NSG 3800 Adult Health II ACTUAL
EXAM 2026/2027: 100% Verified
Questions & Correct Answers
Question 1:
A 68-year-old male with a history of heart failure is admitted with acute decompensation. He
reports orthopnea, 3+ pitting edema, and a 6-lb weight gain in 3 days. Which assessment
finding requires the nurse’s immediate intervention?
A. Oxygen saturation 88% on 2 L nasal cannula
B. Bibasilar crackles that do not clear with cough
C. Jugular venous distention at 45°
D. Heart rate 102 beats/min and regular
Correct Answer: B
Rationale: Bibasilar crackles that persist despite coughing indicate acute pulmonary edema, a
life-threatening complication of decompensated heart failure requiring rapid intervention to
prevent respiratory failure.
Question 2:
The nurse is reviewing morning labs for a patient receiving IV heparin for a pulmonary
embolism. The aPTT is 92 seconds (control 30 seconds). What is the nurse’s priority action?
A. Stop the heparin infusion immediately
B. Reduce the infusion rate by 50%
C. Obtain a stat PT/INR
D. Administer protamine sulfate
Correct Answer: A
,Rationale: An aPTT more than 3 times the control value places the patient at high risk for
bleeding; stopping the infusion is the immediate evidence-based action per 2026 ACCP
guidelines.
Question 3:
A 55-year-old woman with newly diagnosed hypertension is prescribed lisinopril. Which
instruction is most important for the nurse to provide?
A. “Take the medication at bedtime to reduce dizziness.”
B. “Notify your provider if you develop a dry, persistent cough.”
C. “Avoid potassium-rich foods while on this drug.”
D. “Expect ankle swelling within the first week.”
Correct Answer: B
Rationale: ACE inhibitors can cause bradykinin-induced dry cough; early recognition prevents
unnecessary diagnostic workups and guides timely switch to an ARB if indicated.
Question 4:
A postoperative cholecystectomy patient suddenly reports pleuritic chest pain and dyspnea.
SpO₂ drops from 96% to 88%. Which diagnostic test should the nurse anticipate first?
A. D-dimer
B. Chest X-ray
C. Spiral CT pulmonary angiography
D. Arterial blood gas
Correct Answer: C
Rationale: Spiral CT-PA is the gold-standard first-line imaging for suspected pulmonary
embolism in 2026 ACR guidelines due to high sensitivity and rapid availability.
Question 5:
, A patient with COPD has an arterial blood gas pH 7.28, PaCO₂ 65 mmHg, HCO₃⁻ 34 mEq/L,
PaO₂ 54 mmHg. The nurse interprets these values as:
A. Acute respiratory acidosis
B. Acute metabolic acidosis
C. Compensated respiratory acidosis
D. Partially compensated respiratory acidosis
Correct Answer: D
Rationale: Elevated PaCO₂ and bicarbonate with low pH indicate renal compensation is
underway but incomplete, defining partial compensation.
Question 6:
Which nursing action best reduces the risk of aspiration pneumonia in a patient with
dysphagia after a stroke?
A. Feed the patient in the supine position with the head midline
B. Provide thin liquids to facilitate easier swallowing
C. Perform a bedside swallow screen before any oral intake
D. Encourage continuous tube feeds at 150 mL/hr
Correct Answer: C
Rationale: A validated bedside swallow screen identifies unsafe swallow and prevents
aspiration, the cornerstone of post-stroke dysphagia management per 2026 AHA guidelines.
Question 7:
A patient receiving dopamine at 8 mcg/kg/min for cardiogenic shock develops sudden,
severe peripheral IV extravasation. Which antidote should the nurse prepare?
A. Naloxone
B. Phentolamine
C. Protamine
EXAM 2026/2027: 100% Verified
Questions & Correct Answers
Question 1:
A 68-year-old male with a history of heart failure is admitted with acute decompensation. He
reports orthopnea, 3+ pitting edema, and a 6-lb weight gain in 3 days. Which assessment
finding requires the nurse’s immediate intervention?
A. Oxygen saturation 88% on 2 L nasal cannula
B. Bibasilar crackles that do not clear with cough
C. Jugular venous distention at 45°
D. Heart rate 102 beats/min and regular
Correct Answer: B
Rationale: Bibasilar crackles that persist despite coughing indicate acute pulmonary edema, a
life-threatening complication of decompensated heart failure requiring rapid intervention to
prevent respiratory failure.
Question 2:
The nurse is reviewing morning labs for a patient receiving IV heparin for a pulmonary
embolism. The aPTT is 92 seconds (control 30 seconds). What is the nurse’s priority action?
A. Stop the heparin infusion immediately
B. Reduce the infusion rate by 50%
C. Obtain a stat PT/INR
D. Administer protamine sulfate
Correct Answer: A
,Rationale: An aPTT more than 3 times the control value places the patient at high risk for
bleeding; stopping the infusion is the immediate evidence-based action per 2026 ACCP
guidelines.
Question 3:
A 55-year-old woman with newly diagnosed hypertension is prescribed lisinopril. Which
instruction is most important for the nurse to provide?
A. “Take the medication at bedtime to reduce dizziness.”
B. “Notify your provider if you develop a dry, persistent cough.”
C. “Avoid potassium-rich foods while on this drug.”
D. “Expect ankle swelling within the first week.”
Correct Answer: B
Rationale: ACE inhibitors can cause bradykinin-induced dry cough; early recognition prevents
unnecessary diagnostic workups and guides timely switch to an ARB if indicated.
Question 4:
A postoperative cholecystectomy patient suddenly reports pleuritic chest pain and dyspnea.
SpO₂ drops from 96% to 88%. Which diagnostic test should the nurse anticipate first?
A. D-dimer
B. Chest X-ray
C. Spiral CT pulmonary angiography
D. Arterial blood gas
Correct Answer: C
Rationale: Spiral CT-PA is the gold-standard first-line imaging for suspected pulmonary
embolism in 2026 ACR guidelines due to high sensitivity and rapid availability.
Question 5:
, A patient with COPD has an arterial blood gas pH 7.28, PaCO₂ 65 mmHg, HCO₃⁻ 34 mEq/L,
PaO₂ 54 mmHg. The nurse interprets these values as:
A. Acute respiratory acidosis
B. Acute metabolic acidosis
C. Compensated respiratory acidosis
D. Partially compensated respiratory acidosis
Correct Answer: D
Rationale: Elevated PaCO₂ and bicarbonate with low pH indicate renal compensation is
underway but incomplete, defining partial compensation.
Question 6:
Which nursing action best reduces the risk of aspiration pneumonia in a patient with
dysphagia after a stroke?
A. Feed the patient in the supine position with the head midline
B. Provide thin liquids to facilitate easier swallowing
C. Perform a bedside swallow screen before any oral intake
D. Encourage continuous tube feeds at 150 mL/hr
Correct Answer: C
Rationale: A validated bedside swallow screen identifies unsafe swallow and prevents
aspiration, the cornerstone of post-stroke dysphagia management per 2026 AHA guidelines.
Question 7:
A patient receiving dopamine at 8 mcg/kg/min for cardiogenic shock develops sudden,
severe peripheral IV extravasation. Which antidote should the nurse prepare?
A. Naloxone
B. Phentolamine
C. Protamine
