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NSG 430 Adult Health Nursing II — Exam 1 Practice Questions
Complete (Verified Updated!!!! 2026–2027)
Exam 1 Blueprint Coverage:
• Topic 1: Care of the Unstable Adult
• Topic 2: Palliative & End-of-Life Care
• Topic 3: Acute Endocrine Disorders (DKA, HHS, SIADH, DI, thyroid storm,
Addisonian crisis)
• Topic 4: Acute Respiratory Disorders (acute respiratory failure, lung
cancer, chest tube management, mechanical ventilation)
SECTION 1: PALLIATIVE CARE & END-OF-LIFE (Questions)
1. A nurse is caring for a patient with end-stage heart failure.
The patient asks, "What is the difference between palliative
care and hospice care?" Which response by the nurse is most
accurate?
A) "Palliative care is only for patients who are actively dying,
while hospice care is for patients with chronic illness."
B) "Palliative care focuses on comfort and quality of life at any
stage of illness, while hospice care is specifically for patients
with a life expectancy of 6 months or less."
C) "Hospice care is provided in the hospital only, while palliative
care is provided at home."
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D) "There is no difference between palliative care and hospice
care."
Correct Answer: B
Rationale: Palliative care is a multidisciplinary approach that
focuses on symptom management, comfort, and quality of life
for patients at any stage of a serious illness, regardless of
prognosis. Hospice care is a specific type of palliative care
provided to patients with a life expectancy of 6 months or less,
often focused on comfort at the end of life rather than curative
treatment. Option A is incorrect because palliative care is not
limited to actively dying patients. Option C is incorrect because
both can be provided in various settings. Option D is incorrect
because while related, they are distinct.
2. A patient with terminal cancer is receiving morphine for
severe pain. The patient's respiratory rate drops to 8
breaths/min. What is the priority nursing action?
A) Administer naloxone immediately
B) Stop the morphine infusion and notify the provider
C) Place the patient in Trendelenburg position
D) Encourage the patient to take deep breaths
Correct Answer: B
Rationale: The priority is to discontinue the morphine infusion
(or hold the next dose) and notify the provider. Naloxone (A)
may be used if respiratory depression is severe, but it is not the
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first action; it can also reverse analgesia, causing increased
pain. Trendelenburg position (C) is not appropriate and may
worsen respiratory effort. Encouraging deep breaths (D) is
insufficient. The nurse should assess the patient, support
breathing, and prepare to administer naloxone if ordered.
3. A patient with end-stage COPD is receiving hospice care. The
family asks the nurse, "Why is my father so restless and
confused?" The nurse's best response is:
A) "This is a normal part of the dying process caused by
decreased oxygen and metabolic changes."
B) "He is probably just tired and needs more sleep."
C) "This means he is getting better and should be discharged
soon."
D) "I will call the doctor to increase his oxygen; confusion
always means low oxygen."
Correct Answer: A
Rationale: Restlessness and confusion are common
manifestations of the dying process caused by cerebral hypoxia,
metabolic changes, and accumulation of toxins. The nurse
should educate the family that these changes are expected and
provide comfort measures. Simply attributing it to fatigue (B)
dismisses the family's concern. Falsely suggesting improvement
(C) is inappropriate. While hypoxia can cause confusion, it is not
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the only cause, and increasing oxygen indiscriminately can be
harmful in COPD patients with chronic CO₂ retention (D).
4. A nurse is assessing a patient who is actively dying. Which
respiratory pattern is most commonly observed in the final
hours of life?
A) Kussmaul respirations
B) Biot's respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: C
Rationale: Cheyne-Stokes respirations, characterized by
alternating periods of deep, rapid breathing followed by apnea,
are a common end-of-life respiratory pattern as the brainstem
begins to fail. Kussmaul respirations are deep, rapid breaths
seen in metabolic acidosis. Biot's respirations are irregular
clusters of breaths. Apneustic breathing is a pattern of
prolonged inspiratory gasps.
5. A patient with a terminal illness has a Do Not Resuscitate
(DNR) order. The patient becomes unresponsive and stops
breathing. What is the nurse's priority action?
