NSG 430 Exam 2 – Adult Health Nursing II 2026 UPDATE 2026 Update • Verified Answers
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NSG 430 Exam 2 – Adult Health Nursing II 2026
UPDATE
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 430 Exam 2 – Adult Health Nursing II 2026 UPDATE 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient’s ABG results show pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal HCO3 indicates that
the source is respiratory. 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.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Bradycardia
B. Increased urine output
C. Hypotension
D. Cool, clammy skin
Answer: D
Rationale: In the compensatory stage, blood is shunted away from the skin and kidneys to vital organs,
resulting in cool, clammy skin. 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 (D) requires understanding both the pathophysiology and the practical nursing implications.
3. A patient with ARDS is placed on mechanical ventilation with PEEP. What is the primary
purpose of PEEP?
A. To prevent alveolar collapse at the end of expiration
B. To decrease the work of breathing
C. To increase the fraction of inspired oxygen
D. To remove excess carbon dioxide
Answer: A
Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open at the end of expiration, improving
oxygenation and preventing atelectasis. 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.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NSG 430 Exam 2 – Adult Health Nursing II 2026 UPDATE 2026 Update • Verified Answers
4. Which assessment finding in a patient with a tension pneumothorax requires immediate
intervention?
A. Muffled heart sounds
B. Flattened neck veins
C. Tracheal deviation to the unaffected side
D. Bradypnea
Answer: C
Rationale: Tracheal deviation is a late and critical sign of tension pneumothorax, indicating significant
mediastinal shift and potential obstructive shock. 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.
5. Calculate the total fluid requirement for the first 24 hours using the Parkland formula for a 75
kg patient with 40% TBSA burns.
A. 3000 mL
B. 6000 mL
C. 15000 mL
D. 12000 mL
Answer: D
Rationale: Parkland formula: 4 mL x kg x %TBSA. 4 x 75 x 40 = 12,000 mL. 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. In a patient with Septic Shock, which lab value is most indicative of tissue hypoperfusion?
A. Elevated Serum Lactate
B. Decreased Hemoglobin
C. Elevated White Blood Cell count
D. Decreased Blood Urea Nitrogen
Answer: A
Rationale: Lactate levels rise when cells switch to anaerobic metabolism due to inadequate oxygen delivery
(hypoperfusion). 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.
Exam (Elaborations) • Actual Questions & Rationales Page 3
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NSG 430 Exam 2 – Adult Health Nursing II 2026
UPDATE
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 430 Exam 2 – Adult Health Nursing II 2026 UPDATE 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient’s ABG results show pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal HCO3 indicates that
the source is respiratory. 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.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Bradycardia
B. Increased urine output
C. Hypotension
D. Cool, clammy skin
Answer: D
Rationale: In the compensatory stage, blood is shunted away from the skin and kidneys to vital organs,
resulting in cool, clammy skin. 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 (D) requires understanding both the pathophysiology and the practical nursing implications.
3. A patient with ARDS is placed on mechanical ventilation with PEEP. What is the primary
purpose of PEEP?
A. To prevent alveolar collapse at the end of expiration
B. To decrease the work of breathing
C. To increase the fraction of inspired oxygen
D. To remove excess carbon dioxide
Answer: A
Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open at the end of expiration, improving
oxygenation and preventing atelectasis. 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.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NSG 430 Exam 2 – Adult Health Nursing II 2026 UPDATE 2026 Update • Verified Answers
4. Which assessment finding in a patient with a tension pneumothorax requires immediate
intervention?
A. Muffled heart sounds
B. Flattened neck veins
C. Tracheal deviation to the unaffected side
D. Bradypnea
Answer: C
Rationale: Tracheal deviation is a late and critical sign of tension pneumothorax, indicating significant
mediastinal shift and potential obstructive shock. 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.
5. Calculate the total fluid requirement for the first 24 hours using the Parkland formula for a 75
kg patient with 40% TBSA burns.
A. 3000 mL
B. 6000 mL
C. 15000 mL
D. 12000 mL
Answer: D
Rationale: Parkland formula: 4 mL x kg x %TBSA. 4 x 75 x 40 = 12,000 mL. 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. In a patient with Septic Shock, which lab value is most indicative of tissue hypoperfusion?
A. Elevated Serum Lactate
B. Decreased Hemoglobin
C. Elevated White Blood Cell count
D. Decreased Blood Urea Nitrogen
Answer: A
Rationale: Lactate levels rise when cells switch to anaerobic metabolism due to inadequate oxygen delivery
(hypoperfusion). 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.
Exam (Elaborations) • Actual Questions & Rationales Page 3
