,Galen NSG 3800 Exam 2 | Nursing Practice – Adult
Health II (2026) Actual Q&A PDF
1. A client with a long-standing history of COPD is admitted with worsening
dyspnea. Which ABG values are most likely?
A) pH 7.48, PaCO2 32, HCO3 24
B) pH 7.34, PaCO2 55, HCO3 30
C) pH 7.30, PaCO2 48, HCO3 18
D) pH 7.42, PaCO2 40, HCO3 26
Correct Answer: pH 7.34, PaCO2 55, HCO3 30
Rationale: Chronic COPD leads to air trapping and CO2 retention, causing
compensated respiratory acidosis with elevated PaCO2 and HCO3. The pH is
slightly low, indicating partial compensation. Option A represents acute
respiratory alkalosis, C is uncompensated metabolic acidosis, and D is normal.
2. The nurse is providing community education about COPD prevention. Which
intervention is the single most cost-effective measure?
A) Annual influenza vaccination
B) Pulmonary rehabilitation
C) Early antibiotic therapy for respiratory infections
D) Smoking cessation
Correct Answer: Smoking cessation
,Rationale: Smoking cessation is the most cost-effective strategy to prevent
COPD and slow disease progression. While vaccinations and pulmonary rehab
improve outcomes, they do not prevent the initial development of COPD as
effectively as eliminating tobacco exposure.
3. A client has just undergone a transbronchial biopsy under conscious sedation.
What is the priority nursing action?
A) Keep the client NPO until the gag reflex returns
B) Encourage deep breathing and coughing
C) Position the client in high-Fowler’s
D) Administer prescribed opioid for pain
Correct Answer: Keep the client NPO until the gag reflex returns
Rationale: Conscious sedation and local anesthesia impair the gag reflex,
increasing aspiration risk. Maintaining NPO status until the gag reflex returns is
essential to prevent aspiration. Deep breathing is encouraged later, and pain
management is secondary to airway safety.
4. The nurse is monitoring a client with COPD receiving supplemental oxygen.
Which SpO2 goal indicates effective oxygenation without blunting the hypoxic
drive?
A) 85%–88%
B) 90%–92%
C) 88%–92%
D) 95%–100%
, Correct Answer: 88%–92%
Rationale: In COPD, the respiratory drive may rely on hypoxemia. Targeting
SpO2 of 88%–92% provides adequate oxygenation while reducing the risk of
suppressing the hypoxic drive and causing CO2 retention. Higher SpO2 targets
can decrease respiratory effort in these clients.
5. A client arrives in the emergency department after a motor vehicle collision
with severe dyspnea, tracheal deviation to the left, and absent breath sounds
on the right. What is the priority intervention?
A) Insert a chest tube on the left
B) Perform needle decompression on the right
C) Administer high-flow oxygen
D) Prepare for endotracheal intubation
Correct Answer: Perform needle decompression on the right
Rationale: These findings indicate a tension pneumothorax on the right,
requiring immediate needle decompression to release trapped air. Tracheal
deviation away from the affected side is classic. Chest tube insertion follows
decompression. Oxygen alone will not correct the pressure shift.
6. The nurse is caring for a client with a chest tube connected to water seal
drainage. Continuous, vigorous bubbling is observed in the water seal chamber.
What does this finding indicate?
A) The lung has fully re-expanded
B) The suction control is set correctly
Health II (2026) Actual Q&A PDF
1. A client with a long-standing history of COPD is admitted with worsening
dyspnea. Which ABG values are most likely?
A) pH 7.48, PaCO2 32, HCO3 24
B) pH 7.34, PaCO2 55, HCO3 30
C) pH 7.30, PaCO2 48, HCO3 18
D) pH 7.42, PaCO2 40, HCO3 26
Correct Answer: pH 7.34, PaCO2 55, HCO3 30
Rationale: Chronic COPD leads to air trapping and CO2 retention, causing
compensated respiratory acidosis with elevated PaCO2 and HCO3. The pH is
slightly low, indicating partial compensation. Option A represents acute
respiratory alkalosis, C is uncompensated metabolic acidosis, and D is normal.
2. The nurse is providing community education about COPD prevention. Which
intervention is the single most cost-effective measure?
A) Annual influenza vaccination
B) Pulmonary rehabilitation
C) Early antibiotic therapy for respiratory infections
D) Smoking cessation
Correct Answer: Smoking cessation
,Rationale: Smoking cessation is the most cost-effective strategy to prevent
COPD and slow disease progression. While vaccinations and pulmonary rehab
improve outcomes, they do not prevent the initial development of COPD as
effectively as eliminating tobacco exposure.
3. A client has just undergone a transbronchial biopsy under conscious sedation.
What is the priority nursing action?
A) Keep the client NPO until the gag reflex returns
B) Encourage deep breathing and coughing
C) Position the client in high-Fowler’s
D) Administer prescribed opioid for pain
Correct Answer: Keep the client NPO until the gag reflex returns
Rationale: Conscious sedation and local anesthesia impair the gag reflex,
increasing aspiration risk. Maintaining NPO status until the gag reflex returns is
essential to prevent aspiration. Deep breathing is encouraged later, and pain
management is secondary to airway safety.
4. The nurse is monitoring a client with COPD receiving supplemental oxygen.
Which SpO2 goal indicates effective oxygenation without blunting the hypoxic
drive?
A) 85%–88%
B) 90%–92%
C) 88%–92%
D) 95%–100%
, Correct Answer: 88%–92%
Rationale: In COPD, the respiratory drive may rely on hypoxemia. Targeting
SpO2 of 88%–92% provides adequate oxygenation while reducing the risk of
suppressing the hypoxic drive and causing CO2 retention. Higher SpO2 targets
can decrease respiratory effort in these clients.
5. A client arrives in the emergency department after a motor vehicle collision
with severe dyspnea, tracheal deviation to the left, and absent breath sounds
on the right. What is the priority intervention?
A) Insert a chest tube on the left
B) Perform needle decompression on the right
C) Administer high-flow oxygen
D) Prepare for endotracheal intubation
Correct Answer: Perform needle decompression on the right
Rationale: These findings indicate a tension pneumothorax on the right,
requiring immediate needle decompression to release trapped air. Tracheal
deviation away from the affected side is classic. Chest tube insertion follows
decompression. Oxygen alone will not correct the pressure shift.
6. The nurse is caring for a client with a chest tube connected to water seal
drainage. Continuous, vigorous bubbling is observed in the water seal chamber.
What does this finding indicate?
A) The lung has fully re-expanded
B) The suction control is set correctly
