NSG 4800 EXAM / LATEST NSG 4800 GALEN COLLEGE OF
NURSING ACTUAL EXAM TEST BANK 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE
EXAM COMPLETE APPROVED QUESTIONS WITH WELL
ELABORATED ANSWERS AND DETAILED RATIONALES
(RELIABLE ANSWERS) CURRENTLY UPDATED VERSION
2026 EDITION |GUARANTEED SUCCESS A+ |INSTANT
DOWNLOAD PDF |JUST RELEASED
1. A client with chronic heart failure is prescribed digoxin. Which
finding indicates a therapeutic response to the medication?
A. Increased heart rate and blood pressure
B. Decreased peripheral edema and increased urine output
C. Presence of a new S3 heart sound
D. Jugular venous distention
Correct Answer: B. Decreased peripheral edema and increased urine
output are signs of improved cardiac output and reduced fluid
overload, indicating a therapeutic response to digoxin. Option A is
incorrect as digoxin decreases heart rate. Option C and D are signs
of worsening heart failure.
Rationale: Digoxin increases the force of myocardial contraction
(positive inotrope), leading to increased cardiac output, improved
renal perfusion, and subsequent diuresis. This results in a reduction
,of fluid overload symptoms such as peripheral edema and pulmonary
congestion.
2. A patient is receiving a continuous heparin infusion for a
pulmonary embolism. The aPTT result is 110 seconds. What is the
nurse's priority action?
A. Continue the infusion at the current rate.
B. Increase the infusion rate by 2 mL/hr.
C. Stop the infusion and notify the healthcare provider.
D. Decrease the infusion rate by 50%.
Correct Answer: C. Stop the infusion and notify the healthcare
provider. An aPTT of 110 seconds is significantly above the
therapeutic range (typically 1.5-2.5 times the control value, or 60-80
seconds), indicating a high risk for bleeding. The infusion must be
stopped immediately.
Rationale: Heparin is a potent anticoagulant. Supratherapeutic aPTT
levels increase the risk of major hemorrhage. The standard protocol
for a critical aPTT value is to stop the infusion and notify the
provider for further orders, which may include administering
protamine sulfate.
,3. A nurse is assessing a client who is 24 hours post-operative
following a total hip arthroplasty. Which finding requires immediate
intervention?
A. Pain level of 4 on a 0-10 scale
B. Urinary output of 30 mL/hr
C. Dorsiflexion of the affected foot
D. Shortening and external rotation of the affected leg
Correct Answer: D. Shortening and external rotation of the affected
leg are classic signs of hip dislocation, a serious complication that
requires immediate intervention.
Rationale: Post-operative hip precautions are critical to prevent
dislocation. The new prosthetic joint is most vulnerable in the first
48-72 hours. Signs of dislocation include severe pain, inability to
bear weight, and a leg that appears shorter and rotated outward. This
is a surgical emergency.
4. A client with a history of chronic obstructive pulmonary disease
(COPD) is receiving oxygen at 2 L/min via nasal cannula. The nurse
assesses the client and notes they are lethargic and their respiratory
rate is 8 breaths/min. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Apply a non-rebreather mask.
, C. Check the client's pulse oximetry.
D. Prepare to assist with ventilation.
Correct Answer: C. Check the client's pulse oximetry. While the
client is showing signs of respiratory depression, the first action is to
assess the current oxygen saturation to determine the severity of the
problem and guide further intervention.
Rationale: COPD clients can have a hypoxic drive, but this is less
common than believed. The priority is to assess the client's current
oxygenation status. If the SpO2 is low, the nurse may need to
prepare for ventilatory support. If the SpO2 is high, the respiratory
depression may be due to another cause.
5. A patient is prescribed warfarin. Which laboratory value is the
primary indicator for monitoring therapeutic effectiveness?
A. Platelet count
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C. International Normalized Ratio (INR). INR is
the standardized method for monitoring warfarin therapy.
