NSG 6020 3P 2026/2027 | ADVANCED NURSING 3P
EXAM STUDY GUIDE, PRACTICE QUESTIONS &
ANSWERS, PATHOPHYSIOLOGY, PHARMACOLOGY &
PHYSICAL ASSESSMENT REVIEW
1. A client presents with a blood pressure of 88/54 mmHg. Which
assessment finding would the nurse expect?
A. Flushed skin
B. Dizziness and fatigue
C. Bounding pulses
D. Hypertension
CORRECT ANSWER: B
Rationale: A blood pressure of 88/54 mmHg indicates hypotension.
Common symptoms include dizziness, fatigue, lightheadedness, and
possibly syncope due to inadequate perfusion to the brain and other
organs.
2. Which medication is a loop diuretic?
A. Spironolactone
B. Hydrochlorothiazide
C. Furosemide
D. Mannitol
CORRECT ANSWER: C
Rationale: Furosemide is a loop diuretic that acts on the ascending loop
of Henle to inhibit sodium and chloride reabsorption. Spironolactone is
,a potassium-sparing diuretic, and hydrochlorothiazide is a thiazide
diuretic.
3. The primary pathophysiological defect in Type 1 diabetes mellitus
is:
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production
D. Decreased renal glucose threshold
CORRECT ANSWER: B
Rationale: Type 1 diabetes is an autoimmune disease characterized by
the destruction of insulin-producing beta cells in the pancreas, leading
to absolute insulin deficiency.
4. When assessing a client for jugular venous distention (JVD), at what
angle should the head of the bed be elevated?
A. 15 degrees
B. 30 degrees
C. 45 degrees
D. 90 degrees
CORRECT ANSWER: C
Rationale: To assess for JVD, the client should be positioned supine with
the head of the bed elevated to 30 to 45 degrees. The internal jugular
vein is assessed for pulsations, which should normally be less than 3 cm
above the sternal angle.
5. A client is taking warfarin and has an INR of 5.5. Which action
should the nurse anticipate?
A. Administer Vitamin K
B. Administer Protamine sulfate
,C. Increase the warfarin dose
D. Continue the current dose
CORRECT ANSWER: A
Rationale: An INR of 5.5 is supratherapeutic and indicates a high risk of
bleeding. The antidote for warfarin is Vitamin K (phytonadione).
Protamine sulfate is the antidote for heparin.
6. Which type of hypersensitivity reaction is responsible for
anaphylaxis?
A. Type I (IgE-mediated)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Cell-mediated)
CORRECT ANSWER: A
Rationale: Anaphylaxis is a severe, immediate Type I hypersensitivity
reaction mediated by IgE antibodies binding to mast cells and basophils,
triggering the release of histamine and other vasoactive mediators.
7. Which medication is the antidote for an opioid overdose?
A. Flumazenil
B. Naloxone
C. Acetylcysteine
D. Atropine
CORRECT ANSWER: B
Rationale: Naloxone is an opioid antagonist that rapidly reverses the
effects of opioid overdose, including respiratory depression. Flumazenil
is for benzodiazepine overdose, and acetylcysteine is for
acetaminophen overdose.
, 8. Which diagnostic test is the preferred initial imaging study for a
suspected acute ischemic stroke?
A. MRI
B. CT scan without contrast
C. Carotid ultrasound
D. PET scan
CORRECT ANSWER: B
Rationale: A non-contrast CT scan of the head is the preferred initial
imaging study for suspected acute stroke because it is fast and can
quickly rule out hemorrhagic stroke, which is essential before
administering thrombolytic therapy.
9. A client with chronic obstructive pulmonary disease (COPD)
experiences air trapping. Which pathophysiological change best
explains this?
A. Increased elastic recoil of the lungs
B. Destruction of alveolar walls and loss of radial traction
C. Thickening of the pleural space
D. Bronchial smooth muscle hypertrophy
CORRECT ANSWER: B
Rationale: In COPD (specifically emphysema), the destruction of
alveolar walls decreases radial traction, which normally keeps small
airways open during expiration. This leads to airway collapse and air
trapping.
10. Which medication is used to reverse the effects of benzodiazepine
overdose?
