NSG 4800 COMPS EXAM 2 WITH ACTUAL
CORRECT QUESTIONS AND VERIFIED
DETAILED ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
1.A nurse is reviewing prescriptions for four clients. Which prescription should the
nurse question first?
A. Warfarin for a client with an INR of 2.5
B. Metformin for a client scheduled for a CT scan with IV contrast
C. Acetaminophen for a client with a temperature of 38.1°C (100.6°F)
D. Loperamide for a client with diarrhea-predominant IBS
Correct answer: B
Rationale: Metformin may need to be withheld around iodinated IV contrast
because of the risk of metformin-associated lactic acidosis if renal function
deteriorates. The nurse should clarify the prescription according to the patient's
renal function and institutional protocol.
2.A client has a chest tube connected to a water-seal drainage system. Which finding
requires immediate follow-up?
A. Tidaling in the water-seal chamber
B. Gentle bubbling in the suction-control chamber
C. Continuous bubbling in the water-seal chamber
D. Drainage of 50 mL during the previous hour
Correct answer: C
Rationale: Tidaling is generally expected with changes in intrathoracic pressure.
Gentle bubbling in a wet suction chamber can be expected. Continuous bubbling in
the water-seal chamber suggests an air leak and requires assessment of the
system and connections.
3.The chest tube accidentally becomes completely dislodged from the client's chest.
What should the nurse do first?
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,A. Clamp the remaining tubing
B. Apply an occlusive dressing according to emergency protocol
C. Reinsert the chest tube
D. Place the client flat
Correct answer: B
Rationale: The nurse should immediately protect the insertion site and prevent air
from entering the pleural space by applying the appropriate sterile/occlusive
dressing per institutional protocol while obtaining assistance. A nurse should
never reinsert a chest tube independently.
4.A client with asthma suddenly develops severe respiratory distress. Which finding is
most concerning?
A. Expiratory wheezing
B. Productive cough
C. Absence of wheezing despite worsening respiratory distress
D. Respiratory rate of 24/min
Correct answer: C
Rationale: A previously wheezing client who becomes silent or has markedly
diminished breath sounds may have critically reduced airflow. A “silent chest” is
an ominous sign of severe airway obstruction and requires immediate intervention.
5.Which assessment finding is most consistent with worsening left-sided heart failure?
A. Jugular venous distention
B. Crackles in the lung bases
C. Dependent peripheral edema
D. Enlarged liver
Correct answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, producing
crackles, dyspnea, orthopnea, and pulmonary edema. JVD, peripheral edema, and
hepatomegaly are more characteristic of systemic venous congestion associated
with right-sided failure.
6.Before administering digoxin, which assessment is the priority?
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, A. Temperature
B. Apical heart rate
C. Respiratory rate
D. Blood pressure
Correct answer: B
Rationale: Digoxin can cause bradycardia and dysrhythmias. The nurse should
assess the apical pulse for a full minute and follow the prescribed parameters for
withholding the medication.
7.Which finding should the nurse recognize as potentially indicating digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Hypertension
D. Increased urine output
Correct answer: B
Rationale: Digoxin toxicity may produce nausea, vomiting, anorexia, bradycardia,
dysrhythmias, and visual disturbances, including yellow or green vision.
8.A client with SIADH has a sodium level of 122 mEq/L. Which intervention should the
nurse anticipate?
A. Encourage large amounts of oral fluids
B. Restrict fluids
C. Administer hypotonic IV fluids
D. Encourage a low-sodium diet
Correct answer: B
Rationale: SIADH causes excessive water retention and dilutional hyponatremia.
Fluid restriction is commonly used to reduce free-water excess. Severe
symptomatic hyponatremia requires urgent management.
9.Which finding is most consistent with diabetes insipidus?
