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NSG 3250 EXAM NURSING PRACTICE – ADULT HEALTH I
EXAM PREP | VERIFIED Q&A GALEN COLLEGE OF NURSING
1. A 68-year-old client with a history of chronic hypertension and hyperlipidemia
is admitted to the medical-surgical unit after experiencing sudden onset of right-
sided weakness, facial drooping, and difficulty speaking approximately 45 minutes
before arrival. The nurse notes that the client is awake but has expressive aphasia.
Which nursing action is the priority when caring for this client during the initial
assessment?
A. Administer oral antihypertensive medication immediately
B. Determine the exact time the client was last known to be well
C. Place the client in a high-Fowler position and provide oral fluids
D. Encourage the client to ambulate to assess motor strength
Answer: B
2. A client who is recovering from an acute ischemic stroke has difficulty
swallowing liquids and demonstrates coughing during attempts to drink water. The
nurse is preparing the client for oral medication administration. Which intervention
is most appropriate to reduce the client's risk for aspiration?
A. Give medications with a large glass of water
B. Place the client completely flat after medication administration
C. Maintain aspiration precautions and obtain a swallowing evaluation
D. Encourage the client to use a straw with all liquids
Answer: C
3. A 72-year-old client with a history of heart failure is admitted with increasing
dyspnea, bilateral crackles, peripheral edema, and a 3-kg weight gain over four
days. The nurse observes that the client is sitting upright and appears anxious while
reporting difficulty breathing. Which prescription should the nurse implement
first?
A. Encourage oral fluids
B. Place the client in high-Fowler position and administer prescribed oxygen
,2
C. Assist the client to ambulate in the hallway
D. Place the client in a supine position for rest
Answer: B
4. A client with left-sided heart failure has been receiving intravenous diuretics and
reports that breathing has improved. During assessment, the nurse notes a
potassium level of 2.9 mEq/L and observes generalized weakness and an irregular
pulse. Which nursing action is most appropriate?
A. Administer the next dose of the diuretic immediately
B. Notify the healthcare provider about the potassium level and cardiac findings
C. Encourage the client to restrict potassium-containing foods
D. Document the findings as an expected effect of diuretic therapy
Answer: B
5. A 59-year-old client with chronic obstructive pulmonary disease is admitted
with increased dyspnea, wheezing, productive cough, and oxygen saturation of
86% on room air. The provider prescribes supplemental oxygen. Which nursing
intervention is most appropriate?
A. Apply oxygen as prescribed and monitor respiratory status closely
B. Withhold oxygen because oxygen therapy is contraindicated in COPD
C. Place the client flat to improve diaphragmatic movement
D. Encourage rapid shallow breathing to increase oxygen intake
Answer: A
6. A client with COPD is receiving oxygen through a nasal cannula and is sitting
upright while using pursed-lip breathing. The client asks why pursed-lip breathing
is encouraged during episodes of dyspnea. Which response by the nurse is most
appropriate?
,3
A. "It helps keep the airways open longer during exhalation."
B. "It prevents carbon dioxide from entering the lungs."
C. "It completely eliminates the need for supplemental oxygen."
D. "It increases the respiratory rate so more oxygen can enter the blood."
Answer: A
7. A 64-year-old client is admitted with pneumonia and has a temperature of
39.2°C (102.6°F), respiratory rate of 30/min, oxygen saturation of 89%, and
productive cough with thick yellow sputum. Which assessment finding requires the
nurse's most immediate attention?
A. Temperature of 39.2°C
B. Productive cough
C. Respiratory rate of 30/min with oxygen saturation of 89%
D. Thick yellow sputum
Answer: C
8. A client with pneumonia is receiving intravenous antibiotics and supplemental
oxygen. Four hours after admission, the client becomes increasingly confused,
restless, and tachypneic. The oxygen saturation decreases from 94% to 86%.
Which nursing action should occur first?
A. Reassess oxygenation and increase oxygen according to the prescribed protocol
B. Offer the client a meal
C. Encourage the client to sleep
D. Document confusion as an expected finding
Answer: A
9. A 45-year-old client presents to the emergency department with severe
substernal chest pressure radiating to the left arm and jaw, diaphoresis, nausea, and
anxiety. The nurse obtains an electrocardiogram showing changes consistent with
myocardial ischemia. Which action is the priority?
, 4
A. Encourage the client to walk to reduce anxiety
B. Initiate appropriate acute coronary syndrome interventions and continuous
cardiac monitoring
C. Give the client a large meal
D. Place the client in Trendelenburg position
Answer: B
10. A client with suspected acute myocardial infarction reports crushing chest pain
that began approximately 30 minutes ago. The client has no known allergy to
aspirin and has not taken aspirin before arrival. Which medication should the nurse
anticipate administering promptly if prescribed?
A. Aspirin
B. Warfarin
C. Furosemide
D. Insulin
Answer: A
11. A client with stable angina is prescribed sublingual nitroglycerin for episodes
of chest discomfort. Which instruction should the nurse emphasize regarding the
medication?
A. Swallow the tablet whole with water
B. Place the tablet under the tongue and allow it to dissolve
C. Take the medication only after eating a large meal
D. Store the medication in an open container exposed to sunlight
Answer: B
12. A client taking sublingual nitroglycerin for angina reports dizziness shortly
after taking a dose. The nurse recognizes that this finding may occur because
nitroglycerin can cause which effect?
