NSG 430: ADULT HEALTH NURSING I
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is above 45
mmHg (respiratory cause). The bicarbonate is within the normal range, indicating an
uncompensated respiratory acidosis.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in lung bases
B. Paroxysmal nocturnal dyspnea
,C. Jugular venous distention
D. Orthopnea
Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to jugular venous distention, peripheral edema, and hepatomegaly. The other
options are signs of left-sided heart failure.
3. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate cardiac protection?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Conceptual Explanation: While insulin and Kayexalate help lower potassium, calcium
gluconate is administered first in severe hyperkalemia to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
4. A patient is admitted with Diabetic Ketoacidosis (DKA). Which IV fluid should the nurse
anticipate hanging first?
A. 0.45% Normal Saline
, B. Dextrose 5% in 0.9% Normal Saline
C. Lactated Ringer’s
D. 0.9% Normal Saline
Answer: D
Conceptual Explanation: The initial goal in DKA treatment is to restore extracellular fluid
volume and maintain perfusion using an isotonic solution like 0.9% Normal Saline.
5. A patient taking Digoxin reports seeing yellow-green halos around lights. What is the
nurse’s priority action?
A. Document the finding as a normal side effect
B. Increase oral potassium intake
C. Administer the next scheduled dose
D. Assess the patient’s apical pulse and hold the dose
Answer: D
Conceptual Explanation: Visual changes such as yellow-green halos are a classic sign of
digoxin toxicity. The nurse must assess the pulse and hold the medication until the
provider is notified and serum levels are checked.
6. A post-operative patient suddenly develops shortness of breath, chest pain, and a sense of
impending doom. What is the most likely complication?
A. Pulmonary Embolism
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis) and the PaCO2 is above 45
mmHg (respiratory cause). The bicarbonate is within the normal range, indicating an
uncompensated respiratory acidosis.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in lung bases
B. Paroxysmal nocturnal dyspnea
,C. Jugular venous distention
D. Orthopnea
Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to jugular venous distention, peripheral edema, and hepatomegaly. The other
options are signs of left-sided heart failure.
3. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse prioritize for immediate cardiac protection?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Conceptual Explanation: While insulin and Kayexalate help lower potassium, calcium
gluconate is administered first in severe hyperkalemia to stabilize the myocardial cell
membrane and prevent life-threatening dysrhythmias.
4. A patient is admitted with Diabetic Ketoacidosis (DKA). Which IV fluid should the nurse
anticipate hanging first?
A. 0.45% Normal Saline
, B. Dextrose 5% in 0.9% Normal Saline
C. Lactated Ringer’s
D. 0.9% Normal Saline
Answer: D
Conceptual Explanation: The initial goal in DKA treatment is to restore extracellular fluid
volume and maintain perfusion using an isotonic solution like 0.9% Normal Saline.
5. A patient taking Digoxin reports seeing yellow-green halos around lights. What is the
nurse’s priority action?
A. Document the finding as a normal side effect
B. Increase oral potassium intake
C. Administer the next scheduled dose
D. Assess the patient’s apical pulse and hold the dose
Answer: D
Conceptual Explanation: Visual changes such as yellow-green halos are a classic sign of
digoxin toxicity. The nurse must assess the pulse and hold the medication until the
provider is notified and serum levels are checked.
6. A post-operative patient suddenly develops shortness of breath, chest pain, and a sense of
impending doom. What is the most likely complication?
A. Pulmonary Embolism