A. Low urine output
B. Concentrated urine
C. Excessive dilute urine
D. Hyponatremia
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CORRECT QUESTIONS AND VERIFIED
DETAILED ANSWERS| CURRENTLY TESTING
VERSION | ALREADY GRADED A+|EXPERT
VERIFIED FOR GUARANTEED PASS 2026-2027
1.A nurse is reviewing prescriptions for four clients. Which prescription should the
nurse question first?
A. Warfarin for a client with an INR of 2.5
B. Metformin for a client scheduled for a CT scan with IV contrast
C. Acetaminophen for a client with a temperature of 38.1°C (100.6°F)
D. Loperamide for a client with diarrhea-predominant IBS
Correct answer: B
Rationale: Metformin may need to be withheld around iodinated IV contrast
because of the risk of metformin-associated lactic acidosis if renal function
deteriorates. The nurse should clarify the prescription according to the patient's
renal function and institutional protocol.
2.A client has a chest tube connected to a water-seal drainage system. Which finding
requires immediate follow-up?
A. Tidaling in the water-seal chamber
B. Gentle bubbling in the suction-control chamber
C. Continuous bubbling in the water-seal chamber
D. Drainage of 50 mL during the previous hour
Correct answer: C
Rationale: Tidaling is generally expected with changes in intrathoracic pressure.
Gentle bubbling in a wet suction chamber can be expected. Continuous bubbling in
the water-seal chamber suggests an air leak and requires assessment of the
system and connections.
3.The chest tube accidentally becomes completely dislodged from the client's chest.
What should the nurse do first?
1|Page
,A. Clamp the remaining tubing
B. Apply an occlusive dressing according to emergency protocol
C. Reinsert the chest tube
D. Place the client flat
Correct answer: B
Rationale: The nurse should immediately protect the insertion site and prevent air
from entering the pleural space by applying the appropriate sterile/occlusive
dressing per institutional protocol while obtaining assistance. A nurse should
never reinsert a chest tube independently.
4.A client with asthma suddenly develops severe respiratory distress. Which finding is
most concerning?
A. Expiratory wheezing
B. Productive cough
C. Absence of wheezing despite worsening respiratory distress
D. Respiratory rate of 24/min
Correct answer: C
Rationale: A previously wheezing client who becomes silent or has markedly
diminished breath sounds may have critically reduced airflow. A “silent chest” is
an ominous sign of severe airway obstruction and requires immediate intervention.
5.Which assessment finding is most consistent with worsening left-sided heart failure?
A. Jugular venous distention
B. Crackles in the lung bases
C. Dependent peripheral edema
D. Enlarged liver
Correct answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, producing
crackles, dyspnea, orthopnea, and pulmonary edema. JVD, peripheral edema, and
hepatomegaly are more characteristic of systemic venous congestion associated
with right-sided failure.
6.Before administering digoxin, which assessment is the priority?
2|Page
, A. Temperature
B. Apical heart rate
C. Respiratory rate
D. Blood pressure
Correct answer: B
Rationale: Digoxin can cause bradycardia and dysrhythmias. The nurse should
assess the apical pulse for a full minute and follow the prescribed parameters for
withholding the medication.
7.Which finding should the nurse recognize as potentially indicating digoxin toxicity?
A. Increased appetite
B. Yellow-green visual disturbances
C. Hypertension
D. Increased urine output
Correct answer: B
Rationale: Digoxin toxicity may produce nausea, vomiting, anorexia, bradycardia,
dysrhythmias, and visual disturbances, including yellow or green vision.
8.A client with SIADH has a sodium level of 122 mEq/L. Which intervention should the
nurse anticipate?
A. Encourage large amounts of oral fluids
B. Restrict fluids
C. Administer hypotonic IV fluids
D. Encourage a low-sodium diet
Correct answer: B
Rationale: SIADH causes excessive water retention and dilutional hyponatremia.
Fluid restriction is commonly used to reduce free-water excess. Severe
symptomatic hyponatremia requires urgent management.
9.Which finding is most consistent with diabetes insipidus?
A. Low urine output
B. Concentrated urine
C. Excessive dilute urine
D. Hyponatremia
3|Page
