NSG-430 ADULT HEALTH II EXAM
BUNDLE 2026/2027 | 300 VERIFIED
PRACTICE QUESTIONS & ANSWERS
WITH RATIONALES | GCU NURSING
PREP
1. A patient with systolic heart failure has gained 4 lb in 2 days. Which finding
should the nurse report first?
A. Heart rate 88/min
B. Weight gain of 4 lb in 2 days
C. Urine output 40 mL/hr
D. Unchanged basilar crackles
Answer: B. Rapid weight gain suggests fluid retention and worsening heart failure.
2. ABG: pH 7.28, PaCO₂ 58 mm Hg, HCO₃⁻ 26 mEq/L. What is the interpretation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: B. Low pH with high PaCO₂ indicates respiratory acidosis without metabolic
compensation.
3. A patient has oliguria, BUN/Cr ratio 24:1, urine sodium 14 mEq/L, and FENa
<1%. Which AKI type is most likely?
A. Prerenal
B. Intrarenal
C. Postrenal
D. Chronic
Answer: A. These findings reflect decreased renal perfusion.
4. A patient with DKA has glucose 480 mg/dL, pH 7.20, ketones, and K⁺ 5.8
mEq/L. What is the first priority?
A. Regular insulin IV bolus
B. 0.9% sodium chloride IV infusion
C. Sodium bicarbonate IV
D. Potassium chloride IV
Answer: B. Volume resuscitation with isotonic fluid is the initial priority in DKA.
,5. A patient with ischemic stroke was last known well 2 hours ago; CT is
negative for hemorrhage; BP is 178/98 mm Hg. What should the nurse
anticipate?
A. Alteplase per protocol
B. Immediate aspirin 325 mg
C. Lowering BP to <120/80 first
D. Waiting 24 hours
Answer: A. The patient is within the tPA window with no hemorrhage and acceptable
BP.
6. A patient in septic shock remains hypotensive after 30 mL/kg crystalloid.
Which medication should the nurse anticipate?
A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Insulin
Answer: A. Norepinephrine is a first-line vasopressor for fluid-refractory septic shock.
7. A ventilated patient has a high-pressure alarm. Which cause should the nurse
assess first?
A. Secretions increasing airway resistance
B. Low oxygen supply
C. Disconnected tubing
D. Low tidal volume setting
Answer: A. High-pressure alarms often indicate increased airway resistance or
obstruction.
8. A patient on heparin for 6 days has platelets drop from 250,000 to
80,000/mm³. What is the priority action?
A. Stop heparin and notify the provider
B. Administer platelets
C. Continue heparin and recheck in 24 hours
D. Start warfarin alone
Answer: A. This suggests heparin-induced thrombocytopenia; heparin must be stopped.
9. A postoperative patient’s abdominal wound opens and intestines protrude.
What should the nurse do first?
A. Cover with sterile saline-soaked gauze
B. Reinsert the intestines
C. Have the patient cough
D. Apply a tight binder
Answer: A. Cover evisceration with sterile saline-soaked gauze and notify the surgeon.
,10. A COPD patient has PaCO₂ 58 mm Hg and pH 7.28. What is the priority
action?
A. Assess respiratory status and prepare for noninvasive ventilation
B. Apply high-flow oxygen at 10 L/min
C. Place the patient flat
D. Give a PRN anxiolytic
Answer: A. The patient has respiratory acidosis and needs ventilatory support
assessment.
11. A patient with suspected ACS has no aspirin allergy. What should the nurse
anticipate giving first?
A. Chewed aspirin
B. IV furosemide
C. Oral metoprolol
D. Subcutaneous heparin
Answer: A. Chewed aspirin is given early for suspected ACS unless contraindicated.
12. A patient with STEMI is in a facility without PCI. What is the priority?
A. Arrange rapid reperfusion/transfer
B. Give oral potassium
C. Start antibiotics
D. Encourage ambulation
Answer: A. STEMI requires urgent reperfusion, often transfer for PCI or fibrinolysis.
13. Which finding suggests digoxin toxicity?
A. Yellow-green visual halos
B. Polyuria
C. Hypertension
D. Hyperreflexia
Answer: A. Visual changes, nausea, and dysrhythmias are signs of digoxin toxicity.
