NURSING EXAMINATION
NSG 3100 Exam 4 Questions and Answers
2026/2027 | 100% Verified 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Medical-Surgical Nursing: Cardiovascular and Respiratory
Section 2: Medical-Surgical Nursing: Endocrine and Neurological
Section 3: Pharmacology and Medication Safety
Section 4: Nursing Process and Patient Care Management
Section 5: Professional Practice and Evidence-Based Care
STUVIACTUALEXAM
, SECTION 1 | Medical-Surgical Nursing: Cardiovascular and Respiratory | Q1-Q10 | NSG 3100 Exam 4
Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027
Q1 Question 1 of 50
Margaret Holloway, a 68-year-old woman, is admitted to the telemetry unit with New York Heart Association
Class III heart failure. She reports increasing dyspnea on exertion, three-pillow orthopnea, and weight gain of
4.5 kg over the past week. Her vital signs are BP 148/88 mmHg, HR 96 bpm, RR 24 breaths/min, and SpO2
91% on room air. Bilateral crackles are auscultated at the lung bases, and 2+ pitting edema is noted in both
lower extremities. Her daily medications include furosemide 40 mg PO daily, lisinopril 20 mg PO daily, and
carvedilol 12.5 mg PO BID. The nurse reviews her morning laboratory results and notes a serum potassium
level of 3.0 mEq/L.
A. Administer the scheduled furosemide and encourage intake of potassium-rich foods such as bananas and
oranges to correct the deficit
B. Hold the furosemide dose and notify the provider immediately about the hypokalemia before administering any
further cardiac medications
C. Administer the furosemide as scheduled and obtain a stat electrocardiogram to assess for U waves or T-wave
flattening related to hypokalemia
D. Request an order for intravenous potassium replacement prior to giving the scheduled furosemide
dose this morning
Correct Answer: D
Rationale:
Furosemide is a loop diuretic that causes significant potassium wasting, and administering it to a patient who is already
hypokalemic (K+ 3.0 mEq/L) increases the risk of life-threatening cardiac dysrhythmias. The nurse should request potassium
replacement before giving the diuretic to prevent further depletion of serum potassium. Dietary potassium sources alone will
not correct a level this low quickly enough for a patient on a potassium-wasting diuretic.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2
, Q2 Question 2 of 50
Robert Chen, a 58-year-old man, arrives in the emergency department complaining of substernal chest pressure
that began 45 minutes ago while he was mowing the lawn. The pain radiates to his left jaw and arm and is rated
8/10 in intensity. His vital signs are BP 162/98 mmHg, HR 108 bpm, RR 22 breaths/min, and SpO2 95% on 2 L
nasal cannula. A 12-lead ECG reveals ST-segment elevation in leads II, III, and aVF. Troponin I is drawn and
results are pending. The provider orders aspirin 325 mg chewable, nitroglycerin 0.4 mg SL, and prepares for
emergent cardiac catheterization.
A. Administer the nitroglycerin sublingually immediately, then give the chewable aspirin while preparing for the
cardiac catheterization lab
B. Give the chewable aspirin first, confirm the blood pressure remains adequate, and then administer
nitroglycerin while arranging for percutaneous coronary intervention
C. Withhold both medications until the troponin I result returns to confirm the diagnosis of acute myocardial
infarction before proceeding
D. Administer the nitroglycerin and aspirin simultaneously to achieve rapid antiplatelet and vasodilatory effects
before transport to the catheterization lab
Correct Answer: B
Rationale:
ST-segment elevation in leads II, III, and aVF indicates an inferior STEMI, and the ECG finding alone is sufficient to activate
the catheterization lab without waiting for troponin results. Aspirin 325 mg chewable should be given first for immediate
antiplatelet effect, followed by nitroglycerin only after confirming blood pressure is adequate to avoid dangerous hypotension.
Nitroglycerin must also be used cautiously in inferior MI due to potential right ventricular involvement.
Q3 Question 3 of 50
Dorothy Williams, a 72-year-old woman, is brought to the clinic by her daughter for a routine blood pressure
check. Her medical history includes essential hypertension diagnosed 15 years ago, type 2 diabetes mellitus,
and hyperlipidemia. Her current medications are amlodipine 10 mg PO daily, metformin 1000 mg PO BID, and
atorvastatin 40 mg PO at bedtime. Today her blood pressure is 198/112 mmHg in both arms, heart rate is 88
bpm, and she complains of a new-onset throbbing frontal headache and blurred vision that began this morning.
Fundoscopic examination reveals papilledema and retinal hemorrhages.
