NSG 3800 Exam 3 V1 | NSG 3800 Nursing Practice – Adult Health II |
Actual Q&A with Rationale (NSG3800 Exam 3) | Galen
1. A nurse is caring for a patient who has been diagnosed with Sinus Bradycardia and is
symptomatic with a heart rate of 38 bpm. Which medication should the nurse be prepared to
administer first?
A. Amiodarone
B. Digoxin
C. Adenosine
D. Atropine
Answer: D
Rationale: Atropine is the primary medication used to increase heart rate in patients with
symptomatic bradycardia. It acts as an anticholinergic to block vagal effects on the SA node.
The nurse must monitor for improved heart rate and resolution of symptoms like dizziness
or hypotension after administration.
2. When calculating a patient’s output for the 12-hour shift, the nurse notes 350 mL of urine,
150 mL of JP drain fluid, and 200 mL of emesis. What is the total output in milliliters?
A. 500 mL
B. 600 mL
C. 850 mL
D. 700 mL
Answer: D
Rationale: Total output is the sum of all measurable fluids leaving the patient’s body,
including urine and surgical drain contents. In this scenario, combining 350, 150, and 200
results in 700 mL. Accurate intake and output assessment is crucial for evaluating a
patient’s fluid balance and renal function.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary rationale for this intervention?
A. To ease the work of the diaphragm and increase abdominal pressure.
B. To decrease the risk of aspiration of gastric contents.
C. To prevent the development of ventilator-associated pneumonia.
D. To improve oxygenation by recruitment of collapsed posterior alveoli.
,Answer: D
Rationale: Prone positioning in ARDS is utilized to redistribute blood flow and air to the
posterior portions of the lungs. By relieving the pressure of the heart and abdominal
contents on the dorsal lung regions, collapsed alveoli can re-expand. This improves the
ventilation-perfusion ratio and significantly increases arterial oxygenation levels.
4. A nurse is analyzing a patient’s EKG strip and observes a ‘sawtooth’ pattern of P-waves.
Which rhythm does this most likely represent?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. Sinus Rhythm
Answer: A
Rationale: Atrial flutter is characterized by a rapid, regular atrial rate that creates a classic
sawtooth appearance on the EKG. This occurs due to a macro-reentrant circuit in the
atrium, usually the right atrium. The nurse should assess the patient for hemodynamic
stability and monitor for potential conduction to the ventricles.
5. Which assessment finding is most indicative of the Emergent Phase of a major burn injury?
A. Hypernatremia and decreased hematocrit.
B. Hypokalemia and diuresis.
C. Metabolic alkalosis and hypertension.
D. Hyperkalemia and increased hematocrit due to fluid shifts.
Answer: D
Rationale: During the emergent phase, massive fluid shifts from the intracellular to the
interstitial space result in hemoconcentration and cell damage. This damage releases
potassium into the bloodstream, leading to hyperkalemia and a high hematocrit. Immediate
fluid resuscitation is the priority to maintain organ perfusion and prevent hypovolemic
shock.
6. A patient in the ICU develops Ventricular Fibrillation. What is the nurse’s immediate
priority action?
A. Administer a bolus of Epinephrine.
B. Perform synchronized cardioversion.
C. Initiate high-quality CPR and prepare for defibrillation.
D. Check the carotid pulse for 10 seconds.
, Answer: C
Rationale: Ventricular fibrillation is a pulseless, lethal rhythm that requires immediate
action to restore heart function. The priority is to provide chest compressions to maintain
circulation until a defibrillator is available. Defibrillation is the only effective treatment to
stop the chaotic electrical activity and allow the SA node to take over.
7. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
What electrolyte abnormality should the nurse anticipate?
A. Hypercalcemia
B. Hyponatremia
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: SIADH involves the excessive release of ADH, leading to water retention and
delusional hyponatremia. The kidneys reabsorb too much water, which expands the
extracellular fluid volume and dilutes the sodium levels. The nurse should monitor for
neurological symptoms like confusion or seizures as sodium levels drop.
8. A patient with a history of Addison’s disease presents with hypotension, tachycardia, and
hyponatremia. What condition is the patient likely experiencing?
A. Addisonian Crisis
B. Cushing’s Crisis
C. Thyroid Storm
D. Myxedema Coma
Answer: A
Rationale: An Addisonian crisis is a life-threatening emergency caused by an acute
insufficiency of cortisol and aldosterone. Common triggers include stress, infection, or
abrupt withdrawal of steroid therapy. Management involves rapid intravenous fluid
replacement and high-dose hydrocortisone administration.
9. A nurse is providing education to a patient starting peritoneal dialysis. Which of the
following should the nurse include in the teaching?
A. The drainage fluid should always be cloudy.
B. Avoid showering with the catheter in place.
C. Restrict all fluids to less than 500 mL per day.
D. A high-protein diet is necessary to replace losses.
Actual Q&A with Rationale (NSG3800 Exam 3) | Galen
1. A nurse is caring for a patient who has been diagnosed with Sinus Bradycardia and is
symptomatic with a heart rate of 38 bpm. Which medication should the nurse be prepared to
administer first?
