NSG 3 1 3 0 | E X A M 3 PRE PA RATI ON G U I D E |
2026/2027 EDITION
NSG 3130
Exam 3: Fundamental Concepts and Skills for
Nursing Practice II
A complete Exam 3 guide covering oxygenation and
respiratory care, fluid, electrolyte, and acid-base
balance, cardiovascular assessment, medication
administration and IV therapy, pain management,
perioperative nursing, and wound care - every question
paired with a verified answer and a detailed rationale.
100 Questions | Verified Answers | Detailed
Rationales
G RA D E A | 1 0 0 % C O RRE C T | L ATE ST 2 0 2 0 2 7 U P D ATE
, NSG 3130 | EXAM 3 PREPARATION GUIDE | GRADE A | 100% CORRECT
Exam 3: Fundamental Concepts and Skills for Nursing
Practice II
Latest 2026/2027 Update - Exam 3 Guide | Questions & Answers | Verified Answers with Detailed Rationales
100 Questions | 7 Content Sections | Cognitive Levels: 25% Recall / 55% Application / 20% Analysis | 75% Scenario-Based /
25% Direct Recall | Aligned with 2026-2027 Practice Standards
Section Content Focus Questions
Oxygenation and Respiratory Care: respiratory assessment, oxygen delivery systems,
Section 1 Q1 - Q20
suctioning, chest physiotherapy, airway management, mechanical ventilation
Fluid, Electrolyte, and Acid-Base Balance: fluid compartments, IV fluids, electrolyte
Section 2 Q21 - Q40
imbalances, ABG interpretation, acid-base disorders
Cardiovascular and Peripheral Vascular Assessment: heart sounds, peripheral pulses,
Section 3 Q41 - Q55
edema, hemodynamic monitoring, vascular assessment
Medication Administration and Intravenous Therapy: six rights, dosage calculations, IV
Section 4 Q56 - Q70
insertion and maintenance, IV complications, blood products
Pain Management and Comfort: pain scales, pharmacologic and non-pharmacologic
Section 5 Q71 - Q80
interventions, end-of-life comfort care
Perioperative Nursing: preoperative assessment, intraoperative care, postoperative
Section 6 Q81 - Q90
complications, patient teaching
Wound Care and Skin Integrity: wound assessment, pressure injury staging, dressings,
Section 7 Q91 - Q100
drains, wound healing, complications
DIRECTIONS: Select the single best answer (A - D) for each of the 100 questions. The verified correct answer, marked
[CORRECT], and a complete fundamental-nursing rationale explaining why the correct option is right and why each distractor is
wrong follow every item. Rationales include nursing interventions, safety priorities, clinical judgment, and evidence-based
2026-2027 practice standards.
SECTION 1 - Oxygenation and Respiratory Care
Respiratory Assessment, Oxygen Delivery Systems, Suctioning, Chest Physiotherapy, Airway Management, and Mechanical Ventilation -
Questions 1-20
NSG 3130 Exam 3 | 2026/2027 Edition 1
,NSG 3130 Exam 3 | Fundamental Concepts and Skills for Nursing Practice II Exam 3 Guide
Q1: A nurse enters the room of a 66-year-old patient with an acute exacerbation of COPD. The patient is
sitting upright and leaning forward on the overbed table, the respiratory rate is 30 breaths/min, and the
sternocleidomastoid muscles are visibly contracting with each breath. Which interpretation of these findings is
most accurate?
A. The patient is using accessory muscles of respiration, indicating significantly increased work of
breathing [CORRECT]
B. The patient is demonstrating effective pursed-lip breathing with adequately compensated oxygenation
C. The patient is in a normal resting posture with expected respiratory effort for COPD
D. The patient is hyperventilating from anxiety and requires only reassurance at this time
Correct Answer: A
Rationale: Tripod positioning and visible sternocleidomastoid contraction are hallmark signs of accessory muscle
use, which reflects markedly increased work of breathing and impending respiratory fatigue. Pursed-lip breathing
and anxiety are not the primary findings here, and accepting this effort as normal for COPD delays intervention.
The nurse should assess oxygen saturation, auscultate the lungs, and anticipate emergency oxygen and provider
notification.
Q2: A 74-year-old patient with heart failure has bilateral fine crackles at the lung bases that remain unchanged
after the patient coughs forcefully. Which interpretation should the nurse document?
