NUR 6130 EXAM 3 COMPREHENSIVE
REVIEW | QUESTIONS 1-100 AND
ANSWERS | 2026/2027 UPDATED |
DETAILED RATIONALES
Study-use note: This is an original practice question bank designed around common
advanced nursing-exam concepts. It is not an official WPU exam, does not reproduce
confidential exam questions, and no score or grade can be guaranteed.
INTRODUCTION
This comprehensive NUR 6130 Exam 3 practice review is designed to challenge
advanced nursing students with clinically oriented, application-based questions. The
questions emphasize assessment, clinical judgment, prioritization, pharmacologic
considerations, pathophysiology, patient safety, evidence-based interventions, and
evaluation of outcomes. Rather than relying primarily on memorization, the scenarios
require you to interpret clinical findings, identify the most appropriate nursing action,
distinguish expected from concerning findings, and select interventions based on
patient-specific priorities. Several questions incorporate competing clinical priorities,
subtle assessment changes, medication considerations, and safety implications similar
to the reasoning required on graduate-level nursing examinations. Each item includes
four answer choices with one best answer, followed by a detailed rationale explaining
both the correct choice and why the alternatives are less appropriate. Use the set as a
study tool to identify knowledge gaps, practice clinical reasoning, and reinforce
connections among assessment, diagnosis, intervention, and evaluation.
CORE DOMAINS TESTED
1.
Advanced Health Assessment — Interpretation of subjective and objective
findings and identification of clinically significant changes.
2.
3.
Pathophysiology — Connecting disease mechanisms with manifestations and
complications.
4.
5.
1
, Pharmacology — Medication effects, adverse reactions, contraindications,
and monitoring.
6.
7.
Clinical Decision-Making — Selecting the safest and most appropriate
intervention.
8.
9.
Prioritization — Applying ABCs, acute-versus-chronic reasoning, and risk
reduction.
10.
11.
Patient Safety — Recognizing deterioration and preventing adverse events.
12.
13.
Evidence-Based Practice — Applying established principles to clinical
scenarios.
14.
15.
Patient Education — Evaluating understanding and tailoring teaching.
16.
17.
Care Coordination — Identifying when escalation, consultation, or
additional evaluation is needed.
18.
19.
Evaluation of Outcomes — Determining whether interventions have
achieved their intended effect.
20.
QUESTIONS 1–100
2
, Q1: A patient with worsening shortness of breath suddenly
becomes restless and develops a respiratory rate of 32/min.
Oxygen saturation has fallen from 95% to 87%. Which action
should the nurse take first?
A) Obtain a complete medication history
B) Assess airway patency and immediately support oxygenation
C) Ask the patient to describe the onset of symptoms
D) Document the change and reassess in 30 minutes
Rationale: B is correct because acute deterioration in oxygenation requires
immediate assessment and stabilization of the airway and breathing. Restlessness can
be an early manifestation of hypoxemia. A may eventually be necessary but is not the
immediate priority. C provides useful history but delays stabilization. D is unsafe
because significant hypoxemia requires immediate intervention rather than delayed
reassessment.
Q2: A patient receiving an opioid analgesic becomes difficult
to arouse and has a respiratory rate of 8/min. What is the
priority nursing action?
A) Administer the next scheduled analgesic later
B) Place the patient in Trendelenburg position
C) Support ventilation and administer the prescribed opioid antagonist when
indicated
D) Encourage oral fluids
Rationale: C is correct because severe opioid-induced respiratory depression is an
emergency requiring airway and ventilatory support and, when ordered/appropriate,
an opioid antagonist such as naloxone. A does not address the existing respiratory
depression. B does not correct hypoventilation. D is inappropriate for a patient with
depressed consciousness and does not treat the cause.
Q3: A patient with diabetes reports diaphoresis, tremors, and
confusion. Which finding most strongly supports hypoglycemia?
A) Polyuria
B) Fruity breath
C) Tachycardia with diaphoresis
D) Deep, rapid respirations
Rationale: C is correct because adrenergic activation during hypoglycemia
commonly produces sweating, tremor, palpitations, and tachycardia. A is more
consistent with hyperglycemia. B may occur with ketosis. D suggests metabolic
acidosis such as diabetic ketoacidosis.
