NSG 3800 Exam 2 V2 | NSG 3800 Nursing Practice – Adult Health II |
Actual Q&A with Rationale (NSG3800 Exam 2) | Galen
1. A patient is admitted with a diagnosis of sinus bradycardia with a heart rate of 38 bpm. The
patient is symptomatic with dizziness and hypotension. Which medication should the nurse
expect to administer first?
A. Atropine
B. Amiodarone
C. Digoxin
D. Metoprolol
Answer: A
Rationale: Atropine is the first-line medication for symptomatic bradycardia because it
blocks the parasympathetic nervous system and increases the heart rate. The nurse must
monitor the patient for resolution of symptoms and increased heart rate after
administration. If atropine is ineffective, the provider may consider temporary pacing or
dopamine infusions.
2. A nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. Disconnection of the circuit
B. A leak in the cuff
C. Extubation of the patient
D. The patient is biting the tube
Answer: D
Rationale: High-pressure alarms are triggered by increased resistance to air flow, such as
the patient biting the tube, excess secretions, or kinks in the tubing. The nurse should check
the patient first and then assess the equipment for obstruction. Low-pressure alarms are
typically caused by leaks or disconnections in the circuit.
3. A patient with heart failure is receiving Furosemide. Which electrolyte imbalance is the
patient at greatest risk for?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
,Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with sodium and water. Low potassium levels can lead to dangerous cardiac dysrhythmias
and muscle weakness. The nurse must monitor serum potassium levels and often expects a
potassium supplement to be ordered concurrently.
4. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. Computed Tomography Pulmonary Angiography (CTPA)
B. Chest X-ray
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Answer: A
Rationale: CTPA is currently the preferred diagnostic test to confirm the presence of a
pulmonary embolism because it provides high-quality images of the pulmonary
vasculature. D-dimer is often used to rule out PE but is not specific enough to confirm it.
Chest X-rays are useful to rule out other conditions but cannot visualize a clot in the
pulmonary artery.
5. A patient with Acute Kidney Injury (AKI) enters the diuretic phase. What is the nurse’s
priority concern during this phase?
A. Fluid volume deficit and electrolyte imbalance
B. Fluid volume excess
C. Urine output less than 30 mL/hr
D. Development of hypertension
Answer: A
Rationale: In the diuretic phase of AKI, the kidneys begin to recover their ability to excrete
waste but cannot concentrate urine effectively, leading to massive fluid loss. This puts the
patient at significant risk for dehydration and severe electrolyte depletion, especially
potassium and sodium. Frequent monitoring of intake and output, as well as blood
pressure, is essential during this stage.
6. Which clinical manifestation is a hallmark sign of Left-Sided Heart Failure?
A. Jugular venous distention
B. Peripheral edema
C. Pulmonary crackles
, D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure results in blood backing up into the pulmonary
circulation, leading to symptoms like crackles, wheezes, and dyspnea. Right-sided heart
failure typically causes systemic congestion, including peripheral edema and jugular
venous distention. Distinguishing between the two is vital for tailoring nursing
assessments and interventions.
7. A nurse is preparing to administer blood to a patient. Which type of saline solution should
be used to prime the tubing?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in Water (D5W)
Answer: A
Rationale: Only 0.9% Normal Saline is compatible with blood products; other solutions can
cause hemolysis or clotting of the blood. The nurse must use a Y-set tubing with a filter
specifically designed for blood administration. It is critical to follow protocol to ensure
patient safety and prevent transfusion reactions.
8. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Why is it important to maintain the oxygen flow at a low rate (usually 1-2 L/min)?
A. To avoid suppressing the hypoxic drive to breathe
B. To prevent drying of the nasal mucosa
C. To prevent oxygen toxicity
D. Because high flow oxygen causes metabolic acidosis
Answer: A
Rationale: In some chronic COPD patients, the respiratory center becomes insensitive to
high CO2 levels, and breathing is stimulated by low oxygen levels (hypoxic drive).
Administering too much oxygen can increase the PaO2 and potentially stop the stimulus to
breathe, leading to respiratory arrest. Nurses must titrate oxygen to maintain target
saturation without over-oxygenating.
9. A patient is taking Digoxin 0.125 mg daily. Which symptom should the nurse educate the
patient to report as a possible sign of toxicity?
