NSG 430 ADULT HEALTH NURSING I
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a pH of 7.28, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L. Which
acid-base imbalance is occurring?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory
acidosis.
2. When caring for a patient with left-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Jugular venous distention
,B. Crackles in the lungs
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. Options A, B, and D
are signs of right-sided heart failure.
3. A patient is 12 hours post-thyroidectomy. The nurse notes the patient is experiencing
muscle twitching and a positive Chvostek’s sign. What is the priority intervention?
A. Encourage the patient to cough and deep breathe
B. Prepare for emergency tracheostomy
C. Administer intravenous calcium gluconate
D. Place the patient in a semi-Fowler’s position
Answer: C
Conceptual Explanation: Muscle twitching and a positive Chvostek’s sign indicate
hypocalcemia, a potential complication if the parathyroid glands were accidentally
removed or damaged during surgery. IV calcium gluconate is the treatment.
, 4. Which assessment finding is most indicative of an acute myocardial infarction (MI) in an
elderly female patient?
A. Sudden onset of confusion and extreme fatigue
B. Substernal chest pain radiating to the left arm
C. Crushing chest pressure and diaphoresis
D. Nausea, vomiting, and epigastric pain
Answer: A
Conceptual Explanation: Elderly patients, particularly women, often present with atypical
symptoms of MI, such as profound fatigue, dyspnea, or sudden mental status changes,
rather than classic chest pain.
5. A patient with Type 1 Diabetes is found unconscious and diaphoretic. What is the first
action the nurse should take?
A. Administer 10 units of regular insulin subcutaneous
B. Check the blood glucose level immediately
C. Administer 1 mg of glucagon intramuscularly
D. Start an intravenous line with Normal Saline
Answer: C
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient presents with a pH of 7.28, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L. Which
acid-base imbalance is occurring?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory
acidosis.
2. When caring for a patient with left-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Jugular venous distention
,B. Crackles in the lungs
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. Options A, B, and D
are signs of right-sided heart failure.
3. A patient is 12 hours post-thyroidectomy. The nurse notes the patient is experiencing
muscle twitching and a positive Chvostek’s sign. What is the priority intervention?
A. Encourage the patient to cough and deep breathe
B. Prepare for emergency tracheostomy
C. Administer intravenous calcium gluconate
D. Place the patient in a semi-Fowler’s position
Answer: C
Conceptual Explanation: Muscle twitching and a positive Chvostek’s sign indicate
hypocalcemia, a potential complication if the parathyroid glands were accidentally
removed or damaged during surgery. IV calcium gluconate is the treatment.
, 4. Which assessment finding is most indicative of an acute myocardial infarction (MI) in an
elderly female patient?
A. Sudden onset of confusion and extreme fatigue
B. Substernal chest pain radiating to the left arm
C. Crushing chest pressure and diaphoresis
D. Nausea, vomiting, and epigastric pain
Answer: A
Conceptual Explanation: Elderly patients, particularly women, often present with atypical
symptoms of MI, such as profound fatigue, dyspnea, or sudden mental status changes,
rather than classic chest pain.
5. A patient with Type 1 Diabetes is found unconscious and diaphoretic. What is the first
action the nurse should take?
A. Administer 10 units of regular insulin subcutaneous
B. Check the blood glucose level immediately
C. Administer 1 mg of glucagon intramuscularly
D. Start an intravenous line with Normal Saline
Answer: C
