Comprehensive NSG 3250 Adult Health 3 Exam 2
Review | 250 Practice Questions, Verified
Answers, and Rationales (Galen College of
Nursing)
1. A client with heart failure has an ejection fraction of 25%. Which medication is first-line to
reduce mortality?
A) Furosemide
B) *Metoprolol succinate
C) Digoxin
D) Hydralazine
Answer: B
Rationale: Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce mortality in HFrEF.
Diuretics control symptoms only.
2. A client with COPD has a new prescription for home oxygen. Which instruction is most
important?
A) Clean the nasal cannula weekly with soap
B) *Do not smoke or allow anyone to smoke near the oxygen
C) Keep oxygen cylinders lying flat on the floor
D) Adjust the flow rate based on activity level
Answer: B
Rationale: Oxygen supports combustion; smoking is a fire hazard. Safety is the priority.
,3. A client with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which finding
does the nurse expect?
A) Hyporeflexia
B) *Peaked T waves on ECG
C) Prolonged PR interval
D) Flaccid paralysis
Answer: B
Rationale: Hyperkalemia (K+ >5.5) causes peaked T waves, then wide QRS, and eventually sine wave.
4. A client with diabetes mellitus type 1 has a blood glucose of 350 mg/dL, urine ketones large,
and Kussmaul respirations. Which intervention should the nurse implement first?
A) Administer regular insulin IV
B) *Start an IV line with normal saline
C) Apply oxygen via nasal cannula
D) Notify the provider
Answer: B
Rationale: In DKA, fluid resuscitation is the first priority to correct dehydration and improve perfusion.
5. A client 2 days post-operative after a bowel resection reports sudden chest pain and dyspnea.
Vital signs: HR 120, RR 28, SpO2 88%. What is the priority action?
A) Apply oxygen at 2 L/min via nasal cannula
B) *Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer aspirin 325 mg
D) Prepare for a stat chest X-ray
Answer: B
Rationale: Suspected pulmonary embolism requires immediate oxygenation and positioning to support
breathing.
,6. A client with cirrhosis has ascites and a paracentesis is performed. Which finding indicates a
complication?
A) Clear, straw-colored fluid
B) *Fluid with WBC count 500/mm³ and cloudy appearance
C) Albumin level of 2.5 g/dL in the fluid
D) Protein level of 1.0 g/dL in the fluid
Answer: B
Rationale: PMN count >250/mm³ suggests spontaneous bacterial peritonitis (SBP).
7. A client with a stroke has left-sided neglect and difficulty with spatial awareness. Which nursing
intervention is most appropriate?
A) Place all personal items on the client’s right side
B) *Approach the client from the left side and remind to scan to the left
C) Restrain the right arm to encourage use of the left arm
D) Keep the room dark and quiet
Answer: B
Rationale: Encourage attention to the neglected side by positioning and verbal cues.
8. A client with pneumonia has a fever of 39°C (102.2°F) and is reporting pleuritic chest pain.
Which intervention should the nurse implement first?
A) Administer acetaminophen as ordered
B) *Position the client in semi-Fowler’s and encourage deep breathing
C) Apply a cold compress to the forehead
D) Notify the provider of the fever
Answer: B
Rationale: Positioning optimizes ventilation; deep breathing helps expand lungs.
, 9. A client with hyperthyroidism (Graves’ disease) is prescribed propylthiouracil (PTU). Which
adverse effect requires immediate discontinuation?
A) Mild rash
B) *Agranulocytosis (fever, sore throat)
C) Weight gain
D) Diarrhea
Answer: B
Rationale: PTU can cause agranulocytosis; any fever or sore throat warrants CBC.
10. A client with a recent myocardial infarction develops crackles in bilateral lung bases, an S3
gallop, and oxygen saturation of 90%. Which complication does the nurse suspect?
A) Cardiogenic shock
B) *Acute heart failure (pulmonary edema)
C) Pericarditis
D) Recurrent infarction
Answer: B
Rationale: Crackles, S3, and hypoxemia indicate left ventricular failure (pulmonary congestion).
11. A client with chronic kidney disease on hemodialysis has an AV fistula in the left arm. Which
finding requires immediate action?
A) Palpable thrill and audible bruit
B) *Absence of thrill and bruit with arm swelling
C) Mild erythema at the needle site
D) Small hematoma at the access site
Answer: B
Rationale: Loss of thrill/bruit suggests thrombosis; notify provider immediately.
