EXAM 3: NSG3250 / NSG 3250 ( UPDATE)
ADULT HEALTH I | COMPLETE REVIEW WITH QUESTIONS AND VERIFIED ANSWERS
100% Correct | Grade A - Galen College of Nursing
Aligned with NCLEX-RN Test Plan, QSEN Competencies & Adult Health Nursing Standards (2026/2027 Edition)
Cognitive Mix: 20% Recall / 50% Application / 30%
Total Questions: 120 Format: Multiple Choice (A-D)
Analysis
Exam Blueprint
Section Topic Questions Range
1 Cardiovascular Disorders 20 Q1 – Q20
2 Respiratory Disorders 18 Q21 – Q38
3 Gastrointestinal Disorders 15 Q39 – Q53
4 Renal & Genitourinary Disorders 15 Q54 – Q68
5 Endocrine Disorders 15 Q69 – Q83
6 Neurological Disorders 15 Q84 – Q98
7 Musculoskeletal & Integumentary Disorders 12 Q99 – Q110
8 Pharmacology & Medication Management 10 Q111 – Q120
TOTAL 120
Section 1: Cardiovascular Disorders
Q1: The nurse is caring for four assigned clients. Which client should the nurse assess FIRST?
A. A client with hypertension reporting a mild headache.
B. A client with heart failure reporting dyspnea after walking to the bathroom.
C. A client with angina reporting chest pain unrelieved by 3 nitroglycerin tablets over 15 minutes. *[CORRECT]*
D. A client with a deep vein thrombosis receiving heparin with an aPTT of 70 seconds.
Correct Answer: C. A client with angina reporting chest pain unrelieved by 3 nitroglycerin tablets over 15 minutes.
Rationale: Chest pain unrelieved by 3 nitroglycerin tablets suggests acute myocardial infarction requiring immediate
intervention (NCLEX-RN: Management of Care, Prioritization). The client with angina is at highest risk for cardiac ischemia
and potential cardiac arrest. The other clients are stable or have expected findings: aPTT of 70 seconds is within therapeutic
range for heparin (1.5-2 times control). NSG 3250 prioritization follows the ABC and acute vs. chronic framework.
,Q2: A client is prescribed lisinopril 10 mg daily for hypertension. Which finding should the nurse report to the
provider IMMEDIATELY?
A. Blood pressure 124/76 mmHg.
B. Serum potassium 5.8 mEq/L. *[CORRECT]*
C. Dry, persistent cough.
D. Serum sodium 138 mEq/L.
Correct Answer: B. Serum potassium 5.8 mEq/L.
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by inhibiting aldosterone secretion. A potassium of 5.8
mEq/L is critically elevated (normal 3.5-5.0 mEq/L) and risks life-threatening dysrhythmias. The dry cough is a common side
effect requiring medication change but not an emergency. BP of 124/76 indicates effective therapy. NSG 3250 pharmacology
emphasizes monitoring ACE inhibitor adverse effects per QSEN Safety competencies.
Q3: A client with coronary artery disease is prescribed a low-sodium diet. Which client statement indicates
teaching has been effective?
A. "I will season my food with soy sauce instead of salt."
B. "I can eat canned soups as long as I rinse them first."
C. "I will choose fresh fruits and vegetables and avoid processed foods." *[CORRECT]*
D. "I should use sea salt instead of table salt because it has less sodium."
Correct Answer: C. "I will choose fresh fruits and vegetables and avoid processed foods."
Rationale: Fresh fruits and vegetables are naturally low in sodium, while processed foods are the primary source of dietary
sodium. Soy sauce is extremely high in sodium. Rinsing canned soups does not significantly reduce sodium content. Sea salt
contains the same amount of sodium as table salt by weight. NSG 3250 nutrition therapy aligns with AHA guidelines for CAD
management.
Q4: A client presents to the emergency department with chest pain. The client took 1 nitroglycerin tablet
sublingually 5 minutes ago with no relief. What is the nurse's PRIORITY action?
