EXAM 4: NSG4100 / NSG 4100 (LATEST 2026/ 2027
UPDATE) NURSING PRACTICE - ADULT HEALTH III
GUIDE| VERIFIED QUESTIONS & CORRECT
ANSWERS| GRADE A| 100% CORRECT – GALEN
1. The patient with fibromyalgia is suffering from pain at 12 of
the 18 identification sites, including the neck, upper back, and
knees. The patient also reports non-refreshing sleep, depression,
and anxiety when dealing with multiple tasks. The nurse should
teach this patient about what treatments? Select all that apply.
A. Minimal aerobic exercise
B. Relaxation strategies (biofeedback)
C. Antiseizure medication such as phenytoin
D. Serotonin reuptake inhibitor (e.g., sertraline)
E. Establishing a regular sleep pattern
,Correct Answer: B, D, E
Rationale: Fibromyalgia is a chronic pain syndrome commonly
associated with fatigue, sleep disturbances, depression, and anxiety.
Management is multidisciplinary and includes regular,
appropriately paced aerobic exercise, relaxation techniques such as
biofeedback, adequate sleep hygiene, and medications that can
address pain and associated mood symptoms. Serotonin reuptake
inhibitors may be used when depression or anxiety is present.
Phenytoin is not a standard treatment for fibromyalgia. Minimal
exercise is inappropriate because gradual, regular physical activity is
beneficial.
2. The nurse caring for a client with a head injury would
recognize which assessment findings as early signs of increased
intracranial pressure (ICP)? Select all that apply.
A. Kussmaul breathing
B. Projectile vomiting
C. Weakness in one extremity
D. Headache not aggravated by movement or straining
,E. Decreased urine output
F. Papilledema
Correct Answer: A, C, D
Rationale: Early manifestations of increased ICP can include
headache, altered level of consciousness, and focal neurologic
deficits such as unilateral weakness. Changes in respiratory pattern
may also occur as neurologic deterioration progresses. Projectile
vomiting and papilledema are generally associated with more
established or increased ICP rather than the earliest findings.
Kussmaul respirations are classically associated with metabolic
acidosis, although abnormal respiratory patterns can occur with
severe neurologic injury.
3. A nurse caring for a client diagnosed with a head injury should
intervene in which situation?
A. The padded side rails are up.
B. The bed is adjusted to a low level.
C. The client's spouse turns on the TV for 1 hour in the afternoon and
3 hours in the evening.
D. The head of the bed is elevated to a 30-degree angle.
, Correct Answer: C
Rationale: A client with a head injury is at risk for increased ICP.
Environmental stimulation should be minimized because excessive
noise, light, and activity can increase neurologic stimulation and
potentially elevate ICP. Padded side rails promote safety, keeping the
bed low reduces fall risk, and elevating the head of the bed
approximately 30 degrees can promote venous drainage and help
reduce ICP.
4. The critical care nurse is caring for a client with a head injury
secondary to a motorcycle accident who, on morning rounds, is
responsive to painful stimuli and assumes decorticate posturing.
Two hours later, which data would warrant immediate
intervention by the nurse?
A. The client has purposeful movement when the nurse rubs the
sternum.
B. The client extends the upper and lower extremities in response to
painful stimuli.
C. The client is aimlessly thrashing in the bed when a noxious
stimulus is applied.
UPDATE) NURSING PRACTICE - ADULT HEALTH III
GUIDE| VERIFIED QUESTIONS & CORRECT
ANSWERS| GRADE A| 100% CORRECT – GALEN
1. The patient with fibromyalgia is suffering from pain at 12 of
the 18 identification sites, including the neck, upper back, and
knees. The patient also reports non-refreshing sleep, depression,
and anxiety when dealing with multiple tasks. The nurse should
teach this patient about what treatments? Select all that apply.
A. Minimal aerobic exercise
B. Relaxation strategies (biofeedback)
C. Antiseizure medication such as phenytoin
D. Serotonin reuptake inhibitor (e.g., sertraline)
E. Establishing a regular sleep pattern
,Correct Answer: B, D, E
Rationale: Fibromyalgia is a chronic pain syndrome commonly
associated with fatigue, sleep disturbances, depression, and anxiety.
Management is multidisciplinary and includes regular,
appropriately paced aerobic exercise, relaxation techniques such as
biofeedback, adequate sleep hygiene, and medications that can
address pain and associated mood symptoms. Serotonin reuptake
inhibitors may be used when depression or anxiety is present.
Phenytoin is not a standard treatment for fibromyalgia. Minimal
exercise is inappropriate because gradual, regular physical activity is
beneficial.
2. The nurse caring for a client with a head injury would
recognize which assessment findings as early signs of increased
intracranial pressure (ICP)? Select all that apply.
A. Kussmaul breathing
B. Projectile vomiting
C. Weakness in one extremity
D. Headache not aggravated by movement or straining
,E. Decreased urine output
F. Papilledema
Correct Answer: A, C, D
Rationale: Early manifestations of increased ICP can include
headache, altered level of consciousness, and focal neurologic
deficits such as unilateral weakness. Changes in respiratory pattern
may also occur as neurologic deterioration progresses. Projectile
vomiting and papilledema are generally associated with more
established or increased ICP rather than the earliest findings.
Kussmaul respirations are classically associated with metabolic
acidosis, although abnormal respiratory patterns can occur with
severe neurologic injury.
3. A nurse caring for a client diagnosed with a head injury should
intervene in which situation?
A. The padded side rails are up.
B. The bed is adjusted to a low level.
C. The client's spouse turns on the TV for 1 hour in the afternoon and
3 hours in the evening.
D. The head of the bed is elevated to a 30-degree angle.
, Correct Answer: C
Rationale: A client with a head injury is at risk for increased ICP.
Environmental stimulation should be minimized because excessive
noise, light, and activity can increase neurologic stimulation and
potentially elevate ICP. Padded side rails promote safety, keeping the
bed low reduces fall risk, and elevating the head of the bed
approximately 30 degrees can promote venous drainage and help
reduce ICP.
4. The critical care nurse is caring for a client with a head injury
secondary to a motorcycle accident who, on morning rounds, is
responsive to painful stimuli and assumes decorticate posturing.
Two hours later, which data would warrant immediate
intervention by the nurse?
A. The client has purposeful movement when the nurse rubs the
sternum.
B. The client extends the upper and lower extremities in response to
painful stimuli.
C. The client is aimlessly thrashing in the bed when a noxious
stimulus is applied.
