GCU NSG 430 Exam 1 (PDF) | (2026/2027) Adult Health II Exam
Questions | GCU Nursing
1. A nurse is caring for a patient in the intensive care unit who has been declared brain
dead. Which assessment finding is most consistent with brain death?
A) Decerebrate posturing in response to painful stimuli
B) Presence of spontaneous respirations
C) Absence of all brainstem reflexes, including gag and corneal reflexes
D) Withdrawal from painful stimuli
Correct Answer: Absence of all brainstem reflexes, including gag and corneal reflexes
Rationale: Brain death is characterized by irreversible cessation of all brain function,
including the brainstem. This is confirmed by the absence of brainstem reflexes (gag,
corneal, pupillary light, oculocephalic) and apnea. The other options indicate some level
of brainstem or cortical function.
2. A patient with end-stage heart failure is receiving palliative care. The patient's family
asks the nurse, "What is the main difference between palliative care and hospice care?"
Which response by the nurse is most accurate?
A) "Palliative care is only for patients who are expected to live less than 6 months."
B) "Hospice care focuses on comfort and quality of life, while palliative care focuses on
curing the disease."
C) "Palliative care can be provided alongside curative treatments, while hospice care is
for patients who have chosen to forego curative treatments."
D) "Hospice care is provided only in the hospital setting."
Correct Answer: "Palliative care can be provided alongside curative treatments, while
hospice care is for patients who have chosen to forego curative treatments."
Rationale: Palliative care is an interdisciplinary approach to symptom management and
quality of life that can be initiated at any point in a serious illness, concurrently with
,curative treatments. Hospice care is a specific type of palliative care for patients with a
life expectancy of 6 months or less who have chosen comfort over curative measures.
3. A nurse is assessing a patient who is actively dying. Which respiratory pattern is most
commonly observed in the final hours of life?
A) Kussmaul respirations
B) Biot's respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: Cheyne-Stokes respirations
Rationale: Cheyne-Stokes respirations, characterized by alternating periods of deep,
rapid breathing followed by apnea, are a common end-of-life respiratory pattern as the
brainstem begins to fail. Kussmaul respirations are deep, rapid breaths seen in
metabolic acidosis, and Biot's respirations are irregular clusters of breaths.
4. A patient with a terminal illness has a Do Not Resuscitate (DNR) order. The patient
becomes unresponsive and stops breathing. What is the nurse's priority action?
A) Begin chest compressions
B) Call a code blue
C) Provide comfort care and support to the family
D) Administer rescue breaths
Correct Answer: Provide comfort care and support to the family
Rationale: A DNR order indicates that cardiopulmonary resuscitation should not be
initiated. The nurse's role is to provide comfort care, ensure the patient is comfortable,
and offer support to the family during the dying process.
,5. A patient's family is struggling with the decision to transition a loved one to hospice
care. The nurse recognizes that the family is in the "bargaining" stage of grief when they
make which statement?
A) "I can't believe this is happening to us."
B) "If only we had caught this sooner, maybe things would be different."
C) "What did we do to deserve this?"
D) "I am so angry at the doctors for not doing more."
Correct Answer: "If only we had caught this sooner, maybe things would be different."
Rationale: Bargaining is characterized by "if only" statements and attempts to negotiate
a different outcome. Denial is "I can't believe this," anger is "What did we do to deserve
this?" and "I am so angry" is also anger.
6. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with this diagnosis?
A) Serum glucose of 180 mg/dL
B) Serum bicarbonate of 22 mEq/L
C) Serum potassium of 3.0 mEq/L
D) Arterial pH of 7.25
Correct Answer: Arterial pH of 7.25
Rationale: DKA is characterized by metabolic acidosis (pH < 7.30), hyperglycemia
(>250 mg/dL), and low bicarbonate (<15 mEq/L). Initial potassium may be normal or
elevated due to shift, but total body potassium is depleted.
7. A patient with type 1 diabetes is receiving an IV insulin infusion for DKA. Which
laboratory value requires the most frequent monitoring during this therapy?
A) Serum sodium
B) Serum potassium
, C) Serum calcium
D) Serum magnesium
Correct Answer: Serum potassium
Rationale: Insulin therapy drives potassium into the cells, which can cause a rapid and
dangerous drop in serum potassium levels (hypokalemia), potentially leading to fatal
cardiac dysrhythmias. Potassium levels must be monitored closely and replaced as
needed.
8. A nurse is caring for a patient with hyperglycemic hyperosmolar syndrome (HHS).
Which assessment finding is most characteristic of this condition?
A) Serum glucose of 800 mg/dL and absence of ketones
B) Serum glucose of 350 mg/dL and presence of ketones
C) Serum sodium of 130 mEq/L
D) Deep, rapid Kussmaul respirations
Correct Answer: Serum glucose of 800 mg/dL and absence of ketones
Rationale: HHS is characterized by profound hyperglycemia (often >600 mg/dL),
hyperosmolality, and severe dehydration, but without significant ketosis. The absence of
ketones distinguishes it from DKA. Kussmaul respirations are associated with DKA.
9. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum
sodium of 120 mEq/L. Which assessment finding is the priority for the nurse to report?
