NSG 3130 · EXAM 3 REVIEW · RASMUSSEN
Fundamental
Concepts & Skills for
Nursing Practice II
One hundred questions covering oxygenation and
respiratory care, fluid and electrolyte balance,
cardiovascular assessment, medication and IV therapy, pain
management, perioperative nursing, and wound care —
each with a verified answer and detailed rationale.
Rasmussen University
Nursing Program · Fundamental Concepts & Skills II
10 0 Q UES T IO N S · GR A DE A · 10 0 % CO R R ECT
L ATE ST 2 0 2 0 2 7 U P D ATE
,NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Table of Contents
Section 1 - Oxygenation and Respiratory Care 2
Section 2 - Fluid, Electrolyte, and Acid-Base Balance 12
Section 3 - Cardiovascular and Peripheral Vascular Assessment 21
Section 4 - Medication Administration and Intravenous Therapy 27
Section 5 - Pain Management and Comfort 34
Section 6 - Perioperative Nursing 39
Section 7 - Wound Care and Skin Integrity 44
EXAM PROFILE
Course NSG 3130 - Fundamental Concepts and Skills for Nursing Practice II
Institution Rasmussen University · Nursing Program
Edition Latest 2026/2027 Update - aligned to current nursing practice standards and guidelines
Total Questions 100 multiple-choice items across 7 content sections
Item Format 4 options (A-D), one best answer · 75% scenario-based, 25% direct recall and skill
identification
Cognitive Mix 25% recall · 55% application · 20% analysis
Answer Key Correct answer marked [CORRECT] with a detailed fundamental-nursing rationale
following every item
Emphasis Fundamental nursing skills · Clinical judgment · Safety · Evidence-based practice
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 1
,NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Section 1 - Oxygenation and Respiratory Care
Questions 1-20 · Respiratory Assessment · Oxygen Delivery Systems · Suctioning · Chest Physiotherapy · Ventilation
Q1: A nurse auscultates fine, popping, discontinuous crackles over the bilateral lower lobes of a client
who reports sleeping upright on three pillows because of breathlessness. The nurse should interpret
these findings as most consistent with which condition?
A. Air trapped in narrowed lower airways from bronchospasm
B. Inflammation of the pleural surfaces producing a grating sound
C. Secretions pooled in the large airways that clear with coughing
D. Fluid accumulating in the alveoli from left-sided heart failure [CORRECT]
Correct Answer: D
Rationale: Fine crackles are discontinuous popping sounds created when collapsed, fluid-filled alveoli
pop open during inspiration, and their presence in the dependent lower lobes together with orthopnea
strongly suggests pulmonary venous congestion from left-sided heart failure. Option A is incorrect
because trapped air in narrowed airways produces continuous musical wheezes, not crackles. Option C
is incorrect because large-airway secretions produce coarse rhonchi that characteristically clear after
coughing. Option B is incorrect because pleural inflammation produces a leathery friction rub that is
heard on both inspiration and expiration and is unaffected by coughing.
Q2: A client admitted with a severe COPD exacerbation has these arterial blood gas results: pH 7.32,
PaCO2 58 mm Hg, and HCO3 26 mEq/L. Which interpretation should the nurse make?
A. Respiratory acidosis, uncompensated [CORRECT]
B. Metabolic acidosis, uncompensated
C. Respiratory alkalosis, uncompensated
D. Respiratory acidosis, fully compensated
Correct Answer: A
Rationale: The pH is below 7.35 (acidosis), the PaCO2 is elevated above 45 mm Hg, which identifies
the respiratory system as the cause, and the bicarbonate is normal at 26 mEq/L, indicating the kidneys
have not yet begun compensating. Option B is incorrect because metabolic acidosis would show a low
bicarbonate with a low or normal PaCO2. Option C is incorrect because respiratory alkalosis would
produce an elevated pH with a low PaCO2. Option D is incorrect because full compensation requires a
normal pH accompanied by an elevated bicarbonate, which is not present in these results.
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 2
, NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Q3: A nurse is selecting an oxygen delivery system for a client with COPD who needs a low but
precisely controlled oxygen concentration because of the risk of suppressing the hypoxic respiratory
drive. Which device should the nurse choose?
