NSG 430 ADULT HEALTH NURSING I
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic kidney disease presents with a potassium level of 6.8 mEq/L. Which
ECG finding should the nurse prioritize?
A. Prominent U waves
B. Shortened PR interval
C. Tall, peaked T waves
D. ST-segment elevation
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) typically causes tall, peaked T
waves, widened QRS complexes, and prolonged PR intervals on an ECG. U waves are
associated with hypokalemia.
2. An arterial blood gas (ABG) report shows: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Compensated metabolic acidosis
,B. Partially compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation has
occurred yet.
3. Following a thyroidectomy, a patient develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse prepare?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: These are signs of hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are damaged. Calcium gluconate is the treatment
of choice.
, 4. Which assessment finding is most characteristic of a patient in the compensatory stage of
shock?
A. Cold, clammy skin and decreased urine output
B. Hypotension and lethargy
C. Anuria and metabolic acidosis
D. Tachycardia and narrowed pulse pressure
Answer: D
Conceptual Explanation: In the compensatory stage, the body attempts to maintain
perfusion via the SNS, resulting in tachycardia, vasoconstriction (narrowed pulse
pressure), and tachypnea.
5. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 48 mg/dL.
What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Provide 4 ounces of orange juice
C. Start an insulin drip at 0.1 units/kg/hr
D. Administer 1 mg of Glucagon IM or SQ
Answer: D
Conceptual Explanation: For an unconscious patient with hypoglycemia, oral intake is
contraindicated due to aspiration risk. Glucagon IM/SQ or IV Dextrose is the priority.
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with chronic kidney disease presents with a potassium level of 6.8 mEq/L. Which
ECG finding should the nurse prioritize?
A. Prominent U waves
B. Shortened PR interval
C. Tall, peaked T waves
D. ST-segment elevation
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) typically causes tall, peaked T
waves, widened QRS complexes, and prolonged PR intervals on an ECG. U waves are
associated with hypokalemia.
2. An arterial blood gas (ABG) report shows: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Compensated metabolic acidosis
,B. Partially compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (<7.35), indicating acidosis. The PaCO2 is high
(>45), indicating a respiratory cause. The HCO3 is normal, meaning no compensation has
occurred yet.
3. Following a thyroidectomy, a patient develops tingling in the fingers and a positive
Chvostek’s sign. Which medication should the nurse prepare?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: These are signs of hypocalcemia, a potential complication of
thyroidectomy if the parathyroid glands are damaged. Calcium gluconate is the treatment
of choice.
, 4. Which assessment finding is most characteristic of a patient in the compensatory stage of
shock?
A. Cold, clammy skin and decreased urine output
B. Hypotension and lethargy
C. Anuria and metabolic acidosis
D. Tachycardia and narrowed pulse pressure
Answer: D
Conceptual Explanation: In the compensatory stage, the body attempts to maintain
perfusion via the SNS, resulting in tachycardia, vasoconstriction (narrowed pulse
pressure), and tachypnea.
5. A patient with Type 1 Diabetes is found unconscious with a blood glucose of 48 mg/dL.
What is the priority nursing action?
A. Administer 15g of simple carbohydrates orally
B. Provide 4 ounces of orange juice
C. Start an insulin drip at 0.1 units/kg/hr
D. Administer 1 mg of Glucagon IM or SQ
Answer: D
Conceptual Explanation: For an unconscious patient with hypoglycemia, oral intake is
contraindicated due to aspiration risk. Glucagon IM/SQ or IV Dextrose is the priority.