A. Atelectatic crackles that resolve with re-expansion of alveoli
B. Crackles caused by fluid in the alveoli, consistent with pulmonary congestion [CORRECT]
C. Wheezes caused by bronchospasm and airway narrowing
D. A pleural friction rub caused by inflamed pleural surfaces
Correct Answer: B
Rationale: Fine crackles that persist after coughing indicate fluid within the alveoli, a classic finding in pulmonary
congestion associated with heart failure. Atelectatic crackles typically clear with cough or deep breathing, wheezes
are continuous musical sounds of bronchospasm, and a friction rub is a scratchy grating sound heard during both
inspiration and expiration. The nurse should monitor for worsening dyspnea, orthopnea, and weight gain.
Q3: While auscultating the chest of an adult patient, the nurse hears loud, high-pitched, hollow sounds with a
pause between inspiration and expiration directly over the trachea. Which breath sound should the nurse
document?
A. Vesicular breath sounds
B. Bronchovesicular breath sounds
C. Bronchial (tubular) breath sounds [CORRECT]
D. Adventitious crackles
Correct Answer: C
Rationale: Bronchial breath sounds are loud, high-pitched, and hollow, with expiration longer than inspiration, and
they are expected only over the trachea. Vesicular sounds are soft and low-pitched over peripheral lung fields, and
bronchovesicular sounds are moderate with equal inspiration and expiration between the scapulae and over the
sternum. Bronchial sounds heard away from the trachea would suggest consolidation and require further evaluation.
NSG 3130 Exam 3 | 2026/2027 Edition 2
, NSG 3130 Exam 3 | Fundamental Concepts and Skills for Nursing Practice II Exam 3 Guide
Q4: An 81-year-old patient presents with fever, productive cough, and right-sided chest discomfort.
Percussion over the right lower lobe produces a short, soft, thud-like sound. How should the nurse interpret this
percussion finding?
A. Hyperresonance, consistent with air trapping from emphysema
B. Tympany, consistent with a large air-filled cavity
C. Resonance, which is the expected finding over healthy lung tissue
D. Dullness, consistent with consolidation such as pneumonia [CORRECT]
Correct Answer: D
Rationale: Dullness on percussion occurs when normal air-filled lung is replaced by denser material such as fluid or
consolidated tissue, which supports the suspicion of pneumonia in this symptomatic patient. Hyperresonance is the
abnormally long, low sound of hyperinflation seen in emphysema or pneumothorax, tympany is heard over air-filled
abdominal organs, and resonance is the normal lung sound. The nurse should anticipate a chest radiograph and
prepare to auscultate for bronchophony and egophony.
Q5: A patient is receiving oxygen at 4 L/min through a nasal cannula. Approximately what fraction of inspired
oxygen (FiO2) is this patient receiving?
A. Approximately 36% [CORRECT]
B. Approximately 28%
C. Approximately 44%
D. Approximately 60%
Correct Answer: A
Rationale: Each liter per minute of nasal cannula flow adds roughly 4% above room air, so 4 L/min delivers
approximately 20% + 16% = 36% FiO2. At 2 L/min the FiO2 is about 28% and at 6 L/min it reaches only about
44%, while 60% requires a reservoir-containing device such as a non-rebreather. The nurse should also apply
humidification for flows above 4 L/min to prevent drying of the nasal mucosa.
Q6: A patient with moderate hypoxemia is placed on a simple face mask. Which flow rate should the nurse
ensure is delivered?
A. A minimum of 2 L/min to conserve oxygen
B. A minimum of 5 L/min to prevent rebreathing of exhaled carbon dioxide [CORRECT]
C. A minimum of 10 L/min to keep the reservoir bag inflated
D. A maximum of 4 L/min to protect the nasal mucosa
Correct Answer: B
Rationale: A simple face mask requires a minimum flow of 5 L/min so that exhaled carbon dioxide is flushed from
the mask instead of being rebreathed. Flow rates of 2 to 4 L/min are associated with nasal cannula use, and 10 to 15
L/min applies to reservoir systems such as the partial rebreather or non-rebreather mask. The nurse should remove
the mask during eating if indicated and assess skin integrity over the ears and bridge of the nose.
