GCU NSG 430 Exam 4 (PDF) | (2026/2027) Adult Health II
Exam Questions | GCU Nursing
1. A patient with a known history of mitral valve stenosis is admitted with severe
dyspnea and a cough productive of pink, frothy sputum. The nurse suspects the patient
is developing which complication?
A) A pulmonary embolism
B) Acute pericarditis
C) Pulmonary edema
D) A myocardial infarction
Correct Answer: Pulmonary edema
Rationale: Pink, frothy sputum is a classic sign of pulmonary edema, often caused by
left-sided heart failure or valvular stenosis. This condition results from increased
pressure in the pulmonary vasculature, forcing fluid into the alveoli.
2. Which assessment finding in a patient with sepsis indicates progression to multiple
organ dysfunction syndrome (MODS)?
A) A heart rate of 110 beats per minute
B) A respiratory rate of 22 breaths per minute
C) An elevated serum creatinine level
D) A white blood cell count of 14,000/mm³
Correct Answer: An elevated serum creatinine level
Rationale: MODS is the failure of two or more organ systems in a critically ill patient. An
elevated creatinine level indicates acute kidney injury, which is a sign of organ
dysfunction. Tachycardia, tachypnea, and elevated WBCs are signs of systemic
inflammation but do not, by themselves, confirm MODS.
,3. Which of the following is a modifiable risk factor for infective endocarditis?
A) A history of rheumatic fever
B) Intravenous drug use
C) A congenital heart defect
D) The presence of a prosthetic heart valve
Correct Answer: Intravenous drug use
Rationale: Intravenous drug use is a modifiable risk factor because it directly
introduces bacteria into the bloodstream. The other options are structural or historical
conditions that increase risk but are not modifiable behavioral factors.
4. A patient is receiving a heparin infusion for a deep vein thrombosis. The nurse notes
the patient's aPTT is 98 seconds (therapeutic range is 60-80 seconds). Which action
should the nurse take?
A) Increase the infusion rate
B) Continue the infusion at the current rate
C) Decrease the infusion rate and notify the healthcare provider
D) Discontinue the infusion and administer protamine sulfate
Correct Answer: Decrease the infusion rate and notify the healthcare provider
Rationale: An aPTT above the therapeutic range increases the risk of bleeding. The
nurse should decrease the infusion rate and notify the provider for further orders.
Protamine sulfate is used for severe bleeding or complete reversal of heparin.
5. The nurse is assessing a patient with suspected acute pancreatitis. Which laboratory
value is most specific to this diagnosis?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated serum glucose
,D) Elevated white blood cell count
Correct Answer: Elevated serum lipase
Rationale: While both serum amylase and lipase are elevated in pancreatitis, serum
lipase is more specific and remains elevated longer. Elevated glucose and WBCs are non-
specific findings.
6. A patient is receiving a blood transfusion and develops chills, a fever, and low back
pain. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer an antipyretic
C) Stop the transfusion immediately
D) Notify the healthcare provider
Correct Answer: Stop the transfusion immediately
Rationale: Chills, fever, and back pain are signs of an acute hemolytic transfusion
reaction. The priority is to stop the transfusion to prevent further complications. The IV
line should be kept open with normal saline, and the provider should be notified.
7. A patient is admitted with a severe nosebleed (epistaxis) that is unresponsive to
direct pressure. Which is the most appropriate initial intervention?
A) Apply an ice pack to the bridge of the nose
B) Have the patient lean forward and pinch the nostrils
C) Prepare for anterior nasal packing
D) Administer a dose of desmopressin (DDAVP)
Correct Answer: Prepare for anterior nasal packing
, Rationale: For epistaxis not controlled by direct pressure, anterior nasal packing is
often the next step. Having the patient lean forward is part of initial first aid, but if
pressure fails, packing is required. DDAVP is used for von Willebrand disease or platelet
dysfunction.
8. A patient with chronic anemia is prescribed a blood transfusion. Which type of blood
product is most appropriate to increase the patient's oxygen-carrying capacity?
A) Fresh frozen plasma (FFP)
B) Platelets
C) Packed red blood cells (PRBCs)
D) Cryoprecipitate
Correct Answer: Packed red blood cells (PRBCs)
Rationale: Packed red blood cells are administered to increase hemoglobin and oxygen-
carrying capacity in patients with symptomatic anemia. FFP is for clotting factor
deficiencies, platelets for thrombocytopenia, and cryoprecipitate for specific clotting
factor deficits.
9. A patient is diagnosed with stage 4 pressure injury on the sacrum. Which finding is
most characteristic of this stage?
A) Intact skin with non-blanchable erythema
B) Partial-thickness skin loss with exposed dermis
C) Full-thickness skin loss with exposed bone or tendon
D) Full-thickness skin loss with visible adipose tissue
Correct Answer: Full-thickness skin loss with exposed bone or tendon
Rationale: A stage 4 pressure injury involves full-thickness tissue loss with exposed
bone, tendon, or muscle. The other stages describe less severe tissue damage.