A) Muscle cramps
B) Decreased level of consciousness
C) Dry mucous membranes
D) Weight loss
Correct Answer: Decreased level of consciousness
Questions | GCU Nursing
1. A nurse is caring for a patient in the intensive care unit who has been declared brain
dead. Which assessment finding is most consistent with brain death?
A) Decerebrate posturing in response to painful stimuli
B) Presence of spontaneous respirations
C) Absence of all brainstem reflexes, including gag and corneal reflexes
D) Withdrawal from painful stimuli
Correct Answer: Absence of all brainstem reflexes, including gag and corneal reflexes
Rationale: Brain death is characterized by irreversible cessation of all brain function,
including the brainstem. This is confirmed by the absence of brainstem reflexes (gag,
corneal, pupillary light, oculocephalic) and apnea. The other options indicate some level
of brainstem or cortical function.
2. A patient with end-stage heart failure is receiving palliative care. The patient's family
asks the nurse, "What is the main difference between palliative care and hospice care?"
Which response by the nurse is most accurate?
A) "Palliative care is only for patients who are expected to live less than 6 months."
B) "Hospice care focuses on comfort and quality of life, while palliative care focuses on
curing the disease."
C) "Palliative care can be provided alongside curative treatments, while hospice care is
for patients who have chosen to forego curative treatments."
D) "Hospice care is provided only in the hospital setting."
Correct Answer: "Palliative care can be provided alongside curative treatments, while
hospice care is for patients who have chosen to forego curative treatments."
Rationale: Palliative care is an interdisciplinary approach to symptom management and
quality of life that can be initiated at any point in a serious illness, concurrently with
,curative treatments. Hospice care is a specific type of palliative care for patients with a
life expectancy of 6 months or less who have chosen comfort over curative measures.
3. A nurse is assessing a patient who is actively dying. Which respiratory pattern is most
commonly observed in the final hours of life?
A) Kussmaul respirations
B) Biot's respirations
C) Cheyne-Stokes respirations
D) Apneustic breathing
Correct Answer: Cheyne-Stokes respirations
Rationale: Cheyne-Stokes respirations, characterized by alternating periods of deep,
rapid breathing followed by apnea, are a common end-of-life respiratory pattern as the
brainstem begins to fail. Kussmaul respirations are deep, rapid breaths seen in
metabolic acidosis, and Biot's respirations are irregular clusters of breaths.
4. A patient with a terminal illness has a Do Not Resuscitate (DNR) order. The patient
becomes unresponsive and stops breathing. What is the nurse's priority action?
A) Begin chest compressions
B) Call a code blue
C) Provide comfort care and support to the family
D) Administer rescue breaths
Correct Answer: Provide comfort care and support to the family
Rationale: A DNR order indicates that cardiopulmonary resuscitation should not be
initiated. The nurse's role is to provide comfort care, ensure the patient is comfortable,
and offer support to the family during the dying process.
,5. A patient's family is struggling with the decision to transition a loved one to hospice
care. The nurse recognizes that the family is in the "bargaining" stage of grief when they
make which statement?
A) "I can't believe this is happening to us."
B) "If only we had caught this sooner, maybe things would be different."
C) "What did we do to deserve this?"
D) "I am so angry at the doctors for not doing more."
Correct Answer: "If only we had caught this sooner, maybe things would be different."
Rationale: Bargaining is characterized by "if only" statements and attempts to negotiate
a different outcome. Denial is "I can't believe this," anger is "What did we do to deserve
this?" and "I am so angry" is also anger.
6. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with this diagnosis?
A) Serum glucose of 180 mg/dL
B) Serum bicarbonate of 22 mEq/L
C) Serum potassium of 3.0 mEq/L
D) Arterial pH of 7.25
Correct Answer: Arterial pH of 7.25
Rationale: DKA is characterized by metabolic acidosis (pH < 7.30), hyperglycemia
(>250 mg/dL), and low bicarbonate (<15 mEq/L). Initial potassium may be normal or
elevated due to shift, but total body potassium is depleted.
7. A patient with type 1 diabetes is receiving an IV insulin infusion for DKA. Which
laboratory value requires the most frequent monitoring during this therapy?
A) Serum sodium
B) Serum potassium
, C) Serum calcium
D) Serum magnesium
Correct Answer: Serum potassium
Rationale: Insulin therapy drives potassium into the cells, which can cause a rapid and
dangerous drop in serum potassium levels (hypokalemia), potentially leading to fatal
cardiac dysrhythmias. Potassium levels must be monitored closely and replaced as
needed.
8. A nurse is caring for a patient with hyperglycemic hyperosmolar syndrome (HHS).
Which assessment finding is most characteristic of this condition?
A) Serum glucose of 800 mg/dL and absence of ketones
B) Serum glucose of 350 mg/dL and presence of ketones
C) Serum sodium of 130 mEq/L
D) Deep, rapid Kussmaul respirations
Correct Answer: Serum glucose of 800 mg/dL and absence of ketones
Rationale: HHS is characterized by profound hyperglycemia (often >600 mg/dL),
hyperosmolality, and severe dehydration, but without significant ketosis. The absence of
ketones distinguishes it from DKA. Kussmaul respirations are associated with DKA.
9. A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum
sodium of 120 mEq/L. Which assessment finding is the priority for the nurse to report?
A) Muscle cramps
B) Decreased level of consciousness
C) Dry mucous membranes
D) Weight loss
Correct Answer: Decreased level of consciousness
