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NSG 3250 ADULT HEALTH 1 -EXAM 2 LATEST
2026 UPDATE EXAM COVERAGE SUMMARY
ACTUAL QUESTIONS AND CORRECT
RELIABLE ANSWERS
--____________________________________________________________________________
1. Dermatological & Infectious Conditions – Herpes simplex (HSV-1 oral/facial, HSV-2 genital),
herpes zoster (shingles – reactivation of varicella, dermatomal distribution, antivirals within 72
hours), candidiasis (immunocompromised hosts), impetigo (highly contagious, honey-crusted
lesions), cellulitis (spreading erythema, warmth, treat with antibiotics), psoriasis (chronic
autoimmune, silvery scales), acne vulgaris (topical retinoids, benzoyl peroxide, antibiotics,
isotretinoin for severe), contact dermatitis (avoid irritants, topical steroids), atopic dermatitis
(eczema – moisturize, humidifier, avoid triggers), Lyme disease (stages 1-3, bullseye rash, flu-like
symptoms, doxycycline), pediculosis (lice – permethrin, hot water wash), pressure ulcers (stages 1-
4, prevention: turn q2h, nutrition high protein/vitamins), Kaposi sarcoma (HHV-8,
immunocompromised, reddish-purple lesions), basal cell carcinoma (most common, UV exposure,
locally invasive), melanoma (most deadly, ABCDE: asymmetry, border, color, diameter, evolution).
, 2.Immunological Emergencies & Environmental Injuries– Anaphylaxis management (EpiPen first,
ABCs, airway, epinephrine IM, call 911), heat stroke vs heat exhaustion (heat stroke: altered mental
status, temp >104°F, hot dry skin, emergency; heat exhaustion: heavy sweating, normal
Page | 2 mentation), hypothermia (stages: mild, moderate, severe; rewarming: warmed IV fluids, heated
oxygen, avoid afterdrop), cold injuries (frostbite, rewarm in warm water 104-108°F), altitude
sickness (oxygen, hyperbaric chamber if severe).
3. Infectious Disease & Infection Control – Breaking the chain of infection: hand hygiene is #1
priority. Antibiotic reactions (rash, severe diarrhea → notify provider immediately, possible C. diff or
anaphylaxis). Antiviral medications ending in "-clovir" (acyclovir, valacyclovir, famciclovir) treat HSV
and VZV.
4. Post-Operative & Surgical Nursing – PACU assessments: airway first (ABCs). Malignant
hyperthermia: tachycardia is first sign; dantrolene is treatment of choice. Anesthesia phases:
induction, maintenance, emergence. Sterile field maintenance: 1 foot distance, never turn back on
field. Informed consent: patient must demonstrate understanding; nurse witnesses
5. **Endocrine Disorders** – Diabetes mellitus: type 1 (autoimmune, absolute insulin deficiency,
DKA risk) vs type 2 (insulin resistance, HHS risk). DKA: hyperglycemia, ketonuria, metabolic
acidosis (pH <7.35, HCO3 <18). HHS: extreme hyperglycemia (>600 mg/dL), no ketosis, severe
dehydration. A1C >6.4% diagnostic of diabetes. Classic symptoms: polyuria, polydipsia, polyphagia,
weight loss. Insulin administration: rotate sites, abdomen first choice (fastest absorption). Oral
antidiabetics: glipizide/glyburide (sulfonylureas) – check renal function, risk of hypoglycemia.
Metformin – first-line, GI side effects, lactic acidosis risk with renal impairment. Lipodystrophy
prevention: rotate injection sites.
6. **Neurological Disorders** – Stroke: left hemisphere (language deficits – aphasia, right-sided
weakness); right hemisphere (neglect, anosognosia, left-sided weakness). Aphasia types: global
(both expressive and receptive), Broca's (expressive – understands but cannot speak), Wernicke's
(receptive – fluent but meaningless speech, poor comprehension). Glasgow Coma Scale (GCS): 8
or less = severe injury → intubate. Increased ICP management: midline head position, elevate HOB
30 degrees, avoid jugular compression, avoid clustering care, hyperventilation (short-term).
Trigeminal neuralgia (tic douloureux): severe facial pain triggered by light touch, chewing, cold air;
treat with carbamazepine. Parkinson's disease: levodopa-carbidopa taken on empty stomach
(protein interference). Seizure precautions: padded side rails, oxygen/suction at bedside, bed in
lowest position. Lumbar puncture precautions: check CT first for mass lesions (risk of herniation).