A. Administer a second nitroglycerin tablet sublingually. *[CORRECT]*
B. Apply oxygen at 2 L/min via nasal cannula.
C. Obtain a 12-lead ECG.
D. Administer morphine 2 mg IV.
Correct Answer: A. Administer a second nitroglycerin tablet sublingually.
Rationale: Nitroglycerin protocol allows for one tablet every 5 minutes for up to 3 doses (NCLEX-RN: Pharmacology). If chest
pain is unrelieved after 1 dose, the next priority is administering the second dose while continuing to monitor vitals. Oxygen is
only indicated if SpO2 is <90%. An ECG is needed but pain relief takes priority. Morphine is reserved for pain unrelieved by 3
nitroglycerin doses. NSG 3250 follows ACS protocol.
,Q5: A client is admitted with suspected acute myocardial infarction. Which cardiac enzyme is MOST specific for
myocardial damage?
A. Creatine kinase (CK-MB).
B. Myoglobin.
C. Troponin I. *[CORRECT]*
D. Lactate dehydrogenase (LDH).
Correct Answer: C. Troponin I.
Rationale: Troponin I is the most specific and sensitive cardiac biomarker for myocardial injury, elevating within 3-4 hours
and persisting for 7-10 days (NCLEX-RN: Reduction of Risk Potential). CK-MB is less specific and returns to normal within
48-72 hours. Myoglobin elevates early but lacks cardiac specificity. LDH is no longer used clinically for MI diagnosis. NSG
3250 cardiac diagnostics emphasize troponin as the gold standard.
Q6: The nurse is caring for four clients with heart failure. Which client requires IMMEDIATE intervention?
A. A client with bilateral crackles in lung bases and 1+ pitting edema.
B. A client with a 2-pound weight gain over 24 hours and mild dyspnea.
C. A client with pink, frothy sputum and severe dyspnea. *[CORRECT]*
D. A client reporting fatigue and needing to sleep with two pillows.
Correct Answer: C. A client with pink, frothy sputum and severe dyspnea.
Rationale: Pink, frothy sputum with severe dyspnea indicates acute pulmonary edema, a life-threatening complication of heart
failure requiring immediate intervention (NCLEX-RN: Physiological Adaptation). This client shows signs of severe left-sided
heart failure with fluid backing into the alveoli. The other clients have stable or expected manifestations of chronic HF. NSG
3250 prioritization applies ABC and acute vs. chronic.
Q7: A client with heart failure is being discharged with furosemide 40 mg daily. Which client statement indicates
understanding of the medication?
A. "I will take this medication at bedtime to prevent waking at night."
B. "I should eat more bananas and sweet potatoes while taking this medication." *[CORRECT]*
C. "I will weigh myself once a week at the same time of day."
D. "I can stop taking this medication when my swelling goes down."
Correct Answer: B. "I should eat more bananas and sweet potatoes while taking this medication."
Rationale: Furosemide is a loop diuretic that causes potassium loss; consuming potassium-rich foods like bananas and sweet
potatoes helps prevent hypokalemia (NCLEX-RN: Pharmacology). The medication should be taken in the morning to prevent
nocturia. Daily weights are essential for HF management. The medication should never be stopped without provider approval.
NSG 3250 HF teaching aligns with AHA guidelines.
Q8: A client with atrial fibrillation is prescribed warfarin 5 mg daily. The client's INR is 3.5. What is the nurse's BEST
action?
A. Administer the warfarin as prescribed.
B. Hold the warfarin and notify the provider. *[CORRECT]*
C. Administer vitamin K intravenously.
D. Administer protamine sulfate.
Correct Answer: B. Hold the warfarin and notify the provider.
Rationale: For a client with atrial fibrillation, the therapeutic INR range is 2.0-3.0. An INR of 3.5 is elevated and increases
bleeding risk; the nurse should hold the dose and notify the provider (NCLEX-RN: Pharmacology, Lab Values). Vitamin K is
the antidote but is reserved for severe elevation or active bleeding. Protamine sulfate is the antidote for heparin, not warfarin.