14. Which ECG change is associated with hypokalemia?
A. Peaked T waves
B. U waves
C. Wide QRS
D. Prolonged PR only
Answer: B. Hypokalemia may cause U waves, flattened T waves, and dysrhythmias.
15. A patient with hypertensive crisis has chest pain and pulmonary edema.
What is the priority?
A. Rapidly lower BP to normal
B. Assess for target-organ damage and use controlled IV antihypertensives
C. Give oral NSAIDs
D. Encourage fluid intake
, Answer: B. Hypertensive emergency requires controlled BP reduction and treatment of
organ damage.
16. A patient with acute pulmonary edema is anxious, dyspneic, and has
crackles. What position is best?
A. Flat supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Answer: B. High Fowler’s improves ventilation and reduces venous return.
17. Which finding is classic for aortic stenosis?
A. Systolic murmur radiating to the carotids
B. Machinery murmur
C. Pericardial friction rub
D. Pulsus paradoxus
Answer: A. Aortic stenosis causes a systolic ejection murmur radiating to the carotids.
18. A patient with atrial fibrillation is at increased risk for which complication?
A. Stroke
B. Hypoglycemia
C. Renal stones
D. Pneumothorax
Answer: A. AFib increases thrombus formation and stroke risk.
19. A patient receiving IV heparin has a significantly elevated aPTT and
bleeding. What is the priority?
A. Stop heparin and notify the provider
B. Increase heparin
C. Give vitamin K
D. Give platelets
Answer: A. Heparin should be stopped; protamine sulfate may be ordered.
20. A patient on warfarin has an INR of 6.0 and gum bleeding. What should the
nurse anticipate?
A. Vitamin K
B. Protamine sulfate
C. Platelets
D. Heparin
Answer: A. Vitamin K reverses warfarin; severe bleeding may require factor
replacement.
21. During a blood transfusion, the patient develops fever, chills, and flank
pain. What should the nurse do first?
A. Stop the transfusion and maintain IV access
BUNDLE 2026/2027 | 300 VERIFIED
PRACTICE QUESTIONS & ANSWERS
WITH RATIONALES | GCU NURSING
PREP
1. A patient with systolic heart failure has gained 4 lb in 2 days. Which finding
should the nurse report first?
A. Heart rate 88/min
B. Weight gain of 4 lb in 2 days
C. Urine output 40 mL/hr
D. Unchanged basilar crackles
Answer: B. Rapid weight gain suggests fluid retention and worsening heart failure.
2. ABG: pH 7.28, PaCO₂ 58 mm Hg, HCO₃⁻ 26 mEq/L. What is the interpretation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: B. Low pH with high PaCO₂ indicates respiratory acidosis without metabolic
compensation.
3. A patient has oliguria, BUN/Cr ratio 24:1, urine sodium 14 mEq/L, and FENa
<1%. Which AKI type is most likely?
A. Prerenal
B. Intrarenal
C. Postrenal
D. Chronic
Answer: A. These findings reflect decreased renal perfusion.
4. A patient with DKA has glucose 480 mg/dL, pH 7.20, ketones, and K⁺ 5.8
mEq/L. What is the first priority?
A. Regular insulin IV bolus
B. 0.9% sodium chloride IV infusion
C. Sodium bicarbonate IV
D. Potassium chloride IV
Answer: B. Volume resuscitation with isotonic fluid is the initial priority in DKA.
,5. A patient with ischemic stroke was last known well 2 hours ago; CT is
negative for hemorrhage; BP is 178/98 mm Hg. What should the nurse
anticipate?
A. Alteplase per protocol
B. Immediate aspirin 325 mg
C. Lowering BP to <120/80 first
D. Waiting 24 hours
Answer: A. The patient is within the tPA window with no hemorrhage and acceptable
BP.
6. A patient in septic shock remains hypotensive after 30 mL/kg crystalloid.
Which medication should the nurse anticipate?
A. Norepinephrine
B. Furosemide
C. Metoprolol
D. Insulin
Answer: A. Norepinephrine is a first-line vasopressor for fluid-refractory septic shock.
