,South College NSG 2610 Final Exam | Adult Health Nursing
II (2026) Q&A
1. A patient with heart failure reports sudden weight gain of 2 kg in 2 days. What is the
priority nursing action?
A) Encourage increased fluid intake
B) Assess lung sounds and edema
C) Restrict sodium intake immediately
D) Administer insulin
Correct Answer: Assess lung sounds and edema
Rationale: Rapid weight gain suggests fluid retention, which can lead to pulmonary
congestion and worsening heart failure. Assessing for crackles, dyspnea, and peripheral
edema is the priority to determine the severity of fluid overload. Prompt intervention can
prevent further complications like acute pulmonary edema.
2. Which medication is commonly prescribed to reduce preload in heart failure?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid volume and venous return
(preload) by promoting excretion of sodium and water. This decreases the workload on
,the heart and alleviates symptoms of fluid overload. Digoxin increases contractility,
metoprolol is a beta-blocker, and lisinopril is an ACE inhibitor that reduces afterload.
3. A patient with COPD is using accessory muscles to breathe. What does this indicate?
A) Adequate oxygenation
B) Respiratory distress
C) Normal breathing pattern
D) Dehydration
Correct Answer: Respiratory distress
Rationale: Use of accessory muscles (sternocleidomastoid, trapezius, intercostals) indicates
increased work of breathing and respiratory distress. This compensatory mechanism is
seen when the primary respiratory muscles (diaphragm and intercostals) are insufficient to
maintain adequate ventilation. It is a sign of impending respiratory failure that requires
prompt intervention.
4. Which arterial blood gas value indicates respiratory acidosis?
A) pH 7.50, PaCO₂ 30
B) pH 7.35, PaCO₂ 45
C) pH 7.30, PaCO₂ 50
D) pH 7.45, PaCO₂ 40
Correct Answer: pH 7.30, PaCO₂ 50
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and elevated PaCO₂
(>45 mmHg) due to hypoventilation and CO₂ retention. Option C shows both a low pH
and high CO₂, confirming respiratory acidosis. Options A and D show alkalosis, and
option B is within normal limits.
, 5. A patient with diabetes has a blood glucose of 55 mg/dL. What is the first intervention?
A) Administer insulin
B) Give 15 g of fast-acting carbohydrates
C) Start IV fluids
D) Call the physician
Correct Answer: Give 15 g of fast-acting carbohydrates
Rationale: A blood glucose of 55 mg/dL indicates hypoglycemia. For a conscious patient,
the immediate treatment is 15 g of fast-acting carbohydrates (e.g., 4 oz juice, glucose
tablets, or 6-10 hard candies). Recheck glucose in 15 minutes and repeat if needed.
Glucagon or IV dextrose is reserved for unconscious patients.
6. Which sign is characteristic of hyperkalemia?
A) Muscle weakness
B) Bradycardia
C) Tall peaked T waves
D) All of the above
Correct Answer: All of the above
Rationale: Hyperkalemia (elevated serum potassium) causes muscle weakness,
bradycardia, and characteristic ECG changes including tall peaked T waves, widened QRS,
and prolonged PR interval. Severe hyperkalemia can lead to life-threatening arrhythmias.
Prompt recognition and treatment are essential.
7. A patient with asthma is wheezing. What does this indicate?
II (2026) Q&A
1. A patient with heart failure reports sudden weight gain of 2 kg in 2 days. What is the
priority nursing action?
A) Encourage increased fluid intake
B) Assess lung sounds and edema
C) Restrict sodium intake immediately
D) Administer insulin
Correct Answer: Assess lung sounds and edema
Rationale: Rapid weight gain suggests fluid retention, which can lead to pulmonary
congestion and worsening heart failure. Assessing for crackles, dyspnea, and peripheral
edema is the priority to determine the severity of fluid overload. Prompt intervention can
prevent further complications like acute pulmonary edema.
2. Which medication is commonly prescribed to reduce preload in heart failure?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
Correct Answer: Furosemide
Rationale: Furosemide is a loop diuretic that reduces fluid volume and venous return
(preload) by promoting excretion of sodium and water. This decreases the workload on
,the heart and alleviates symptoms of fluid overload. Digoxin increases contractility,
metoprolol is a beta-blocker, and lisinopril is an ACE inhibitor that reduces afterload.
3. A patient with COPD is using accessory muscles to breathe. What does this indicate?
A) Adequate oxygenation
B) Respiratory distress
C) Normal breathing pattern
D) Dehydration
Correct Answer: Respiratory distress
Rationale: Use of accessory muscles (sternocleidomastoid, trapezius, intercostals) indicates
increased work of breathing and respiratory distress. This compensatory mechanism is
seen when the primary respiratory muscles (diaphragm and intercostals) are insufficient to
maintain adequate ventilation. It is a sign of impending respiratory failure that requires
prompt intervention.
4. Which arterial blood gas value indicates respiratory acidosis?
A) pH 7.50, PaCO₂ 30
B) pH 7.35, PaCO₂ 45
C) pH 7.30, PaCO₂ 50
D) pH 7.45, PaCO₂ 40
Correct Answer: pH 7.30, PaCO₂ 50
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and elevated PaCO₂
(>45 mmHg) due to hypoventilation and CO₂ retention. Option C shows both a low pH
and high CO₂, confirming respiratory acidosis. Options A and D show alkalosis, and
option B is within normal limits.
, 5. A patient with diabetes has a blood glucose of 55 mg/dL. What is the first intervention?
A) Administer insulin
B) Give 15 g of fast-acting carbohydrates
C) Start IV fluids
D) Call the physician
Correct Answer: Give 15 g of fast-acting carbohydrates
Rationale: A blood glucose of 55 mg/dL indicates hypoglycemia. For a conscious patient,
the immediate treatment is 15 g of fast-acting carbohydrates (e.g., 4 oz juice, glucose
tablets, or 6-10 hard candies). Recheck glucose in 15 minutes and repeat if needed.
Glucagon or IV dextrose is reserved for unconscious patients.
6. Which sign is characteristic of hyperkalemia?
A) Muscle weakness
B) Bradycardia
C) Tall peaked T waves
D) All of the above
Correct Answer: All of the above
Rationale: Hyperkalemia (elevated serum potassium) causes muscle weakness,
bradycardia, and characteristic ECG changes including tall peaked T waves, widened QRS,
and prolonged PR interval. Severe hyperkalemia can lead to life-threatening arrhythmias.
Prompt recognition and treatment are essential.
7. A patient with asthma is wheezing. What does this indicate?
