NSG 430 ADULT HEALTH NURSING I
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3- of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45
mmHg indicates a respiratory cause, while the HCO3- is within normal range, suggesting
respiratory acidosis.
2. Which clinical manifestation is a hallmark sign of Left-Sided Heart Failure?
A. Peripheral edema in the lower extremities
B. Hepatosplenomegaly
,C. Jugular venous distention (JVD)
D. Crackles or wheezing upon lung auscultation
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. The other options
are signs of right-sided heart failure.
3. When caring for a patient with a chest tube, which finding should the nurse report to the
provider immediately?
A. Tidaling in the water-seal chamber during respiration
B. Drainage of 50 mL of serosanguinous fluid in 2 hours
C. Intermittent bubbling in the suction control chamber
D. Continuous bubbling in the water-seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system. Tidaling is normal, and serosanguinous drainage under 70-100 mL/hr is
generally expected post-operatively.
4. A patient with Type 1 Diabetes is found unconscious and diaphoretic. What is the priority
nursing action?
A. Administer 15g of oral glucose gel
, B. Check the patient’s blood glucose level
C. Administer Glucagon IM or SubQ
D. Start an insulin drip immediately
Answer: C
Conceptual Explanation: In an unconscious patient with suspected hypoglycemia, the
priority is to restore glucose safely without aspiration risk. Glucagon is the appropriate
emergency intervention when IV access is not immediate.
5. Which EKG change is most indicative of hyperkalemia?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Conceptual Explanation: Hyperkalemia typically causes tall, peaked T waves, followed by
widening of the QRS and eventual loss of P waves as levels rise.
6. A patient is 12 hours post-thyroidectomy. The nurse notes positive Chvostek’s and
Trousseau’s signs. Which electrolyte should be replaced?
A. Sodium
B. Calcium
COMPREHENSIVE EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3- of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45
mmHg indicates a respiratory cause, while the HCO3- is within normal range, suggesting
respiratory acidosis.
2. Which clinical manifestation is a hallmark sign of Left-Sided Heart Failure?
A. Peripheral edema in the lower extremities
B. Hepatosplenomegaly
,C. Jugular venous distention (JVD)
D. Crackles or wheezing upon lung auscultation
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion and crackles. The other options
are signs of right-sided heart failure.
3. When caring for a patient with a chest tube, which finding should the nurse report to the
provider immediately?
A. Tidaling in the water-seal chamber during respiration
B. Drainage of 50 mL of serosanguinous fluid in 2 hours
C. Intermittent bubbling in the suction control chamber
D. Continuous bubbling in the water-seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system. Tidaling is normal, and serosanguinous drainage under 70-100 mL/hr is
generally expected post-operatively.
4. A patient with Type 1 Diabetes is found unconscious and diaphoretic. What is the priority
nursing action?
A. Administer 15g of oral glucose gel
, B. Check the patient’s blood glucose level
C. Administer Glucagon IM or SubQ
D. Start an insulin drip immediately
Answer: C
Conceptual Explanation: In an unconscious patient with suspected hypoglycemia, the
priority is to restore glucose safely without aspiration risk. Glucagon is the appropriate
emergency intervention when IV access is not immediate.
5. Which EKG change is most indicative of hyperkalemia?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Answer: C
Conceptual Explanation: Hyperkalemia typically causes tall, peaked T waves, followed by
widening of the QRS and eventual loss of P waves as levels rise.
6. A patient is 12 hours post-thyroidectomy. The nurse notes positive Chvostek’s and
Trousseau’s signs. Which electrolyte should be replaced?
A. Sodium
B. Calcium
