NSG 3130 EXAM 4 REVIEW (GALEN) 200 COMPREHENSIVE PRACTICE
QUESTIONS WITH CORRECT ANSWERS & RATIONALES – FULL
COVERAGE OF CARDIAC, RESPIRATORY, COPD, HEART FAILURE,
ARTERIAL BLOOD GASES, MEDICATION MANAGEMENT, OXYGEN
DELIVERY DEVICES, CHEST TUBE CARE, AND CRITICAL NURSING SKILLS
FOR FUNDAMENTALS II
1. A patient with COPD is receiving oxygen at 4 L/min via nasal cannula.
The pulse oximetry reading is 88%. What is the nurse's priority action?
A) Increase the oxygen flow rate to 6 L/min
B) Place the patient in a high Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory status and lung sounds
Correct Answer: D) Assess the patient's respiratory status and lung
sounds
Rationale: Before making any changes to oxygen therapy, the nurse
must first assess the patient's respiratory status, including lung sounds,
respiratory rate, and work of breathing. Simply increasing oxygen
without assessment could mask underlying issues.
2. Which diagnostic test will best indicate if there is significant blockage
of important blood vessels that provide oxygen to the heart muscle?
A) Chest x-ray
B) Echocardiogram
C) Electrocardiogram
D) Cardiac catheterization
Correct Answer: D) Cardiac catheterization
,Rationale: Cardiac catheterization includes the use of contrast dye to
visualize the coronary arteries and determine blood flow to cardiac
muscle. The other tests will not allow the physician to determine which
(if any) coronary arteries are occluded.
3. Which oxygen delivery device would best allow for precise delivery of
40% oxygen?
A) Simple face mask
B) Nonrebreather mask
C) Partial rebreather mask
D) Venturi mask
Correct Answer: D) Venturi mask
Rationale: The Venturi mask delivers the most precise concentration of
oxygen, making it ideal for patients who require a specific FiO2.
4. A patient with heart failure has crackles in the lung fields and reports
difficulty breathing when lying flat. Which intervention is most
appropriate?
A) Encourage the patient to ambulate in the hallway
B) Place the patient on 2 liters of oxygen via nasal cannula
C) Elevate the head of the bed and support with three pillows
D) Instruct the patient to deep breathe and cough every hour
Correct Answer: C) Elevate the head of the bed and support with three
pillows
Rationale: Orthopnea (difficulty breathing when lying flat) is a classic
symptom of left-sided heart failure due to fluid accumulation in the
lungs. Elevating the head of the bed (semi-Fowler's to high-Fowler's)
uses gravity to reduce pulmonary congestion and improve breathing.
,5. The nurse hears a loud murmur when listening to the patient's heart.
Which diagnostic test will best display the condition of the valves and
structures within the patient's heart?
A) Chest x-ray
B) Cardiac catheterization
C) Echocardiogram
D) Electrocardiogram
Correct Answer: C) Echocardiogram
Rationale: Echocardiograms allow for ultrasound visualization of the
structures of the heart along with function of the heart valves and
cardiac musculature.
6. The nurse finds the patient in cardiopulmonary arrest with no pulse
or respirations. Which oxygen delivery device will the nurse use for this
patient?
A) Non-rebreather mask
B) Bag-valve-mask unit
C) Continuous positive airway pressure (CPAP)
D) High-flow nasal cannula
Correct Answer: B) Bag-valve-mask unit
Rationale: In a cardiopulmonary arrest, the bag-valve-mask (BVM) unit
is used to deliver positive-pressure ventilation to the patient until
advanced airway management can be established.
7. A patient with chronic bronchitis and a congested, productive cough
would benefit from which intervention to help clear the airway?
A) Incentive spirometry
B) Postural drainage
C) Coughing and deep breathing
D) Chest physiotherapy
, Correct Answer: B) Postural drainage
Rationale: Patients with chronic bronchitis and a congested, productive
cough would benefit from postural drainage because it helps clear the
airway.
8. A patient with a deep vein thrombosis (DVT) who just came out of
surgery reports sudden chest pain and shortness of breath. What is the
priority nursing action?
A) Administer prescribed pain medication
B) Assess for signs of a pulmonary embolism
C) Encourage the patient to ambulate
D) Apply warm compresses to the affected leg
Correct Answer: B) Assess for signs of a pulmonary embolism
Rationale: The priority is to assess for signs of a pulmonary embolism
(PE), which is a life-threatening complication of DVT. Chest pain and
shortness of breath are key symptoms of PE.
9. While auscultating a patient's lung fields, the nurse hears fine
crackles at the lung bases. This finding is most consistent with:
A) Asthma
B) Pulmonary fibrosis
C) Left-sided heart failure
D) Pneumothorax
Correct Answer: C) Left-sided heart failure
Rationale: Fine crackles (rales) at the lung bases are characteristic of
left-sided heart failure, where fluid backs up into the pulmonary
interstitial spaces.
