NSG 3800 Exam 1 V3 | NSG 3800 Nursing Practice – Adult Health II |
Actual Q&A with Rationale (NSG3800 Exam 1) | Galen
1. A patient with atrial fibrillation is receiving warfarin. Which laboratory value should the
nurse monitor to determine the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) only
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Rationale: The INR is the standard laboratory value used to monitor the effectiveness of
warfarin therapy in patients with atrial fibrillation. A therapeutic INR range for most
patients is typically between 2.0 and 3.0. Monitoring this value ensures that the patient is
protected against clot formation without being at excessive risk for bleeding.
2. A nurse is caring for a patient who develops sinus bradycardia with a heart rate of 38
beats/min and reports feeling dizzy. Which medication should the nurse expect to
administer?
A. Atropine
B. Digoxin
C. Amiodarone
D. Metoprolol
Answer: A
Rationale: Atropine is an anticholinergic medication used to increase the heart rate in
symptomatic bradycardia by blocking the effects of the vagus nerve. The patient’s dizziness
indicates they are symptomatic, requiring immediate intervention to improve cardiac
output. Other medications like metoprolol or digoxin would further slow the heart rate and
are contraindicated in this situation.
3. A patient’s cardiac monitor shows ventricular tachycardia. The patient is awake and has a
palpable pulse. Which action should the nurse prepare for?
A. Immediate defibrillation
B. Administration of epinephrine
C. Synchronized cardioversion
D. Initiation of chest compressions
,Answer: C
Rationale: Synchronized cardioversion is the treatment of choice for a stable patient with
a pulse who is experiencing ventricular tachycardia. This procedure delivers a timed
electrical shock on the R wave of the QRS complex to avoid inducing ventricular fibrillation.
Defibrillation is only indicated for patients without a pulse, such as those in ventricular
fibrillation or pulseless ventricular tachycardia.
4. The nurse is evaluating the central venous pressure (CVP) of a patient. What does a CVP
reading of 1 mmHg primarily indicate?
A. Hypovolemia
B. Hypervolemia
C. Right ventricular heart failure
D. Pulmonary hypertension
Answer: A
Rationale: A low CVP reading, typically below 2 mmHg, is a clinical indicator of
hypovolemia or decreased venous return. The nurse should assess the patient for other
signs of dehydration or blood loss to confirm this finding. Treatment usually involves fluid
resuscitation to restore adequate circulating volume and improve cardiac output.
5. Which assessment finding is most characteristic of a patient experiencing a tension
pneumothorax?
A. Resonance on percussion of the chest wall
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Bradycardia and hypertension
Answer: C
Rationale: Tracheal deviation to the unaffected side is a late and classic sign of tension
pneumothorax caused by high intrapleural pressure. This condition is a life-threatening
emergency that requires immediate needle decompression or chest tube insertion. The
nurse would also observe absent breath sounds on the affected side and signs of
obstructive shock.
6. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). The nurse knows
that the hallmark feature of ARDS is:
A. Resolution with high-flow oxygen therapy
B. Increased lung compliance
C. Hypoxemia refractory to supplemental oxygen
, D. Left-sided heart failure
Answer: C
Rationale: Refractory hypoxemia, which is low arterial oxygen despite high concentrations
of inspired oxygen, is the primary hallmark of ARDS. This occurs due to severe shunting
and alveolar collapse within the lungs. Nursing care focuses on mechanical ventilation with
PEEP to keep alveoli open and improve gas exchange.
7. A nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which of the following could be the cause?
A. A disconnection in the ventilator tubing
B. Excessive secretions in the airway
C. A leak in the endotracheal tube cuff
D. The patient is not breathing spontaneously
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance in the circuit, such
as airway secretions, kinks in the tubing, or the patient biting the endotracheal tube. The
nurse should immediately assess the patient’s breath sounds and suction if necessary to
clear the blockage. Low-pressure alarms, by contrast, are usually caused by leaks or
disconnections in the system.
8. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L.
Which medication is most appropriate for a rapid, temporary shift of potassium into the
cells?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Intravenous insulin and glucose
C. Calcium gluconate
D. Furosemide (Lasix)
Answer: B
Rationale: Intravenous insulin along with glucose is used to rapidly shift potassium from
the extracellular fluid into the intracellular space. While calcium gluconate protects the
heart from the effects of hyperkalemia, it does not actually lower the potassium level itself.
Sodium polystyrene sulfonate is effective for removing potassium from the body but works
much more slowly than insulin.
9. Which assessment finding should the nurse prioritize when caring for a patient with a new
arteriovenous (AV) fistula?
