Galen NSG 3130 Exam 4 | Fundamental Concepts & Skills for
Nursing Practice II (2026) Actual Q&A PDF
1. Which statement best describes the primary purpose of a nurse using evidence-based
practice (EBP) when providing patient care?
A) To follow traditional nursing routines passed down through generations
B) To integrate the best available research evidence with clinical expertise and patient
preferences
C) To reduce the cost of healthcare by limiting unnecessary interventions
D) To ensure that all patients receive identical treatment protocols
Correct Answer: To integrate the best available research evidence with clinical expertise and
patient preferences
Rationale: Evidence-based practice integrates the best available research evidence with clinical
expertise and patient values and preferences to guide nursing care. It does not rely on tradition,
focuses on quality rather than cost reduction, and emphasizes individualized care rather than
identical protocols for all patients.
2. Which action by the nurse best demonstrates the ethical principle of beneficence?
A) Respecting a patient's right to refuse treatment
B) Providing honest information about a medical error
,C) Taking positive actions to help others and promote their well-being
D) Treating all patients fairly and without discrimination
Correct Answer: Taking positive actions to help others and promote their well-being
Rationale: Beneficence is the ethical principle that requires nurses to take positive actions to
help others and promote good. Respecting a patient's right to refuse treatment is autonomy,
providing honest information is fidelity, and treating all patients fairly is justice.
3. A nurse is reviewing a patient's arterial blood gas results: pH 7.28, PaCO2 55 mm Hg, HCO3 24
mEq/L. How should the nurse interpret these results?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Uncompensated respiratory alkalosis
Correct Answer: Uncompensated respiratory acidosis
Rationale: The low pH indicates acidosis, and the elevated PaCO2 above 45 mm Hg indicates a
respiratory cause. The HCO3 is within normal limits, indicating no metabolic compensation. This
pattern is consistent with uncompensated respiratory acidosis, often caused by hypoventilation.
,4. A client with a new tracheostomy requires tracheostomy tie replacement. Which action is
most important to prevent accidental decannulation?
A) Have a second nurse hold the tracheostomy tube securely during the tie change
B) Ask the client to hold the tube while the ties are replaced
C) Remove the inner cannula before changing the ties
D) Position the client flat and instruct them not to move
Correct Answer: Have a second nurse hold the tracheostomy tube securely during the tie
change
Rationale: Accidental decannulation is a life-threatening emergency. A second nurse stabilizes
the tracheostomy tube while the ties are changed, preventing dislodgement if the client coughs
or moves. The client cannot reliably hold the tube, and removing the inner cannula or
positioning flat does not secure the airway.
5. A nurse is preparing to suction an adult client's nasopharyngeal airway. Which intervention
best prevents hypoxia during the procedure?
A) Limit suctioning to 30 seconds per pass
B) Hyperoxygenate the client with 100% oxygen before and after suctioning
C) Apply a water-soluble lubricant to the catheter
, D) Use clean technique instead of sterile technique
Correct Answer: Hyperoxygenate the client with 100% oxygen before and after suctioning
Rationale: Hyperoxygenation before and after suctioning prevents hypoxia, a common
complication of airway suctioning. Suctioning should be limited to 10 to 15 seconds per pass.
Lubricant eases insertion but does not prevent hypoxia. Sterile technique is required to reduce
infection risk.
6. A client with a chest tube develops new subcutaneous emphysema around the insertion site.
What is the priority nursing action?
A) Clamp the chest tube near the insertion site
B) Administer the prescribed analgesic
C) Notify the healthcare provider immediately
D) Reposition the client onto the unaffected side
Correct Answer: Notify the healthcare provider immediately
Rationale: Subcutaneous emphysema indicates air leaking into tissues and may signal chest tube
malfunction or a new air leak. The provider must be notified immediately for evaluation.
Clamping can cause tension pneumothorax and is contraindicated. Analgesics and repositioning
do not address the underlying problem.
7. What is the primary distinction between palliative care and hospice care for a patient with a
serious illness?
