NSG 3130 / NSG 3130 Exam 3: Fundamental Concepts & Skills for Nursing Practice II (2026/2027 Update)
OBJECTIVE ASSESSMENT - EXAM
NSG 3130 / NSG 3130 Exam 3:
Fundamental Concepts & Skills
for Nursing Practice II (2026/2027
Update)
A+ Verified
— 2026/2027 Official
Edition: 2026/2027 Update Passing Score: 80%
Exam
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Vital Signs, Physical Assessment & Health Promotion
Section 2: Medication Administration & Safety
Section 3: Infection Control, Asepsis & Safety
Section 4: Fluid, Electrolyte, Acid-Base Balance & Elimination
Section 5: Communication, Documentation & Patient Education
NSG 3130 / NSG 3130 Exam 3: Fundamental Concepts & Skills for Nursing Practice II
Difficulty: Undergraduate nursing — foundational nursing skills and concepts at the baccalaureate level
Question Types: Multiple choice, 4 options (A-D) | Marks: 1 mark per question | Passing Score: 80%
Bloom's Taxonomy Level: Application/Analysis
Section 1: Vital Signs, Physical Assessment & Health Promotion
QUESTION 1
Q1. A 68-year-old male patient is admitted to the medical-surgical unit with a diagnosis of
community-acquired pneumonia. During the initial assessment, the nurse auscultates bilateral crackles
in the lower lung fields and notes a respiratory rate of 28 breaths per minute with shallow depth. The
patient's oxygen saturation is 91% on room air. Which action should the nurse prioritize first?
A. Apply supplemental oxygen via nasal cannula at 2 L/min
B. Administer the prescribed albuterol nebulizer treatment
C. Encourage the patient to use the incentive spirometer
D. Notify the physician immediately about the lung sounds
Correct Answer: A
Rationale: The patient's SpO2 of 91% indicates hypoxemia, which takes priority over other interventions per the ABC
framework. Supplemental oxygen should be initiated first to improve oxygenation. While albuterol and spirometry are
appropriate, they do not address the immediate oxygenation deficit.
QUESTION 2
Q2. During a routine wellness visit, a 45-year-old female patient reports occasional headaches and
dizziness. The nurse obtains a blood pressure reading of 158/96 mmHg in the right arm after the patient
has been seated quietly for five minutes. A repeat measurement taken 10 minutes later yields 162/98
mmHg. Based on these findings, which classification and recommendation are most appropriate?
A. Stage 1 hypertension; recommend lifestyle modifications only
B. Stage 2 hypertension; advise follow-up with primary care within one month
C. Elevated blood pressure; recheck again in six months
D. Hypertensive crisis; refer to emergency department immediately
Correct Answer: B
Rationale: Averaged readings of ≥140/90 mmHg on two occasions meet criteria for Stage 2 hypertension. Lifestyle
modifications alone are insufficient at this stage, and prompt follow-up for possible pharmacologic management is
warranted. A hypertensive crisis requires readings ≥180/120 mmHg.
, QUESTION 3
Q3. A school nurse is conducting vision screenings for third-grade students. One child consistently
fails to identify letters on the 20/40 line of the Snellen chart with the right eye but achieves 20/20 with
the left eye. The child denies eye pain or recent trauma. Which is the most appropriate next step?
A. Reassure the parents that asymmetric vision is normal in children
B. Repeat the screening in one year during the next routine check
C. Document the finding and schedule a referral to an ophthalmologist
D. Instruct the child to patch the left eye for two hours daily
Correct Answer: C
Rationale: A two-line difference in visual acuity between eyes warrants referral for comprehensive eye examination to rule
out amblyopia or refractive error. Patching without diagnosis is inappropriate, and delaying evaluation risks permanent
vision loss in the affected eye.
QUESTION 4
Q4. A nurse is assessing a 72-year-old patient who was found wandering confused in a parking lot and
brought to the emergency department by paramedics. The patient's tympanic temperature is 35.8°C
(96.4°F), heart rate is 52 bpm, and blood pressure is 98/58 mmHg. The skin is cool and dry. Which
underlying condition should the nurse suspect as the most likely cause?
A. Hyperthyroidism causing increased metabolic rate
B. Septic shock causing peripheral vasodilation
C. Diabetic ketoacidosis causing metabolic acidosis
D. Hypothyroidism causing decreased metabolic rate
Correct Answer: D
Rationale: Hypothermia, bradycardia, hypotension, and cool dry skin are classic manifestations of hypothyroidism or
myxedema coma. Hyperthyroidism would produce fever and tachycardia. Septic shock typically presents with fever and
warm flushed skin, not hypothermia and cool skin.
QUESTION 5
Q5. During morning rounds, a nurse notices that a postoperative patient's apical pulse is irregularly
irregular with a rate of 112 bpm. The radial pulse is 96 bpm. The patient reports mild fatigue but denies
chest pain or dyspnea. Which nursing action is most appropriate at this time?
A. Obtain a 12-lead electrocardiogram and notify the provider
B. Document the finding as a normal postoperative variation
C. Administer the scheduled beta-blocker and reassess in one hour
D. Apply oxygen at 4 L/min via nasal cannula and call a rapid response
Correct Answer: A
Rationale: A pulse deficit (apical rate exceeding radial rate) in an irregularly irregular rhythm suggests atrial fibrillation,
which requires ECG confirmation and provider notification. Delaying assessment could allow thromboembolic
complications. Oxygen and rapid response are not indicated without respiratory compromise.
