GCU NSG 430 Exam 3 (PDF) | (2026/2027) Adult Health II Exam
Questions | GCU Nursing
1. A patient with a facial fracture arrives in the emergency department. What is the
nurse's priority action?
A) Ask the patient how the injury occurred
B) Suction the patient's oral secretions
C) Use a cervical collar to stabilize the spine
D) Apply ice packs to the face
Correct Answer: Use a cervical collar to stabilize the spine
Rationale: Facial trauma often coexists with cervical spine injury. In trauma, airway and
cervical spine stabilization are top priorities (ABCs with spinal precautions).
Immobilizing the cervical spine prevents possible spinal cord damage during further
assessment and treatment.
2. A patient who had open reduction and internal fixation (ORIF) of left lower leg
fractures continues to report severe pain in the leg 15 minutes after receiving IV
morphine. The nurse determines pulses are faintly palpable and the foot is cool to the
touch. Which action should the nurse take next?
A) Reassess the pain in 30 minutes
B) Apply a warm compress to the leg
C) Notify the healthcare provider
D) Elevate the leg above the heart
Correct Answer: Notify the healthcare provider
Rationale: Severe pain unrelieved by opioids, combined with diminished pulses and
coolness, are classic signs of compartment syndrome. This is a surgical emergency that
requires immediate notification of the provider.
,3. A nurse is providing discharge teaching to a patient who has had a repair of a
fractured mandible. Which instruction is most important to include?
A) "Avoid chewing for 3–6 months."
B) "Keep wire cutters with you at all times."
C) "Take daily oral antibiotics for 2 weeks."
D) "Avoid oral fluids for 7 days."
Correct Answer: "Keep wire cutters with you at all times."
Rationale: After mandibular fixation, a wire cutter must be kept with the patient at all
times to prevent airway compromise if vomiting or respiratory distress occurs. Teaching
the patient how and when to cut the wires is critical for safety.
4. The nurse is caring for a patient who is using Buck's traction after a hip fracture.
Which action can the nurse delegate to experienced unlicensed assistive personnel
(UAP)?
A) Assessing skin integrity under the traction boot
B) Performing neurovascular assessments of the affected leg
C) Ensuring the weight for the traction is hanging freely
D) Adjusting the traction to maintain proper alignment
Correct Answer: Ensuring the weight for the traction is hanging freely
Rationale: Ensuring the weights hang freely is a routine task that can be delegated to
UAP. Assessment of skin integrity, neurovascular status, and adjustment of traction
require the clinical judgment of a licensed nurse.
5. A patient arrives in the emergency department after a motorcycle accident with
severe swelling of the left lower leg. What should the nurse do first?
A) Apply ice to the affected leg
B) Assess leg pulses and sensation
,C) Elevate the leg above the heart
D) Notify the healthcare provider
Correct Answer: Assess leg pulses and sensation
Rationale: The priority is to perform a neurovascular assessment to evaluate for
compartment syndrome or vascular injury. Pulses and sensation should be assessed
before any other interventions.
6. Which information about a patient with a lumbar vertebral compression fracture
should the nurse immediately report to the healthcare provider?
A) The patient reports pain at the fracture site
B) The patient has been incontinent of urine and stool
C) The patient is requesting pain medication
D) The patient's blood pressure is 140/90 mm Hg
Correct Answer: The patient has been incontinent of urine and stool
Rationale: Bowel or bladder incontinence in a patient with a spinal fracture is a sign of
spinal cord compression or cauda equina syndrome, a surgical emergency that requires
immediate reporting.
7. After a laminectomy, which action can the nurse delegate to experienced UAP?
A) Assess the patient's motor function
B) Log roll the patient from side to side every 2 hours
C) Evaluate the patient's pain level
D) Check the surgical incision for drainage
Correct Answer: Log roll the patient from side to side every 2 hours
, Rationale: Log rolling is a routine, non-invasive task that can be delegated to UAP.
Assessment of motor function, pain evaluation, and incision assessment require the
clinical judgment of a licensed nurse.
8. A new clinic patient with joint swelling and pain is having diagnostic tests. Which test
is specific to systemic lupus erythematosus (SLE)?
A) Rheumatoid factor (RF)
B) Anti-Smith antibody (Anti-Sm)
C) Uric acid level
D) Erythrocyte sedimentation rate (ESR)
Correct Answer: Anti-Smith antibody (Anti-Sm)
Rationale: Anti-Smith (Anti-Sm) antibody is a highly specific test for SLE. RF is
associated with rheumatoid arthritis, uric acid with gout, and ESR is a non-specific
marker of inflammation.
9. The emergency department (ED) nurse receives report that a seriously injured
patient involved in a motor vehicle crash is being transported with an estimated arrival
in 5 minutes. What should the nurse obtain in preparation for the patient's arrival?
A) Two 16-gauge IV catheters
B) A central line insertion kit
C) A chest tube insertion tray
D) A cervical collar
Correct Answer: Two 16-gauge IV catheters
Rationale: Large-bore IV access (14- or 16-gauge) is critical for fluid resuscitation in
trauma patients. Having two large-bore IV catheters prepared allows for rapid
administration of fluids and blood products.