A. Simple face mask at 8 L/min
B. Non-rebreather mask at 12 L/min
C. Venturi mask [CORRECT]
D. Nasal cannula at 2 L/min
Correct Answer: C
Rationale: The Venturi mask entrains a fixed amount of room air through calibrated ports, delivering
the most precise FiO2 available (approximately 24 to 50 percent), which makes it the device of choice
when exact low concentrations are required. Option A is incorrect because a simple face mask delivers
a variable concentration of roughly 40 to 60 percent and cannot achieve precise control. Option B is
incorrect because a non-rebreather mask delivers the highest concentrations (80 to 95 percent) for
severe hypoxemia and offers no precision. Option D is incorrect because nasal cannula flow is diluted
by the client's breathing pattern, giving an approximate rather than precise FiO2.
Q4: A firefighter rescued from a burning building has a carboxyhemoglobin level of 25 percent and
displays a pulse oximetry reading of 98 percent on room air. Which intervention should the nurse
anticipate?
A. Deep-breathing exercises with incentive spirometry every hour
B. Low-flow oxygen at 2 L/min via nasal cannula
C. High-flow 100 percent oxygen via non-rebreather mask [CORRECT]
D. Continuous pulse oximetry monitoring without supplemental oxygen
Correct Answer: C
Rationale: Carbon monoxide binds hemoglobin with an affinity approximately 200 times greater than
oxygen, and standard pulse oximetry cannot distinguish carboxyhemoglobin from oxyhemoglobin, so
the 98 percent reading is falsely reassuring. The priority treatment is 100 percent oxygen via
non-rebreather mask to rapidly displace carbon monoxide from hemoglobin and restore
oxygen-carrying capacity. Option A is incorrect because breathing exercises cannot displace carbon
monoxide from hemoglobin. Option B is incorrect because low-flow oxygen provides an inadequate
concentration for significant carboxyhemoglobin levels. Option D is incorrect because monitoring
alone delays definitive treatment and permits continued tissue hypoxia.
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 3
Fundamental
Concepts & Skills for
Nursing Practice II
One hundred questions covering oxygenation and
respiratory care, fluid and electrolyte balance,
cardiovascular assessment, medication and IV therapy, pain
management, perioperative nursing, and wound care —
each with a verified answer and detailed rationale.
Rasmussen University
Nursing Program · Fundamental Concepts & Skills II
10 0 Q UES T IO N S · GR A DE A · 10 0 % CO R R ECT
L ATE ST 2 0 2 0 2 7 U P D ATE
,NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Table of Contents
Section 1 - Oxygenation and Respiratory Care 2
Section 2 - Fluid, Electrolyte, and Acid-Base Balance 12
Section 3 - Cardiovascular and Peripheral Vascular Assessment 21
Section 4 - Medication Administration and Intravenous Therapy 27
Section 5 - Pain Management and Comfort 34
Section 6 - Perioperative Nursing 39
Section 7 - Wound Care and Skin Integrity 44
EXAM PROFILE
Course NSG 3130 - Fundamental Concepts and Skills for Nursing Practice II
Institution Rasmussen University · Nursing Program
Edition Latest 2026/2027 Update - aligned to current nursing practice standards and guidelines
Total Questions 100 multiple-choice items across 7 content sections
Item Format 4 options (A-D), one best answer · 75% scenario-based, 25% direct recall and skill
identification
Cognitive Mix 25% recall · 55% application · 20% analysis
Answer Key Correct answer marked [CORRECT] with a detailed fundamental-nursing rationale
following every item
Emphasis Fundamental nursing skills · Clinical judgment · Safety · Evidence-based practice
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 1
,NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Section 1 - Oxygenation and Respiratory Care
Questions 1-20 · Respiratory Assessment · Oxygen Delivery Systems · Suctioning · Chest Physiotherapy · Ventilation
Q1: A nurse auscultates fine, popping, discontinuous crackles over the bilateral lower lobes of a client
who reports sleeping upright on three pillows because of breathlessness. The nurse should interpret
these findings as most consistent with which condition?