A) Begin chest compressions
B) Call a code blue
NSG 430 Adult Health Nursing II — Exam 1 Practice Questions
Complete (Verified Updated!!!! 2026–2027)
Exam 1 Blueprint Coverage:
• Topic 1: Care of the Unstable Adult
• Topic 2: Palliative & End-of-Life Care
• Topic 3: Acute Endocrine Disorders (DKA, HHS, SIADH, DI, thyroid storm,
Addisonian crisis)
• Topic 4: Acute Respiratory Disorders (acute respiratory failure, lung
cancer, chest tube management, mechanical ventilation)
SECTION 1: PALLIATIVE CARE & END-OF-LIFE (Questions)
1. A nurse is caring for a patient with end-stage heart failure.
The patient asks, "What is the difference between palliative
care and hospice care?" Which response by the nurse is most
accurate?
A) "Palliative care is only for patients who are actively dying,
while hospice care is for patients with chronic illness."
B) "Palliative care focuses on comfort and quality of life at any
stage of illness, while hospice care is specifically for patients
with a life expectancy of 6 months or less."
C) "Hospice care is provided in the hospital only, while palliative
care is provided at home."
, Page |2
D) "There is no difference between palliative care and hospice
care."
Correct Answer: B
Rationale: Palliative care is a multidisciplinary approach that
focuses on symptom management, comfort, and quality of life
for patients at any stage of a serious illness, regardless of
prognosis. Hospice care is a specific type of palliative care
provided to patients with a life expectancy of 6 months or less,
often focused on comfort at the end of life rather than curative
treatment. Option A is incorrect because palliative care is not
limited to actively dying patients. Option C is incorrect because
both can be provided in various settings. Option D is incorrect
because while related, they are distinct.
2. A patient with terminal cancer is receiving morphine for
severe pain. The patient's respiratory rate drops to 8
breaths/min. What is the priority nursing action?
A) Administer naloxone immediately
B) Stop the morphine infusion and notify the provider
C) Place the patient in Trendelenburg position
D) Encourage the patient to take deep breaths
Correct Answer: B
Rationale: The priority is to discontinue the morphine infusion
(or hold the next dose) and notify the provider. Naloxone (A)
may be used if respiratory depression is severe, but it is not the
, Page |3
first action; it can also reverse analgesia, causing increased
pain. Trendelenburg position (C) is not appropriate and may
worsen respiratory effort. Encouraging deep breaths (D) is
insufficient. The nurse should assess the patient, support
breathing, and prepare to administer naloxone if ordered.
3. A patient with end-stage COPD is receiving hospice care. The
family asks the nurse, "Why is my father so restless and
confused?" The nurse's best response is:
A) "This is a normal part of the dying process caused by
decreased oxygen and metabolic changes."
B) "He is probably just tired and needs more sleep."
C) "This means he is getting better and should be discharged
soon."
D) "I will call the doctor to increase his oxygen; confusion
always means low oxygen."
Correct Answer: A
Rationale: Restlessness and confusion are common
manifestations of the dying process caused by cerebral hypoxia,
metabolic changes, and accumulation of toxins. The nurse
should educate the family that these changes are expected and
provide comfort measures. Simply attributing it to fatigue (B)
dismisses the family's concern. Falsely suggesting improvement
(C) is inappropriate. While hypoxia can cause confusion, it is not
, Page |4
the only cause, and increasing oxygen indiscriminately can be
harmful in COPD patients with chronic CO₂ retention (D).
4. A nurse is assessing a patient who is actively dying. Which
respiratory pattern is most commonly observed in the final
hours of life?
A) Kussmaul respirations
B) Biot's respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: C
Rationale: Cheyne-Stokes respirations, characterized by
alternating periods of deep, rapid breathing followed by apnea,
are a common end-of-life respiratory pattern as the brainstem
begins to fail. Kussmaul respirations are deep, rapid breaths
seen in metabolic acidosis. Biot's respirations are irregular
clusters of breaths. Apneustic breathing is a pattern of
prolonged inspiratory gasps.
5. A patient with a terminal illness has a Do Not Resuscitate
(DNR) order. The patient becomes unresponsive and stops
breathing. What is the nurse's priority action?
A) Begin chest compressions
B) Call a code blue