3
REVIEW | QUESTIONS 1-100 AND
ANSWERS | 2026/2027 UPDATED |
DETAILED RATIONALES
Study-use note: This is an original practice question bank designed around common
advanced nursing-exam concepts. It is not an official WPU exam, does not reproduce
confidential exam questions, and no score or grade can be guaranteed.
INTRODUCTION
This comprehensive NUR 6130 Exam 3 practice review is designed to challenge
advanced nursing students with clinically oriented, application-based questions. The
questions emphasize assessment, clinical judgment, prioritization, pharmacologic
considerations, pathophysiology, patient safety, evidence-based interventions, and
evaluation of outcomes. Rather than relying primarily on memorization, the scenarios
require you to interpret clinical findings, identify the most appropriate nursing action,
distinguish expected from concerning findings, and select interventions based on
patient-specific priorities. Several questions incorporate competing clinical priorities,
subtle assessment changes, medication considerations, and safety implications similar
to the reasoning required on graduate-level nursing examinations. Each item includes
four answer choices with one best answer, followed by a detailed rationale explaining
both the correct choice and why the alternatives are less appropriate. Use the set as a
study tool to identify knowledge gaps, practice clinical reasoning, and reinforce
connections among assessment, diagnosis, intervention, and evaluation.
CORE DOMAINS TESTED
1.
Advanced Health Assessment — Interpretation of subjective and objective
findings and identification of clinically significant changes.
2.
3.
Pathophysiology — Connecting disease mechanisms with manifestations and
complications.
4.
5.
1
, Pharmacology — Medication effects, adverse reactions, contraindications,
and monitoring.
6.
7.
Clinical Decision-Making — Selecting the safest and most appropriate
intervention.
8.
9.
Prioritization — Applying ABCs, acute-versus-chronic reasoning, and risk
reduction.
10.
11.
Patient Safety — Recognizing deterioration and preventing adverse events.
12.
13.
Evidence-Based Practice — Applying established principles to clinical
scenarios.
14.
15.
Patient Education — Evaluating understanding and tailoring teaching.
16.
17.
Care Coordination — Identifying when escalation, consultation, or
additional evaluation is needed.
18.
19.
Evaluation of Outcomes — Determining whether interventions have
achieved their intended effect.
20.
QUESTIONS 1–100
2
, Q1: A patient with worsening shortness of breath suddenly
becomes restless and develops a respiratory rate of 32/min.
Oxygen saturation has fallen from 95% to 87%. Which action
should the nurse take first?
A) Obtain a complete medication history
B) Assess airway patency and immediately support oxygenation
C) Ask the patient to describe the onset of symptoms
D) Document the change and reassess in 30 minutes
Rationale: B is correct because acute deterioration in oxygenation requires
immediate assessment and stabilization of the airway and breathing. Restlessness can
be an early manifestation of hypoxemia. A may eventually be necessary but is not the
immediate priority. C provides useful history but delays stabilization. D is unsafe
because significant hypoxemia requires immediate intervention rather than delayed
reassessment.
Q2: A patient receiving an opioid analgesic becomes difficult
to arouse and has a respiratory rate of 8/min. What is the
priority nursing action?
A) Administer the next scheduled analgesic later
B) Place the patient in Trendelenburg position
C) Support ventilation and administer the prescribed opioid antagonist when
indicated
D) Encourage oral fluids
Rationale: C is correct because severe opioid-induced respiratory depression is an
emergency requiring airway and ventilatory support and, when ordered/appropriate,
an opioid antagonist such as naloxone. A does not address the existing respiratory
depression. B does not correct hypoventilation. D is inappropriate for a patient with
depressed consciousness and does not treat the cause.
Q3: A patient with diabetes reports diaphoresis, tremors, and
confusion. Which finding most strongly supports hypoglycemia?
A) Polyuria
B) Fruity breath
C) Tachycardia with diaphoresis
D) Deep, rapid respirations
Rationale: C is correct because adrenergic activation during hypoglycemia
commonly produces sweating, tremor, palpitations, and tachycardia. A is more
consistent with hyperglycemia. B may occur with ketosis. D suggests metabolic
acidosis such as diabetic ketoacidosis.
3