NSG 3850 Adult Health II Practice Exam 2026
NSG 3850 Adult Health II Practice Exam
2026 Edition 100 Advanced Questions with
Answers and Detailed Rationales
NSG 3850 Adult Health II Practice Exam
(2026 Edition)
Part 1: Questions 1–25
Question 1
A patient with septic shock has received 30 mL/kg of crystalloid fluids. The blood pressure
remains 82/48 mmHg (MAP 56 mmHg). Which prescription should the nurse anticipate next?
A. Administer IV furosemide
B. Begin norepinephrine infusion
C. Increase maintenance IV fluids to 50 mL/hr
D. Administer oral midodrine
Answer: B
Rationale:
Persistent hypotension after adequate fluid resuscitation requires vasopressor therapy.
Norepinephrine is the first-line vasopressor for septic shock.
Question 2
A nurse assesses a patient with acute respiratory distress syndrome (ARDS). Which assessment
finding requires immediate intervention?
A. Bilateral crackles
B. PaO₂ 55 mmHg despite FiO₂ 80%
C. Respiratory rate 30/min
D. Productive cough
Answer: B
, NSG 3850 Adult Health II Practice Exam 2026
Rationale:
Refractory hypoxemia despite high oxygen concentrations is the hallmark of severe ARDS and
requires aggressive ventilatory support.
Question 3
A patient develops peaked T waves after receiving multiple blood transfusions. Which
electrolyte imbalance does the nurse suspect?
A. Hyponatremia
B. Hypercalcemia
C. Hyperkalemia
D. Hypomagnesemia
Answer: C
Rationale:
Stored blood releases potassium over time. Hyperkalemia commonly presents with peaked T
waves and may progress to life-threatening dysrhythmias.
Question 4
Which patient is at greatest risk for developing acute kidney injury?
A. Patient receiving acetaminophen
B. Patient with severe dehydration and hypotension
C. Patient with controlled hypertension
D. Patient receiving oral antibiotics
Answer: B
Rationale:
Hypoperfusion from dehydration and hypotension commonly causes prerenal acute kidney
injury.
Question 5
A patient with diabetic ketoacidosis has:
Glucose 620 mg/dL
, NSG 3850 Adult Health II Practice Exam 2026
Potassium 3.1 mEq/L
Which intervention is priority?
A. Administer IV insulin immediately
B. Replace potassium before insulin
C. Restrict fluids
D. Give sodium bicarbonate
Answer: B
Rationale:
Insulin drives potassium intracellularly, worsening hypokalemia. Potassium replacement must
occur before insulin if serum potassium is below 3.3 mEq/L.
Question 6
Which assessment finding most strongly suggests left-sided heart failure?
A. Jugular venous distention
B. Hepatomegaly
C. Pulmonary crackles
D. Peripheral edema
Answer: C
Rationale:
Left ventricular failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
Question 7
A patient suddenly develops unilateral facial droop and right arm weakness. What is the nurse's
priority?
A. Obtain blood glucose
B. Administer aspirin
C. Call a stroke alert
D. Perform complete neurological assessment
Answer: C
, NSG 3850 Adult Health II Practice Exam 2026
Rationale:
Rapid activation of the stroke protocol is essential to minimize delays in reperfusion therapy.
Question 8
Which laboratory finding indicates effective treatment of bacterial sepsis?
A. Rising lactate
B. Decreasing serum lactate
C. Increasing WBC count
D. Increasing creatinine
Answer: B
Rationale:
A declining lactate level indicates improved tissue perfusion and response to therapy.
Question 9
A patient receiving heparin develops a platelet count of 58,000/mm³. Which action is most
appropriate?
A. Continue infusion
B. Reduce dosage
C. Stop heparin immediately
D. Administer vitamin K
Answer: C
Rationale:
This finding suggests heparin-induced thrombocytopenia (HIT). Heparin should be discontinued
immediately.
Question 10
Which patient requires airborne isolation?
