Comprehensive NSG 3250 Adult Health I
Exam 3 Review | Practice Questions, Verified
Answers, and Expert Rationales (Galen
College of Nursing) 2026/2027
Q1
A client with heart failure has an ejection fraction of 25%. Which medication is first-line to reduce
mortality?
A) Furosemide
B) Metoprolol succinate CORRECT
C) Digoxin
D) Hydralazine
Rationale
Beta-blockers reduce mortality in HFrEF. Diuretics control symptoms only.
Q2
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 CORRECT
C) Keep oxygen cylinders lying flat on the floor
D) Adjust the flow rate based on activity level
Rationale
Oxygen supports combustion; smoking is a fire hazard.
Page 1
,Q3
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 CORRECT
C) Prolonged PR interval
D) Flaccid paralysis
Rationale
Hyperkalemia causes peaked T waves, then wide QRS.
Q4
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 CORRECT
C) Apply oxygen via nasal cannula
D) Notify the provider
Rationale
In DKA, fluid resuscitation is the first priority.
Q5
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 CORRECT
C) Administer aspirin 325 mg
Page 2
,D) Prepare for a stat chest X-ray
Rationale
Suspected PE requires immediate oxygenation and positioning.
Q6
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 CORRECT
C) Albumin level of 2.5 g/dL in the fluid
D) Protein level of 1.0 g/dL in the fluid
Rationale
PMN >250/mm³ suggests spontaneous bacterial peritonitis.
Q7
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 CORRECT
C) Restrain the right arm to encourage use of the left arm
D) Keep the room dark and quiet
Rationale
Encourage attention to the neglected side.
Page 3
, Q8
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 CORRECT
C) Apply a cold compress to the forehead
D) Notify the provider of the fever
Rationale
Positioning optimizes ventilation.
Q9
A client with hyperthyroidism (Graves’ disease) is prescribed propylthiouracil (PTU). Which
adverse effect requires immediate discontinuation?
A) Mild rash
B) Agranulocytosis (fever, sore throat) CORRECT
C) Weight gain
D) Diarrhea
Rationale
PTU can cause agranulocytosis; any fever warrants CBC.
Q10
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) CORRECT
C) Pericarditis
Page 4
Exam 3 Review | Practice Questions, Verified
Answers, and Expert Rationales (Galen
College of Nursing) 2026/2027
Q1
A client with heart failure has an ejection fraction of 25%. Which medication is first-line to reduce
mortality?
A) Furosemide
B) Metoprolol succinate CORRECT
C) Digoxin
D) Hydralazine
Rationale
Beta-blockers reduce mortality in HFrEF. Diuretics control symptoms only.
Q2
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 CORRECT
C) Keep oxygen cylinders lying flat on the floor
D) Adjust the flow rate based on activity level
Rationale
Oxygen supports combustion; smoking is a fire hazard.
Page 1
,Q3
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 CORRECT
C) Prolonged PR interval
D) Flaccid paralysis
Rationale
Hyperkalemia causes peaked T waves, then wide QRS.
Q4
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 CORRECT
C) Apply oxygen via nasal cannula
D) Notify the provider
Rationale
In DKA, fluid resuscitation is the first priority.
Q5
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 CORRECT
C) Administer aspirin 325 mg
Page 2
,D) Prepare for a stat chest X-ray
Rationale
Suspected PE requires immediate oxygenation and positioning.
Q6
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 CORRECT
C) Albumin level of 2.5 g/dL in the fluid
D) Protein level of 1.0 g/dL in the fluid
Rationale
PMN >250/mm³ suggests spontaneous bacterial peritonitis.
Q7
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 CORRECT
C) Restrain the right arm to encourage use of the left arm
D) Keep the room dark and quiet
Rationale
Encourage attention to the neglected side.
Page 3
, Q8
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 CORRECT
C) Apply a cold compress to the forehead
D) Notify the provider of the fever
Rationale
Positioning optimizes ventilation.
Q9
A client with hyperthyroidism (Graves’ disease) is prescribed propylthiouracil (PTU). Which
adverse effect requires immediate discontinuation?
A) Mild rash
B) Agranulocytosis (fever, sore throat) CORRECT
C) Weight gain
D) Diarrhea
Rationale
PTU can cause agranulocytosis; any fever warrants CBC.
Q10
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) CORRECT
C) Pericarditis
Page 4