A. Air trapped in narrowed lower airways from bronchospasm
B. Inflammation of the pleural surfaces producing a grating sound
C. Secretions pooled in the large airways that clear with coughing
D. Fluid accumulating in the alveoli from left-sided heart failure [CORRECT]
Correct Answer: D
Rationale: Fine crackles are discontinuous popping sounds created when collapsed, fluid-filled alveoli
pop open during inspiration, and their presence in the dependent lower lobes together with orthopnea
strongly suggests pulmonary venous congestion from left-sided heart failure. Option A is incorrect
because trapped air in narrowed airways produces continuous musical wheezes, not crackles. Option C
is incorrect because large-airway secretions produce coarse rhonchi that characteristically clear after
coughing. Option B is incorrect because pleural inflammation produces a leathery friction rub that is
heard on both inspiration and expiration and is unaffected by coughing.
Q2: A client admitted with a severe COPD exacerbation has these arterial blood gas results: pH 7.32,
PaCO2 58 mm Hg, and HCO3 26 mEq/L. Which interpretation should the nurse make?
A. Respiratory acidosis, uncompensated [CORRECT]
B. Metabolic acidosis, uncompensated
C. Respiratory alkalosis, uncompensated
D. Respiratory acidosis, fully compensated
Correct Answer: A
Rationale: The pH is below 7.35 (acidosis), the PaCO2 is elevated above 45 mm Hg, which identifies
the respiratory system as the cause, and the bicarbonate is normal at 26 mEq/L, indicating the kidneys
have not yet begun compensating. Option B is incorrect because metabolic acidosis would show a low
bicarbonate with a low or normal PaCO2. Option C is incorrect because respiratory alkalosis would
produce an elevated pH with a low PaCO2. Option D is incorrect because full compensation requires a
normal pH accompanied by an elevated bicarbonate, which is not present in these results.
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 2
, NSG 3130 Fundamental Concepts and Skills II · Exam 3 Review · 2026/2027 Update Total: 100 Questions
Q3: A nurse is selecting an oxygen delivery system for a client with COPD who needs a low but
precisely controlled oxygen concentration because of the risk of suppressing the hypoxic respiratory
drive. Which device should the nurse choose?
A. Simple face mask at 8 L/min
B. Non-rebreather mask at 12 L/min
C. Venturi mask [CORRECT]
D. Nasal cannula at 2 L/min
Correct Answer: C
Rationale: The Venturi mask entrains a fixed amount of room air through calibrated ports, delivering
the most precise FiO2 available (approximately 24 to 50 percent), which makes it the device of choice
when exact low concentrations are required. Option A is incorrect because a simple face mask delivers
a variable concentration of roughly 40 to 60 percent and cannot achieve precise control. Option B is
incorrect because a non-rebreather mask delivers the highest concentrations (80 to 95 percent) for
severe hypoxemia and offers no precision. Option D is incorrect because nasal cannula flow is diluted
by the client's breathing pattern, giving an approximate rather than precise FiO2.
Q4: A firefighter rescued from a burning building has a carboxyhemoglobin level of 25 percent and
displays a pulse oximetry reading of 98 percent on room air. Which intervention should the nurse
anticipate?
A. Deep-breathing exercises with incentive spirometry every hour
B. Low-flow oxygen at 2 L/min via nasal cannula
C. High-flow 100 percent oxygen via non-rebreather mask [CORRECT]
D. Continuous pulse oximetry monitoring without supplemental oxygen
Correct Answer: C
Rationale: Carbon monoxide binds hemoglobin with an affinity approximately 200 times greater than
oxygen, and standard pulse oximetry cannot distinguish carboxyhemoglobin from oxyhemoglobin, so
the 98 percent reading is falsely reassuring. The priority treatment is 100 percent oxygen via
non-rebreather mask to rapidly displace carbon monoxide from hemoglobin and restore
oxygen-carrying capacity. Option A is incorrect because breathing exercises cannot displace carbon
monoxide from hemoglobin. Option B is incorrect because low-flow oxygen provides an inadequate
concentration for significant carboxyhemoglobin levels. Option D is incorrect because monitoring
alone delays definitive treatment and permits continued tissue hypoxia.
Rasmussen University · Nursing Program · Verified Answers · Grade A · 100% Correct 3