NSG 3130 Exam 3 | 2026/2027 Edition 3
2026/2027 EDITION
NSG 3130
Exam 3: Fundamental Concepts and Skills for
Nursing Practice II
A complete Exam 3 guide covering oxygenation and
respiratory care, fluid, electrolyte, and acid-base
balance, cardiovascular assessment, medication
administration and IV therapy, pain management,
perioperative nursing, and wound care - every question
paired with a verified answer and a detailed rationale.
100 Questions | Verified Answers | Detailed
Rationales
G RA D E A | 1 0 0 % C O RRE C T | L ATE ST 2 0 2 0 2 7 U P D ATE
, NSG 3130 | EXAM 3 PREPARATION GUIDE | GRADE A | 100% CORRECT
Exam 3: Fundamental Concepts and Skills for Nursing
Practice II
Latest 2026/2027 Update - Exam 3 Guide | Questions & Answers | Verified Answers with Detailed Rationales
100 Questions | 7 Content Sections | Cognitive Levels: 25% Recall / 55% Application / 20% Analysis | 75% Scenario-Based /
25% Direct Recall | Aligned with 2026-2027 Practice Standards
Section Content Focus Questions
Oxygenation and Respiratory Care: respiratory assessment, oxygen delivery systems,
Section 1 Q1 - Q20
suctioning, chest physiotherapy, airway management, mechanical ventilation
Fluid, Electrolyte, and Acid-Base Balance: fluid compartments, IV fluids, electrolyte
Section 2 Q21 - Q40
imbalances, ABG interpretation, acid-base disorders
Cardiovascular and Peripheral Vascular Assessment: heart sounds, peripheral pulses,
Section 3 Q41 - Q55
edema, hemodynamic monitoring, vascular assessment
Medication Administration and Intravenous Therapy: six rights, dosage calculations, IV
Section 4 Q56 - Q70
insertion and maintenance, IV complications, blood products
Pain Management and Comfort: pain scales, pharmacologic and non-pharmacologic
Section 5 Q71 - Q80
interventions, end-of-life comfort care
Perioperative Nursing: preoperative assessment, intraoperative care, postoperative
Section 6 Q81 - Q90
complications, patient teaching
Wound Care and Skin Integrity: wound assessment, pressure injury staging, dressings,
Section 7 Q91 - Q100
drains, wound healing, complications
DIRECTIONS: Select the single best answer (A - D) for each of the 100 questions. The verified correct answer, marked
[CORRECT], and a complete fundamental-nursing rationale explaining why the correct option is right and why each distractor is
wrong follow every item. Rationales include nursing interventions, safety priorities, clinical judgment, and evidence-based
2026-2027 practice standards.
SECTION 1 - Oxygenation and Respiratory Care
Respiratory Assessment, Oxygen Delivery Systems, Suctioning, Chest Physiotherapy, Airway Management, and Mechanical Ventilation -
Questions 1-20
NSG 3130 Exam 3 | 2026/2027 Edition 1
,NSG 3130 Exam 3 | Fundamental Concepts and Skills for Nursing Practice II Exam 3 Guide
Q1: A nurse enters the room of a 66-year-old patient with an acute exacerbation of COPD. The patient is
sitting upright and leaning forward on the overbed table, the respiratory rate is 30 breaths/min, and the
sternocleidomastoid muscles are visibly contracting with each breath. Which interpretation of these findings is
most accurate?
A. The patient is using accessory muscles of respiration, indicating significantly increased work of
breathing [CORRECT]
B. The patient is demonstrating effective pursed-lip breathing with adequately compensated oxygenation
C. The patient is in a normal resting posture with expected respiratory effort for COPD
D. The patient is hyperventilating from anxiety and requires only reassurance at this time
Correct Answer: A
Rationale: Tripod positioning and visible sternocleidomastoid contraction are hallmark signs of accessory muscle
use, which reflects markedly increased work of breathing and impending respiratory fatigue. Pursed-lip breathing
and anxiety are not the primary findings here, and accepting this effort as normal for COPD delays intervention.
The nurse should assess oxygen saturation, auscultate the lungs, and anticipate emergency oxygen and provider
notification.
Q2: A 74-year-old patient with heart failure has bilateral fine crackles at the lung bases that remain unchanged
after the patient coughs forcefully. Which interpretation should the nurse document?