NSG 3130 / NSG 3130 Exam 3: Fundamental Concepts & Skills for Nursing Practice II (2026/2027 Update) — 2026/2027 Official Exam
OBJECTIVE ASSESSMENT - EXAM
NSG 3130 / NSG 3130 Exam 3:
Fundamental Concepts & Skills
for Nursing Practice II (2026/2027
Update)
A+ Verified
— 2026/2027 Official
Edition: 2026/2027 Update Passing Score: 80%
Exam
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Vital Signs, Physical Assessment & Health Promotion
Section 2: Medication Administration & Safety
Section 3: Infection Control, Asepsis & Safety
Section 4: Fluid, Electrolyte, Acid-Base Balance & Elimination
Section 5: Communication, Documentation & Patient Education
NSG 3130 / NSG 3130 Exam 3: Fundamental Concepts & Skills for Nursing Practice II
Difficulty: Undergraduate nursing — foundational nursing skills and concepts at the baccalaureate level
Question Types: Multiple choice, 4 options (A-D) | Marks: 1 mark per question | Passing Score: 80%
Bloom's Taxonomy Level: Application/Analysis
Section 1: Vital Signs, Physical Assessment & Health Promotion
QUESTION 1
Q1. A 68-year-old male patient is admitted to the medical-surgical unit with a diagnosis of
community-acquired pneumonia. During the initial assessment, the nurse auscultates bilateral crackles
in the lower lung fields and notes a respiratory rate of 28 breaths per minute with shallow depth. The
patient's oxygen saturation is 91% on room air. Which action should the nurse prioritize first?
A. Apply supplemental oxygen via nasal cannula at 2 L/min
B. Administer the prescribed albuterol nebulizer treatment
C. Encourage the patient to use the incentive spirometer
D. Notify the physician immediately about the lung sounds
Correct Answer: A
Rationale: The patient's SpO2 of 91% indicates hypoxemia, which takes priority over other interventions per the ABC
framework. Supplemental oxygen should be initiated first to improve oxygenation. While albuterol and spirometry are
appropriate, they do not address the immediate oxygenation deficit.
QUESTION 2
Q2. During a routine wellness visit, a 45-year-old female patient reports occasional headaches and
dizziness. The nurse obtains a blood pressure reading of 158/96 mmHg in the right arm after the patient
has been seated quietly for five minutes. A repeat measurement taken 10 minutes later yields 162/98
mmHg. Based on these findings, which classification and recommendation are most appropriate?
A. Stage 1 hypertension; recommend lifestyle modifications only
B. Stage 2 hypertension; advise follow-up with primary care within one month
C. Elevated blood pressure; recheck again in six months
D. Hypertensive crisis; refer to emergency department immediately
Correct Answer: B
Rationale: Averaged readings of ≥140/90 mmHg on two occasions meet criteria for Stage 2 hypertension. Lifestyle
modifications alone are insufficient at this stage, and prompt follow-up for possible pharmacologic management is
warranted. A hypertensive crisis requires readings ≥180/120 mmHg.
, QUESTION 3
Q3. A school nurse is conducting vision screenings for third-grade students. One child consistently
fails to identify letters on the 20/40 line of the Snellen chart with the right eye but achieves 20/20 with
the left eye. The child denies eye pain or recent trauma. Which is the most appropriate next step?
A. Reassure the parents that asymmetric vision is normal in children
B. Repeat the screening in one year during the next routine check
C. Document the finding and schedule a referral to an ophthalmologist
D. Instruct the child to patch the left eye for two hours daily
Correct Answer: C
Rationale: A two-line difference in visual acuity between eyes warrants referral for comprehensive eye examination to rule
out amblyopia or refractive error. Patching without diagnosis is inappropriate, and delaying evaluation risks permanent
vision loss in the affected eye.
QUESTION 4
Q4. A nurse is assessing a 72-year-old patient who was found wandering confused in a parking lot and
brought to the emergency department by paramedics. The patient's tympanic temperature is 35.8°C
(96.4°F), heart rate is 52 bpm, and blood pressure is 98/58 mmHg. The skin is cool and dry. Which
underlying condition should the nurse suspect as the most likely cause?
A. Hyperthyroidism causing increased metabolic rate
B. Septic shock causing peripheral vasodilation
C. Diabetic ketoacidosis causing metabolic acidosis
D. Hypothyroidism causing decreased metabolic rate
Correct Answer: D
Rationale: Hypothermia, bradycardia, hypotension, and cool dry skin are classic manifestations of hypothyroidism or
myxedema coma. Hyperthyroidism would produce fever and tachycardia. Septic shock typically presents with fever and
warm flushed skin, not hypothermia and cool skin.
QUESTION 5
Q5. During morning rounds, a nurse notices that a postoperative patient's apical pulse is irregularly
irregular with a rate of 112 bpm. The radial pulse is 96 bpm. The patient reports mild fatigue but denies
chest pain or dyspnea. Which nursing action is most appropriate at this time?
A. Obtain a 12-lead electrocardiogram and notify the provider
B. Document the finding as a normal postoperative variation
C. Administer the scheduled beta-blocker and reassess in one hour
D. Apply oxygen at 4 L/min via nasal cannula and call a rapid response
Correct Answer: A
Rationale: A pulse deficit (apical rate exceeding radial rate) in an irregularly irregular rhythm suggests atrial fibrillation,
which requires ECG confirmation and provider notification. Delaying assessment could allow thromboembolic
complications. Oxygen and rapid response are not indicated without respiratory compromise.
NSG 3130 / NSG 3130 Exam 3: Fundamental Concepts & Skills for Nursing Practice II (2026/2027 Update) — 2026/2027 Official Exam
