action?
A. Slow the infusion rate and monitor the patient closely.
B. Stop the transfusion and infuse normal saline with a new administration set.
C. Administer an antihistamine as a prescribed PRN medication.
D. Document the findings and continue the transfusion.
🟢B
🔴 Explanation: The patient is exhibiting classic signs of an acute hemolytic transfusion reaction. The immediate
priority is to stop the transfusion to prevent further complications and maintain IV access with normal saline using
new tubing. The blood bag and tubing must be returned to the blood bank for analysis.
6. A nurse is assessing a patient who has a history of chronic obstructive pulmonary disease (COPD). Which of
the following arterial blood gas (ABG) values indicates a state of uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 50 mm Hg, HCO3- 24 mEq/L
B. pH 7.45, PaCO2 40 mm Hg, HCO3- 26 mEq/L
C. pH 7.35, PaCO2 60 mm Hg, HCO3- 32 mEq/L
D. pH 7.48, PaCO2 30 mm Hg, HCO3- 22 mEq/L
🟢A
🔴 Explanation: Uncompensated respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2
(>45 mm Hg) with a normal bicarbonate level. Option A fits this profile. Option C shows partially compensated
respiratory acidosis because the bicarbonate is elevated, attempting to compensate.