NURSING ACTUAL EXAM TEST BANK 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE ACCURATE
EXAM COMPLETE APPROVED QUESTIONS WITH WELL
ELABORATED ANSWERS AND DETAILED RATIONALES
(RELIABLE ANSWERS) CURRENTLY UPDATED VERSION
2026 EDITION |GUARANTEED SUCCESS A+ |INSTANT
DOWNLOAD PDF |JUST RELEASED
1. A client with chronic heart failure is prescribed digoxin. Which
finding indicates a therapeutic response to the medication?
A. Increased heart rate and blood pressure
B. Decreased peripheral edema and increased urine output
C. Presence of a new S3 heart sound
D. Jugular venous distention
Correct Answer: B. Decreased peripheral edema and increased urine
output are signs of improved cardiac output and reduced fluid
overload, indicating a therapeutic response to digoxin. Option A is
incorrect as digoxin decreases heart rate. Option C and D are signs
of worsening heart failure.
Rationale: Digoxin increases the force of myocardial contraction
(positive inotrope), leading to increased cardiac output, improved
renal perfusion, and subsequent diuresis. This results in a reduction
,of fluid overload symptoms such as peripheral edema and pulmonary
congestion.
2. A patient is receiving a continuous heparin infusion for a
pulmonary embolism. The aPTT result is 110 seconds. What is the
nurse's priority action?
A. Continue the infusion at the current rate.
B. Increase the infusion rate by 2 mL/hr.
C. Stop the infusion and notify the healthcare provider.
D. Decrease the infusion rate by 50%.
Correct Answer: C. Stop the infusion and notify the healthcare
provider. An aPTT of 110 seconds is significantly above the
therapeutic range (typically 1.5-2.5 times the control value, or 60-80
seconds), indicating a high risk for bleeding. The infusion must be
stopped immediately.
Rationale: Heparin is a potent anticoagulant. Supratherapeutic aPTT
levels increase the risk of major hemorrhage. The standard protocol
for a critical aPTT value is to stop the infusion and notify the
provider for further orders, which may include administering
protamine sulfate.
,3. A nurse is assessing a client who is 24 hours post-operative
following a total hip arthroplasty. Which finding requires immediate
intervention?
A. Pain level of 4 on a 0-10 scale
B. Urinary output of 30 mL/hr
C. Dorsiflexion of the affected foot
D. Shortening and external rotation of the affected leg
Correct Answer: D. Shortening and external rotation of the affected
leg are classic signs of hip dislocation, a serious complication that
requires immediate intervention.
Rationale: Post-operative hip precautions are critical to prevent
dislocation. The new prosthetic joint is most vulnerable in the first
48-72 hours. Signs of dislocation include severe pain, inability to
bear weight, and a leg that appears shorter and rotated outward. This
is a surgical emergency.
4. A client with a history of chronic obstructive pulmonary disease
(COPD) is receiving oxygen at 2 L/min via nasal cannula. The nurse
assesses the client and notes they are lethargic and their respiratory
rate is 8 breaths/min. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Apply a non-rebreather mask.
, C. Check the client's pulse oximetry.
D. Prepare to assist with ventilation.
Correct Answer: C. Check the client's pulse oximetry. While the
client is showing signs of respiratory depression, the first action is to
assess the current oxygen saturation to determine the severity of the
problem and guide further intervention.
Rationale: COPD clients can have a hypoxic drive, but this is less
common than believed. The priority is to assess the client's current
oxygenation status. If the SpO2 is low, the nurse may need to
prepare for ventilatory support. If the SpO2 is high, the respiratory
depression may be due to another cause.
5. A patient is prescribed warfarin. Which laboratory value is the
primary indicator for monitoring therapeutic effectiveness?
A. Platelet count
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C. International Normalized Ratio (INR). INR is
the standardized method for monitoring warfarin therapy.
