NSG 3250 ADULT HEALTH I
OBJECTIVE ASSESSMENT - EXAM
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I |
Complete Review with Questions and Verified Answers | 100% Correct |
Grade A - Galen 2026/2027
Undergraduate Nursing - Adult Health Nursing Practice
Clinical Judgment, Disease Management & Patient-Centered Care
A+ Verified Passing Score: 75%
Edition 2026/2027 1 Mark per Question
COVER PAGE - 1
, SECTIONS COVERED
1. Fluid, Electrolyte & Acid-Base Balance
2. Diabetes Mellitus & Endocrine Disorders
3. Respiratory Disorders
4. Cardiovascular Disorders & Hypertension
5. Gastrointestinal & Related Chronic Conditions
EXAMINATION INFORMATION
This examination assesses competency in Adult Health I nursing practice consistent with
undergraduate nursing curriculum standards. Questions emphasize application and analysis of
clinical judgment, patient assessment, and evidence-based interventions for common adult health
problems. Each question is worth 1 mark. A score of 75% or higher is required to pass.
Select the single best answer for each question. All items have been verified for accuracy and relevance.
SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q1
Q1. A 68-year-old patient admitted with dehydration secondary to prolonged vomiting has a serum sodium of 152 mEq/L
and urine specific gravity of 1.032. The nurse notes dry mucous membranes and decreased skin turgor. Which nursing
intervention should be the priority?
A. Encourage oral fluids as tolerated and administer isotonic IV fluids as prescribed while monitoring intake and output
closely.
B. Restrict oral fluid intake to 1000 mL per day to prevent further sodium elevation.
C. Administer a loop diuretic immediately to promote sodium excretion.
D. Limit sodium in the diet and withhold all intravenous fluids until laboratory values normalize.
Correct Answer: A
Rationale:
Hypernatremia with signs of dehydration indicates fluid volume deficit. Isotonic fluids replace volume and gradually correct sodium
while close monitoring prevents overcorrection. Fluid restriction would worsen dehydration, and diuretics are not indicated in
hypovolemic hypernatremia.
Q2
Q2. A patient with chronic kidney disease has a serum potassium of 6.1 mEq/L. The nurse observes peaked T waves on
the cardiac monitor. After notifying the provider, which order should the nurse anticipate administering first?
A. Oral potassium supplements to stabilize cardiac membranes.
B. Intravenous calcium gluconate to protect the myocardium while other measures lower potassium.
C. A high-potassium diet to restore balance through gastrointestinal losses.
D. Subcutaneous insulin without glucose to drive potassium into cells.
Correct Answer: B
Rationale:
Severe hyperkalemia with ECG changes requires immediate myocardial protection with IV calcium. Subsequent measures (insulin
with glucose, binders, dialysis) lower potassium. Oral potassium or high-K diet would worsen the condition.
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I | Complete Rev... Page 2
, Q3
Q3. A postoperative patient receiving continuous IV normal saline develops crackles in the lung bases, bounding pulses,
and a weight gain of 2.5 kg in 24 hours. Which nursing action is most appropriate?
A. Increase the IV rate to improve renal perfusion and promote diuresis.
B. Encourage the patient to drink additional free water to dilute extracellular sodium.
C. Notify the provider of possible fluid volume overload and prepare to slow or stop the infusion while monitoring respiratory
status.
D. Place the patient in Trendelenburg position to improve venous return.
Correct Answer: C
Rationale:
Signs indicate fluid volume overload. Slowing the infusion and notifying the provider prevents further accumulation and allows
assessment for pulmonary edema. Increasing fluids or Trendelenburg would worsen overload.
Q4
Q4. A patient with nasogastric suction for three days has a serum potassium of 3.1 mEq/L and reports muscle weakness.
Which electrocardiogram finding is most consistent with this electrolyte imbalance?
A. Peaked T waves and widened QRS complex.
B. ST-segment elevation in multiple leads.
C. Prolonged PR interval with dropped QRS complexes.
D. Flattened T waves and the presence of U waves.
Correct Answer: D
Rationale:
Hypokalemia classically produces flattened T waves and U waves. Peaked T waves are associated with hyperkalemia. Recognizing
ECG changes guides priority cardiac monitoring and potassium replacement.
Q5
Q5. An older adult with diarrhea for four days presents with a serum bicarbonate of 16 mEq/L, pH 7.30, and PaCO2 of 32
mm Hg. The nurse interprets these arterial blood gas results as which acid-base imbalance?
A. Metabolic acidosis, partially compensated.
B. Metabolic alkalosis, fully compensated.
C. Respiratory acidosis, uncompensated.
D. Respiratory alkalosis, fully compensated.
Correct Answer: A
Rationale:
Low pH with low bicarbonate indicates metabolic acidosis; the decreased PaCO2 shows respiratory compensation (hyperventilation).
Diarrhea causes bicarbonate loss, consistent with this pattern. Full compensation would normalize pH.
