NSG 3100 EXAM 4 ACTUAL 2026/2027 - COMPLETE QUESTIONS
WITH DETAILED RATIONALES 100% VERIFIED CORRECT
ANSWERS - PASS GUARANTEED - A+ GRADED EXAM
170 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Analyze and interpret advanced hemodynamic and laboratory data to guide nursing interventions
2 Synthesize multiple system assessments to prioritize care for critically ill patients
3 Evaluate the ethical and legal dimensions of nursing decisions in complex clinical situations
4 Apply current evidence-based guidelines to the management of acute and chronic conditions
5 NSG 3100 Exam 4 Actual 2026
6 2027
7 Complete Questions with Detailed Rationales 100% Verified Correct Answers
8 Pass Guaranteed
9 A+ Graded Exam
10 Foundations of Medical-Surgical Nursing / Adult Health
11 Applied Medical-Surgical Nursing / Adult Health
12 Advanced Medical-Surgical Nursing / Adult Health
13 Medical-Surgical Nursing / Adult Health Review
Page 1
,Q1 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A patient in the intensive care unit has a pulmonary artery catheter with the
following readings: central venous pressure 12 mm Hg, pulmonary artery wedge
pressure 18 mm Hg, cardiac index 2.1 L/min/m², and systemic vascular resistance
1,900 dynes/sec/cm. Which condition is most consistent with these findings?
A. Hypovolemic shock
B. Cardiogenic shock CORRECT
C. Septic shock (hyperdynamic)
D. Neurogenic shock
RATIONALE: High filling pressures with low cardiac index and elevated SVR indicate impaired
myocardial contractility with compensatory vasoconstriction, classic for cardiogenic shock.
Hypovolemia would show low pressures; septic shock typically presents with high cardiac output
and low SVR; neurogenic shock has low SVR with bradycardia.
Q2 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which finding in a patient with acute respiratory distress syndrome (ARDS) would
indicate that the current positive end-expiratory pressure (PEEP) setting is too
high, requiring immediate adjustment?
A. PaO/FiO ratio of 150
B. Decreased static compliance
C. Plateau pressure of 30 cm HO
D. Increased dead space ventilation CORRECT
RATIONALE: Excessive PEEP can overdistend alveoli, compressing pulmonary capillaries and
increasing dead space, leading to elevated PaCO and wasted ventilation. While high plateau
pressures (>30) are concerning, increased dead space is a more direct indicator of
overdistension. Low compliance and low PaO/FiO reflect the underlying ARDS, not necessarily
PEEP-induced injury.
Page 2
,Q3 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A patient with sepsis has a serum lactate of 6 mmol/L and a mean arterial pressure
(MAP) of 58 mm Hg despite a 30 mL/kg crystalloid bolus. According to the
Surviving Sepsis Campaign Hour-1 Bundle, which intervention should be initiated
immediately?
A. Start norepinephrine and titrate to achieve a MAP of at least 65 mm Hg CORRECT
B. Administer a second 30 mL/kg crystalloid bolus
C. Insert a central venous catheter for measurement of central venous oxygen saturation
D. Begin broad-spectrum antibiotics within 3 hours
RATIONALE: After fluid resuscitation, persistent hypotension (MAP <65) with lactate 4 indicates
septic shock; vasopressors (norepinephrine) should be started to maintain MAP 65, per current
guidelines. Additional fluids may be considered, but vasopressors are the priority. Antibiotics
should be given within 1 hour, and ScvO monitoring is not required in the Hour-1 Bundle.
Q4 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which laboratory finding is most indicative of acute tubular necrosis (ATN) rather
than prerenal azotemia in a patient with acute kidney injury?
A. Urine sodium of 15 mEq/L
B. Fractional excretion of sodium (FENa) of 3% CORRECT
C. Urine osmolality of 600 mOsm/kg
D. BUN:creatinine ratio of 20:1
RATIONALE: A FENa >2% suggests intrinsic renal damage (ATN), whereas prerenal states
typically have FENa <1%. Low urine sodium and high urine osmolality are consistent with
prerenal azotemia; a high BUN:creatinine ratio also indicates prerenal causes.
Page 3
, Q5 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A nurse is caring for a patient receiving a continuous infusion of unfractionated
heparin. Which finding requires immediate action?
A. Activated partial thromboplastin time (aPTT) of 65 seconds (therapeutic range 60-80)
B. Platelet count drop from 250,000 to 90,000/mm³ over 3 days CORRECT
C. Occasional blood-tinged sputum after suctioning
D. Hemoglobin decrease from 13.5 to 12.8 g/dL over 24 hours
RATIONALE: A significant platelet drop may indicate heparin-induced thrombocytopenia (HIT), a
life-threatening complication requiring immediate cessation of heparin and alternative
anticoagulation. The other findings are within normal or expected ranges for anticoagulation
therapy; a small hemoglobin drop is not as critical as HIT.
Q6 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which nursing intervention is most appropriate for a patient with increased
intracranial pressure (ICP) who is exhibiting Cushing's triad?
A. Elevate the head of the bed to 30 degrees and maintain neutral neck alignment
B. Suction the endotracheal tube frequently to maintain airway patency
C. Administer a hypertonic saline bolus as prescribed CORRECT
D. Place the patient in a supine position to promote venous return
RATIONALE: Cushing's triad (hypertension, bradycardia, irregular respirations) indicates
impending herniation; immediate intervention is required to reduce ICP. Hypertonic saline is an
osmotic agent that rapidly decreases ICP. Elevating the head is a general measure but not the
most immediate for herniation; suctioning can increase ICP; supine positioning worsens ICP.
