Galen College of Nursing NSG 3250 Adult Health
3 Exam 2 Study Guide: Review Questions and
Rationales (2026/2027)
Question 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
Answer: B
Rationale
Beta-blockers reduce mortality in HFrEF. Diuretics control symptoms only.
Question 2
A client with COPD has an SpO2 of 88% on 2 L/min. Which oxygen delivery device is safest?
A) Non-rebreather at 10 L/min
B) *Venturi mask at 28%
C) Simple face mask at 6 L/min
D) Nasal cannula at 6 L/min
Answer
Answer: B
Rationale
,Venturi provides precise FiO2, reducing CO2 retention risk in COPD.
Question 3
A client with AKI has a potassium of 6.8 mEq/L. Which finding is most concerning?
A) Muscle weakness
B) *Peaked T waves
C) Nausea
D) Polyuria
Answer
Answer: B
Rationale
Hyperkalemia causes peaked T waves, then wide QRS, and cardiac arrest.
Question 4
A client with DKA has a blood glucose of 450 mg/dL. Which initial IV fluid is appropriate?
A) D5W
B) *0.9% normal saline
C) 0.45% normal saline
D) Lactated Ringer’s
Answer
Answer: B
Rationale
Isotonic fluids restore volume before insulin is started.
,Question 5
A client with cirrhosis has asterixis. Which medication is anticipated?
A) Spironolactone
B) *Lactulose
C) Furosemide
D) Octreotide
Answer
Answer: B
Rationale
Lactulose traps ammonia in the gut, reducing encephalopathy.
Question 6
A client with a stroke has left-sided neglect. Which intervention is appropriate?
A) Place items on the right side
B) *Approach from the left and remind to scan left
C) Restrain the right arm
D) Keep the room dark
Answer
Answer: B
Rationale
Encourage attention to the neglected side.
Question 7
A client with a pulmonary embolism is on heparin. aPTT is 110 sec. Which action is correct?
A) Continue same rate
, B) *Decrease rate and notify provider
C) Increase rate
D) Stop heparin and give protamine
Answer
Answer: B
Rationale
aPTT >75 is supratherapeutic; reduce rate.
Question 8
A client with sepsis has a lactate of 4 mmol/L. Which action is priority?
A) Administer antibiotics
B) *Infuse 30 mL/kg crystalloid bolus
C) Obtain blood cultures
D) Start vasopressors
Answer
Answer: B
Rationale
Fluid resuscitation is first for sepsis-induced hypoperfusion.
Question 9
A client with anaphylaxis has stridor. Which medication is first?
A) Diphenhydramine
B) *Epinephrine IM
C) Albuterol nebulizer
D) Methylprednisolone
3 Exam 2 Study Guide: Review Questions and
Rationales (2026/2027)
Question 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
Answer: B
Rationale
Beta-blockers reduce mortality in HFrEF. Diuretics control symptoms only.
Question 2
A client with COPD has an SpO2 of 88% on 2 L/min. Which oxygen delivery device is safest?
A) Non-rebreather at 10 L/min
B) *Venturi mask at 28%
C) Simple face mask at 6 L/min
D) Nasal cannula at 6 L/min
Answer
Answer: B
Rationale
,Venturi provides precise FiO2, reducing CO2 retention risk in COPD.
Question 3
A client with AKI has a potassium of 6.8 mEq/L. Which finding is most concerning?
A) Muscle weakness
B) *Peaked T waves
C) Nausea
D) Polyuria
Answer
Answer: B
Rationale
Hyperkalemia causes peaked T waves, then wide QRS, and cardiac arrest.
Question 4
A client with DKA has a blood glucose of 450 mg/dL. Which initial IV fluid is appropriate?
A) D5W
B) *0.9% normal saline
C) 0.45% normal saline
D) Lactated Ringer’s
Answer
Answer: B
Rationale
Isotonic fluids restore volume before insulin is started.
,Question 5
A client with cirrhosis has asterixis. Which medication is anticipated?
A) Spironolactone
B) *Lactulose
C) Furosemide
D) Octreotide
Answer
Answer: B
Rationale
Lactulose traps ammonia in the gut, reducing encephalopathy.
Question 6
A client with a stroke has left-sided neglect. Which intervention is appropriate?
A) Place items on the right side
B) *Approach from the left and remind to scan left
C) Restrain the right arm
D) Keep the room dark
Answer
Answer: B
Rationale
Encourage attention to the neglected side.
Question 7
A client with a pulmonary embolism is on heparin. aPTT is 110 sec. Which action is correct?
A) Continue same rate
, B) *Decrease rate and notify provider
C) Increase rate
D) Stop heparin and give protamine
Answer
Answer: B
Rationale
aPTT >75 is supratherapeutic; reduce rate.
Question 8
A client with sepsis has a lactate of 4 mmol/L. Which action is priority?
A) Administer antibiotics
B) *Infuse 30 mL/kg crystalloid bolus
C) Obtain blood cultures
D) Start vasopressors
Answer
Answer: B
Rationale
Fluid resuscitation is first for sepsis-induced hypoperfusion.
Question 9
A client with anaphylaxis has stridor. Which medication is first?
A) Diphenhydramine
B) *Epinephrine IM
C) Albuterol nebulizer
D) Methylprednisolone