A. Initiate a continuous intravenous nicardipine infusion in the intensive care unit with frequent
neurologic assessments and blood pressure monitoring every 5 minutes
B. Instruct the patient to take an extra dose of amlodipine 10 mg now and return to the clinic in 48 hours for a
follow-up blood pressure recheck
C. Administer oral clonidine 0.1 mg and arrange for an outpatient CT scan of the head within the next week to
evaluate the headache
D. Increase the amlodipine to 20 mg PO daily and add hydrochlorothiazide 25 mg PO daily, then discharge home
with follow-up in one week
Correct Answer: A
Rationale:
This patient presents with a hypertensive emergency, evidenced by severely elevated blood pressure (198/112 mmHg) with
target organ damage including papilledema, retinal hemorrhages, visual changes, and headache. Hypertensive emergencies
require IV antihypertensive therapy in an intensive care setting with rapid but controlled blood pressure reduction, not oral
medication adjustments. Nicardipine is a calcium channel blocker commonly used for controlled IV blood pressure reduction
in hypertensive emergencies.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3
, Q4 Question 4 of 50
James Patterson, a 71-year-old man with a 40-pack-year smoking history and severe COPD (FEV1 32%
predicted), is admitted with a COPD exacerbation. He reports increased dyspnea, productive cough with thick
yellow-green sputum, and wheezing for the past three days. His vital signs are BP 138/82 mmHg, HR 104 bpm,
RR 28 breaths/min, temperature 38.4 degrees C, and SpO2 87% on room air. He is using accessory muscles
and has prolonged expiratory phases. Arterial blood gas results are pH 7.30, PaCO2 58 mmHg, PaO2 52
mmHg, and HCO3 30 mEq/L. He is currently on 2 L oxygen via nasal cannula.
A. Increase the oxygen to 6 L via nasal cannula to achieve a SpO2 of 98% and prepare for immediate
endotracheal intubation given the acute respiratory acidosis
B. Begin bilevel positive airway pressure (BiPAP) at high settings and increase oxygen to 4 L nasal cannula while
waiting for repeat arterial blood gas results
C. Maintain oxygen at 2 L via nasal cannula titrated to a SpO2 target of 88-92%, administer
albuterol/ipratropium nebulizer, and obtain sputum cultures before starting antibiotics
D. Switch to a non-rebreather mask at 10 L/min to rapidly correct the hypoxemia and administer IV
methylprednisolone 125 mg STAT
Correct Answer: C
Rationale:
This patient with severe COPD has chronic CO2 retention and is at high risk for oxygen-induced hypercapnia due to loss of
hypoxic respiratory drive. Oxygen should be titrated to a conservative SpO2 target of 88-92% to avoid suppressing
ventilation and worsening respiratory acidosis. Albuterol/ipratropium nebulizers provide bronchodilation, and sputum cultures
should be obtained before starting antibiotics to guide pathogen-directed therapy.
Q5 Question 5 of 50
Helen Kowalski, an 82-year-old woman residing in a long-term care facility, develops a fever of 38.9 degrees C,
tachypnea with a respiratory rate of 30 breaths/min, and a new cough producing rust-colored sputum. Her vital
signs are BP 104/62 mmHg, HR 112 bpm, SpO2 90% on room air, and temperature 38.9 degrees C. A chest
X-ray reveals a dense consolidation in the right lower lobe. Her white blood cell count is 16,400/?L with a left
shift. She has a history of type 2 diabetes (HbA1c 7.8%), osteoarthritis, and mild cognitive impairment. Her
CURB-65 score is calculated as 3.