Nursing Practice II (2026) Actual Q&A PDF
1. Which statement best describes the primary purpose of a nurse using evidence-based
practice (EBP) when providing patient care?
A) To follow traditional nursing routines passed down through generations
B) To integrate the best available research evidence with clinical expertise and patient
preferences
C) To reduce the cost of healthcare by limiting unnecessary interventions
D) To ensure that all patients receive identical treatment protocols
Correct Answer: To integrate the best available research evidence with clinical expertise and
patient preferences
Rationale: Evidence-based practice integrates the best available research evidence with clinical
expertise and patient values and preferences to guide nursing care. It does not rely on tradition,
focuses on quality rather than cost reduction, and emphasizes individualized care rather than
identical protocols for all patients.
2. Which action by the nurse best demonstrates the ethical principle of beneficence?
A) Respecting a patient's right to refuse treatment
B) Providing honest information about a medical error
,C) Taking positive actions to help others and promote their well-being
D) Treating all patients fairly and without discrimination
Correct Answer: Taking positive actions to help others and promote their well-being
Rationale: Beneficence is the ethical principle that requires nurses to take positive actions to
help others and promote good. Respecting a patient's right to refuse treatment is autonomy,
providing honest information is fidelity, and treating all patients fairly is justice.
3. A nurse is reviewing a patient's arterial blood gas results: pH 7.28, PaCO2 55 mm Hg, HCO3 24
mEq/L. How should the nurse interpret these results?
A) Metabolic acidosis
B) Respiratory alkalosis
C) Uncompensated respiratory acidosis
D) Uncompensated respiratory alkalosis
Correct Answer: Uncompensated respiratory acidosis
Rationale: The low pH indicates acidosis, and the elevated PaCO2 above 45 mm Hg indicates a
respiratory cause. The HCO3 is within normal limits, indicating no metabolic compensation. This
pattern is consistent with uncompensated respiratory acidosis, often caused by hypoventilation.
,4. A client with a new tracheostomy requires tracheostomy tie replacement. Which action is
most important to prevent accidental decannulation?
A) Have a second nurse hold the tracheostomy tube securely during the tie change
B) Ask the client to hold the tube while the ties are replaced
C) Remove the inner cannula before changing the ties
D) Position the client flat and instruct them not to move
Correct Answer: Have a second nurse hold the tracheostomy tube securely during the tie
change
Rationale: Accidental decannulation is a life-threatening emergency. A second nurse stabilizes
the tracheostomy tube while the ties are changed, preventing dislodgement if the client coughs
or moves. The client cannot reliably hold the tube, and removing the inner cannula or
positioning flat does not secure the airway.
5. A nurse is preparing to suction an adult client's nasopharyngeal airway. Which intervention
best prevents hypoxia during the procedure?
A) Limit suctioning to 30 seconds per pass
B) Hyperoxygenate the client with 100% oxygen before and after suctioning
C) Apply a water-soluble lubricant to the catheter
, D) Use clean technique instead of sterile technique
Correct Answer: Hyperoxygenate the client with 100% oxygen before and after suctioning
Rationale: Hyperoxygenation before and after suctioning prevents hypoxia, a common
complication of airway suctioning. Suctioning should be limited to 10 to 15 seconds per pass.
Lubricant eases insertion but does not prevent hypoxia. Sterile technique is required to reduce
infection risk.
6. A client with a chest tube develops new subcutaneous emphysema around the insertion site.
What is the priority nursing action?
A) Clamp the chest tube near the insertion site
B) Administer the prescribed analgesic
C) Notify the healthcare provider immediately
D) Reposition the client onto the unaffected side
Correct Answer: Notify the healthcare provider immediately
Rationale: Subcutaneous emphysema indicates air leaking into tissues and may signal chest tube
malfunction or a new air leak. The provider must be notified immediately for evaluation.
Clamping can cause tension pneumothorax and is contraindicated. Analgesics and repositioning
do not address the underlying problem.
7. What is the primary distinction between palliative care and hospice care for a patient with a
serious illness?