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I | Complete Rev... Page 3
OBJECTIVE ASSESSMENT - EXAM
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I |
Complete Review with Questions and Verified Answers | 100% Correct |
Grade A - Galen 2026/2027
Undergraduate Nursing - Adult Health Nursing Practice
Clinical Judgment, Disease Management & Patient-Centered Care
A+ Verified Passing Score: 75%
Edition 2026/2027 1 Mark per Question
COVER PAGE - 1
, SECTIONS COVERED
1. Fluid, Electrolyte & Acid-Base Balance
2. Diabetes Mellitus & Endocrine Disorders
3. Respiratory Disorders
4. Cardiovascular Disorders & Hypertension
5. Gastrointestinal & Related Chronic Conditions
EXAMINATION INFORMATION
This examination assesses competency in Adult Health I nursing practice consistent with
undergraduate nursing curriculum standards. Questions emphasize application and analysis of
clinical judgment, patient assessment, and evidence-based interventions for common adult health
problems. Each question is worth 1 mark. A score of 75% or higher is required to pass.
Select the single best answer for each question. All items have been verified for accuracy and relevance.
SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q1
Q1. A 68-year-old patient admitted with dehydration secondary to prolonged vomiting has a serum sodium of 152 mEq/L
and urine specific gravity of 1.032. The nurse notes dry mucous membranes and decreased skin turgor. Which nursing
intervention should be the priority?
A. Encourage oral fluids as tolerated and administer isotonic IV fluids as prescribed while monitoring intake and output
closely.
B. Restrict oral fluid intake to 1000 mL per day to prevent further sodium elevation.
C. Administer a loop diuretic immediately to promote sodium excretion.
D. Limit sodium in the diet and withhold all intravenous fluids until laboratory values normalize.
Correct Answer: A
Rationale:
Hypernatremia with signs of dehydration indicates fluid volume deficit. Isotonic fluids replace volume and gradually correct sodium
while close monitoring prevents overcorrection. Fluid restriction would worsen dehydration, and diuretics are not indicated in
hypovolemic hypernatremia.
Q2
Q2. A patient with chronic kidney disease has a serum potassium of 6.1 mEq/L. The nurse observes peaked T waves on
the cardiac monitor. After notifying the provider, which order should the nurse anticipate administering first?
A. Oral potassium supplements to stabilize cardiac membranes.
B. Intravenous calcium gluconate to protect the myocardium while other measures lower potassium.
C. A high-potassium diet to restore balance through gastrointestinal losses.
D. Subcutaneous insulin without glucose to drive potassium into cells.
Correct Answer: B
Rationale:
Severe hyperkalemia with ECG changes requires immediate myocardial protection with IV calcium. Subsequent measures (insulin
with glucose, binders, dialysis) lower potassium. Oral potassium or high-K diet would worsen the condition.
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I | Complete Rev... Page 2
, Q3
Q3. A postoperative patient receiving continuous IV normal saline develops crackles in the lung bases, bounding pulses,
and a weight gain of 2.5 kg in 24 hours. Which nursing action is most appropriate?
A. Increase the IV rate to improve renal perfusion and promote diuresis.
B. Encourage the patient to drink additional free water to dilute extracellular sodium.
C. Notify the provider of possible fluid volume overload and prepare to slow or stop the infusion while monitoring respiratory
status.
D. Place the patient in Trendelenburg position to improve venous return.
Correct Answer: C
Rationale:
Signs indicate fluid volume overload. Slowing the infusion and notifying the provider prevents further accumulation and allows
assessment for pulmonary edema. Increasing fluids or Trendelenburg would worsen overload.
Q4
Q4. A patient with nasogastric suction for three days has a serum potassium of 3.1 mEq/L and reports muscle weakness.
Which electrocardiogram finding is most consistent with this electrolyte imbalance?
A. Peaked T waves and widened QRS complex.
B. ST-segment elevation in multiple leads.
C. Prolonged PR interval with dropped QRS complexes.
D. Flattened T waves and the presence of U waves.
Correct Answer: D
Rationale:
Hypokalemia classically produces flattened T waves and U waves. Peaked T waves are associated with hyperkalemia. Recognizing
ECG changes guides priority cardiac monitoring and potassium replacement.
Q5
Q5. An older adult with diarrhea for four days presents with a serum bicarbonate of 16 mEq/L, pH 7.30, and PaCO2 of 32
mm Hg. The nurse interprets these arterial blood gas results as which acid-base imbalance?
A. Metabolic acidosis, partially compensated.
B. Metabolic alkalosis, fully compensated.
C. Respiratory acidosis, uncompensated.
D. Respiratory alkalosis, fully compensated.
Correct Answer: A
Rationale:
Low pH with low bicarbonate indicates metabolic acidosis; the decreased PaCO2 shows respiratory compensation (hyperventilation).
Diarrhea causes bicarbonate loss, consistent with this pattern. Full compensation would normalize pH.
Exam 1: NSG3250 / NSG 3250 (2026/2027 Update) Adult Health I | Complete Rev... Page 3