A. Treat as an outpatient with oral amoxicillin-clavulanate and schedule a follow-up chest X-ray in one week to
assess resolution of the consolidation
B. Obtain blood cultures and sputum cultures, then start empiric IV ceftriaxone and azithromycin while
preparing for admission to the medical ward for close monitoring
C. Administer a single dose of oral levofloxacin 750 mg and observe for 24 hours in the emergency department
before deciding on disposition
D. Place the patient on contact precautions, start IV vancomycin, and consult the infectious disease service
before initiating any further antibiotic therapy
Correct Answer: B
Rationale:
A CURB-65 score of 3 indicates increased mortality risk and warrants hospital admission for IV antibiotic therapy and close
monitoring. Empiric therapy with IV ceftriaxone (a third-generation cephalosporin) plus azithromycin (a macrolide) provides
appropriate coverage for the most common pneumonia pathogens including Streptococcus pneumoniae, Haemophilus
influenzae, and atypical organisms. Blood and sputum cultures should be obtained before antibiotics but should not delay
initiation of empiric therapy.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 4
NSG 3100 Exam 4 Questions and Answers
2026/2027 | 100% Verified 2026/2027
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Medical-Surgical Nursing: Cardiovascular and Respiratory
Section 2: Medical-Surgical Nursing: Endocrine and Neurological
Section 3: Pharmacology and Medication Safety
Section 4: Nursing Process and Patient Care Management
Section 5: Professional Practice and Evidence-Based Care
STUVIACTUALEXAM
, SECTION 1 | Medical-Surgical Nursing: Cardiovascular and Respiratory | Q1-Q10 | NSG 3100 Exam 4
Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027
Q1 Question 1 of 50
Margaret Holloway, a 68-year-old woman, is admitted to the telemetry unit with New York Heart Association
Class III heart failure. She reports increasing dyspnea on exertion, three-pillow orthopnea, and weight gain of
4.5 kg over the past week. Her vital signs are BP 148/88 mmHg, HR 96 bpm, RR 24 breaths/min, and SpO2
91% on room air. Bilateral crackles are auscultated at the lung bases, and 2+ pitting edema is noted in both
lower extremities. Her daily medications include furosemide 40 mg PO daily, lisinopril 20 mg PO daily, and
carvedilol 12.5 mg PO BID. The nurse reviews her morning laboratory results and notes a serum potassium
level of 3.0 mEq/L.
A. Administer the scheduled furosemide and encourage intake of potassium-rich foods such as bananas and
oranges to correct the deficit
B. Hold the furosemide dose and notify the provider immediately about the hypokalemia before administering any
further cardiac medications
C. Administer the furosemide as scheduled and obtain a stat electrocardiogram to assess for U waves or T-wave
flattening related to hypokalemia
D. Request an order for intravenous potassium replacement prior to giving the scheduled furosemide
dose this morning
Correct Answer: D
Rationale:
Furosemide is a loop diuretic that causes significant potassium wasting, and administering it to a patient who is already
hypokalemic (K+ 3.0 mEq/L) increases the risk of life-threatening cardiac dysrhythmias. The nurse should request potassium
replacement before giving the diuretic to prevent further depletion of serum potassium. Dietary potassium sources alone will
not correct a level this low quickly enough for a patient on a potassium-wasting diuretic.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2
, Q2 Question 2 of 50
Robert Chen, a 58-year-old man, arrives in the emergency department complaining of substernal chest pressure
that began 45 minutes ago while he was mowing the lawn. The pain radiates to his left jaw and arm and is rated
8/10 in intensity. His vital signs are BP 162/98 mmHg, HR 108 bpm, RR 22 breaths/min, and SpO2 95% on 2 L
nasal cannula. A 12-lead ECG reveals ST-segment elevation in leads II, III, and aVF. Troponin I is drawn and
results are pending. The provider orders aspirin 325 mg chewable, nitroglycerin 0.4 mg SL, and prepares for
emergent cardiac catheterization.
A. Administer the nitroglycerin sublingually immediately, then give the chewable aspirin while preparing for the
cardiac catheterization lab
B. Give the chewable aspirin first, confirm the blood pressure remains adequate, and then administer
nitroglycerin while arranging for percutaneous coronary intervention
C. Withhold both medications until the troponin I result returns to confirm the diagnosis of acute myocardial
infarction before proceeding
D. Administer the nitroglycerin and aspirin simultaneously to achieve rapid antiplatelet and vasodilatory effects
before transport to the catheterization lab
Correct Answer: B
Rationale:
ST-segment elevation in leads II, III, and aVF indicates an inferior STEMI, and the ECG finding alone is sufficient to activate
the catheterization lab without waiting for troponin results. Aspirin 325 mg chewable should be given first for immediate
antiplatelet effect, followed by nitroglycerin only after confirming blood pressure is adequate to avoid dangerous hypotension.
Nitroglycerin must also be used cautiously in inferior MI due to potential right ventricular involvement.
Q3 Question 3 of 50
Dorothy Williams, a 72-year-old woman, is brought to the clinic by her daughter for a routine blood pressure
check. Her medical history includes essential hypertension diagnosed 15 years ago, type 2 diabetes mellitus,
and hyperlipidemia. Her current medications are amlodipine 10 mg PO daily, metformin 1000 mg PO BID, and
atorvastatin 40 mg PO at bedtime. Today her blood pressure is 198/112 mmHg in both arms, heart rate is 88
bpm, and she complains of a new-onset throbbing frontal headache and blurred vision that began this morning.
Fundoscopic examination reveals papilledema and retinal hemorrhages.