7. A ventilated patient has a high-pressure alarm. Which cause should the nurse
assess first?
A. Secretions increasing airway resistance
B. Low oxygen supply
C. Disconnected tubing
D. Low tidal volume setting
Answer: A. High-pressure alarms often indicate increased airway resistance or
obstruction.
8. A patient on heparin for 6 days has platelets drop from 250,000 to
80,000/mm³. What is the priority action?
A. Stop heparin and notify the provider
B. Administer platelets
C. Continue heparin and recheck in 24 hours
D. Start warfarin alone
Answer: A. This suggests heparin-induced thrombocytopenia; heparin must be stopped.
9. A postoperative patient’s abdominal wound opens and intestines protrude.
What should the nurse do first?
A. Cover with sterile saline-soaked gauze
B. Reinsert the intestines
C. Have the patient cough
D. Apply a tight binder
Answer: A. Cover evisceration with sterile saline-soaked gauze and notify the surgeon.
,10. A COPD patient has PaCO₂ 58 mm Hg and pH 7.28. What is the priority
action?
A. Assess respiratory status and prepare for noninvasive ventilation
B. Apply high-flow oxygen at 10 L/min
C. Place the patient flat
D. Give a PRN anxiolytic
Answer: A. The patient has respiratory acidosis and needs ventilatory support
assessment.
11. A patient with suspected ACS has no aspirin allergy. What should the nurse
anticipate giving first?
A. Chewed aspirin
B. IV furosemide
C. Oral metoprolol
D. Subcutaneous heparin
Answer: A. Chewed aspirin is given early for suspected ACS unless contraindicated.
12. A patient with STEMI is in a facility without PCI. What is the priority?
A. Arrange rapid reperfusion/transfer
B. Give oral potassium
C. Start antibiotics
D. Encourage ambulation
Answer: A. STEMI requires urgent reperfusion, often transfer for PCI or fibrinolysis.
13. Which finding suggests digoxin toxicity?
A. Yellow-green visual halos
B. Polyuria
C. Hypertension
D. Hyperreflexia
Answer: A. Visual changes, nausea, and dysrhythmias are signs of digoxin toxicity.
14. Which ECG change is associated with hypokalemia?
A. Peaked T waves
B. U waves
C. Wide QRS
D. Prolonged PR only
Answer: B. Hypokalemia may cause U waves, flattened T waves, and dysrhythmias.
15. A patient with hypertensive crisis has chest pain and pulmonary edema.
What is the priority?
A. Rapidly lower BP to normal
B. Assess for target-organ damage and use controlled IV antihypertensives
C. Give oral NSAIDs
D. Encourage fluid intake
, Answer: B. Hypertensive emergency requires controlled BP reduction and treatment of
organ damage.
16. A patient with acute pulmonary edema is anxious, dyspneic, and has
crackles. What position is best?
A. Flat supine
B. High Fowler’s
C. Trendelenburg
D. Prone
Answer: B. High Fowler’s improves ventilation and reduces venous return.
17. Which finding is classic for aortic stenosis?
A. Systolic murmur radiating to the carotids
B. Machinery murmur
C. Pericardial friction rub
D. Pulsus paradoxus
Answer: A. Aortic stenosis causes a systolic ejection murmur radiating to the carotids.
18. A patient with atrial fibrillation is at increased risk for which complication?
A. Stroke
B. Hypoglycemia
C. Renal stones
D. Pneumothorax
Answer: A. AFib increases thrombus formation and stroke risk.
19. A patient receiving IV heparin has a significantly elevated aPTT and
bleeding. What is the priority?
A. Stop heparin and notify the provider
B. Increase heparin
C. Give vitamin K
D. Give platelets
Answer: A. Heparin should be stopped; protamine sulfate may be ordered.
20. A patient on warfarin has an INR of 6.0 and gum bleeding. What should the
nurse anticipate?
A. Vitamin K
B. Protamine sulfate
C. Platelets
D. Heparin
Answer: A. Vitamin K reverses warfarin; severe bleeding may require factor
replacement.
21. During a blood transfusion, the patient develops fever, chills, and flank
pain. What should the nurse do first?
A. Stop the transfusion and maintain IV access
