NSG 3800 Final Exam V2 | NSG 3800 Nursing Practice – Adult Health II
| Actual Q&A with Rationale (NSG3800 Final Exam) | Galen
1. A patient is admitted with a pH of 7.25, PaCO2 of 55, and HCO3 of 24. Which condition is
this patient experiencing?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: The pH level is below 7.35, which indicates the patient is in an acidotic state.
Because the PaCO2 is elevated above 45 mmHg while the bicarbonate remains normal, the
origin is respiratory. The nurse should assess for signs of hypoventilation or airway
obstruction that might be causing carbon dioxide retention.
2. When a high-pressure alarm sounds on a mechanical ventilator, what is the nurse’s priority
action?
A. Check for a disconnected tube
B. Call the physician immediately
C. Increase the oxygen concentration
D. Suction the patient’s airway
Answer: D
Rationale: A high-pressure alarm typically signifies resistance in the circuit, which is often
caused by secretions, biting the tube, or kinks. Suctioning helps clear the airway of mucus
plugs that could be obstructing airflow. The nurse must also assess the patient’s breath
sounds to ensure adequate ventilation after the intervention.
3. Which clinical manifestation is a hallmark sign of early Disseminated Intravascular
Coagulation (DIC)?
A. Rapid weight gain
B. High fever and chills
C. Localized leg swelling
D. Excessive bruising and petechiae
Answer: D
,Rationale: Early DIC involves the depletion of clotting factors and platelets, leading to
abnormal bleeding tendencies. Petechiae and purpura occur as small blood vessels begin to
leak into the skin and mucous membranes. Monitoring for these signs is critical in patients
with sepsis or trauma who are at high risk for developing coagulopathies.
4. A patient with ARDS is placed in a prone position. What is the primary physiological benefit
of this intervention?
A. Improving recruitment of posterior lung segments
B. Decreasing intracranial pressure
C. Enhancing cardiac output
D. Reducing the risk of aspiration
Answer: A
Rationale: Prone positioning helps to redistribute pulmonary edema and improve
ventilation-perfusion matching in the dorsal lung regions. By relieving pressure from the
heart and abdomen, it allows previously collapsed alveoli to participate in gas exchange.
This technique is frequently used in severe ARDS to improve oxygenation when standard
settings fail.
5. The nurse notes continuous bubbling in the water-seal chamber of a chest tube drainage
system. How should the nurse interpret this finding?
A. It is a normal finding for a patient with a pneumothorax
B. The system is functioning correctly to remove air
C. The suction pressure is set too high
D. There is a persistent air leak in the system or patient
Answer: D
Rationale: Intermittent bubbling is normal for a pneumothorax, but continuous bubbling
indicates a leak in the system or the pleural space. The nurse should check all connections
and the insertion site to locate the source of the air entry. Prompt intervention is necessary
to ensure the chest tube effectively re-expands the lung.
6. Which medication is typically the first-line treatment for a patient experiencing Ventricular
Fibrillation (V-fib)?
A. Atropine
B. Epinephrine
C. Adenosine
D. Digoxin
, Answer: B
Rationale: Epinephrine is the primary vasopressor used during cardiac arrest to increase
coronary and cerebral perfusion. While defibrillation is the most critical step, epinephrine
helps restore organized electrical activity. It is usually administered every 3 to 5 minutes
during the resuscitation effort.
7. A patient presents with crushing chest pain and ST-segment elevation in leads II, III, and
aVF. Which area of the heart is affected?
A. Anterior wall
B. Inferior wall
C. Lateral wall
D. Posterior wall
Answer: B
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, usually involving the right coronary artery. The nurse should be alert for
bradycardia and heart blocks due to the proximity of the AV node. Assessment of right-
sided heart function is also essential in these patients.
8. Which lab value is most specific for diagnosing an acute myocardial infarction?
A. Creatine Kinase (CK)
B. Troponin I
C. Myoglobin
D. C-reactive protein
Answer: B
Rationale: Troponin I is highly specific to cardiac muscle and remains elevated for several
days after injury. Unlike myoglobin, which rises quickly but is found in other muscles,
troponin provides a reliable diagnostic window for MI. Serial troponin levels are monitored
to determine the extent of myocardial damage.
9. A patient with heart failure has a Central Venous Pressure (CVP) of 12 mmHg. How should
the nurse interpret this?