A. Amiodarone
B. Digoxin
C. Adenosine
D. Atropine
Answer: D
Rationale: Atropine is the primary medication used to increase heart rate in patients with
symptomatic bradycardia. It acts as an anticholinergic to block vagal effects on the SA node.
The nurse must monitor for improved heart rate and resolution of symptoms like dizziness
or hypotension after administration.
2. When calculating a patient’s output for the 12-hour shift, the nurse notes 350 mL of urine,
150 mL of JP drain fluid, and 200 mL of emesis. What is the total output in milliliters?
A. 500 mL
B. 600 mL
C. 850 mL
D. 700 mL
Answer: D
Rationale: Total output is the sum of all measurable fluids leaving the patient’s body,
including urine and surgical drain contents. In this scenario, combining 350, 150, and 200
results in 700 mL. Accurate intake and output assessment is crucial for evaluating a
patient’s fluid balance and renal function.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary rationale for this intervention?
A. To ease the work of the diaphragm and increase abdominal pressure.
B. To decrease the risk of aspiration of gastric contents.
C. To prevent the development of ventilator-associated pneumonia.
D. To improve oxygenation by recruitment of collapsed posterior alveoli.
,Answer: D
Rationale: Prone positioning in ARDS is utilized to redistribute blood flow and air to the
posterior portions of the lungs. By relieving the pressure of the heart and abdominal
contents on the dorsal lung regions, collapsed alveoli can re-expand. This improves the
ventilation-perfusion ratio and significantly increases arterial oxygenation levels.
4. A nurse is analyzing a patient’s EKG strip and observes a ‘sawtooth’ pattern of P-waves.
Which rhythm does this most likely represent?
A. Atrial Flutter
B. Atrial Fibrillation
C. Ventricular Tachycardia
D. Sinus Rhythm
Answer: A
Rationale: Atrial flutter is characterized by a rapid, regular atrial rate that creates a classic
sawtooth appearance on the EKG. This occurs due to a macro-reentrant circuit in the
atrium, usually the right atrium. The nurse should assess the patient for hemodynamic
stability and monitor for potential conduction to the ventricles.
5. Which assessment finding is most indicative of the Emergent Phase of a major burn injury?
A. Hypernatremia and decreased hematocrit.
B. Hypokalemia and diuresis.
C. Metabolic alkalosis and hypertension.
D. Hyperkalemia and increased hematocrit due to fluid shifts.
Answer: D
Rationale: During the emergent phase, massive fluid shifts from the intracellular to the
interstitial space result in hemoconcentration and cell damage. This damage releases
potassium into the bloodstream, leading to hyperkalemia and a high hematocrit. Immediate
fluid resuscitation is the priority to maintain organ perfusion and prevent hypovolemic
shock.
6. A patient in the ICU develops Ventricular Fibrillation. What is the nurse’s immediate
priority action?
A. Administer a bolus of Epinephrine.
B. Perform synchronized cardioversion.
C. Initiate high-quality CPR and prepare for defibrillation.
D. Check the carotid pulse for 10 seconds.
, Answer: C
Rationale: Ventricular fibrillation is a pulseless, lethal rhythm that requires immediate
action to restore heart function. The priority is to provide chest compressions to maintain
circulation until a defibrillator is available. Defibrillation is the only effective treatment to
stop the chaotic electrical activity and allow the SA node to take over.
7. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
What electrolyte abnormality should the nurse anticipate?
A. Hypercalcemia
B. Hyponatremia
C. Hypernatremia
D. Hypokalemia
Answer: B
Rationale: SIADH involves the excessive release of ADH, leading to water retention and
delusional hyponatremia. The kidneys reabsorb too much water, which expands the
extracellular fluid volume and dilutes the sodium levels. The nurse should monitor for
neurological symptoms like confusion or seizures as sodium levels drop.
8. A patient with a history of Addison’s disease presents with hypotension, tachycardia, and
hyponatremia. What condition is the patient likely experiencing?
A. Addisonian Crisis
B. Cushing’s Crisis
C. Thyroid Storm
D. Myxedema Coma
Answer: A
Rationale: An Addisonian crisis is a life-threatening emergency caused by an acute
insufficiency of cortisol and aldosterone. Common triggers include stress, infection, or
abrupt withdrawal of steroid therapy. Management involves rapid intravenous fluid
replacement and high-dose hydrocortisone administration.
9. A nurse is providing education to a patient starting peritoneal dialysis. Which of the
following should the nurse include in the teaching?
A. The drainage fluid should always be cloudy.
B. Avoid showering with the catheter in place.
C. Restrict all fluids to less than 500 mL per day.
D. A high-protein diet is necessary to replace losses.