10. To perform an accurate assessment of jugular venous pressure (JVP)
in a patient with suspected heart failure, the nurse should position the
QUESTIONS WITH CORRECT ANSWERS & RATIONALES – FULL
COVERAGE OF CARDIAC, RESPIRATORY, COPD, HEART FAILURE,
ARTERIAL BLOOD GASES, MEDICATION MANAGEMENT, OXYGEN
DELIVERY DEVICES, CHEST TUBE CARE, AND CRITICAL NURSING SKILLS
FOR FUNDAMENTALS II
1. A patient with COPD is receiving oxygen at 4 L/min via nasal cannula.
The pulse oximetry reading is 88%. What is the nurse's priority action?
A) Increase the oxygen flow rate to 6 L/min
B) Place the patient in a high Fowler's position
C) Notify the healthcare provider immediately
D) Assess the patient's respiratory status and lung sounds
Correct Answer: D) Assess the patient's respiratory status and lung
sounds
Rationale: Before making any changes to oxygen therapy, the nurse
must first assess the patient's respiratory status, including lung sounds,
respiratory rate, and work of breathing. Simply increasing oxygen
without assessment could mask underlying issues.
2. Which diagnostic test will best indicate if there is significant blockage
of important blood vessels that provide oxygen to the heart muscle?
A) Chest x-ray
B) Echocardiogram
C) Electrocardiogram
D) Cardiac catheterization
Correct Answer: D) Cardiac catheterization
,Rationale: Cardiac catheterization includes the use of contrast dye to
visualize the coronary arteries and determine blood flow to cardiac
muscle. The other tests will not allow the physician to determine which
(if any) coronary arteries are occluded.
3. Which oxygen delivery device would best allow for precise delivery of
40% oxygen?
A) Simple face mask
B) Nonrebreather mask
C) Partial rebreather mask
D) Venturi mask
Correct Answer: D) Venturi mask
Rationale: The Venturi mask delivers the most precise concentration of
oxygen, making it ideal for patients who require a specific FiO2.
4. A patient with heart failure has crackles in the lung fields and reports
difficulty breathing when lying flat. Which intervention is most
appropriate?
A) Encourage the patient to ambulate in the hallway
B) Place the patient on 2 liters of oxygen via nasal cannula
C) Elevate the head of the bed and support with three pillows
D) Instruct the patient to deep breathe and cough every hour
Correct Answer: C) Elevate the head of the bed and support with three
pillows
Rationale: Orthopnea (difficulty breathing when lying flat) is a classic
symptom of left-sided heart failure due to fluid accumulation in the
lungs. Elevating the head of the bed (semi-Fowler's to high-Fowler's)
uses gravity to reduce pulmonary congestion and improve breathing.
,5. The nurse hears a loud murmur when listening to the patient's heart.
Which diagnostic test will best display the condition of the valves and
structures within the patient's heart?
A) Chest x-ray
B) Cardiac catheterization
C) Echocardiogram
D) Electrocardiogram
Correct Answer: C) Echocardiogram
Rationale: Echocardiograms allow for ultrasound visualization of the
structures of the heart along with function of the heart valves and
cardiac musculature.
6. The nurse finds the patient in cardiopulmonary arrest with no pulse
or respirations. Which oxygen delivery device will the nurse use for this
patient?
A) Non-rebreather mask
B) Bag-valve-mask unit
C) Continuous positive airway pressure (CPAP)
D) High-flow nasal cannula
Correct Answer: B) Bag-valve-mask unit
Rationale: In a cardiopulmonary arrest, the bag-valve-mask (BVM) unit
is used to deliver positive-pressure ventilation to the patient until
advanced airway management can be established.
7. A patient with chronic bronchitis and a congested, productive cough
would benefit from which intervention to help clear the airway?
A) Incentive spirometry
B) Postural drainage
C) Coughing and deep breathing
D) Chest physiotherapy
, Correct Answer: B) Postural drainage
Rationale: Patients with chronic bronchitis and a congested, productive
cough would benefit from postural drainage because it helps clear the
airway.
8. A patient with a deep vein thrombosis (DVT) who just came out of
surgery reports sudden chest pain and shortness of breath. What is the
priority nursing action?
A) Administer prescribed pain medication
B) Assess for signs of a pulmonary embolism
C) Encourage the patient to ambulate
D) Apply warm compresses to the affected leg
Correct Answer: B) Assess for signs of a pulmonary embolism
Rationale: The priority is to assess for signs of a pulmonary embolism
(PE), which is a life-threatening complication of DVT. Chest pain and
shortness of breath are key symptoms of PE.
9. While auscultating a patient's lung fields, the nurse hears fine
crackles at the lung bases. This finding is most consistent with:
A) Asthma
B) Pulmonary fibrosis
C) Left-sided heart failure
D) Pneumothorax
Correct Answer: C) Left-sided heart failure
Rationale: Fine crackles (rales) at the lung bases are characteristic of
left-sided heart failure, where fluid backs up into the pulmonary
interstitial spaces.
10. To perform an accurate assessment of jugular venous pressure (JVP)
in a patient with suspected heart failure, the nurse should position the
