NSG 320 ADULT HEALTH NURSING
EXAM STUDY GUIDE
1. A patient with a history of heart failure presents with orthopnea, crackles in the lung
bases, and a cough productive of frothy, pink-tinged sputum. Which condition should the
nurse suspect first?
A. Right-sided heart failure
B. Acute pulmonary edema
C. Pulmonary embolism
D. Pneumonia
Answer: B
Conceptual Explanation: Frothy, pink-tinged sputum is a hallmark sign of acute
pulmonary edema, which is a life-threatening complication of left-sided heart failure where
fluid leaks into the alveoli.
2. An arterial blood gas (ABG) result shows: pH 7.25, PaCO2 50 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory Acidosis
,B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
3. Which clinical manifestation is a classic sign of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Tachycardia, hypertension, and Cheyne-Stokes respirations
D. Bradycardia, hypotension, and shallow breathing
Answer: A
Conceptual Explanation: Cushing’s Triad consists of bradycardia, hypertension
(specifically a widening pulse pressure), and irregular or labored breathing (often
Bradypnea).
, 4. A nurse is caring for a patient with Diabetic Ketoacidosis (DKA). Which electrolyte
abnormality is the nurse most likely to observe initially?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
Answer: C
Conceptual Explanation: In DKA, acidosis and insulin deficiency cause potassium to move
from the intracellular space to the extracellular space, leading to initial hyperkalemia,
despite a total body potassium deficit.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.5 mEq/L. Which
medication should the nurse prepare to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide
C. Calcium Gluconate
D. Regular Insulin and Dextrose
Answer: C
EXAM STUDY GUIDE
1. A patient with a history of heart failure presents with orthopnea, crackles in the lung
bases, and a cough productive of frothy, pink-tinged sputum. Which condition should the
nurse suspect first?
A. Right-sided heart failure
B. Acute pulmonary edema
C. Pulmonary embolism
D. Pneumonia
Answer: B
Conceptual Explanation: Frothy, pink-tinged sputum is a hallmark sign of acute
pulmonary edema, which is a life-threatening complication of left-sided heart failure where
fluid leaks into the alveoli.
2. An arterial blood gas (ABG) result shows: pH 7.25, PaCO2 50 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these findings?
A. Respiratory Acidosis
,B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
3. Which clinical manifestation is a classic sign of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
B. Tachycardia, hypotension, and tachypnea
C. Tachycardia, hypertension, and Cheyne-Stokes respirations
D. Bradycardia, hypotension, and shallow breathing
Answer: A
Conceptual Explanation: Cushing’s Triad consists of bradycardia, hypertension
(specifically a widening pulse pressure), and irregular or labored breathing (often
Bradypnea).
, 4. A nurse is caring for a patient with Diabetic Ketoacidosis (DKA). Which electrolyte
abnormality is the nurse most likely to observe initially?
A. Hypercalcemia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
Answer: C
Conceptual Explanation: In DKA, acidosis and insulin deficiency cause potassium to move
from the intracellular space to the extracellular space, leading to initial hyperkalemia,
despite a total body potassium deficit.
5. A patient with chronic kidney disease (CKD) has a potassium level of 6.5 mEq/L. Which
medication should the nurse prepare to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide
C. Calcium Gluconate
D. Regular Insulin and Dextrose
Answer: C