, 7. **Leadership & Management** – Leadership styles: autocratic (crisis situations),
transformational (inspires change, innovation), situational (adapts to team needs), democratic
(collaborative). Delegation: purpose = safe, efficient care; five rights of delegation: right task,
circumstance, person, direction/communication, supervision/evaluation. Conflict management:
compromising (both parties give something), collaborating (win-win), avoiding, competing,
Page | 3 accommodating. Shared governance: empowers staff nurses in decision-making. Emotional
intelligence: self-awareness, self-regulation, empathy, social skills. Magnet Recognition Program:
recognition for nursing excellence. Servant leadership: focuses on serving others. Evidence-based
leadership: integrates research, clinical expertise, patient preferences. Root cause analysis (RCA):
identifies system failures after adverse events. Performance appraisals: evaluate job performance,
set goals.
8. Perioperative & Anesthesia Care – Geriatric surgical concerns: decreased cardiac, renal, hepatic
reserves → increased risk, longer recovery. Bariatric surgery complications: subcutaneous tissue
(poor wound healing, infection risk), shallow respirations (atelectasis, pneumonia). Types of
surgery: emergency (life-threatening), diagnostic (biopsy), ablative (removal), curative (tumor
resection), palliative (symptom relief). Informed consent requirements: patient voluntarily consents
after receiving information (risks, benefits, alternatives, procedure). Nurse's role: witness signature,
ensure patient is not sedated. Sterile field distance: 1 foot (12 inches) – maintain distance.
Preoperative medication safety: stay in bed (falls risk from sedation). Smoking cessation teaching:
stop before surgery to reduce respiratory complications (atelectasis, pneumonia). PACU priorities:
airway, breathing, circulation (ABCs). Epidural vs spinal positioning: epidural does NOT require flat
bedrest (spinal anesthesia requires flat 4-6 hours to prevent headache). Transsacral block (caudal
block): anesthesia for perineum/lower abdomen. Circulating nurse role: documentation, non-sterile,
coordinates team.
---
Question 1
On a hot humid day, an emergency department nurse is caring for a client who is confused and has
a temperature of 104.1°F (40.1°C), pulse 132/min, respirations 26/min, BP 106/66 mm Hg.
Which action should the nurse take first?
A) Encourage the client to drink cool water or sports drinks
B) Start an intravenous line and infuse 0.9% saline solution
C) Administer acetaminophen (Tylenol) 650 mg orally
NSG 3250 ADULT HEALTH 1 -EXAM 2 LATEST
2026 UPDATE EXAM COVERAGE SUMMARY
ACTUAL QUESTIONS AND CORRECT
RELIABLE ANSWERS
--____________________________________________________________________________
1. Dermatological & Infectious Conditions – Herpes simplex (HSV-1 oral/facial, HSV-2 genital),
herpes zoster (shingles – reactivation of varicella, dermatomal distribution, antivirals within 72
hours), candidiasis (immunocompromised hosts), impetigo (highly contagious, honey-crusted
lesions), cellulitis (spreading erythema, warmth, treat with antibiotics), psoriasis (chronic
autoimmune, silvery scales), acne vulgaris (topical retinoids, benzoyl peroxide, antibiotics,
isotretinoin for severe), contact dermatitis (avoid irritants, topical steroids), atopic dermatitis
(eczema – moisturize, humidifier, avoid triggers), Lyme disease (stages 1-3, bullseye rash, flu-like
symptoms, doxycycline), pediculosis (lice – permethrin, hot water wash), pressure ulcers (stages 1-
4, prevention: turn q2h, nutrition high protein/vitamins), Kaposi sarcoma (HHV-8,
immunocompromised, reddish-purple lesions), basal cell carcinoma (most common, UV exposure,
locally invasive), melanoma (most deadly, ABCDE: asymmetry, border, color, diameter, evolution).
, 2.Immunological Emergencies & Environmental Injuries– Anaphylaxis management (EpiPen first,
ABCs, airway, epinephrine IM, call 911), heat stroke vs heat exhaustion (heat stroke: altered mental
status, temp >104°F, hot dry skin, emergency; heat exhaustion: heavy sweating, normal
Page | 2 mentation), hypothermia (stages: mild, moderate, severe; rewarming: warmed IV fluids, heated
oxygen, avoid afterdrop), cold injuries (frostbite, rewarm in warm water 104-108°F), altitude
sickness (oxygen, hyperbaric chamber if severe).
3. Infectious Disease & Infection Control – Breaking the chain of infection: hand hygiene is #1
priority. Antibiotic reactions (rash, severe diarrhea → notify provider immediately, possible C. diff or
anaphylaxis). Antiviral medications ending in "-clovir" (acyclovir, valacyclovir, famciclovir) treat HSV
and VZV.
