NSG 430 ADULT HEALTH NURSING II -
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
of the following ventilator settings is most critical for improving oxygenation by preventing
alveolar collapse?
A. High Tidal Volume
B. Positive End-Expiratory Pressure (PEEP)
C. Increased Fraction of Inspired Oxygen (FiO2)
D. Pressure Support Ventilation (PSV)
Answer: B
Conceptual Explanation: PEEP is used in ARDS to keep the alveoli open at the end of
expiration, which improves gas exchange and prevents atelectasis.
2. A nurse is caring for a patient with a Mean Arterial Pressure (MAP) of 55 mmHg. Which
organ system is most at risk for immediate dysfunction?
A. The Renal System
B. The Integumentary System
,C. The Musculoskeletal System
D. The Gastrointestinal System
Answer: A
Conceptual Explanation: A MAP of at least 60-65 mmHg is required to maintain adequate
perfusion to vital organs, especially the kidneys.
3. Which assessment finding is most indicative of Cushing’s Triad in a patient with a traumatic
brain injury?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and kussmaul respirations
Answer: B
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
consisting of bradycardia, hypertension (widening pulse pressure), and altered breathing
patterns.
4. A patient with Type 1 Diabetes presents to the Emergency Department with a blood
glucose of 550 mg/dL, ketones in the urine, and an arterial pH of 7.25. What is the priority
nursing intervention?
A. Administering subcutaneous long-acting insulin
, B. Administering sodium bicarbonate to correct the pH
C. Starting a potassium infusion at 40 mEq/hr
D. Initiating intravenous fluid resuscitation with Normal Saline
Answer: D
Conceptual Explanation: The first priority in Diabetic Ketoacidosis (DKA) is volume
repletion to treat dehydration and restore perfusion before addressing insulin deficiency.
5. A patient with a T6 spinal cord injury reports a sudden, severe headache and is found to
have a blood pressure of 210/110 mmHg. What should be the nurse’s first action?
A. Check the patient for bladder distention
B. Place the patient in a supine position
C. Administer PRN Hydralazine
D. Call a Rapid Response
Answer: A
Conceptual Explanation: These are classic signs of Autonomic Dysreflexia. The priority is
to sit the patient up and then identify/remove the noxious stimulus, usually a full bladder
or impacted bowel.
6. Which of the following cardiac rhythms requires immediate unsynchronized defibrillation?
A. Atrial Fibrillation with RVR
B. Ventricular Tachycardia with a pulse
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
of the following ventilator settings is most critical for improving oxygenation by preventing
alveolar collapse?
A. High Tidal Volume
B. Positive End-Expiratory Pressure (PEEP)
C. Increased Fraction of Inspired Oxygen (FiO2)
D. Pressure Support Ventilation (PSV)
Answer: B
Conceptual Explanation: PEEP is used in ARDS to keep the alveoli open at the end of
expiration, which improves gas exchange and prevents atelectasis.
2. A nurse is caring for a patient with a Mean Arterial Pressure (MAP) of 55 mmHg. Which
organ system is most at risk for immediate dysfunction?
A. The Renal System
B. The Integumentary System
,C. The Musculoskeletal System
D. The Gastrointestinal System
Answer: A
Conceptual Explanation: A MAP of at least 60-65 mmHg is required to maintain adequate
perfusion to vital organs, especially the kidneys.
3. Which assessment finding is most indicative of Cushing’s Triad in a patient with a traumatic
brain injury?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
C. Bradycardia, hypotension, and Cheyne-Stokes respirations
D. Tachycardia, hypertension, and kussmaul respirations
Answer: B
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
consisting of bradycardia, hypertension (widening pulse pressure), and altered breathing
patterns.
4. A patient with Type 1 Diabetes presents to the Emergency Department with a blood
glucose of 550 mg/dL, ketones in the urine, and an arterial pH of 7.25. What is the priority
nursing intervention?
A. Administering subcutaneous long-acting insulin
, B. Administering sodium bicarbonate to correct the pH
C. Starting a potassium infusion at 40 mEq/hr
D. Initiating intravenous fluid resuscitation with Normal Saline
Answer: D
Conceptual Explanation: The first priority in Diabetic Ketoacidosis (DKA) is volume
repletion to treat dehydration and restore perfusion before addressing insulin deficiency.
5. A patient with a T6 spinal cord injury reports a sudden, severe headache and is found to
have a blood pressure of 210/110 mmHg. What should be the nurse’s first action?
A. Check the patient for bladder distention
B. Place the patient in a supine position
C. Administer PRN Hydralazine
D. Call a Rapid Response
Answer: A
Conceptual Explanation: These are classic signs of Autonomic Dysreflexia. The priority is
to sit the patient up and then identify/remove the noxious stimulus, usually a full bladder
or impacted bowel.
6. Which of the following cardiac rhythms requires immediate unsynchronized defibrillation?
A. Atrial Fibrillation with RVR
B. Ventricular Tachycardia with a pulse