A. Atelectatic crackles that resolve with re-expansion of alveoli
B. Crackles caused by fluid in the alveoli, consistent with pulmonary congestion [CORRECT]
C. Wheezes caused by bronchospasm and airway narrowing
D. A pleural friction rub caused by inflamed pleural surfaces
Correct Answer: B
Rationale: Fine crackles that persist after coughing indicate fluid within the alveoli, a classic finding in pulmonary
congestion associated with heart failure. Atelectatic crackles typically clear with cough or deep breathing, wheezes
are continuous musical sounds of bronchospasm, and a friction rub is a scratchy grating sound heard during both
inspiration and expiration. The nurse should monitor for worsening dyspnea, orthopnea, and weight gain.
Q3: While auscultating the chest of an adult patient, the nurse hears loud, high-pitched, hollow sounds with a
pause between inspiration and expiration directly over the trachea. Which breath sound should the nurse
document?
A. Vesicular breath sounds
B. Bronchovesicular breath sounds
C. Bronchial (tubular) breath sounds [CORRECT]
D. Adventitious crackles
Correct Answer: C
Rationale: Bronchial breath sounds are loud, high-pitched, and hollow, with expiration longer than inspiration, and
they are expected only over the trachea. Vesicular sounds are soft and low-pitched over peripheral lung fields, and
bronchovesicular sounds are moderate with equal inspiration and expiration between the scapulae and over the
sternum. Bronchial sounds heard away from the trachea would suggest consolidation and require further evaluation.
NSG 3130 Exam 3 | 2026/2027 Edition 2
, NSG 3130 Exam 3 | Fundamental Concepts and Skills for Nursing Practice II Exam 3 Guide
Q4: An 81-year-old patient presents with fever, productive cough, and right-sided chest discomfort.
Percussion over the right lower lobe produces a short, soft, thud-like sound. How should the nurse interpret this
percussion finding?
A. Hyperresonance, consistent with air trapping from emphysema
B. Tympany, consistent with a large air-filled cavity
C. Resonance, which is the expected finding over healthy lung tissue
D. Dullness, consistent with consolidation such as pneumonia [CORRECT]
Correct Answer: D
Rationale: Dullness on percussion occurs when normal air-filled lung is replaced by denser material such as fluid or
consolidated tissue, which supports the suspicion of pneumonia in this symptomatic patient. Hyperresonance is the
abnormally long, low sound of hyperinflation seen in emphysema or pneumothorax, tympany is heard over air-filled
abdominal organs, and resonance is the normal lung sound. The nurse should anticipate a chest radiograph and
prepare to auscultate for bronchophony and egophony.
Q5: A patient is receiving oxygen at 4 L/min through a nasal cannula. Approximately what fraction of inspired
oxygen (FiO2) is this patient receiving?
A. Approximately 36% [CORRECT]
B. Approximately 28%
C. Approximately 44%
D. Approximately 60%
Correct Answer: A
Rationale: Each liter per minute of nasal cannula flow adds roughly 4% above room air, so 4 L/min delivers
approximately 20% + 16% = 36% FiO2. At 2 L/min the FiO2 is about 28% and at 6 L/min it reaches only about
44%, while 60% requires a reservoir-containing device such as a non-rebreather. The nurse should also apply
humidification for flows above 4 L/min to prevent drying of the nasal mucosa.
Q6: A patient with moderate hypoxemia is placed on a simple face mask. Which flow rate should the nurse
ensure is delivered?
A. A minimum of 2 L/min to conserve oxygen
B. A minimum of 5 L/min to prevent rebreathing of exhaled carbon dioxide [CORRECT]
C. A minimum of 10 L/min to keep the reservoir bag inflated
D. A maximum of 4 L/min to protect the nasal mucosa
Correct Answer: B
Rationale: A simple face mask requires a minimum flow of 5 L/min so that exhaled carbon dioxide is flushed from
the mask instead of being rebreathed. Flow rates of 2 to 4 L/min are associated with nasal cannula use, and 10 to 15
L/min applies to reservoir systems such as the partial rebreather or non-rebreather mask. The nurse should remove
the mask during eating if indicated and assess skin integrity over the ears and bridge of the nose.
NSG 3130 Exam 3 | 2026/2027 Edition 3
