NSG 3130 EXAM 300 ACTUAL TEST BANK QUESTIONS AND
CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+
This comprehensive collection of 300 unique questions is specifically designed
to mirror the clinical rigour and format of advanced nursing examinations
such as NSG 3130 and the NZ NCAP. Each question presents a distinct, real-
world clinical scenario that tests critical nursing competencies across
pharmacology, pathophysiology, and priority-setting. The questions cover a
wide spectrum of conditions, medications, and patient populations, ensuring
broad revision coverage. Every entry includes the correct answer and a
detailed, evidence-based rationale that explains the underlying clinical
reasoning, pharmacokinetics, or nursing priority, making this an effective
self-assessment and high-yield learning tool for exam preparation and clinical
practice.
1 An older adult patient with a history of falls is admitted with confusion and
dehydration. The family reports the patient has been eating poorly for a week.
What is the nurse's priority action upon admission?
A) Insert a urinary catheter to monitor output
B) Apply a fall risk alert and initiate hourly rounding
C) Order a dietary consult for nutritional assessment
D) Administer IV fluids as prescribed and monitor electrolytes
Answer: D
Rationale: Dehydration with confusion in an older adult can quickly lead to acute
kidney injury and electrolyte imbalances. The priority is to correct the fluid deficit
and monitor electrolytes. Fall precautions are important but addressing the
physiological instability comes first.
2 A patient with chronic obstructive pulmonary disease is receiving oxygen at
3L/min via nasal cannula. The nurse notes the patient is drowsy and has a
respiratory rate of 10/min. What is the most appropriate nursing intervention?
A) Increase oxygen to 5L/min to improve saturation
B) Decrease oxygen to 1L/min and reassess respiratory status
C) Apply a non-rebreathing mask at 15L/min
,D) Prepare for immediate intubation
Answer: B
Rationale: The patient may be experiencing carbon dioxide narcosis due to
hypoventilation from excessive oxygen in a COPD patient with a hypoxic drive.
Reducing oxygen to 1-2L/min and reassessing is appropriate. If respiratory failure
worsens, intubation may be needed.
3 A patient with a new diagnosis of heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Weight loss of 1kg in 24 hours and decreased dyspnoea
B) Increased jugular venous distension
C) Blood pressure of 150/90 mmHg
D) Peripheral oedema worsening
Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. Desired
effects include weight loss, reduced oedema, decreased dyspnoea, and improved
breathing. Worsening oedema and elevated JVD indicate failure of therapy.
4 A patient with a history of depression is started on sertraline. The nurse should
teach the patient that this medication may take how long to achieve full therapeutic
effect?
A) 1 to 2 days
B) 1 to 2 weeks
C) 4 to 6 weeks
D) 8 to 12 weeks
Answer: C
Rationale: SSRIs like sertraline typically take 4 to 6 weeks to reach full therapeutic
effect, although some improvement may be seen earlier. Patients should be
educated not to discontinue the medication prematurely.
5 A patient with acute pancreatitis reports severe abdominal pain that radiates to
the back. What is the priority nursing intervention?
A) Administer oral analgesics
B) Place the patient in a supine position
C) Maintain NPO status and administer IV fluids as prescribed
D) Encourage oral fluids to prevent dehydration
Answer: C
Rationale: Acute pancreatitis requires pancreatic rest, which is achieved by
keeping the patient NPO. IV fluids are essential to maintain hydration and correct
,electrolyte imbalances. Pain management is important but the priority is resting the
pancreas.
6 A patient with a history of atrial fibrillation is on warfarin. The INR is 6.5 and
the patient has no bleeding. What should the nurse do?
A) Administer vitamin K 10mg orally
B) Hold the warfarin and notify the prescriber
C) Continue the warfarin as prescribed
D) Administer fresh frozen plasma
Answer: B
Rationale: An INR above 5.0 without bleeding requires holding the warfarin and
notifying the prescriber. Vitamin K is indicated for INR >5.0 with bleeding or INR
>8.0 without bleeding.
7 A patient with diabetes mellitus type 2 is prescribed metformin. Which statement
by the patient indicates a need for further teaching?
A) I will take this medication with meals to reduce stomach upset
B) I need to monitor my blood glucose regularly while on this medication
C) I can stop taking this medication once my blood glucose is normal
D) I should report any muscle pain or weakness to my doctor
Answer: C
Rationale: Metformin is a chronic medication for diabetes management. It should
not be stopped once glucose levels normalise; it must be continued to maintain
glycaemic control. The other statements are correct.
