GALEN NURSING SCHOOL NSG 3180
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a patient who refuses a scheduled blood transfusion due to religious
beliefs. The nurse documents the refusal and informs the provider. Which ethical principle is
the nurse upholding?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy refers to the right of the patient to make their own
decisions regarding their healthcare, even if those decisions conflict with the provider’s
recommendations.
,2. When assessing a patient’s blood pressure, the nurse notes a difference of 20 mmHg
between the systolic pressure in the sitting and standing positions. How should the nurse
document this finding?
A. Hypertensive crisis
B. Orthostatic hypotension
C. Normal physiological variant
D. Pulse pressure deficit
Answer: B
Conceptual Explanation: A drop in systolic blood pressure of 20 mmHg or more (or a
diastolic drop of 10 mmHg or more) within three minutes of standing is defined as
orthostatic hypotension.
3. A nurse is auscultating heart sounds and hears a high-pitched, scratchy sound during both
systole and diastole at the left sternal border. This is most indicative of:
A. Aortic stenosis
B. Pericardial friction rub
C. Mitral valve prolapse
D. Ventricular gallop (S3)
Answer: B
, Conceptual Explanation: A pericardial friction rub is a scratchy, high-pitched sound
caused by inflammation of the pericardial sac and is typically heard throughout the cardiac
cycle.
4. The nurse is preparing to administer an intramuscular injection to an obese patient. Which
angle of insertion should the nurse use?
A. 15 degrees
B. 45 degrees
C. 90 degrees
D. 30 degrees
Answer: C
Conceptual Explanation: All intramuscular injections should be administered at a 90-
degree angle to ensure the medication reaches the muscle tissue, regardless of the patient’s
size.
5. Which assessment finding in a patient with a stage 3 pressure injury would distinguish it
from a stage 2 pressure injury?
A. Non-blanchable erythema of intact skin
B. Visible subcutaneous fat
C. Partial-thickness loss of dermis
D. Exposed bone or tendon
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A nurse is caring for a patient who refuses a scheduled blood transfusion due to religious
beliefs. The nurse documents the refusal and informs the provider. Which ethical principle is
the nurse upholding?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Answer: D
Conceptual Explanation: Autonomy refers to the right of the patient to make their own
decisions regarding their healthcare, even if those decisions conflict with the provider’s
recommendations.
,2. When assessing a patient’s blood pressure, the nurse notes a difference of 20 mmHg
between the systolic pressure in the sitting and standing positions. How should the nurse
document this finding?
A. Hypertensive crisis
B. Orthostatic hypotension
C. Normal physiological variant
D. Pulse pressure deficit
Answer: B
Conceptual Explanation: A drop in systolic blood pressure of 20 mmHg or more (or a
diastolic drop of 10 mmHg or more) within three minutes of standing is defined as
orthostatic hypotension.
3. A nurse is auscultating heart sounds and hears a high-pitched, scratchy sound during both
systole and diastole at the left sternal border. This is most indicative of:
A. Aortic stenosis
B. Pericardial friction rub
C. Mitral valve prolapse
D. Ventricular gallop (S3)
Answer: B
, Conceptual Explanation: A pericardial friction rub is a scratchy, high-pitched sound
caused by inflammation of the pericardial sac and is typically heard throughout the cardiac
cycle.
4. The nurse is preparing to administer an intramuscular injection to an obese patient. Which
angle of insertion should the nurse use?
A. 15 degrees
B. 45 degrees
C. 90 degrees
D. 30 degrees
Answer: C
Conceptual Explanation: All intramuscular injections should be administered at a 90-
degree angle to ensure the medication reaches the muscle tissue, regardless of the patient’s
size.
5. Which assessment finding in a patient with a stage 3 pressure injury would distinguish it
from a stage 2 pressure injury?
A. Non-blanchable erythema of intact skin
B. Visible subcutaneous fat
C. Partial-thickness loss of dermis
D. Exposed bone or tendon
