NSG 3800 Exam 2 V3 | NSG 3800 Nursing Practice – Adult Health II |
Actual Q&A with Rationale (NSG3800 Exam 2) | Galen
1. A patient with a history of heart failure presents with increased shortness of breath and
crackles in the lung bases. Which medication should the nurse anticipate administering first?
A. Furosemide
B. Atenolol
C. Digoxin
D. Diltiazem
Answer: A
Rationale: Furosemide is a loop diuretic that helps to rapidly remove excess fluid from the
pulmonary system in patients with heart failure exacerbation. This intervention directly
addresses the patient’s acute symptoms of dyspnea and crackles by reducing preload. The
nurse must monitor the patient’s potassium levels and blood pressure closely after
administration.
2. A nurse is caring for a patient who is in the oliguric phase of acute kidney injury (AKI).
Which electrolyte abnormality is most expected?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase of AKI, the kidneys are unable to excrete potassium
effectively, leading to elevated serum levels. Hyperkalemia is a serious complication that
can result in life-threatening cardiac dysrhythmias if not managed promptly. The nurse
should monitor the ECG for tall, peaked T-waves and avoid potassium-rich foods or
medications.
3. Which clinical manifestation is most characteristic of a patient experiencing an Addisonian
crisis?
A. Hypokalemia and weight gain
B. Hypertension and bradycardia
C. Hyperglycemia and moon face
D. Severe hypotension and tachycardia
,Answer: D
Rationale: An Addisonian crisis is a medical emergency caused by an acute insufficiency of
adrenocortical hormones. It typically manifests as profound hypotension, tachycardia, and
signs of shock due to vascular collapse. Treatment involves immediate administration of
intravenous fluids and high-dose hydrocortisone to stabilize the patient.
4. A patient is diagnosed with Atrial Fibrillation. What is the primary reason the nurse expects
an order for an anticoagulant?
A. To increase the ventricular heart rate
B. To prevent the formation of thrombi in the atria
C. To convert the rhythm back to normal sinus
D. To decrease the blood pressure
Answer: B
Rationale: In Atrial Fibrillation, the atria quiver instead of contracting effectively, which
allows blood to pool and potentially form clots. These clots can travel to the brain and
cause an embolic stroke, making anticoagulation a priority for long-term management.
Common medications used for this purpose include warfarin or direct oral anticoagulants
like apixaban.
5. Which arterial blood gas (ABG) result indicates compensated respiratory acidosis?
A. pH 7.40, PaCO2 40, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.25, PaCO2 60, HCO3 24
D. pH 7.35, PaCO2 50, HCO3 30
Answer: D
Rationale: Compensated respiratory acidosis is identified by a pH within the normal range
but on the acidic side, along with an elevated PaCO2 and an elevated HCO3. The kidneys
compensate for the high CO2 by retaining bicarbonate to bring the pH back toward normal.
In this specific scenario, the pH of 7.35 indicates successful compensation as it is within the
7.35-7.45 range.
6. The nurse is assessing a patient with cirrhosis and notes a flapping tremor of the hands
(asterixis). What lab value is likely elevated?
A. Sodium
B. Bilirubin
C. Calcium
, D. Ammonia
Answer: D
Rationale: Asterixis, or ‘liver flap,’ is a classic sign of hepatic encephalopathy caused by
high levels of ammonia in the blood. Ammonia is a neurotoxin that the failing liver can no
longer convert into urea for excretion. Treatment often includes lactulose to promote the
excretion of ammonia through the stool.
7. A patient with a chest tube has continuous bubbling in the water-seal chamber. What
should the nurse suspect?
A. There is an air leak in the system
B. The lung has fully re-expanded
C. The system is functioning normally
D. The suction setting is too high
Answer: A
Rationale: Continuous bubbling in the water-seal chamber is abnormal and indicates that
air is leaking into the drainage system. The nurse should check all connections and the
insertion site to locate and resolve the leak. Intermittent bubbling is expected during
expiration or coughing, but constant bubbling requires immediate investigation.
8. A patient is receiving Levothyroxine for hypothyroidism. Which finding suggests the dose is
too high?
A. Weight gain and lethargy
B. Insomnia and palpitations
C. Cold intolerance and constipation
D. Bradycardia and dry skin
Answer: B
Rationale: Levothyroxine replaces thyroid hormone, and an overdose can lead to
symptoms of hyperthyroidism. Insomnia, palpitations, tremors, and heat intolerance are
signs that the metabolic rate is overly stimulated. The nurse should report these findings to
the provider so the dosage can be adjusted downward.
9. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of 40 mg/dL.