8 A patient with a history of asthma is prescribed salbutamol inhaler. The nurse
should instruct the patient to use this medication:
A) Daily to prevent asthma attacks
B) When experiencing shortness of breath or wheezing
C) Only at bedtime to prevent nocturnal symptoms
D) In place of their corticosteroid inhaler
Answer: B
Rationale: Salbutamol is a short-acting beta-agonist used as a rescue medication
for acute symptoms. It is not a controller medication and should not replace
inhaled corticosteroids.
9 A patient with chronic kidney disease has a serum potassium of 6.8 mmol/L. The
ECG shows tall peaked T waves. What is the priority nursing action?
A) Restrict dietary potassium
B) Administer oral kayexalate
, C) Administer IV calcium gluconate and notify the prescriber
D) Prepare for haemodialysis
Answer: C
Rationale: Hyperkalaemia with ECG changes is a medical emergency. IV calcium
gluconate stabilises the cardiac membrane. The prescriber should be notified
immediately for further interventions.
10 A patient with a head injury has a Glasgow Coma Scale score of 8. What is the
most important nursing action?
A) Document the score and continue monitoring
B) Place the patient in a supine position
C) Assess the airway and prepare for possible intubation
D) Administer analgesia for pain
Answer: C
Rationale: A GCS of 8 or less indicates severe brain injury and the patient is at
high risk for airway compromise. The priority is airway assessment and
preparation for intubation to protect the airway.
11 A patient with a new colostomy is distressed and refuses to look at the stoma.
What is the most appropriate nursing response?
A) You will get used to it in time
B) It is normal to feel this way; we can work together when you are ready
C) You need to accept this as part of your body now
D) Let me show you how to change the pouch first
Answer: B
Rationale: This response validates the patient's feelings and offers support without
pressure. It respects the patient's readiness and promotes a therapeutic relationship.
12 A patient with pneumonia has a fever of 39.2°C and is shivering. What is the
priority nursing intervention?
A) Apply cold packs to the axillae and groin
B) Administer antipyretics as prescribed and remove excess blankets
C) Cover the patient with warm blankets to stop the shivering
D) Increase the room temperature
Answer: B
Rationale: Shivering indicates the body is trying to generate heat. Antipyretics help
lower the set point, and removing excess blankets allows heat to dissipate. Cold
packs can cause shivering and are not first-line.
CORRECT ANSWERS WITH RATIONALE LATEST 2026
ALREADY GRADED A+
This comprehensive collection of 300 unique questions is specifically designed
to mirror the clinical rigour and format of advanced nursing examinations
such as NSG 3130 and the NZ NCAP. Each question presents a distinct, real-
world clinical scenario that tests critical nursing competencies across
pharmacology, pathophysiology, and priority-setting. The questions cover a
wide spectrum of conditions, medications, and patient populations, ensuring
broad revision coverage. Every entry includes the correct answer and a
detailed, evidence-based rationale that explains the underlying clinical
reasoning, pharmacokinetics, or nursing priority, making this an effective
self-assessment and high-yield learning tool for exam preparation and clinical
practice.
1 An older adult patient with a history of falls is admitted with confusion and
dehydration. The family reports the patient has been eating poorly for a week.
What is the nurse's priority action upon admission?
A) Insert a urinary catheter to monitor output
B) Apply a fall risk alert and initiate hourly rounding
C) Order a dietary consult for nutritional assessment
D) Administer IV fluids as prescribed and monitor electrolytes
Answer: D
Rationale: Dehydration with confusion in an older adult can quickly lead to acute
kidney injury and electrolyte imbalances. The priority is to correct the fluid deficit
and monitor electrolytes. Fall precautions are important but addressing the
physiological instability comes first.
2 A patient with chronic obstructive pulmonary disease is receiving oxygen at
3L/min via nasal cannula. The nurse notes the patient is drowsy and has a
respiratory rate of 10/min. What is the most appropriate nursing intervention?
A) Increase oxygen to 5L/min to improve saturation
B) Decrease oxygen to 1L/min and reassess respiratory status
C) Apply a non-rebreathing mask at 15L/min
,D) Prepare for immediate intubation
Answer: B
Rationale: The patient may be experiencing carbon dioxide narcosis due to
hypoventilation from excessive oxygen in a COPD patient with a hypoxic drive.
Reducing oxygen to 1-2L/min and reassessing is appropriate. If respiratory failure
worsens, intubation may be needed.
3 A patient with a new diagnosis of heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Weight loss of 1kg in 24 hours and decreased dyspnoea
B) Increased jugular venous distension
C) Blood pressure of 150/90 mmHg
D) Peripheral oedema worsening
Answer: A
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. Desired
effects include weight loss, reduced oedema, decreased dyspnoea, and improved
breathing. Worsening oedema and elevated JVD indicate failure of therapy.