A. Absence of a bruit or thrill
Actual Q&A with Rationale (NSG3800 Exam 1) | Galen
1. A patient with atrial fibrillation is receiving warfarin. Which laboratory value should the
nurse monitor to determine the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) only
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Rationale: The INR is the standard laboratory value used to monitor the effectiveness of
warfarin therapy in patients with atrial fibrillation. A therapeutic INR range for most
patients is typically between 2.0 and 3.0. Monitoring this value ensures that the patient is
protected against clot formation without being at excessive risk for bleeding.
2. A nurse is caring for a patient who develops sinus bradycardia with a heart rate of 38
beats/min and reports feeling dizzy. Which medication should the nurse expect to
administer?
A. Atropine
B. Digoxin
C. Amiodarone
D. Metoprolol
Answer: A
Rationale: Atropine is an anticholinergic medication used to increase the heart rate in
symptomatic bradycardia by blocking the effects of the vagus nerve. The patient’s dizziness
indicates they are symptomatic, requiring immediate intervention to improve cardiac
output. Other medications like metoprolol or digoxin would further slow the heart rate and
are contraindicated in this situation.
3. A patient’s cardiac monitor shows ventricular tachycardia. The patient is awake and has a
palpable pulse. Which action should the nurse prepare for?
A. Immediate defibrillation
B. Administration of epinephrine
C. Synchronized cardioversion
D. Initiation of chest compressions
,Answer: C
Rationale: Synchronized cardioversion is the treatment of choice for a stable patient with
a pulse who is experiencing ventricular tachycardia. This procedure delivers a timed
electrical shock on the R wave of the QRS complex to avoid inducing ventricular fibrillation.
Defibrillation is only indicated for patients without a pulse, such as those in ventricular
fibrillation or pulseless ventricular tachycardia.
4. The nurse is evaluating the central venous pressure (CVP) of a patient. What does a CVP
reading of 1 mmHg primarily indicate?
A. Hypovolemia
B. Hypervolemia
C. Right ventricular heart failure
D. Pulmonary hypertension
Answer: A
Rationale: A low CVP reading, typically below 2 mmHg, is a clinical indicator of
hypovolemia or decreased venous return. The nurse should assess the patient for other
signs of dehydration or blood loss to confirm this finding. Treatment usually involves fluid
resuscitation to restore adequate circulating volume and improve cardiac output.
5. Which assessment finding is most characteristic of a patient experiencing a tension
pneumothorax?
A. Resonance on percussion of the chest wall
B. Increased breath sounds on the affected side
C. Tracheal deviation to the unaffected side
D. Bradycardia and hypertension
Answer: C
Rationale: Tracheal deviation to the unaffected side is a late and classic sign of tension
pneumothorax caused by high intrapleural pressure. This condition is a life-threatening
emergency that requires immediate needle decompression or chest tube insertion. The
nurse would also observe absent breath sounds on the affected side and signs of
obstructive shock.
6. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). The nurse knows
that the hallmark feature of ARDS is:
A. Resolution with high-flow oxygen therapy
B. Increased lung compliance
C. Hypoxemia refractory to supplemental oxygen
, D. Left-sided heart failure
Answer: C
Rationale: Refractory hypoxemia, which is low arterial oxygen despite high concentrations
of inspired oxygen, is the primary hallmark of ARDS. This occurs due to severe shunting
and alveolar collapse within the lungs. Nursing care focuses on mechanical ventilation with
PEEP to keep alveoli open and improve gas exchange.
7. A nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which of the following could be the cause?
A. A disconnection in the ventilator tubing
B. Excessive secretions in the airway
C. A leak in the endotracheal tube cuff
D. The patient is not breathing spontaneously
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance in the circuit, such
as airway secretions, kinks in the tubing, or the patient biting the endotracheal tube. The
nurse should immediately assess the patient’s breath sounds and suction if necessary to
clear the blockage. Low-pressure alarms, by contrast, are usually caused by leaks or
disconnections in the system.
8. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L.
Which medication is most appropriate for a rapid, temporary shift of potassium into the
cells?
A. Sodium polystyrene sulfonate (Kayexalate)
B. Intravenous insulin and glucose
C. Calcium gluconate
D. Furosemide (Lasix)
Answer: B
Rationale: Intravenous insulin along with glucose is used to rapidly shift potassium from
the extracellular fluid into the intracellular space. While calcium gluconate protects the
heart from the effects of hyperkalemia, it does not actually lower the potassium level itself.
Sodium polystyrene sulfonate is effective for removing potassium from the body but works
much more slowly than insulin.
9. Which assessment finding should the nurse prioritize when caring for a patient with a new
arteriovenous (AV) fistula?
A. Absence of a bruit or thrill