4. Post-Operative & Surgical Nursing – PACU assessments: airway first (ABCs). Malignant
hyperthermia: tachycardia is first sign; dantrolene is treatment of choice. Anesthesia phases:
induction, maintenance, emergence. Sterile field maintenance: 1 foot distance, never turn back on
field. Informed consent: patient must demonstrate understanding; nurse witnesses
5. **Endocrine Disorders** – Diabetes mellitus: type 1 (autoimmune, absolute insulin deficiency,
DKA risk) vs type 2 (insulin resistance, HHS risk). DKA: hyperglycemia, ketonuria, metabolic
acidosis (pH <7.35, HCO3 <18). HHS: extreme hyperglycemia (>600 mg/dL), no ketosis, severe
dehydration. A1C >6.4% diagnostic of diabetes. Classic symptoms: polyuria, polydipsia, polyphagia,
weight loss. Insulin administration: rotate sites, abdomen first choice (fastest absorption). Oral
antidiabetics: glipizide/glyburide (sulfonylureas) – check renal function, risk of hypoglycemia.
Metformin – first-line, GI side effects, lactic acidosis risk with renal impairment. Lipodystrophy
prevention: rotate injection sites.
6. **Neurological Disorders** – Stroke: left hemisphere (language deficits – aphasia, right-sided
weakness); right hemisphere (neglect, anosognosia, left-sided weakness). Aphasia types: global
(both expressive and receptive), Broca's (expressive – understands but cannot speak), Wernicke's
(receptive – fluent but meaningless speech, poor comprehension). Glasgow Coma Scale (GCS): 8
or less = severe injury → intubate. Increased ICP management: midline head position, elevate HOB
30 degrees, avoid jugular compression, avoid clustering care, hyperventilation (short-term).
Trigeminal neuralgia (tic douloureux): severe facial pain triggered by light touch, chewing, cold air;
treat with carbamazepine. Parkinson's disease: levodopa-carbidopa taken on empty stomach
(protein interference). Seizure precautions: padded side rails, oxygen/suction at bedside, bed in
lowest position. Lumbar puncture precautions: check CT first for mass lesions (risk of herniation).
, 7. **Leadership & Management** – Leadership styles: autocratic (crisis situations),
transformational (inspires change, innovation), situational (adapts to team needs), democratic
(collaborative). Delegation: purpose = safe, efficient care; five rights of delegation: right task,
circumstance, person, direction/communication, supervision/evaluation. Conflict management:
compromising (both parties give something), collaborating (win-win), avoiding, competing,
Page | 3 accommodating. Shared governance: empowers staff nurses in decision-making. Emotional
intelligence: self-awareness, self-regulation, empathy, social skills. Magnet Recognition Program:
recognition for nursing excellence. Servant leadership: focuses on serving others. Evidence-based
leadership: integrates research, clinical expertise, patient preferences. Root cause analysis (RCA):
identifies system failures after adverse events. Performance appraisals: evaluate job performance,
set goals.
8. Perioperative & Anesthesia Care – Geriatric surgical concerns: decreased cardiac, renal, hepatic
reserves → increased risk, longer recovery. Bariatric surgery complications: subcutaneous tissue
(poor wound healing, infection risk), shallow respirations (atelectasis, pneumonia). Types of
surgery: emergency (life-threatening), diagnostic (biopsy), ablative (removal), curative (tumor
resection), palliative (symptom relief). Informed consent requirements: patient voluntarily consents
after receiving information (risks, benefits, alternatives, procedure). Nurse's role: witness signature,
ensure patient is not sedated. Sterile field distance: 1 foot (12 inches) – maintain distance.
Preoperative medication safety: stay in bed (falls risk from sedation). Smoking cessation teaching:
stop before surgery to reduce respiratory complications (atelectasis, pneumonia). PACU priorities:
airway, breathing, circulation (ABCs). Epidural vs spinal positioning: epidural does NOT require flat
bedrest (spinal anesthesia requires flat 4-6 hours to prevent headache). Transsacral block (caudal
block): anesthesia for perineum/lower abdomen. Circulating nurse role: documentation, non-sterile,
coordinates team.
---
Question 1
On a hot humid day, an emergency department nurse is caring for a client who is confused and has
a temperature of 104.1°F (40.1°C), pulse 132/min, respirations 26/min, BP 106/66 mm Hg.
Which action should the nurse take first?
A) Encourage the client to drink cool water or sports drinks
B) Start an intravenous line and infuse 0.9% saline solution
C) Administer acetaminophen (Tylenol) 650 mg orally