Exam Questions | GCU Nursing
1. A patient with a known history of mitral valve stenosis is admitted with severe
dyspnea and a cough productive of pink, frothy sputum. The nurse suspects the patient
is developing which complication?
A) A pulmonary embolism
B) Acute pericarditis
C) Pulmonary edema
D) A myocardial infarction
Correct Answer: Pulmonary edema
Rationale: Pink, frothy sputum is a classic sign of pulmonary edema, often caused by
left-sided heart failure or valvular stenosis. This condition results from increased
pressure in the pulmonary vasculature, forcing fluid into the alveoli.
2. Which assessment finding in a patient with sepsis indicates progression to multiple
organ dysfunction syndrome (MODS)?
A) A heart rate of 110 beats per minute
B) A respiratory rate of 22 breaths per minute
C) An elevated serum creatinine level
D) A white blood cell count of 14,000/mm³
Correct Answer: An elevated serum creatinine level
Rationale: MODS is the failure of two or more organ systems in a critically ill patient. An
elevated creatinine level indicates acute kidney injury, which is a sign of organ
dysfunction. Tachycardia, tachypnea, and elevated WBCs are signs of systemic
inflammation but do not, by themselves, confirm MODS.
,3. Which of the following is a modifiable risk factor for infective endocarditis?
A) A history of rheumatic fever
B) Intravenous drug use
C) A congenital heart defect
D) The presence of a prosthetic heart valve
Correct Answer: Intravenous drug use
Rationale: Intravenous drug use is a modifiable risk factor because it directly
introduces bacteria into the bloodstream. The other options are structural or historical
conditions that increase risk but are not modifiable behavioral factors.
4. A patient is receiving a heparin infusion for a deep vein thrombosis. The nurse notes
the patient's aPTT is 98 seconds (therapeutic range is 60-80 seconds). Which action
should the nurse take?
A) Increase the infusion rate
B) Continue the infusion at the current rate
C) Decrease the infusion rate and notify the healthcare provider
D) Discontinue the infusion and administer protamine sulfate
Correct Answer: Decrease the infusion rate and notify the healthcare provider
Rationale: An aPTT above the therapeutic range increases the risk of bleeding. The
nurse should decrease the infusion rate and notify the provider for further orders.
Protamine sulfate is used for severe bleeding or complete reversal of heparin.
5. The nurse is assessing a patient with suspected acute pancreatitis. Which laboratory
value is most specific to this diagnosis?
A) Elevated serum amylase
B) Elevated serum lipase
C) Elevated serum glucose
,D) Elevated white blood cell count
Correct Answer: Elevated serum lipase
Rationale: While both serum amylase and lipase are elevated in pancreatitis, serum
lipase is more specific and remains elevated longer. Elevated glucose and WBCs are non-
specific findings.
6. A patient is receiving a blood transfusion and develops chills, a fever, and low back
pain. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer an antipyretic
C) Stop the transfusion immediately
D) Notify the healthcare provider
Correct Answer: Stop the transfusion immediately
Rationale: Chills, fever, and back pain are signs of an acute hemolytic transfusion
reaction. The priority is to stop the transfusion to prevent further complications. The IV
line should be kept open with normal saline, and the provider should be notified.
7. A patient is admitted with a severe nosebleed (epistaxis) that is unresponsive to
direct pressure. Which is the most appropriate initial intervention?
A) Apply an ice pack to the bridge of the nose
B) Have the patient lean forward and pinch the nostrils
C) Prepare for anterior nasal packing
D) Administer a dose of desmopressin (DDAVP)
Correct Answer: Prepare for anterior nasal packing
, Rationale: For epistaxis not controlled by direct pressure, anterior nasal packing is
often the next step. Having the patient lean forward is part of initial first aid, but if
pressure fails, packing is required. DDAVP is used for von Willebrand disease or platelet
dysfunction.
8. A patient with chronic anemia is prescribed a blood transfusion. Which type of blood
product is most appropriate to increase the patient's oxygen-carrying capacity?
A) Fresh frozen plasma (FFP)
B) Platelets
C) Packed red blood cells (PRBCs)
D) Cryoprecipitate
Correct Answer: Packed red blood cells (PRBCs)
Rationale: Packed red blood cells are administered to increase hemoglobin and oxygen-
carrying capacity in patients with symptomatic anemia. FFP is for clotting factor
deficiencies, platelets for thrombocytopenia, and cryoprecipitate for specific clotting
factor deficits.
9. A patient is diagnosed with stage 4 pressure injury on the sacrum. Which finding is
most characteristic of this stage?
A) Intact skin with non-blanchable erythema
B) Partial-thickness skin loss with exposed dermis
C) Full-thickness skin loss with exposed bone or tendon
D) Full-thickness skin loss with visible adipose tissue
Correct Answer: Full-thickness skin loss with exposed bone or tendon
Rationale: A stage 4 pressure injury involves full-thickness tissue loss with exposed
bone, tendon, or muscle. The other stages describe less severe tissue damage.