A. Naloxone
B. Flumazenil
C. Atropine
EXAM STUDY GUIDE, PRACTICE QUESTIONS &
ANSWERS, PATHOPHYSIOLOGY, PHARMACOLOGY &
PHYSICAL ASSESSMENT REVIEW
1. A client presents with a blood pressure of 88/54 mmHg. Which
assessment finding would the nurse expect?
A. Flushed skin
B. Dizziness and fatigue
C. Bounding pulses
D. Hypertension
CORRECT ANSWER: B
Rationale: A blood pressure of 88/54 mmHg indicates hypotension.
Common symptoms include dizziness, fatigue, lightheadedness, and
possibly syncope due to inadequate perfusion to the brain and other
organs.
2. Which medication is a loop diuretic?
A. Spironolactone
B. Hydrochlorothiazide
C. Furosemide
D. Mannitol
CORRECT ANSWER: C
Rationale: Furosemide is a loop diuretic that acts on the ascending loop
of Henle to inhibit sodium and chloride reabsorption. Spironolactone is
,a potassium-sparing diuretic, and hydrochlorothiazide is a thiazide
diuretic.
3. The primary pathophysiological defect in Type 1 diabetes mellitus
is:
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells
C. Excessive glucagon production
D. Decreased renal glucose threshold
CORRECT ANSWER: B
Rationale: Type 1 diabetes is an autoimmune disease characterized by
the destruction of insulin-producing beta cells in the pancreas, leading
to absolute insulin deficiency.
4. When assessing a client for jugular venous distention (JVD), at what
angle should the head of the bed be elevated?
A. 15 degrees
B. 30 degrees
C. 45 degrees
D. 90 degrees
CORRECT ANSWER: C
Rationale: To assess for JVD, the client should be positioned supine with
the head of the bed elevated to 30 to 45 degrees. The internal jugular
vein is assessed for pulsations, which should normally be less than 3 cm
above the sternal angle.
5. A client is taking warfarin and has an INR of 5.5. Which action
should the nurse anticipate?
A. Administer Vitamin K
B. Administer Protamine sulfate
,C. Increase the warfarin dose
D. Continue the current dose
CORRECT ANSWER: A
Rationale: An INR of 5.5 is supratherapeutic and indicates a high risk of
bleeding. The antidote for warfarin is Vitamin K (phytonadione).
Protamine sulfate is the antidote for heparin.
6. Which type of hypersensitivity reaction is responsible for
anaphylaxis?
A. Type I (IgE-mediated)
B. Type II (Cytotoxic)
C. Type III (Immune complex)
D. Type IV (Cell-mediated)
CORRECT ANSWER: A
Rationale: Anaphylaxis is a severe, immediate Type I hypersensitivity
reaction mediated by IgE antibodies binding to mast cells and basophils,
triggering the release of histamine and other vasoactive mediators.
7. Which medication is the antidote for an opioid overdose?
A. Flumazenil
B. Naloxone
C. Acetylcysteine
D. Atropine
CORRECT ANSWER: B
Rationale: Naloxone is an opioid antagonist that rapidly reverses the
effects of opioid overdose, including respiratory depression. Flumazenil
is for benzodiazepine overdose, and acetylcysteine is for
acetaminophen overdose.
, 8. Which diagnostic test is the preferred initial imaging study for a
suspected acute ischemic stroke?
A. MRI
B. CT scan without contrast
C. Carotid ultrasound
D. PET scan
CORRECT ANSWER: B
Rationale: A non-contrast CT scan of the head is the preferred initial
imaging study for suspected acute stroke because it is fast and can
quickly rule out hemorrhagic stroke, which is essential before
administering thrombolytic therapy.
9. A client with chronic obstructive pulmonary disease (COPD)
experiences air trapping. Which pathophysiological change best
explains this?
A. Increased elastic recoil of the lungs
B. Destruction of alveolar walls and loss of radial traction
C. Thickening of the pleural space
D. Bronchial smooth muscle hypertrophy
CORRECT ANSWER: B
Rationale: In COPD (specifically emphysema), the destruction of
alveolar walls decreases radial traction, which normally keeps small
airways open during expiration. This leads to airway collapse and air
trapping.
10. Which medication is used to reverse the effects of benzodiazepine
overdose?
A. Naloxone
B. Flumazenil
C. Atropine