A. Increased appetite
B. Dry cough
Actual Q&A with Rationale (NSG3800 Exam 2) | Galen
1. A patient is admitted with a diagnosis of sinus bradycardia with a heart rate of 38 bpm. The
patient is symptomatic with dizziness and hypotension. Which medication should the nurse
expect to administer first?
A. Atropine
B. Amiodarone
C. Digoxin
D. Metoprolol
Answer: A
Rationale: Atropine is the first-line medication for symptomatic bradycardia because it
blocks the parasympathetic nervous system and increases the heart rate. The nurse must
monitor the patient for resolution of symptoms and increased heart rate after
administration. If atropine is ineffective, the provider may consider temporary pacing or
dopamine infusions.
2. A nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. Disconnection of the circuit
B. A leak in the cuff
C. Extubation of the patient
D. The patient is biting the tube
Answer: D
Rationale: High-pressure alarms are triggered by increased resistance to air flow, such as
the patient biting the tube, excess secretions, or kinks in the tubing. The nurse should check
the patient first and then assess the equipment for obstruction. Low-pressure alarms are
typically caused by leaks or disconnections in the circuit.
3. A patient with heart failure is receiving Furosemide. Which electrolyte imbalance is the
patient at greatest risk for?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
,Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with sodium and water. Low potassium levels can lead to dangerous cardiac dysrhythmias
and muscle weakness. The nurse must monitor serum potassium levels and often expects a
potassium supplement to be ordered concurrently.
4. A patient is suspected of having a Pulmonary Embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. Computed Tomography Pulmonary Angiography (CTPA)
B. Chest X-ray
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Answer: A
Rationale: CTPA is currently the preferred diagnostic test to confirm the presence of a
pulmonary embolism because it provides high-quality images of the pulmonary
vasculature. D-dimer is often used to rule out PE but is not specific enough to confirm it.
Chest X-rays are useful to rule out other conditions but cannot visualize a clot in the
pulmonary artery.
5. A patient with Acute Kidney Injury (AKI) enters the diuretic phase. What is the nurse’s
priority concern during this phase?
A. Fluid volume deficit and electrolyte imbalance
B. Fluid volume excess
C. Urine output less than 30 mL/hr
D. Development of hypertension
Answer: A
Rationale: In the diuretic phase of AKI, the kidneys begin to recover their ability to excrete
waste but cannot concentrate urine effectively, leading to massive fluid loss. This puts the
patient at significant risk for dehydration and severe electrolyte depletion, especially
potassium and sodium. Frequent monitoring of intake and output, as well as blood
pressure, is essential during this stage.
6. Which clinical manifestation is a hallmark sign of Left-Sided Heart Failure?
A. Jugular venous distention
B. Peripheral edema
C. Pulmonary crackles
, D. Hepatomegaly
Answer: C
Rationale: Left-sided heart failure results in blood backing up into the pulmonary
circulation, leading to symptoms like crackles, wheezes, and dyspnea. Right-sided heart
failure typically causes systemic congestion, including peripheral edema and jugular
venous distention. Distinguishing between the two is vital for tailoring nursing
assessments and interventions.
7. A nurse is preparing to administer blood to a patient. Which type of saline solution should
be used to prime the tubing?
A. 0.9% Normal Saline
B. 0.45% Normal Saline
C. Lactated Ringer’s
D. 5% Dextrose in Water (D5W)
Answer: A
Rationale: Only 0.9% Normal Saline is compatible with blood products; other solutions can
cause hemolysis or clotting of the blood. The nurse must use a Y-set tubing with a filter
specifically designed for blood administration. It is critical to follow protocol to ensure
patient safety and prevent transfusion reactions.
8. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. Why is it important to maintain the oxygen flow at a low rate (usually 1-2 L/min)?
A. To avoid suppressing the hypoxic drive to breathe
B. To prevent drying of the nasal mucosa
C. To prevent oxygen toxicity
D. Because high flow oxygen causes metabolic acidosis
Answer: A
Rationale: In some chronic COPD patients, the respiratory center becomes insensitive to
high CO2 levels, and breathing is stimulated by low oxygen levels (hypoxic drive).
Administering too much oxygen can increase the PaO2 and potentially stop the stimulus to
breathe, leading to respiratory arrest. Nurses must titrate oxygen to maintain target
saturation without over-oxygenating.
9. A patient is taking Digoxin 0.125 mg daily. Which symptom should the nurse educate the
patient to report as a possible sign of toxicity?
A. Increased appetite
B. Dry cough
