NSG 300 Exam 4 Blueprint – Foundations of Nursing (GCU)… 2026 Update • Verified Answers
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NSG 300 Exam 4 Blueprint – Foundations of Nursing
(GCU) Study Guide (2026/2027)
Actual Exam Questions & Verified Answers
with Detailed Rationales
Document Type: Exam (Elaborations)
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Full Rationales
Status: Verified & Updated for 2026
Exam (Elaborations) • Actual Questions & Rationales Page 1
,NSG 300 Exam 4 Blueprint – Foundations of Nursing (GCU)… 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which assessment finding is
most consistent with this lab value?
A. Hyperactive bowel sounds
B. Peaked T-waves on ECG
C. Muscle weakness and leg cramps
D. Tingly sensation around the mouth
Answer: C
Rationale: Hypokalemia (low potassium) typically presents with muscle weakness, leg cramps, and decreased
bowel sounds. Peaked T-waves are a sign of hyperkalemia. This is an important clinical concept because
selecting the correct answer (C) requires understanding both the pathophysiology and the practical nursing
implications. Recognizing this principle allows the nurse to prioritize care, anticipate complications, and provide
accurate patient education.
2. Which of the following patients is at the highest risk for developing respiratory acidosis?
A. A patient with COPD and pneumonia
B. A patient having a severe panic attack
C. A patient with excessive vomiting
D. A patient taking excessive antacids
Answer: A
Rationale: Respiratory acidosis is caused by hypoventilation and carbon dioxide retention. COPD and
pneumonia interfere with gas exchange, leading to high CO2 levels. This is an important clinical concept
because selecting the correct answer (A) requires understanding both the pathophysiology and the practical
nursing implications. Recognizing this principle allows the nurse to prioritize care, anticipate complications, and
provide accurate patient education.
3. A nurse is caring for a patient with a serum sodium level of 150 mEq/L. Which nursing
intervention is a priority?
A. Administering 3% saline solution
B. Monitoring for signs of dehydration and confusion
C. Encouraging the intake of salty snacks
D. Restricting oral fluid intake
Answer: B
Rationale: A sodium level of 150 mEq/L indicates hypernatremia. The priority is to monitor neurological status
(confusion) and hydration levels to ensure safety. Applying this knowledge in clinical settings supports safe,
evidence-based practice and improves patient outcomes. This is an important clinical concept because
selecting the correct answer (B) requires understanding both the pathophysiology and the practical nursing
implications.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NSG 300 Exam 4 Blueprint – Foundations of Nursing (GCU)… 2026 Update • Verified Answers
4. Which arterial blood gas (ABG) result indicates metabolic alkalosis?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.50, PaCO2 38, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 22
Answer: B
Rationale: Metabolic alkalosis is characterized by a high pH (>7.45) and a high bicarbonate (HCO3 >26) with a
normal or compensating PaCO2. Recognizing this principle allows the nurse to prioritize care, anticipate
complications, and provide accurate patient education. Exam questions often test the ability to distinguish this
concept from closely related distractors, making a clear rationale essential for mastery.
5. During a physical assessment, the nurse notes a positive Chvostek’s sign. This finding is
associated with a deficiency in which electrolyte?
A. Sodium
B. Calcium
C. Potassium
D. Phosphorus
Answer: B
Rationale: Chvostek’s sign (facial twitching) and Trousseau’s sign (carpal spasm) are classic clinical indicators
of hypocalcemia. Exam questions often test the ability to distinguish this concept from closely related
distractors, making a clear rationale essential for mastery. Applying this knowledge in clinical settings supports
safe, evidence-based practice and improves patient outcomes.
6. A patient is experiencing fluid volume excess. Which of the following clinical manifestations
should the nurse expect?
A. Tenting skin turgor
B. Crackles in the lungs
C. Flat neck veins when supine
D. Weight loss of 2 lbs in 24 hours
Answer: B
Rationale: Fluid volume excess (hypervolemia) leads to pulmonary congestion, resulting in crackles, as well as
edema and distended neck veins. This is an important clinical concept because selecting the correct answer
(B) requires understanding both the pathophysiology and the practical nursing implications. Recognizing this
principle allows the nurse to prioritize care, anticipate complications, and provide accurate patient education.