Page 4
WITH DETAILED RATIONALES 100% VERIFIED CORRECT
ANSWERS - PASS GUARANTEED - A+ GRADED EXAM
170 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Analyze and interpret advanced hemodynamic and laboratory data to guide nursing interventions
2 Synthesize multiple system assessments to prioritize care for critically ill patients
3 Evaluate the ethical and legal dimensions of nursing decisions in complex clinical situations
4 Apply current evidence-based guidelines to the management of acute and chronic conditions
5 NSG 3100 Exam 4 Actual 2026
6 2027
7 Complete Questions with Detailed Rationales 100% Verified Correct Answers
8 Pass Guaranteed
9 A+ Graded Exam
10 Foundations of Medical-Surgical Nursing / Adult Health
11 Applied Medical-Surgical Nursing / Adult Health
12 Advanced Medical-Surgical Nursing / Adult Health
13 Medical-Surgical Nursing / Adult Health Review
Page 1
,Q1 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A patient in the intensive care unit has a pulmonary artery catheter with the
following readings: central venous pressure 12 mm Hg, pulmonary artery wedge
pressure 18 mm Hg, cardiac index 2.1 L/min/m², and systemic vascular resistance
1,900 dynes/sec/cm. Which condition is most consistent with these findings?
A. Hypovolemic shock
B. Cardiogenic shock CORRECT
C. Septic shock (hyperdynamic)
D. Neurogenic shock
RATIONALE: High filling pressures with low cardiac index and elevated SVR indicate impaired
myocardial contractility with compensatory vasoconstriction, classic for cardiogenic shock.
Hypovolemia would show low pressures; septic shock typically presents with high cardiac output
and low SVR; neurogenic shock has low SVR with bradycardia.
Q2 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which finding in a patient with acute respiratory distress syndrome (ARDS) would
indicate that the current positive end-expiratory pressure (PEEP) setting is too
high, requiring immediate adjustment?
A. PaO/FiO ratio of 150
B. Decreased static compliance
C. Plateau pressure of 30 cm HO
D. Increased dead space ventilation CORRECT
RATIONALE: Excessive PEEP can overdistend alveoli, compressing pulmonary capillaries and
increasing dead space, leading to elevated PaCO and wasted ventilation. While high plateau
pressures (>30) are concerning, increased dead space is a more direct indicator of
overdistension. Low compliance and low PaO/FiO reflect the underlying ARDS, not necessarily
PEEP-induced injury.
Page 2
,Q3 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A patient with sepsis has a serum lactate of 6 mmol/L and a mean arterial pressure
(MAP) of 58 mm Hg despite a 30 mL/kg crystalloid bolus. According to the
Surviving Sepsis Campaign Hour-1 Bundle, which intervention should be initiated
immediately?
A. Start norepinephrine and titrate to achieve a MAP of at least 65 mm Hg CORRECT
B. Administer a second 30 mL/kg crystalloid bolus
C. Insert a central venous catheter for measurement of central venous oxygen saturation
D. Begin broad-spectrum antibiotics within 3 hours
RATIONALE: After fluid resuscitation, persistent hypotension (MAP <65) with lactate 4 indicates
septic shock; vasopressors (norepinephrine) should be started to maintain MAP 65, per current
guidelines. Additional fluids may be considered, but vasopressors are the priority. Antibiotics
should be given within 1 hour, and ScvO monitoring is not required in the Hour-1 Bundle.
Q4 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which laboratory finding is most indicative of acute tubular necrosis (ATN) rather
than prerenal azotemia in a patient with acute kidney injury?
A. Urine sodium of 15 mEq/L
B. Fractional excretion of sodium (FENa) of 3% CORRECT
C. Urine osmolality of 600 mOsm/kg
D. BUN:creatinine ratio of 20:1
RATIONALE: A FENa >2% suggests intrinsic renal damage (ATN), whereas prerenal states
typically have FENa <1%. Low urine sodium and high urine osmolality are consistent with
prerenal azotemia; a high BUN:creatinine ratio also indicates prerenal causes.
Page 3
, Q5 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
A nurse is caring for a patient receiving a continuous infusion of unfractionated
heparin. Which finding requires immediate action?
A. Activated partial thromboplastin time (aPTT) of 65 seconds (therapeutic range 60-80)
B. Platelet count drop from 250,000 to 90,000/mm³ over 3 days CORRECT
C. Occasional blood-tinged sputum after suctioning
D. Hemoglobin decrease from 13.5 to 12.8 g/dL over 24 hours
RATIONALE: A significant platelet drop may indicate heparin-induced thrombocytopenia (HIT), a
life-threatening complication requiring immediate cessation of heparin and alternative
anticoagulation. The other findings are within normal or expected ranges for anticoagulation
therapy; a small hemoglobin drop is not as critical as HIT.
Q6 ANALYZE AND INTERPRET ADVANCED HEMODYNAMIC AND LABORATORY DATA TO
GUIDE NURSING INTERVENTIONS
Which nursing intervention is most appropriate for a patient with increased
intracranial pressure (ICP) who is exhibiting Cushing's triad?
A. Elevate the head of the bed to 30 degrees and maintain neutral neck alignment
B. Suction the endotracheal tube frequently to maintain airway patency
C. Administer a hypertonic saline bolus as prescribed CORRECT
D. Place the patient in a supine position to promote venous return
RATIONALE: Cushing's triad (hypertension, bradycardia, irregular respirations) indicates
impending herniation; immediate intervention is required to reduce ICP. Hypertonic saline is an
osmotic agent that rapidly decreases ICP. Elevating the head is a general measure but not the
most immediate for herniation; suctioning can increase ICP; supine positioning worsens ICP.
Page 4