A. The patient has fluid volume excess
B. The patient is dehydrated
C. The patient is in cardiogenic shock
D. This is a normal CVP value
Answer: A
| Actual Q&A with Rationale (NSG3800 Final Exam) | Galen
1. A patient is admitted with a pH of 7.25, PaCO2 of 55, and HCO3 of 24. Which condition is
this patient experiencing?
A. Respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: The pH level is below 7.35, which indicates the patient is in an acidotic state.
Because the PaCO2 is elevated above 45 mmHg while the bicarbonate remains normal, the
origin is respiratory. The nurse should assess for signs of hypoventilation or airway
obstruction that might be causing carbon dioxide retention.
2. When a high-pressure alarm sounds on a mechanical ventilator, what is the nurse’s priority
action?
A. Check for a disconnected tube
B. Call the physician immediately
C. Increase the oxygen concentration
D. Suction the patient’s airway
Answer: D
Rationale: A high-pressure alarm typically signifies resistance in the circuit, which is often
caused by secretions, biting the tube, or kinks. Suctioning helps clear the airway of mucus
plugs that could be obstructing airflow. The nurse must also assess the patient’s breath
sounds to ensure adequate ventilation after the intervention.
3. Which clinical manifestation is a hallmark sign of early Disseminated Intravascular
Coagulation (DIC)?
A. Rapid weight gain
B. High fever and chills
C. Localized leg swelling
D. Excessive bruising and petechiae
Answer: D
,Rationale: Early DIC involves the depletion of clotting factors and platelets, leading to
abnormal bleeding tendencies. Petechiae and purpura occur as small blood vessels begin to
leak into the skin and mucous membranes. Monitoring for these signs is critical in patients
with sepsis or trauma who are at high risk for developing coagulopathies.
4. A patient with ARDS is placed in a prone position. What is the primary physiological benefit
of this intervention?
A. Improving recruitment of posterior lung segments
B. Decreasing intracranial pressure
C. Enhancing cardiac output
D. Reducing the risk of aspiration
Answer: A
Rationale: Prone positioning helps to redistribute pulmonary edema and improve
ventilation-perfusion matching in the dorsal lung regions. By relieving pressure from the
heart and abdomen, it allows previously collapsed alveoli to participate in gas exchange.
This technique is frequently used in severe ARDS to improve oxygenation when standard
settings fail.
5. The nurse notes continuous bubbling in the water-seal chamber of a chest tube drainage
system. How should the nurse interpret this finding?
A. It is a normal finding for a patient with a pneumothorax
B. The system is functioning correctly to remove air
C. The suction pressure is set too high
D. There is a persistent air leak in the system or patient
Answer: D
Rationale: Intermittent bubbling is normal for a pneumothorax, but continuous bubbling
indicates a leak in the system or the pleural space. The nurse should check all connections
and the insertion site to locate the source of the air entry. Prompt intervention is necessary
to ensure the chest tube effectively re-expands the lung.
6. Which medication is typically the first-line treatment for a patient experiencing Ventricular
Fibrillation (V-fib)?
A. Atropine
B. Epinephrine
C. Adenosine
D. Digoxin
, Answer: B
Rationale: Epinephrine is the primary vasopressor used during cardiac arrest to increase
coronary and cerebral perfusion. While defibrillation is the most critical step, epinephrine
helps restore organized electrical activity. It is usually administered every 3 to 5 minutes
during the resuscitation effort.
7. A patient presents with crushing chest pain and ST-segment elevation in leads II, III, and
aVF. Which area of the heart is affected?
A. Anterior wall
B. Inferior wall
C. Lateral wall
D. Posterior wall
Answer: B
Rationale: ST elevation in leads II, III, and aVF indicates an inferior wall myocardial
infarction, usually involving the right coronary artery. The nurse should be alert for
bradycardia and heart blocks due to the proximity of the AV node. Assessment of right-
sided heart function is also essential in these patients.
8. Which lab value is most specific for diagnosing an acute myocardial infarction?
A. Creatine Kinase (CK)
B. Troponin I
C. Myoglobin
D. C-reactive protein
Answer: B
Rationale: Troponin I is highly specific to cardiac muscle and remains elevated for several
days after injury. Unlike myoglobin, which rises quickly but is found in other muscles,
troponin provides a reliable diagnostic window for MI. Serial troponin levels are monitored
to determine the extent of myocardial damage.
9. A patient with heart failure has a Central Venous Pressure (CVP) of 12 mmHg. How should
the nurse interpret this?
A. The patient has fluid volume excess
B. The patient is dehydrated
C. The patient is in cardiogenic shock
D. This is a normal CVP value
Answer: A
