https://www.stuvia.com/user/Performance
NSG 4800 – COMPREHENSIVE NURSING EXAMINATION –QUESTIONS With Answers
and Rationales Updated for 2026/2027
SECTION 1: MEDICAL-SURGICAL NURSING (Questions)
1. A nurse is caring for a patient with heart failure who
develops pulmonary edema. Which finding requires
immediate intervention?
A) Heart rate of 88 bpm
B) Oxygen saturation of 86% on room air
C) Mild crackles at the lung bases
D) Weight gain of 1 lb in 24 hours
Answer: B
Rationale: SpO₂ of 86% indicates severe hypoxemia requiring
immediate oxygen therapy and intervention.
2. A patient with diabetes mellitus has a blood glucose of 45
mg/dL and is conscious. What should the nurse administer
first?
,https://www.stuvia.com/user/Performance
A) Insulin
B) 15 grams of fast-acting carbohydrate
C) A high-protein snack
D) Nothing; recheck in 1 hour
Answer: B
Rationale: For conscious hypoglycemic patients, give 15 g of
fast-acting carbs (glucose tablets, juice).
3. A nurse is caring for a patient with a chest tube. The chest
tube accidentally becomes disconnected from the drainage
system. What is the priority action?
A) Clamp the chest tube immediately
B) Place the end of the tube in sterile water
C) Notify the physician
D) Cover the insertion site with gauze
Answer: B
Rationale: Placing the tube in sterile water creates a water seal
and prevents pneumothorax.
4. A patient with chronic kidney disease has a potassium level
of 6.2 mEq/L. What is the priority nursing intervention?
,https://www.stuvia.com/user/Performance
A) Encourage potassium-rich foods
B) Notify the healthcare provider and prepare for treatment
C) Administer IV fluids
D) No action needed
Answer: B
Rationale: Hyperkalemia (K⁺ >6.0) is life-threatening; immediate
provider notification is essential.
5. A nurse is caring for a patient after a thyroidectomy. Which
finding suggests hypocalcemia?
A) Bradycardia
B) Numbness and tingling around the mouth (Chvostek's sign)
C) Hypertension
D) Constipation
Answer: B
Rationale: Hypocalcemia causes neuromuscular irritability
(Chvostek's sign, Trousseau's sign).
6. A patient with cirrhosis develops ascites. Which
intervention is most appropriate?
A) Encourage high-sodium diet
, https://www.stuvia.com/user/Performance
B) Administer diuretics as ordered and monitor weight
C) Restrict fluid intake completely
D) No intervention needed
Answer: B
Rationale: Diuretics and daily weights manage ascites; sodium
restriction is also important.
7. A patient with COPD is receiving oxygen at 2 L/min via nasal
cannula. The nurse should monitor for which complication?
A) Oxygen toxicity
B) Carbon dioxide retention (hypoventilation)
C) Hyperventilation
D) Hypokalemia
Answer: B
Rationale: COPD patients may retain CO₂ with high oxygen; low-
flow oxygen prevents hypoventilation.
8. A nurse is assessing a patient with increased intracranial
pressure (ICP). Which finding is most concerning?
A) Temperature of 98.6°F
B) Widening pulse pressure and bradycardia (Cushing's triad)
NSG 4800 – COMPREHENSIVE NURSING EXAMINATION –QUESTIONS With Answers
and Rationales Updated for 2026/2027
SECTION 1: MEDICAL-SURGICAL NURSING (Questions)
1. A nurse is caring for a patient with heart failure who
develops pulmonary edema. Which finding requires
immediate intervention?
A) Heart rate of 88 bpm
B) Oxygen saturation of 86% on room air
C) Mild crackles at the lung bases
D) Weight gain of 1 lb in 24 hours
Answer: B
Rationale: SpO₂ of 86% indicates severe hypoxemia requiring
immediate oxygen therapy and intervention.
2. A patient with diabetes mellitus has a blood glucose of 45
mg/dL and is conscious. What should the nurse administer
first?
,https://www.stuvia.com/user/Performance
A) Insulin
B) 15 grams of fast-acting carbohydrate
C) A high-protein snack
D) Nothing; recheck in 1 hour
Answer: B
Rationale: For conscious hypoglycemic patients, give 15 g of
fast-acting carbs (glucose tablets, juice).
3. A nurse is caring for a patient with a chest tube. The chest
tube accidentally becomes disconnected from the drainage
system. What is the priority action?
A) Clamp the chest tube immediately
B) Place the end of the tube in sterile water
C) Notify the physician
D) Cover the insertion site with gauze
Answer: B
Rationale: Placing the tube in sterile water creates a water seal
and prevents pneumothorax.
4. A patient with chronic kidney disease has a potassium level
of 6.2 mEq/L. What is the priority nursing intervention?
,https://www.stuvia.com/user/Performance
A) Encourage potassium-rich foods
B) Notify the healthcare provider and prepare for treatment
C) Administer IV fluids
D) No action needed
Answer: B
Rationale: Hyperkalemia (K⁺ >6.0) is life-threatening; immediate
provider notification is essential.
5. A nurse is caring for a patient after a thyroidectomy. Which
finding suggests hypocalcemia?
A) Bradycardia
B) Numbness and tingling around the mouth (Chvostek's sign)
C) Hypertension
D) Constipation
Answer: B
Rationale: Hypocalcemia causes neuromuscular irritability
(Chvostek's sign, Trousseau's sign).
6. A patient with cirrhosis develops ascites. Which
intervention is most appropriate?
A) Encourage high-sodium diet
, https://www.stuvia.com/user/Performance
B) Administer diuretics as ordered and monitor weight
C) Restrict fluid intake completely
D) No intervention needed
Answer: B
Rationale: Diuretics and daily weights manage ascites; sodium
restriction is also important.
7. A patient with COPD is receiving oxygen at 2 L/min via nasal
cannula. The nurse should monitor for which complication?
A) Oxygen toxicity
B) Carbon dioxide retention (hypoventilation)
C) Hyperventilation
D) Hypokalemia
Answer: B
Rationale: COPD patients may retain CO₂ with high oxygen; low-
flow oxygen prevents hypoventilation.
8. A nurse is assessing a patient with increased intracranial
pressure (ICP). Which finding is most concerning?
A) Temperature of 98.6°F
B) Widening pulse pressure and bradycardia (Cushing's triad)