4 A patient with a history of depression is started on sertraline. The nurse should
teach the patient that this medication may take how long to achieve full therapeutic
effect?
A) 1 to 2 days
B) 1 to 2 weeks
C) 4 to 6 weeks
D) 8 to 12 weeks
Answer: C
Rationale: SSRIs like sertraline typically take 4 to 6 weeks to reach full therapeutic
effect, although some improvement may be seen earlier. Patients should be
educated not to discontinue the medication prematurely.
5 A patient with acute pancreatitis reports severe abdominal pain that radiates to
the back. What is the priority nursing intervention?
A) Administer oral analgesics
B) Place the patient in a supine position
C) Maintain NPO status and administer IV fluids as prescribed
D) Encourage oral fluids to prevent dehydration
Answer: C
Rationale: Acute pancreatitis requires pancreatic rest, which is achieved by
keeping the patient NPO. IV fluids are essential to maintain hydration and correct
,electrolyte imbalances. Pain management is important but the priority is resting the
pancreas.
6 A patient with a history of atrial fibrillation is on warfarin. The INR is 6.5 and
the patient has no bleeding. What should the nurse do?
A) Administer vitamin K 10mg orally
B) Hold the warfarin and notify the prescriber
C) Continue the warfarin as prescribed
D) Administer fresh frozen plasma
Answer: B
Rationale: An INR above 5.0 without bleeding requires holding the warfarin and
notifying the prescriber. Vitamin K is indicated for INR >5.0 with bleeding or INR
>8.0 without bleeding.
7 A patient with diabetes mellitus type 2 is prescribed metformin. Which statement
by the patient indicates a need for further teaching?
A) I will take this medication with meals to reduce stomach upset
B) I need to monitor my blood glucose regularly while on this medication
C) I can stop taking this medication once my blood glucose is normal
D) I should report any muscle pain or weakness to my doctor
Answer: C
Rationale: Metformin is a chronic medication for diabetes management. It should
not be stopped once glucose levels normalise; it must be continued to maintain
glycaemic control. The other statements are correct.
8 A patient with a history of asthma is prescribed salbutamol inhaler. The nurse
should instruct the patient to use this medication:
A) Daily to prevent asthma attacks
B) When experiencing shortness of breath or wheezing
C) Only at bedtime to prevent nocturnal symptoms
D) In place of their corticosteroid inhaler
Answer: B
Rationale: Salbutamol is a short-acting beta-agonist used as a rescue medication
for acute symptoms. It is not a controller medication and should not replace
inhaled corticosteroids.
9 A patient with chronic kidney disease has a serum potassium of 6.8 mmol/L. The
ECG shows tall peaked T waves. What is the priority nursing action?
A) Restrict dietary potassium
B) Administer oral kayexalate
, C) Administer IV calcium gluconate and notify the prescriber
D) Prepare for haemodialysis
Answer: C
Rationale: Hyperkalaemia with ECG changes is a medical emergency. IV calcium
gluconate stabilises the cardiac membrane. The prescriber should be notified
immediately for further interventions.
10 A patient with a head injury has a Glasgow Coma Scale score of 8. What is the
most important nursing action?
A) Document the score and continue monitoring
B) Place the patient in a supine position
C) Assess the airway and prepare for possible intubation
D) Administer analgesia for pain
Answer: C
Rationale: A GCS of 8 or less indicates severe brain injury and the patient is at
high risk for airway compromise. The priority is airway assessment and
preparation for intubation to protect the airway.
11 A patient with a new colostomy is distressed and refuses to look at the stoma.
What is the most appropriate nursing response?
A) You will get used to it in time
B) It is normal to feel this way; we can work together when you are ready
C) You need to accept this as part of your body now
D) Let me show you how to change the pouch first
Answer: B
Rationale: This response validates the patient's feelings and offers support without
pressure. It respects the patient's readiness and promotes a therapeutic relationship.
12 A patient with pneumonia has a fever of 39.2°C and is shivering. What is the
priority nursing intervention?
A) Apply cold packs to the axillae and groin
B) Administer antipyretics as prescribed and remove excess blankets
C) Cover the patient with warm blankets to stop the shivering
D) Increase the room temperature
Answer: B
Rationale: Shivering indicates the body is trying to generate heat. Antipyretics help
lower the set point, and removing excess blankets allows heat to dissipate. Cold
packs can cause shivering and are not first-line.