A. Influenza
B. Tuberculosis
NSG 3850 Adult Health II Practice Exam
2026 Edition 100 Advanced Questions with
Answers and Detailed Rationales
NSG 3850 Adult Health II Practice Exam
(2026 Edition)
Part 1: Questions 1–25
Question 1
A patient with septic shock has received 30 mL/kg of crystalloid fluids. The blood pressure
remains 82/48 mmHg (MAP 56 mmHg). Which prescription should the nurse anticipate next?
A. Administer IV furosemide
B. Begin norepinephrine infusion
C. Increase maintenance IV fluids to 50 mL/hr
D. Administer oral midodrine
Answer: B
Rationale:
Persistent hypotension after adequate fluid resuscitation requires vasopressor therapy.
Norepinephrine is the first-line vasopressor for septic shock.
Question 2
A nurse assesses a patient with acute respiratory distress syndrome (ARDS). Which assessment
finding requires immediate intervention?
A. Bilateral crackles
B. PaO₂ 55 mmHg despite FiO₂ 80%
C. Respiratory rate 30/min
D. Productive cough
Answer: B
, NSG 3850 Adult Health II Practice Exam 2026
Rationale:
Refractory hypoxemia despite high oxygen concentrations is the hallmark of severe ARDS and
requires aggressive ventilatory support.
Question 3
A patient develops peaked T waves after receiving multiple blood transfusions. Which
electrolyte imbalance does the nurse suspect?
A. Hyponatremia
B. Hypercalcemia
C. Hyperkalemia
D. Hypomagnesemia
Answer: C
Rationale:
Stored blood releases potassium over time. Hyperkalemia commonly presents with peaked T
waves and may progress to life-threatening dysrhythmias.
Question 4
Which patient is at greatest risk for developing acute kidney injury?
A. Patient receiving acetaminophen
B. Patient with severe dehydration and hypotension
C. Patient with controlled hypertension
D. Patient receiving oral antibiotics
Answer: B
Rationale:
Hypoperfusion from dehydration and hypotension commonly causes prerenal acute kidney
injury.
Question 5
A patient with diabetic ketoacidosis has:
Glucose 620 mg/dL
, NSG 3850 Adult Health II Practice Exam 2026
Potassium 3.1 mEq/L
Which intervention is priority?
A. Administer IV insulin immediately
B. Replace potassium before insulin
C. Restrict fluids
D. Give sodium bicarbonate
Answer: B
Rationale:
Insulin drives potassium intracellularly, worsening hypokalemia. Potassium replacement must
occur before insulin if serum potassium is below 3.3 mEq/L.
Question 6
Which assessment finding most strongly suggests left-sided heart failure?
A. Jugular venous distention
B. Hepatomegaly
C. Pulmonary crackles
D. Peripheral edema
Answer: C
Rationale:
Left ventricular failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
Question 7
A patient suddenly develops unilateral facial droop and right arm weakness. What is the nurse's
priority?
A. Obtain blood glucose
B. Administer aspirin
C. Call a stroke alert
D. Perform complete neurological assessment
Answer: C
, NSG 3850 Adult Health II Practice Exam 2026
Rationale:
Rapid activation of the stroke protocol is essential to minimize delays in reperfusion therapy.
Question 8
Which laboratory finding indicates effective treatment of bacterial sepsis?
A. Rising lactate
B. Decreasing serum lactate
C. Increasing WBC count
D. Increasing creatinine
Answer: B
Rationale:
A declining lactate level indicates improved tissue perfusion and response to therapy.
Question 9
A patient receiving heparin develops a platelet count of 58,000/mm³. Which action is most
appropriate?
A. Continue infusion
B. Reduce dosage
C. Stop heparin immediately
D. Administer vitamin K
Answer: C
Rationale:
This finding suggests heparin-induced thrombocytopenia (HIT). Heparin should be discontinued
immediately.
Question 10
Which patient requires airborne isolation?
A. Influenza
B. Tuberculosis