A. Initiate a continuous intravenous nicardipine infusion in the intensive care unit with frequent
neurologic assessments and blood pressure monitoring every 5 minutes
B. Instruct the patient to take an extra dose of amlodipine 10 mg now and return to the clinic in 48 hours for a
follow-up blood pressure recheck
C. Administer oral clonidine 0.1 mg and arrange for an outpatient CT scan of the head within the next week to
evaluate the headache
D. Increase the amlodipine to 20 mg PO daily and add hydrochlorothiazide 25 mg PO daily, then discharge home
with follow-up in one week
Correct Answer: A
Rationale:
This patient presents with a hypertensive emergency, evidenced by severely elevated blood pressure (198/112 mmHg) with
target organ damage including papilledema, retinal hemorrhages, visual changes, and headache. Hypertensive emergencies
require IV antihypertensive therapy in an intensive care setting with rapid but controlled blood pressure reduction, not oral
medication adjustments. Nicardipine is a calcium channel blocker commonly used for controlled IV blood pressure reduction
in hypertensive emergencies.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3
, Q4 Question 4 of 50
James Patterson, a 71-year-old man with a 40-pack-year smoking history and severe COPD (FEV1 32%
predicted), is admitted with a COPD exacerbation. He reports increased dyspnea, productive cough with thick
yellow-green sputum, and wheezing for the past three days. His vital signs are BP 138/82 mmHg, HR 104 bpm,
RR 28 breaths/min, temperature 38.4 degrees C, and SpO2 87% on room air. He is using accessory muscles
and has prolonged expiratory phases. Arterial blood gas results are pH 7.30, PaCO2 58 mmHg, PaO2 52
mmHg, and HCO3 30 mEq/L. He is currently on 2 L oxygen via nasal cannula.
A. Increase the oxygen to 6 L via nasal cannula to achieve a SpO2 of 98% and prepare for immediate
endotracheal intubation given the acute respiratory acidosis
B. Begin bilevel positive airway pressure (BiPAP) at high settings and increase oxygen to 4 L nasal cannula while
waiting for repeat arterial blood gas results
C. Maintain oxygen at 2 L via nasal cannula titrated to a SpO2 target of 88-92%, administer
albuterol/ipratropium nebulizer, and obtain sputum cultures before starting antibiotics
D. Switch to a non-rebreather mask at 10 L/min to rapidly correct the hypoxemia and administer IV
methylprednisolone 125 mg STAT
Correct Answer: C
Rationale:
This patient with severe COPD has chronic CO2 retention and is at high risk for oxygen-induced hypercapnia due to loss of
hypoxic respiratory drive. Oxygen should be titrated to a conservative SpO2 target of 88-92% to avoid suppressing
ventilation and worsening respiratory acidosis. Albuterol/ipratropium nebulizers provide bronchodilation, and sputum cultures
should be obtained before starting antibiotics to guide pathogen-directed therapy.
Q5 Question 5 of 50
Helen Kowalski, an 82-year-old woman residing in a long-term care facility, develops a fever of 38.9 degrees C,
tachypnea with a respiratory rate of 30 breaths/min, and a new cough producing rust-colored sputum. Her vital
signs are BP 104/62 mmHg, HR 112 bpm, SpO2 90% on room air, and temperature 38.9 degrees C. A chest
X-ray reveals a dense consolidation in the right lower lobe. Her white blood cell count is 16,400/?L with a left
shift. She has a history of type 2 diabetes (HbA1c 7.8%), osteoarthritis, and mild cognitive impairment. Her
CURB-65 score is calculated as 3.
A. Treat as an outpatient with oral amoxicillin-clavulanate and schedule a follow-up chest X-ray in one week to
assess resolution of the consolidation
B. Obtain blood cultures and sputum cultures, then start empiric IV ceftriaxone and azithromycin while
preparing for admission to the medical ward for close monitoring
C. Administer a single dose of oral levofloxacin 750 mg and observe for 24 hours in the emergency department
before deciding on disposition
D. Place the patient on contact precautions, start IV vancomycin, and consult the infectious disease service
before initiating any further antibiotic therapy
Correct Answer: B
Rationale:
A CURB-65 score of 3 indicates increased mortality risk and warrants hospital admission for IV antibiotic therapy and close
monitoring. Empiric therapy with IV ceftriaxone (a third-generation cephalosporin) plus azithromycin (a macrolide) provides
appropriate coverage for the most common pneumonia pathogens including Streptococcus pneumoniae, Haemophilus
influenzae, and atypical organisms. Blood and sputum cultures should be obtained before antibiotics but should not delay
initiation of empiric therapy.
NSG 3100 Exam 4 Questions and Answers 2026/2027 | 100% Verified 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 4
