GALEN NUR 283 COMP 1–3 EXAMS 2027
QUESTIONS AND ANSWERS
1. A patient presents with arterial blood gas (ABG) results: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. Which condition does the nurse suspect?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause, and since the HCO3 is normal, it is uncompensated
respiratory acidosis.
2. A client is receiving a continuous heparin infusion for a pulmonary embolism. The nurse
notes an aPTT of 105 seconds. What is the priority nursing action?
A. Increase the infusion rate per protocol
B. Document the finding and reassess in 4 hours
,C. Administer Vitamin K intramuscularly
D. Stop the infusion and notify the provider
Answer: D
Conceptual Explanation: The therapeutic range for aPTT is typically 1.5 to 2.5 times the
control (approx 60-80 seconds). A value of 105 is dangerously high, increasing bleeding
risk; the infusion must be stopped.
3. Which assessment finding in a patient with a head injury most strongly indicates increasing
intracranial pressure (ICP)?
A. Cushing’s triad: bradycardia, hypertension, and irregular respirations
B. Tachycardia and hypotension
C. Narrowing pulse pressure
D. Hyperactive bowel sounds
Answer: A
Conceptual Explanation: Cushing’s triad (widened pulse pressure/hypertension,
bradycardia, and irregular respirations) is a late sign of significantly increased ICP and
impending herniation.
4. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which laboratory value
should the nurse monitor most closely to prevent toxicity?
A. Serum Calcium
, B. Serum Potassium
C. Serum Sodium
D. Serum Glucose
Answer: B
Conceptual Explanation: Hypokalemia increases the risk of Digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
5. A client in the emergency department reports a sudden onset of ‘the worst headache of my
life.’ The nurse should prepare for which diagnostic test first?
A. Non-contrast CT scan of the head
B. Electroencephalogram (EEG)
C. Lumbar puncture
D. Magnetic resonance imaging (MRI)
Answer: A
Conceptual Explanation: Sudden ‘thunderclap’ headaches are indicative of a
subarachnoid hemorrhage. A non-contrast CT is the gold standard for rapid detection of
acute intracranial bleeding.
QUESTIONS AND ANSWERS
1. A patient presents with arterial blood gas (ABG) results: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. Which condition does the nurse suspect?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause, and since the HCO3 is normal, it is uncompensated
respiratory acidosis.
2. A client is receiving a continuous heparin infusion for a pulmonary embolism. The nurse
notes an aPTT of 105 seconds. What is the priority nursing action?
A. Increase the infusion rate per protocol
B. Document the finding and reassess in 4 hours
,C. Administer Vitamin K intramuscularly
D. Stop the infusion and notify the provider
Answer: D
Conceptual Explanation: The therapeutic range for aPTT is typically 1.5 to 2.5 times the
control (approx 60-80 seconds). A value of 105 is dangerously high, increasing bleeding
risk; the infusion must be stopped.
3. Which assessment finding in a patient with a head injury most strongly indicates increasing
intracranial pressure (ICP)?
A. Cushing’s triad: bradycardia, hypertension, and irregular respirations
B. Tachycardia and hypotension
C. Narrowing pulse pressure
D. Hyperactive bowel sounds
Answer: A
Conceptual Explanation: Cushing’s triad (widened pulse pressure/hypertension,
bradycardia, and irregular respirations) is a late sign of significantly increased ICP and
impending herniation.
4. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which laboratory value
should the nurse monitor most closely to prevent toxicity?
A. Serum Calcium
, B. Serum Potassium
C. Serum Sodium
D. Serum Glucose
Answer: B
Conceptual Explanation: Hypokalemia increases the risk of Digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
5. A client in the emergency department reports a sudden onset of ‘the worst headache of my
life.’ The nurse should prepare for which diagnostic test first?
A. Non-contrast CT scan of the head
B. Electroencephalogram (EEG)
C. Lumbar puncture
D. Magnetic resonance imaging (MRI)
Answer: A
Conceptual Explanation: Sudden ‘thunderclap’ headaches are indicative of a
subarachnoid hemorrhage. A non-contrast CT is the gold standard for rapid detection of
acute intracranial bleeding.
