NRSG 3420 NRSG3420 Ultimate Final Exam QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025 Northeastern
University
The questions cover a summary-level mix of topics typically found in advanced med-surg nursing, critical
care, and complex adult health, which is common for NRSG 3420
1. A patient with chronic heart failure has an ejection fraction of 35%. Which
medication should the nurse anticipate administering to improve cardiac
contractility?
Digoxin
Digoxin increases the force of myocardial contraction, which helps improve
cardiac output in patients with low ejection fraction.
2. A patient is admitted with status asthmaticus. Which intervention should
the nurse implement first?
Administer a short-acting beta-agonist (albuterol)
A rapid-acting bronchodilator should be given immediately to open the airways
and improve oxygenation.
3. A patient with cirrhosis is at risk for hepatic encephalopathy. Which lab
value should the nurse monitor closely?
,Ammonia
Elevated ammonia levels can lead to changes in mental status and are indicative
of worsening hepatic encephalopathy.
4. The nurse assesses a patient with a chest tube and notes continuous
bubbling in the water-seal chamber. What does this indicate?
There is an air leak
Continuous bubbling suggests air is entering the system, which can be due to a
leak that must be identified and corrected.
5. Which dietary instruction is most appropriate for a patient with chronic
kidney disease (CKD)?
Limit protein intake
Protein restriction helps reduce the buildup of nitrogenous waste products in
CKD.
6. A patient with a mechanical valve replacement must take which medication
for life?
Warfarin
Patients with mechanical valves require lifelong anticoagulation to prevent
thrombus formation.
, 7. A nurse is caring for a patient with SIADH. Which electrolyte imbalance
should be anticipated?
Hyponatremia
SIADH causes excess water retention, diluting serum sodium and leading to
hyponatremia.
8. Which assessment finding requires immediate intervention in a patient
with a thyroidectomy?
Stridor
Stridor indicates airway obstruction, possibly due to laryngeal edema or
hypocalcemia-induced laryngospasm.
9. Which medication is contraindicated in a patient with peptic ulcer disease?
Ibuprofen
NSAIDs can exacerbate ulcers by inhibiting prostaglandin synthesis, increasing
gastric acid secretion.
10.Which lab value indicates that heparin therapy is effective?
aPTT is 1.5–2.5 times the control
This therapeutic range shows adequate anticoagulation for patients on heparin.
, 11.The nurse prepares to administer rapid IV potassium chloride. What action
is correct?
Clarify the order
Potassium chloride should never be given IV push because it can cause fatal
arrhythmias.
12.Which complication should the nurse monitor for after a paracentesis?
Hypotension
Rapid removal of fluid can cause vascular volume shifts leading to hypotension.
13.Which symptom is most indicative of digoxin toxicity?
Visual disturbances
Blurred or yellow vision is a classic sign of digoxin toxicity.
14.A patient with DKA has K+ of 5.8 mEq/L. What should the nurse do?
Administer insulin as ordered
Insulin shifts potassium into cells, helping lower elevated serum potassium in
DKA.
15.Which finding in a burn patient requires immediate action?
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025 Northeastern
University
The questions cover a summary-level mix of topics typically found in advanced med-surg nursing, critical
care, and complex adult health, which is common for NRSG 3420
1. A patient with chronic heart failure has an ejection fraction of 35%. Which
medication should the nurse anticipate administering to improve cardiac
contractility?
Digoxin
Digoxin increases the force of myocardial contraction, which helps improve
cardiac output in patients with low ejection fraction.
2. A patient is admitted with status asthmaticus. Which intervention should
the nurse implement first?
Administer a short-acting beta-agonist (albuterol)
A rapid-acting bronchodilator should be given immediately to open the airways
and improve oxygenation.
3. A patient with cirrhosis is at risk for hepatic encephalopathy. Which lab
value should the nurse monitor closely?
,Ammonia
Elevated ammonia levels can lead to changes in mental status and are indicative
of worsening hepatic encephalopathy.
4. The nurse assesses a patient with a chest tube and notes continuous
bubbling in the water-seal chamber. What does this indicate?
There is an air leak
Continuous bubbling suggests air is entering the system, which can be due to a
leak that must be identified and corrected.
5. Which dietary instruction is most appropriate for a patient with chronic
kidney disease (CKD)?
Limit protein intake
Protein restriction helps reduce the buildup of nitrogenous waste products in
CKD.
6. A patient with a mechanical valve replacement must take which medication
for life?
Warfarin
Patients with mechanical valves require lifelong anticoagulation to prevent
thrombus formation.
, 7. A nurse is caring for a patient with SIADH. Which electrolyte imbalance
should be anticipated?
Hyponatremia
SIADH causes excess water retention, diluting serum sodium and leading to
hyponatremia.
8. Which assessment finding requires immediate intervention in a patient
with a thyroidectomy?
Stridor
Stridor indicates airway obstruction, possibly due to laryngeal edema or
hypocalcemia-induced laryngospasm.
9. Which medication is contraindicated in a patient with peptic ulcer disease?
Ibuprofen
NSAIDs can exacerbate ulcers by inhibiting prostaglandin synthesis, increasing
gastric acid secretion.
10.Which lab value indicates that heparin therapy is effective?
aPTT is 1.5–2.5 times the control
This therapeutic range shows adequate anticoagulation for patients on heparin.
, 11.The nurse prepares to administer rapid IV potassium chloride. What action
is correct?
Clarify the order
Potassium chloride should never be given IV push because it can cause fatal
arrhythmias.
12.Which complication should the nurse monitor for after a paracentesis?
Hypotension
Rapid removal of fluid can cause vascular volume shifts leading to hypotension.
13.Which symptom is most indicative of digoxin toxicity?
Visual disturbances
Blurred or yellow vision is a classic sign of digoxin toxicity.
14.A patient with DKA has K+ of 5.8 mEq/L. What should the nurse do?
Administer insulin as ordered
Insulin shifts potassium into cells, helping lower elevated serum potassium in
DKA.
15.Which finding in a burn patient requires immediate action?
