,Galen NSG 4100 Exam 4 | Nursing Practice – Adult
Health III (2026) Actual Q&A PDF
1. A client with a traumatic brain injury has had urine output of 300 mL/hr for
the past 2 hours. What is the nurse's priority action?
A) Restrict oral fluids immediately
B) Administer prescribed desmopressin
C) Check the specific gravity of the urine
D) Notify the healthcare provider
Correct Answer: Notify the healthcare provider
Rationale: Polyuria >250 mL/hr for 2 consecutive hours after head trauma
suggests diabetes insipidus from pituitary damage. The provider must be
notified for prompt diagnosis and treatment to prevent severe dehydration and
hypernatremia. The nurse should anticipate orders for desmopressin and fluid
replacement after reporting.
2. A client with increased intracranial pressure is being assessed. Which pupil
change indicates a worsening condition?
A) Bilateral pupil constriction from 3 mm to 2 mm
B) Pupil size increasing from 5 mm to 9 mm
C) Pupils remaining briskly reactive at 3 mm
D) One pupil dilated and fixed at 4 mm
Correct Answer: Pupil size increasing from 5 mm to 9 mm
,Rationale: A rapidly dilating pupil, especially unilaterally, signals oculomotor
nerve compression from rising ICP or herniation. Normal pupil size is 2-4 mm.
Fixed and dilated is later. The change to 9 mm is an acute emergency.
3. A client is at risk for increased intracranial pressure. The nurse places the
client in which position?
A) Supine with the head elevated 15 degrees
B) Trendelenburg to improve cerebral perfusion
C) Semi-Fowler's with the head in midline
D) High-Fowler's with the neck flexed
Correct Answer: Semi-Fowler's with the head in midline
Rationale: Semi-Fowler's (30-degree head elevation) promotes cerebral venous
drainage and reduces ICP. The head is kept midline to avoid jugular
compression. High-Fowler's may decrease cerebral perfusion pressure, and
Trendelenburg increases ICP.
4. A client is 24 hours post-craniotomy for tumor resection. Which finding
indicates a possible complication?
A) Mild periorbital edema and bruising
B) BP of 130/84 mm Hg
C) Headache rated 4 out of 10
D) Client reports feeling drainage at the back of the throat
Correct Answer: Client reports feeling drainage at the back of the throat
, Rationale: The sensation of drainage or a salty taste may indicate a
cerebrospinal fluid leak, a serious complication after craniotomy. Clear nasal or
postnasal drainage that tests glucose-positive should be reported immediately.
Periorbital edema and mild headache are expected.
5. A client with Huntington's disease is admitted with pneumonia. Which
nursing action is the priority?
A) Administer broad-spectrum antibiotics
B) Provide humidified air and encourage fluid intake
C) Place the client in a negative-pressure room
D) Restrict oral intake to prevent aspiration
Correct Answer: Provide humidified air and encourage fluid intake
Rationale: Huntington's disease impairs swallowing and cough, making
secretion clearance difficult. Humidification and hydration thin secretions,
aiding airway clearance. Antibiotics are important but not the priority over
airway maintenance. Isolation is not needed.
6. A client with myasthenia gravis is prescribed pyridostigmine. The nurse
explains that this medication:
A) Cures the underlying autoimmune process
B) Increases the breakdown of acetylcholine
C) Improves muscle strength temporarily
D) Prevents respiratory muscle weakness
Correct Answer: Improves muscle strength temporarily
Health III (2026) Actual Q&A PDF
1. A client with a traumatic brain injury has had urine output of 300 mL/hr for
the past 2 hours. What is the nurse's priority action?
A) Restrict oral fluids immediately
B) Administer prescribed desmopressin
C) Check the specific gravity of the urine
D) Notify the healthcare provider
Correct Answer: Notify the healthcare provider
Rationale: Polyuria >250 mL/hr for 2 consecutive hours after head trauma
suggests diabetes insipidus from pituitary damage. The provider must be
notified for prompt diagnosis and treatment to prevent severe dehydration and
hypernatremia. The nurse should anticipate orders for desmopressin and fluid
replacement after reporting.
2. A client with increased intracranial pressure is being assessed. Which pupil
change indicates a worsening condition?
A) Bilateral pupil constriction from 3 mm to 2 mm
B) Pupil size increasing from 5 mm to 9 mm
C) Pupils remaining briskly reactive at 3 mm
D) One pupil dilated and fixed at 4 mm
Correct Answer: Pupil size increasing from 5 mm to 9 mm
,Rationale: A rapidly dilating pupil, especially unilaterally, signals oculomotor
nerve compression from rising ICP or herniation. Normal pupil size is 2-4 mm.
Fixed and dilated is later. The change to 9 mm is an acute emergency.
3. A client is at risk for increased intracranial pressure. The nurse places the
client in which position?
A) Supine with the head elevated 15 degrees
B) Trendelenburg to improve cerebral perfusion
C) Semi-Fowler's with the head in midline
D) High-Fowler's with the neck flexed
Correct Answer: Semi-Fowler's with the head in midline
Rationale: Semi-Fowler's (30-degree head elevation) promotes cerebral venous
drainage and reduces ICP. The head is kept midline to avoid jugular
compression. High-Fowler's may decrease cerebral perfusion pressure, and
Trendelenburg increases ICP.
4. A client is 24 hours post-craniotomy for tumor resection. Which finding
indicates a possible complication?
A) Mild periorbital edema and bruising
B) BP of 130/84 mm Hg
C) Headache rated 4 out of 10
D) Client reports feeling drainage at the back of the throat
Correct Answer: Client reports feeling drainage at the back of the throat
, Rationale: The sensation of drainage or a salty taste may indicate a
cerebrospinal fluid leak, a serious complication after craniotomy. Clear nasal or
postnasal drainage that tests glucose-positive should be reported immediately.
Periorbital edema and mild headache are expected.
5. A client with Huntington's disease is admitted with pneumonia. Which
nursing action is the priority?
A) Administer broad-spectrum antibiotics
B) Provide humidified air and encourage fluid intake
C) Place the client in a negative-pressure room
D) Restrict oral intake to prevent aspiration
Correct Answer: Provide humidified air and encourage fluid intake
Rationale: Huntington's disease impairs swallowing and cough, making
secretion clearance difficult. Humidification and hydration thin secretions,
aiding airway clearance. Antibiotics are important but not the priority over
airway maintenance. Isolation is not needed.
6. A client with myasthenia gravis is prescribed pyridostigmine. The nurse
explains that this medication:
A) Cures the underlying autoimmune process
B) Increases the breakdown of acetylcholine
C) Improves muscle strength temporarily
D) Prevents respiratory muscle weakness
Correct Answer: Improves muscle strength temporarily