Review | 250 Practice Questions, Verified
Answers, and Rationales (Galen College of
Nursing)
1. A client with heart failure has an ejection fraction of 25%. Which medication is first-line to
reduce mortality?
A) Furosemide
B) *Metoprolol succinate
C) Digoxin
D) Hydralazine
Answer: B
Rationale: Beta-blockers (carvedilol, metoprolol succinate, bisoprolol) reduce mortality in HFrEF.
Diuretics control symptoms only.
2. A client with COPD has a new prescription for home oxygen. Which instruction is most
important?
A) Clean the nasal cannula weekly with soap
B) *Do not smoke or allow anyone to smoke near the oxygen
C) Keep oxygen cylinders lying flat on the floor
D) Adjust the flow rate based on activity level
Answer: B
Rationale: Oxygen supports combustion; smoking is a fire hazard. Safety is the priority.
,3. A client with chronic kidney disease (CKD) has a potassium level of 6.2 mEq/L. Which finding
does the nurse expect?
A) Hyporeflexia
B) *Peaked T waves on ECG
C) Prolonged PR interval
D) Flaccid paralysis
Answer: B
Rationale: Hyperkalemia (K+ >5.5) causes peaked T waves, then wide QRS, and eventually sine wave.
4. A client with diabetes mellitus type 1 has a blood glucose of 350 mg/dL, urine ketones large,
and Kussmaul respirations. Which intervention should the nurse implement first?
A) Administer regular insulin IV
B) *Start an IV line with normal saline
C) Apply oxygen via nasal cannula
D) Notify the provider
Answer: B
Rationale: In DKA, fluid resuscitation is the first priority to correct dehydration and improve perfusion.
5. A client 2 days post-operative after a bowel resection reports sudden chest pain and dyspnea.
Vital signs: HR 120, RR 28, SpO2 88%. What is the priority action?
A) Apply oxygen at 2 L/min via nasal cannula
B) *Elevate the head of the bed and apply oxygen at 10 L/min via non-rebreather
C) Administer aspirin 325 mg
D) Prepare for a stat chest X-ray
Answer: B
Rationale: Suspected pulmonary embolism requires immediate oxygenation and positioning to support
breathing.
,6. A client with cirrhosis has ascites and a paracentesis is performed. Which finding indicates a
complication?
A) Clear, straw-colored fluid
B) *Fluid with WBC count 500/mm³ and cloudy appearance
C) Albumin level of 2.5 g/dL in the fluid
D) Protein level of 1.0 g/dL in the fluid
Answer: B
Rationale: PMN count >250/mm³ suggests spontaneous bacterial peritonitis (SBP).
7. A client with a stroke has left-sided neglect and difficulty with spatial awareness. Which nursing
intervention is most appropriate?
A) Place all personal items on the client’s right side
B) *Approach the client from the left side and remind to scan to the left
C) Restrain the right arm to encourage use of the left arm
D) Keep the room dark and quiet
Answer: B
Rationale: Encourage attention to the neglected side by positioning and verbal cues.
8. A client with pneumonia has a fever of 39°C (102.2°F) and is reporting pleuritic chest pain.
Which intervention should the nurse implement first?
A) Administer acetaminophen as ordered
B) *Position the client in semi-Fowler’s and encourage deep breathing
C) Apply a cold compress to the forehead
D) Notify the provider of the fever
Answer: B
Rationale: Positioning optimizes ventilation; deep breathing helps expand lungs.
, 9. A client with hyperthyroidism (Graves’ disease) is prescribed propylthiouracil (PTU). Which
adverse effect requires immediate discontinuation?
A) Mild rash
B) *Agranulocytosis (fever, sore throat)
C) Weight gain
D) Diarrhea
Answer: B
Rationale: PTU can cause agranulocytosis; any fever or sore throat warrants CBC.
10. A client with a recent myocardial infarction develops crackles in bilateral lung bases, an S3
gallop, and oxygen saturation of 90%. Which complication does the nurse suspect?
A) Cardiogenic shock
B) *Acute heart failure (pulmonary edema)
C) Pericarditis
D) Recurrent infarction
Answer: B
Rationale: Crackles, S3, and hypoxemia indicate left ventricular failure (pulmonary congestion).
11. A client with chronic kidney disease on hemodialysis has an AV fistula in the left arm. Which
finding requires immediate action?
A) Palpable thrill and audible bruit
B) *Absence of thrill and bruit with arm swelling
C) Mild erythema at the needle site
D) Small hematoma at the access site
Answer: B
Rationale: Loss of thrill/bruit suggests thrombosis; notify provider immediately.
