NSG 320 ADULT HEALTH NURSING -
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with heart failure is receiving Furosemide. Which laboratory value should the
nurse monitor most closely to prevent complications?
A. Serum Sodium
B. Serum Calcium
C. Blood Urea Nitrogen (BUN)
D. Serum Potassium
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes significant excretion of
potassium, which can lead to life-threatening arrhythmias or digoxin toxicity.
2. Which arterial blood gas (ABG) result is most indicative of a patient in early stage
respiratory failure due to COPD?
A. pH 7.38, PaCO2 40, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
,C. pH 7.30, PaCO2 58, HCO3 26
D. pH 7.32, PaCO2 45, HCO3 18
Answer: C
Conceptual Explanation: Respiratory acidosis (low pH and high PaCO2) is a hallmark of
hypoventilation and respiratory failure in COPD patients who retain CO2.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. What is the priority nursing action?
A. Assess for Chvostek’s sign.
B. Check the surgical dressing for bleeding.
C. Administer a prescribed analgesic.
D. Encourage the patient to cough and deep breathe.
Answer: A
Conceptual Explanation: Tingling is a sign of hypocalcemia, often caused by accidental
damage to the parathyroid glands during thyroidectomy. Chvostek’s sign assesses for
neuromuscular irritability related to low calcium.
4. In the hyperosmolar hyperglycemic state (HHS), which clinical finding distinguishes it from
diabetic ketoacidosis (DKA)?
A. Absence of significant ketosis
B. Significant metabolic acidosis
, C. Presence of Kussmaul respirations
D. Blood glucose levels above 300 mg/dL
Answer: A
Conceptual Explanation: Unlike DKA, HHS involves enough insulin production to prevent
fat breakdown and ketone formation, but not enough to prevent severe hyperglycemia.
5. Which assessment finding is the most sensitive early indicator of increased intracranial
pressure (ICP)?
A. Widening pulse pressure
B. Dilated and sluggish pupils
C. Decorticate posturing
D. Change in level of consciousness
Answer: D
Conceptual Explanation: A change in the level of consciousness (LOC) is the earliest and
most reliable sign of increasing ICP due to brain tissue sensitivity to oxygen and pressure
changes.
6. A patient with a spinal cord injury at T6 reports a sudden severe headache and is found to
be hypertensive (190/100). What is the nurse’s first action?
A. Administer an antihypertensive medication.
B. Assess the urinary catheter for kinks.
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with heart failure is receiving Furosemide. Which laboratory value should the
nurse monitor most closely to prevent complications?
A. Serum Sodium
B. Serum Calcium
C. Blood Urea Nitrogen (BUN)
D. Serum Potassium
Answer: D
Conceptual Explanation: Furosemide is a loop diuretic that causes significant excretion of
potassium, which can lead to life-threatening arrhythmias or digoxin toxicity.
2. Which arterial blood gas (ABG) result is most indicative of a patient in early stage
respiratory failure due to COPD?
A. pH 7.38, PaCO2 40, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
,C. pH 7.30, PaCO2 58, HCO3 26
D. pH 7.32, PaCO2 45, HCO3 18
Answer: C
Conceptual Explanation: Respiratory acidosis (low pH and high PaCO2) is a hallmark of
hypoventilation and respiratory failure in COPD patients who retain CO2.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingers and toes. What is the priority nursing action?
A. Assess for Chvostek’s sign.
B. Check the surgical dressing for bleeding.
C. Administer a prescribed analgesic.
D. Encourage the patient to cough and deep breathe.
Answer: A
Conceptual Explanation: Tingling is a sign of hypocalcemia, often caused by accidental
damage to the parathyroid glands during thyroidectomy. Chvostek’s sign assesses for
neuromuscular irritability related to low calcium.
4. In the hyperosmolar hyperglycemic state (HHS), which clinical finding distinguishes it from
diabetic ketoacidosis (DKA)?
A. Absence of significant ketosis
B. Significant metabolic acidosis
, C. Presence of Kussmaul respirations
D. Blood glucose levels above 300 mg/dL
Answer: A
Conceptual Explanation: Unlike DKA, HHS involves enough insulin production to prevent
fat breakdown and ketone formation, but not enough to prevent severe hyperglycemia.
5. Which assessment finding is the most sensitive early indicator of increased intracranial
pressure (ICP)?
A. Widening pulse pressure
B. Dilated and sluggish pupils
C. Decorticate posturing
D. Change in level of consciousness
Answer: D
Conceptual Explanation: A change in the level of consciousness (LOC) is the earliest and
most reliable sign of increasing ICP due to brain tissue sensitivity to oxygen and pressure
changes.
6. A patient with a spinal cord injury at T6 reports a sudden severe headache and is found to
be hypertensive (190/100). What is the nurse’s first action?
A. Administer an antihypertensive medication.
B. Assess the urinary catheter for kinks.