Questions | GCU Nursing
1. A patient with a facial fracture arrives in the emergency department. What is the
nurse's priority action?
A) Ask the patient how the injury occurred
B) Suction the patient's oral secretions
C) Use a cervical collar to stabilize the spine
D) Apply ice packs to the face
Correct Answer: Use a cervical collar to stabilize the spine
Rationale: Facial trauma often coexists with cervical spine injury. In trauma, airway and
cervical spine stabilization are top priorities (ABCs with spinal precautions).
Immobilizing the cervical spine prevents possible spinal cord damage during further
assessment and treatment.
2. A patient who had open reduction and internal fixation (ORIF) of left lower leg
fractures continues to report severe pain in the leg 15 minutes after receiving IV
morphine. The nurse determines pulses are faintly palpable and the foot is cool to the
touch. Which action should the nurse take next?
A) Reassess the pain in 30 minutes
B) Apply a warm compress to the leg
C) Notify the healthcare provider
D) Elevate the leg above the heart
Correct Answer: Notify the healthcare provider
Rationale: Severe pain unrelieved by opioids, combined with diminished pulses and
coolness, are classic signs of compartment syndrome. This is a surgical emergency that
requires immediate notification of the provider.
,3. A nurse is providing discharge teaching to a patient who has had a repair of a
fractured mandible. Which instruction is most important to include?
A) "Avoid chewing for 3–6 months."
B) "Keep wire cutters with you at all times."
C) "Take daily oral antibiotics for 2 weeks."
D) "Avoid oral fluids for 7 days."
Correct Answer: "Keep wire cutters with you at all times."
Rationale: After mandibular fixation, a wire cutter must be kept with the patient at all
times to prevent airway compromise if vomiting or respiratory distress occurs. Teaching
the patient how and when to cut the wires is critical for safety.
4. The nurse is caring for a patient who is using Buck's traction after a hip fracture.
Which action can the nurse delegate to experienced unlicensed assistive personnel
(UAP)?
A) Assessing skin integrity under the traction boot
B) Performing neurovascular assessments of the affected leg
C) Ensuring the weight for the traction is hanging freely
D) Adjusting the traction to maintain proper alignment
Correct Answer: Ensuring the weight for the traction is hanging freely
Rationale: Ensuring the weights hang freely is a routine task that can be delegated to
UAP. Assessment of skin integrity, neurovascular status, and adjustment of traction
require the clinical judgment of a licensed nurse.
5. A patient arrives in the emergency department after a motorcycle accident with
severe swelling of the left lower leg. What should the nurse do first?
A) Apply ice to the affected leg
B) Assess leg pulses and sensation
,C) Elevate the leg above the heart
D) Notify the healthcare provider
Correct Answer: Assess leg pulses and sensation
Rationale: The priority is to perform a neurovascular assessment to evaluate for
compartment syndrome or vascular injury. Pulses and sensation should be assessed
before any other interventions.
6. Which information about a patient with a lumbar vertebral compression fracture
should the nurse immediately report to the healthcare provider?
A) The patient reports pain at the fracture site
B) The patient has been incontinent of urine and stool
C) The patient is requesting pain medication
D) The patient's blood pressure is 140/90 mm Hg
Correct Answer: The patient has been incontinent of urine and stool
Rationale: Bowel or bladder incontinence in a patient with a spinal fracture is a sign of
spinal cord compression or cauda equina syndrome, a surgical emergency that requires
immediate reporting.
7. After a laminectomy, which action can the nurse delegate to experienced UAP?
A) Assess the patient's motor function
B) Log roll the patient from side to side every 2 hours
C) Evaluate the patient's pain level
D) Check the surgical incision for drainage
Correct Answer: Log roll the patient from side to side every 2 hours
, Rationale: Log rolling is a routine, non-invasive task that can be delegated to UAP.
Assessment of motor function, pain evaluation, and incision assessment require the
clinical judgment of a licensed nurse.
8. A new clinic patient with joint swelling and pain is having diagnostic tests. Which test
is specific to systemic lupus erythematosus (SLE)?
A) Rheumatoid factor (RF)
B) Anti-Smith antibody (Anti-Sm)
C) Uric acid level
D) Erythrocyte sedimentation rate (ESR)
Correct Answer: Anti-Smith antibody (Anti-Sm)
Rationale: Anti-Smith (Anti-Sm) antibody is a highly specific test for SLE. RF is
associated with rheumatoid arthritis, uric acid with gout, and ESR is a non-specific
marker of inflammation.
9. The emergency department (ED) nurse receives report that a seriously injured
patient involved in a motor vehicle crash is being transported with an estimated arrival
in 5 minutes. What should the nurse obtain in preparation for the patient's arrival?
A) Two 16-gauge IV catheters
B) A central line insertion kit
C) A chest tube insertion tray
D) A cervical collar
Correct Answer: Two 16-gauge IV catheters
Rationale: Large-bore IV access (14- or 16-gauge) is critical for fluid resuscitation in
trauma patients. Having two large-bore IV catheters prepared allows for rapid
administration of fluids and blood products.
