Galen College NSG 3130 Exam 4 (pdf) | 2026/2027 | Fundamental
Concepts & Skills for Nursing Practice II Q&A | Nursing
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. Coarse crackles are more typical of bronchitis or pneumonia. 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:
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:
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. Which lung sound would the nurse expect to hear in a patient
experiencing an acute asthma exacerbation?
A) Fine crackles
B) Rhonchi
C) Wheezes
D) Pleural friction rub
Correct Answer: Wheezes
Rationale: Wheezing is a high-pitched musical sound produced by air passing
through narrowed airways, which is characteristic of an acute asthma
exacerbation. Crackles are associated with fluid, rhonchi with secretions, and
a pleural friction rub with inflammation of the pleura.
,5. A patient is receiving oxygen at 4 L/min via nasal cannula and has an
oxygen saturation of 88%. What is the nurse's priority action?
A) Increase the oxygen flow rate to 6 L/min
B) Place the patient in high Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory effort and lung sounds
Correct Answer: Assess the patient's respiratory effort and lung sounds
Rationale: Before making changes to oxygen therapy, the nurse should
assess the patient's respiratory status, including effort, depth, and lung
sounds, to determine the cause of the low saturation. Placing the patient in
semi-Fowler's position may help, but assessment is the priority.
6. A patient with left-sided heart failure has crackles in the lung fields. Which
intervention should the nurse implement to promote comfort?
A) Place the patient in a supine position
B) Use three pillows for support
C) Restrict all fluids
D) Encourage the patient to ambulate
Correct Answer: Use three pillows for support
Rationale: Elevating the head of the bed with pillows helps reduce venous
return, decrease pulmonary congestion, and improve oxygenation in patients
with left-sided heart failure.
7. A patient with a deep vein thrombosis (DVT) just came out of surgery.
What is the priority assessment question for this patient?
, A) "Do you have any pain in your legs?"
B) "Do you have chest pain or shortness of breath?"
C) "Are you able to move your toes?"
D) "Do you feel any numbness in your feet?"
Correct Answer: "Do you have chest pain or shortness of breath?"
Rationale: A patient with a DVT is at high risk for a pulmonary embolism,
which can present with sudden chest pain and shortness of breath. This is a
life-threatening emergency and requires immediate assessment.
8. A patient who is taking anticoagulants asks the nurse, "What if I stop
taking my meds?" What is the nurse's best response?
A) "The patient can have a stroke"
B) "You may experience increased bleeding"
C) "Your blood pressure may increase"
D) "You will need to restart the medication"
Correct Answer: The patient can have a stroke
Rationale: Anticoagulants are prescribed to prevent clot formation. Stopping
them abruptly can lead to clot formation, which can cause a stroke or other
thromboembolic events.
9. A patient has had a coronary artery bypass graft (CABG). Which diet is
correct for this patient?
A) High-protein, high-carbohydrate diet
B) Low-fat, low-cholesterol diet
C) High-sodium, high-potassium diet
Concepts & Skills for Nursing Practice II Q&A | Nursing
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. Coarse crackles are more typical of bronchitis or pneumonia. 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:
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:
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. Which lung sound would the nurse expect to hear in a patient
experiencing an acute asthma exacerbation?
A) Fine crackles
B) Rhonchi
C) Wheezes
D) Pleural friction rub
Correct Answer: Wheezes
Rationale: Wheezing is a high-pitched musical sound produced by air passing
through narrowed airways, which is characteristic of an acute asthma
exacerbation. Crackles are associated with fluid, rhonchi with secretions, and
a pleural friction rub with inflammation of the pleura.
,5. A patient is receiving oxygen at 4 L/min via nasal cannula and has an
oxygen saturation of 88%. What is the nurse's priority action?
A) Increase the oxygen flow rate to 6 L/min
B) Place the patient in high Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory effort and lung sounds
Correct Answer: Assess the patient's respiratory effort and lung sounds
Rationale: Before making changes to oxygen therapy, the nurse should
assess the patient's respiratory status, including effort, depth, and lung
sounds, to determine the cause of the low saturation. Placing the patient in
semi-Fowler's position may help, but assessment is the priority.
6. A patient with left-sided heart failure has crackles in the lung fields. Which
intervention should the nurse implement to promote comfort?
A) Place the patient in a supine position
B) Use three pillows for support
C) Restrict all fluids
D) Encourage the patient to ambulate
Correct Answer: Use three pillows for support
Rationale: Elevating the head of the bed with pillows helps reduce venous
return, decrease pulmonary congestion, and improve oxygenation in patients
with left-sided heart failure.
7. A patient with a deep vein thrombosis (DVT) just came out of surgery.
What is the priority assessment question for this patient?
, A) "Do you have any pain in your legs?"
B) "Do you have chest pain or shortness of breath?"
C) "Are you able to move your toes?"
D) "Do you feel any numbness in your feet?"
Correct Answer: "Do you have chest pain or shortness of breath?"
Rationale: A patient with a DVT is at high risk for a pulmonary embolism,
which can present with sudden chest pain and shortness of breath. This is a
life-threatening emergency and requires immediate assessment.
8. A patient who is taking anticoagulants asks the nurse, "What if I stop
taking my meds?" What is the nurse's best response?
A) "The patient can have a stroke"
B) "You may experience increased bleeding"
C) "Your blood pressure may increase"
D) "You will need to restart the medication"
Correct Answer: The patient can have a stroke
Rationale: Anticoagulants are prescribed to prevent clot formation. Stopping
them abruptly can lead to clot formation, which can cause a stroke or other
thromboembolic events.
9. A patient has had a coronary artery bypass graft (CABG). Which diet is
correct for this patient?
A) High-protein, high-carbohydrate diet
B) Low-fat, low-cholesterol diet
C) High-sodium, high-potassium diet
