NSG320 ADULT HEALTH NURSING I
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s SpO2 is 89% and the patient appears slightly
dyspneic. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min immediately.
B. Assess the patient’s respiratory rate and lung sounds.
C. Place the patient in a high-Fowler’s position.
D. Notify the healthcare provider of the oxygen saturation level.
Answer: C
Conceptual Explanation: For a patient with COPD experiencing dyspnea, the first nursing
intervention is to optimize positioning. High-Fowler’s or an orthopneic position allows for
maximum chest expansion. Increasing oxygen too much in COPD patients can potentially
suppress their hypoxic drive to breathe, and assessment should follow immediate safety
positioning.
,2. The nurse is caring for a patient who is 24 hours post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the nurse perform
next?
A. Check for a positive Trousseau’s sign.
B. Assess the surgical dressing for hemorrhage.
C. Monitor the patient’s heart rate for tachycardia.
D. Evaluate the patient’s ability to speak clearly.
Answer: A
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) and
fingertips are early signs of hypocalcemia, which can occur if the parathyroid glands were
accidentally damaged or removed during a thyroidectomy. Trousseau’s sign (carpal spasm
induced by inflating a BP cuff) is a classic indicator of neuromuscular irritability due to low
calcium.
3. Which arterial blood gas (ABG) result would the nurse expect to see in a patient who has
been vomiting for the past 48 hours?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.32, PaCO2 35, HCO3 18
C. pH 7.50, PaCO2 40, HCO3 34
D. pH 7.48, PaCO2 30, HCO3 22
, Answer: C
Conceptual Explanation: Prolonged vomiting leads to a loss of gastric acid (hydrochloric
acid), resulting in metabolic alkalosis. This is characterized by a high pH (>7.45) and an
elevated bicarbonate (HCO3) level (>26 mEq/L). Option B shows metabolic alkalosis.
4. A patient with Type 1 Diabetes Mellitus presents to the ER with a blood glucose of 560
mg/dL, fruity breath, and Kussmaul respirations. What is the priority nursing intervention?
A. Administer subcutaneous glargine insulin.
B. Provide a fast-acting carbohydrate snack.
C. Administer intravenous potassium chloride.
D. Initiate an intravenous infusion of 0.9% Normal Saline.
Answer: D
Conceptual Explanation: This patient is in Diabetic Ketoacidosis (DKA). The priority is
fluid resuscitation with Normal Saline to treat dehydration and restore circulatory volume
before starting insulin therapy. Potassium is monitored closely but is not the first step
before fluid volume is addressed.
5. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Jugular venous distention and peripheral edema.
B. Orthopnea and paroxysmal nocturnal dyspnea.
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s SpO2 is 89% and the patient appears slightly
dyspneic. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min immediately.
B. Assess the patient’s respiratory rate and lung sounds.
C. Place the patient in a high-Fowler’s position.
D. Notify the healthcare provider of the oxygen saturation level.
Answer: C
Conceptual Explanation: For a patient with COPD experiencing dyspnea, the first nursing
intervention is to optimize positioning. High-Fowler’s or an orthopneic position allows for
maximum chest expansion. Increasing oxygen too much in COPD patients can potentially
suppress their hypoxic drive to breathe, and assessment should follow immediate safety
positioning.
,2. The nurse is caring for a patient who is 24 hours post-thyroidectomy. The patient reports
tingling in the fingertips and around the mouth. Which assessment should the nurse perform
next?
A. Check for a positive Trousseau’s sign.
B. Assess the surgical dressing for hemorrhage.
C. Monitor the patient’s heart rate for tachycardia.
D. Evaluate the patient’s ability to speak clearly.
Answer: A
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) and
fingertips are early signs of hypocalcemia, which can occur if the parathyroid glands were
accidentally damaged or removed during a thyroidectomy. Trousseau’s sign (carpal spasm
induced by inflating a BP cuff) is a classic indicator of neuromuscular irritability due to low
calcium.
3. Which arterial blood gas (ABG) result would the nurse expect to see in a patient who has
been vomiting for the past 48 hours?
A. pH 7.30, PaCO2 50, HCO3 26
B. pH 7.32, PaCO2 35, HCO3 18
C. pH 7.50, PaCO2 40, HCO3 34
D. pH 7.48, PaCO2 30, HCO3 22
, Answer: C
Conceptual Explanation: Prolonged vomiting leads to a loss of gastric acid (hydrochloric
acid), resulting in metabolic alkalosis. This is characterized by a high pH (>7.45) and an
elevated bicarbonate (HCO3) level (>26 mEq/L). Option B shows metabolic alkalosis.
4. A patient with Type 1 Diabetes Mellitus presents to the ER with a blood glucose of 560
mg/dL, fruity breath, and Kussmaul respirations. What is the priority nursing intervention?
A. Administer subcutaneous glargine insulin.
B. Provide a fast-acting carbohydrate snack.
C. Administer intravenous potassium chloride.
D. Initiate an intravenous infusion of 0.9% Normal Saline.
Answer: D
Conceptual Explanation: This patient is in Diabetic Ketoacidosis (DKA). The priority is
fluid resuscitation with Normal Saline to treat dehydration and restore circulatory volume
before starting insulin therapy. Potassium is monitored closely but is not the first step
before fluid volume is addressed.
5. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Jugular venous distention and peripheral edema.
B. Orthopnea and paroxysmal nocturnal dyspnea.