Exam (Elaborations) • Actual Questions & Rationales Page 3
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NSG 300 Exam 4 Blueprint – Foundations of Nursing
(GCU) Study Guide (2026/2027)
Actual Exam Questions & Verified Answers
with Detailed Rationales
Document Type: Exam (Elaborations)
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Full Rationales
Status: Verified & Updated for 2026
Exam (Elaborations) • Actual Questions & Rationales Page 1
,NSG 300 Exam 4 Blueprint – Foundations of Nursing (GCU)… 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient presents with a serum potassium level of 2.8 mEq/L. Which assessment finding is
most consistent with this lab value?
A. Hyperactive bowel sounds
B. Peaked T-waves on ECG
C. Muscle weakness and leg cramps
D. Tingly sensation around the mouth
Answer: C
Rationale: Hypokalemia (low potassium) typically presents with muscle weakness, leg cramps, and decreased
bowel sounds. Peaked T-waves are a sign of hyperkalemia. This is an important clinical concept because
selecting the correct answer (C) requires understanding both the pathophysiology and the practical nursing
implications. Recognizing this principle allows the nurse to prioritize care, anticipate complications, and provide
accurate patient education.
2. Which of the following patients is at the highest risk for developing respiratory acidosis?
A. A patient with COPD and pneumonia
B. A patient having a severe panic attack
C. A patient with excessive vomiting
D. A patient taking excessive antacids
Answer: A
Rationale: Respiratory acidosis is caused by hypoventilation and carbon dioxide retention. COPD and
pneumonia interfere with gas exchange, leading to high CO2 levels. This is an important clinical concept
because selecting the correct answer (A) requires understanding both the pathophysiology and the practical
nursing implications. Recognizing this principle allows the nurse to prioritize care, anticipate complications, and
provide accurate patient education.
3. A nurse is caring for a patient with a serum sodium level of 150 mEq/L. Which nursing
intervention is a priority?
A. Administering 3% saline solution
B. Monitoring for signs of dehydration and confusion
C. Encouraging the intake of salty snacks
D. Restricting oral fluid intake
Answer: B
Rationale: A sodium level of 150 mEq/L indicates hypernatremia. The priority is to monitor neurological status
(confusion) and hydration levels to ensure safety. Applying this knowledge in clinical settings supports safe,
evidence-based practice and improves patient outcomes. This is an important clinical concept because
selecting the correct answer (B) requires understanding both the pathophysiology and the practical nursing
implications.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NSG 300 Exam 4 Blueprint – Foundations of Nursing (GCU)… 2026 Update • Verified Answers
4. Which arterial blood gas (ABG) result indicates metabolic alkalosis?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.50, PaCO2 38, HCO3 30
C. pH 7.32, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 22
Answer: B
Rationale: Metabolic alkalosis is characterized by a high pH (>7.45) and a high bicarbonate (HCO3 >26) with a
normal or compensating PaCO2. Recognizing this principle allows the nurse to prioritize care, anticipate
complications, and provide accurate patient education. Exam questions often test the ability to distinguish this
concept from closely related distractors, making a clear rationale essential for mastery.
5. During a physical assessment, the nurse notes a positive Chvostek’s sign. This finding is
associated with a deficiency in which electrolyte?
A. Sodium
B. Calcium
C. Potassium
D. Phosphorus
Answer: B
Rationale: Chvostek’s sign (facial twitching) and Trousseau’s sign (carpal spasm) are classic clinical indicators
of hypocalcemia. Exam questions often test the ability to distinguish this concept from closely related
distractors, making a clear rationale essential for mastery. Applying this knowledge in clinical settings supports
safe, evidence-based practice and improves patient outcomes.
6. A patient is experiencing fluid volume excess. Which of the following clinical manifestations
should the nurse expect?
A. Tenting skin turgor
B. Crackles in the lungs
C. Flat neck veins when supine
D. Weight loss of 2 lbs in 24 hours
Answer: B
Rationale: Fluid volume excess (hypervolemia) leads to pulmonary congestion, resulting in crackles, as well as
edema and distended neck veins. This is an important clinical concept because selecting the correct answer
(B) requires understanding both the pathophysiology and the practical nursing implications. Recognizing this
principle allows the nurse to prioritize care, anticipate complications, and provide accurate patient education.
Exam (Elaborations) • Actual Questions & Rationales Page 3
