NSG 430 Final Exam (PDF) | (2026/2027) Adult Health II
Exam Questions | GCU Nursing
1. The nurse is caring for a patient with a terminal illness who is planning a trip to settle
family issues. The nurse recognizes this as a manifestation of which psychosocial
response to dying?
A) Protesting the unfairness of death
B) Anxiety about unfinished business
C) Fear of having lived a meaningless life
D) Restlessness about the uncertain prognosis
Correct Answer: Anxiety about unfinished business
Rationale: The patient's statement indicates a desire to address unresolved family
issues before dying, which reflects anxiety about unfinished business. There is no
indication of protesting the prognosis, feeling uncertain about the prognosis, or fearing
a meaningless life.
2. A 23-year-old female is injured in a motor vehicle accident. Which laboratory test
should the nurse ensure is collected first?
A) Serum electrolytes
B) Complete blood count (CBC)
C) Blood type and crossmatch
D) Pregnancy test
Correct Answer: Pregnancy test
Rationale: A pregnancy test is essential for any female of childbearing age who
experiences trauma, as management of injuries, medication administration, and
diagnostic imaging must consider potential pregnancy to avoid fetal harm. The other
tests are important but do not take priority over confirming pregnancy status.
,3. A patient with a traumatic brain injury has a blood pressure of 180/60 mmHg, a heart
rate of 48 bpm, and irregular respirations. What does this clinical triad indicate?
A) Beck's Triad
B) Cushing's Triad
C) Virchow's Triad
D) Wernicke's Encephalopathy
Correct Answer: Cushing's Triad
Rationale: Cushing's triad consists of widened pulse pressure, bradycardia, and
irregular respirations. These are late signs of significantly increased intracranial
pressure (ICP) and require immediate intervention to prevent brain herniation.
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is not responding to
increasing levels of supplemental oxygen. What is this phenomenon called?
A) Refractory hypoxemia
B) Respiratory alkalosis
C) Hypoventilation
D) Diffusion limitation
Correct Answer: Refractory hypoxemia
Rationale: Refractory hypoxemia is a hallmark sign of ARDS where oxygen levels
remain low regardless of the oxygen concentration delivered. It occurs because the
alveoli are filled with fluid or have collapsed, preventing gas exchange.
5. Which medication should the nurse anticipate administering to a patient with hepatic
encephalopathy to reduce serum ammonia levels?
A) Spironolactone
B) Lactulose
C) Propranolol
,D) Rifaximin
Correct Answer: Lactulose
Rationale: Lactulose works by drawing ammonia into the colon where it is excreted
through the stool. The goal is to achieve 2 to 3 soft bowel movements per day, and
effective treatment is measured by an improvement in the patient's neurological status.
6. 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 is the priority nursing action?
A) Administer an anti-hypertensive medication
B) Place the patient in a flat, supine position
C) Assess the patient for bladder distension
D) Check the patient's pupils for reactivity
Correct Answer: Assess the patient for bladder distension
Rationale: This presentation is classic for autonomic dysreflexia, a life-threatening
emergency in patients with spinal cord injuries at or above the T6 level. The priority is
to identify and remove the triggering stimulus, most commonly a full bladder or fecal
impaction.
7. Which of the following is a classic sign of a tension pneumothorax?
A) Decreased breath sounds on the affected side
B) Tracheal deviation to the opposite side
C) Hyperresonance on percussion
D) Subcutaneous emphysema
Correct Answer: Tracheal deviation to the opposite side
, Rationale: Tension pneumothorax is a life-threatening emergency where air
accumulates in the pleural space, causing a mediastinal shift. This shift pushes the
trachea away from the affected side.
8. 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.
9. 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.
Exam Questions | GCU Nursing
1. The nurse is caring for a patient with a terminal illness who is planning a trip to settle
family issues. The nurse recognizes this as a manifestation of which psychosocial
response to dying?
A) Protesting the unfairness of death
B) Anxiety about unfinished business
C) Fear of having lived a meaningless life
D) Restlessness about the uncertain prognosis
Correct Answer: Anxiety about unfinished business
Rationale: The patient's statement indicates a desire to address unresolved family
issues before dying, which reflects anxiety about unfinished business. There is no
indication of protesting the prognosis, feeling uncertain about the prognosis, or fearing
a meaningless life.
2. A 23-year-old female is injured in a motor vehicle accident. Which laboratory test
should the nurse ensure is collected first?
A) Serum electrolytes
B) Complete blood count (CBC)
C) Blood type and crossmatch
D) Pregnancy test
Correct Answer: Pregnancy test
Rationale: A pregnancy test is essential for any female of childbearing age who
experiences trauma, as management of injuries, medication administration, and
diagnostic imaging must consider potential pregnancy to avoid fetal harm. The other
tests are important but do not take priority over confirming pregnancy status.
,3. A patient with a traumatic brain injury has a blood pressure of 180/60 mmHg, a heart
rate of 48 bpm, and irregular respirations. What does this clinical triad indicate?
A) Beck's Triad
B) Cushing's Triad
C) Virchow's Triad
D) Wernicke's Encephalopathy
Correct Answer: Cushing's Triad
Rationale: Cushing's triad consists of widened pulse pressure, bradycardia, and
irregular respirations. These are late signs of significantly increased intracranial
pressure (ICP) and require immediate intervention to prevent brain herniation.
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is not responding to
increasing levels of supplemental oxygen. What is this phenomenon called?
A) Refractory hypoxemia
B) Respiratory alkalosis
C) Hypoventilation
D) Diffusion limitation
Correct Answer: Refractory hypoxemia
Rationale: Refractory hypoxemia is a hallmark sign of ARDS where oxygen levels
remain low regardless of the oxygen concentration delivered. It occurs because the
alveoli are filled with fluid or have collapsed, preventing gas exchange.
5. Which medication should the nurse anticipate administering to a patient with hepatic
encephalopathy to reduce serum ammonia levels?
A) Spironolactone
B) Lactulose
C) Propranolol
,D) Rifaximin
Correct Answer: Lactulose
Rationale: Lactulose works by drawing ammonia into the colon where it is excreted
through the stool. The goal is to achieve 2 to 3 soft bowel movements per day, and
effective treatment is measured by an improvement in the patient's neurological status.
6. 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 is the priority nursing action?
A) Administer an anti-hypertensive medication
B) Place the patient in a flat, supine position
C) Assess the patient for bladder distension
D) Check the patient's pupils for reactivity
Correct Answer: Assess the patient for bladder distension
Rationale: This presentation is classic for autonomic dysreflexia, a life-threatening
emergency in patients with spinal cord injuries at or above the T6 level. The priority is
to identify and remove the triggering stimulus, most commonly a full bladder or fecal
impaction.
7. Which of the following is a classic sign of a tension pneumothorax?
A) Decreased breath sounds on the affected side
B) Tracheal deviation to the opposite side
C) Hyperresonance on percussion
D) Subcutaneous emphysema
Correct Answer: Tracheal deviation to the opposite side
, Rationale: Tension pneumothorax is a life-threatening emergency where air
accumulates in the pleural space, causing a mediastinal shift. This shift pushes the
trachea away from the affected side.
8. 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.
9. 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.