NSG 3250 EXAM NURSING PRACTICE – ADULT HEALTH I
EXAM PREP | VERIFIED Q&A GALEN COLLEGE OF NURSING
1. A 68-year-old client with a history of chronic hypertension and hyperlipidemia
is admitted to the medical-surgical unit after experiencing sudden onset of right-
sided weakness, facial drooping, and difficulty speaking approximately 45 minutes
before arrival. The nurse notes that the client is awake but has expressive aphasia.
Which nursing action is the priority when caring for this client during the initial
assessment?
A. Administer oral antihypertensive medication immediately
B. Determine the exact time the client was last known to be well
C. Place the client in a high-Fowler position and provide oral fluids
D. Encourage the client to ambulate to assess motor strength
Answer: B
2. A client who is recovering from an acute ischemic stroke has difficulty
swallowing liquids and demonstrates coughing during attempts to drink water. The
nurse is preparing the client for oral medication administration. Which intervention
is most appropriate to reduce the client's risk for aspiration?
A. Give medications with a large glass of water
B. Place the client completely flat after medication administration
C. Maintain aspiration precautions and obtain a swallowing evaluation
D. Encourage the client to use a straw with all liquids
Answer: C
3. A 72-year-old client with a history of heart failure is admitted with increasing
dyspnea, bilateral crackles, peripheral edema, and a 3-kg weight gain over four
days. The nurse observes that the client is sitting upright and appears anxious while
reporting difficulty breathing. Which prescription should the nurse implement
first?
A. Encourage oral fluids
B. Place the client in high-Fowler position and administer prescribed oxygen
,2
C. Assist the client to ambulate in the hallway
D. Place the client in a supine position for rest
Answer: B
4. A client with left-sided heart failure has been receiving intravenous diuretics and
reports that breathing has improved. During assessment, the nurse notes a
potassium level of 2.9 mEq/L and observes generalized weakness and an irregular
pulse. Which nursing action is most appropriate?
A. Administer the next dose of the diuretic immediately
B. Notify the healthcare provider about the potassium level and cardiac findings
C. Encourage the client to restrict potassium-containing foods
D. Document the findings as an expected effect of diuretic therapy
Answer: B
5. A 59-year-old client with chronic obstructive pulmonary disease is admitted
with increased dyspnea, wheezing, productive cough, and oxygen saturation of
86% on room air. The provider prescribes supplemental oxygen. Which nursing
intervention is most appropriate?
A. Apply oxygen as prescribed and monitor respiratory status closely
B. Withhold oxygen because oxygen therapy is contraindicated in COPD
C. Place the client flat to improve diaphragmatic movement
D. Encourage rapid shallow breathing to increase oxygen intake
Answer: A
6. A client with COPD is receiving oxygen through a nasal cannula and is sitting
upright while using pursed-lip breathing. The client asks why pursed-lip breathing
is encouraged during episodes of dyspnea. Which response by the nurse is most
appropriate?
,3
A. "It helps keep the airways open longer during exhalation."
B. "It prevents carbon dioxide from entering the lungs."
C. "It completely eliminates the need for supplemental oxygen."
D. "It increases the respiratory rate so more oxygen can enter the blood."
Answer: A
7. A 64-year-old client is admitted with pneumonia and has a temperature of
39.2°C (102.6°F), respiratory rate of 30/min, oxygen saturation of 89%, and
productive cough with thick yellow sputum. Which assessment finding requires the
nurse's most immediate attention?
A. Temperature of 39.2°C
B. Productive cough
C. Respiratory rate of 30/min with oxygen saturation of 89%
D. Thick yellow sputum
Answer: C
8. A client with pneumonia is receiving intravenous antibiotics and supplemental
oxygen. Four hours after admission, the client becomes increasingly confused,
restless, and tachypneic. The oxygen saturation decreases from 94% to 86%.
Which nursing action should occur first?
A. Reassess oxygenation and increase oxygen according to the prescribed protocol
B. Offer the client a meal
C. Encourage the client to sleep
D. Document confusion as an expected finding
Answer: A
9. A 45-year-old client presents to the emergency department with severe
substernal chest pressure radiating to the left arm and jaw, diaphoresis, nausea, and
anxiety. The nurse obtains an electrocardiogram showing changes consistent with
myocardial ischemia. Which action is the priority?
, 4
A. Encourage the client to walk to reduce anxiety
B. Initiate appropriate acute coronary syndrome interventions and continuous
cardiac monitoring
C. Give the client a large meal
D. Place the client in Trendelenburg position
Answer: B
10. A client with suspected acute myocardial infarction reports crushing chest pain
that began approximately 30 minutes ago. The client has no known allergy to
aspirin and has not taken aspirin before arrival. Which medication should the nurse
anticipate administering promptly if prescribed?
A. Aspirin
B. Warfarin
C. Furosemide
D. Insulin
Answer: A
11. A client with stable angina is prescribed sublingual nitroglycerin for episodes
of chest discomfort. Which instruction should the nurse emphasize regarding the
medication?
A. Swallow the tablet whole with water
B. Place the tablet under the tongue and allow it to dissolve
C. Take the medication only after eating a large meal
D. Store the medication in an open container exposed to sunlight
Answer: B
12. A client taking sublingual nitroglycerin for angina reports dizziness shortly
after taking a dose. The nurse recognizes that this finding may occur because
nitroglycerin can cause which effect?