What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Administer 50% Dextrose (D50) IV push
C. Give a subcutaneous injection of rapid-acting insulin
Actual Q&A with Rationale (NSG3800 Exam 2) | Galen
1. A patient with a history of heart failure presents with increased shortness of breath and
crackles in the lung bases. Which medication should the nurse anticipate administering first?
A. Furosemide
B. Atenolol
C. Digoxin
D. Diltiazem
Answer: A
Rationale: Furosemide is a loop diuretic that helps to rapidly remove excess fluid from the
pulmonary system in patients with heart failure exacerbation. This intervention directly
addresses the patient’s acute symptoms of dyspnea and crackles by reducing preload. The
nurse must monitor the patient’s potassium levels and blood pressure closely after
administration.
2. A nurse is caring for a patient who is in the oliguric phase of acute kidney injury (AKI).
Which electrolyte abnormality is most expected?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Rationale: During the oliguric phase of AKI, the kidneys are unable to excrete potassium
effectively, leading to elevated serum levels. Hyperkalemia is a serious complication that
can result in life-threatening cardiac dysrhythmias if not managed promptly. The nurse
should monitor the ECG for tall, peaked T-waves and avoid potassium-rich foods or
medications.
3. Which clinical manifestation is most characteristic of a patient experiencing an Addisonian
crisis?
A. Hypokalemia and weight gain
B. Hypertension and bradycardia
C. Hyperglycemia and moon face
D. Severe hypotension and tachycardia
,Answer: D
Rationale: An Addisonian crisis is a medical emergency caused by an acute insufficiency of
adrenocortical hormones. It typically manifests as profound hypotension, tachycardia, and
signs of shock due to vascular collapse. Treatment involves immediate administration of
intravenous fluids and high-dose hydrocortisone to stabilize the patient.
4. A patient is diagnosed with Atrial Fibrillation. What is the primary reason the nurse expects
an order for an anticoagulant?
A. To increase the ventricular heart rate
B. To prevent the formation of thrombi in the atria
C. To convert the rhythm back to normal sinus
D. To decrease the blood pressure
Answer: B
Rationale: In Atrial Fibrillation, the atria quiver instead of contracting effectively, which
allows blood to pool and potentially form clots. These clots can travel to the brain and
cause an embolic stroke, making anticoagulation a priority for long-term management.
Common medications used for this purpose include warfarin or direct oral anticoagulants
like apixaban.
5. Which arterial blood gas (ABG) result indicates compensated respiratory acidosis?
A. pH 7.40, PaCO2 40, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.25, PaCO2 60, HCO3 24
D. pH 7.35, PaCO2 50, HCO3 30
Answer: D
Rationale: Compensated respiratory acidosis is identified by a pH within the normal range
but on the acidic side, along with an elevated PaCO2 and an elevated HCO3. The kidneys
compensate for the high CO2 by retaining bicarbonate to bring the pH back toward normal.
In this specific scenario, the pH of 7.35 indicates successful compensation as it is within the
7.35-7.45 range.
6. The nurse is assessing a patient with cirrhosis and notes a flapping tremor of the hands
(asterixis). What lab value is likely elevated?
A. Sodium
B. Bilirubin
C. Calcium
, D. Ammonia
Answer: D
Rationale: Asterixis, or ‘liver flap,’ is a classic sign of hepatic encephalopathy caused by
high levels of ammonia in the blood. Ammonia is a neurotoxin that the failing liver can no
longer convert into urea for excretion. Treatment often includes lactulose to promote the
excretion of ammonia through the stool.
7. A patient with a chest tube has continuous bubbling in the water-seal chamber. What
should the nurse suspect?
A. There is an air leak in the system
B. The lung has fully re-expanded
C. The system is functioning normally
D. The suction setting is too high
Answer: A
Rationale: Continuous bubbling in the water-seal chamber is abnormal and indicates that
air is leaking into the drainage system. The nurse should check all connections and the
insertion site to locate and resolve the leak. Intermittent bubbling is expected during
expiration or coughing, but constant bubbling requires immediate investigation.
8. A patient is receiving Levothyroxine for hypothyroidism. Which finding suggests the dose is
too high?
A. Weight gain and lethargy
B. Insomnia and palpitations
C. Cold intolerance and constipation
D. Bradycardia and dry skin
Answer: B
Rationale: Levothyroxine replaces thyroid hormone, and an overdose can lead to
symptoms of hyperthyroidism. Insomnia, palpitations, tremors, and heat intolerance are
signs that the metabolic rate is overly stimulated. The nurse should report these findings to
the provider so the dosage can be adjusted downward.
9. A patient with Type 1 Diabetes is found unresponsive with a blood glucose of 40 mg/dL.
What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Administer 50% Dextrose (D50) IV push
C. Give a subcutaneous injection of rapid-acting insulin