NSG 3250 anticoagulation therapy follows evidence-based protocols.
, Q9: The nurse notes the client's cardiac monitor shows an irregular rhythm with no discernible P waves and an
irregular R-R interval. The client's apical pulse is 92 beats/minute. What is the nurse's interpretation?
A. Sinus arrhythmia.
B. Atrial fibrillation. *[CORRECT]*
C. Ventricular tachycardia.
D. First-degree AV block.
Correct Answer: B. Atrial fibrillation.
Rationale: Atrial fibrillation is characterized by absent P waves, irregular R-R intervals, and an irregularly irregular rhythm
(NCLEX-RN: Physiological Adaptation). The lack of organized atrial contraction produces no P waves. Sinus arrhythmia has
P waves. Ventricular tachycardia has wide QRS complexes. First-degree AV block has a prolonged PR interval. NSG 3250
dysrhythmia interpretation follows AHA guidelines.
Q10: A client with aortic stenosis is being assessed. Which finding is the nurse MOST likely to observe?
A. Bounding peripheral pulses.
B. Systolic murmur heard at the second intercostal space, right sternal border. *[CORRECT]*
C. Diastolic murmur heard at the apex.
D. Wide pulse pressure.
Correct Answer: B. Systolic murmur heard at the second intercostal space, right sternal border.
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the second intercostal space, right sternal border
(aortic area), radiating to the carotids (NCLEX-RN: Physiological Adaptation). The narrowed valve obstructs outflow,
producing a systolic murmur. Pulse pressure narrows rather than widens. Pulses are weak and delayed (pulsus parvus et
tardus). NSG 3250 valvular assessment differentiates stenosis from regurgitation.
Q11: A client with peripheral vascular disease reports leg pain that occurs when walking and resolves with rest.
The nurse documents this finding as:
A. Rest pain.
B. Intermittent claudication. *[CORRECT]*
C. Deep vein thrombosis.
D. Compartment syndrome.
Correct Answer: B. Intermittent claudication.
Rationale: Intermittent claudication is the classic manifestation of peripheral arterial disease, characterized by reproducible
pain with activity that resolves with rest (NCLEX-RN: Physiological Adaptation). It results from inadequate blood flow during
exercise. Rest pain indicates severe disease. DVT presents with unilateral edema and warmth, not activity-related pain. NSG
3250 PVD assessment emphasizes the location and pattern of pain.
Q12: The nurse is assessing a client with suspected deep vein thrombosis (DVT) in the left leg. Which finding
requires the MOST immediate intervention?
A. Calf tenderness and 1 cm difference in calf circumference.
B. Sudden onset of chest pain and dyspnea. *[CORRECT]*
C. Erythema and warmth along the inner thigh.
D. Positive Homans' sign.
Correct Answer: B. Sudden onset of chest pain and dyspnea.
Rationale: Sudden chest pain and dyspnea in a client with DVT suggests pulmonary embolism, a life-threatening complication
requiring immediate intervention (NCLEX-RN: Physiological Adaptation, Prioritization). The priority is to stabilize the client
and administer oxygen. Homans' sign is unreliable and no longer recommended for DVT diagnosis. Calf tenderness and
erythema are expected findings of DVT itself. NSG 3250 DVT complications follow PE protocols.
ADULT HEALTH I | COMPLETE REVIEW WITH QUESTIONS AND VERIFIED ANSWERS
100% Correct | Grade A - Galen College of Nursing
Aligned with NCLEX-RN Test Plan, QSEN Competencies & Adult Health Nursing Standards (2026/2027 Edition)
Cognitive Mix: 20% Recall / 50% Application / 30%
Total Questions: 120 Format: Multiple Choice (A-D)
Analysis
Exam Blueprint
Section Topic Questions Range
1 Cardiovascular Disorders 20 Q1 – Q20
2 Respiratory Disorders 18 Q21 – Q38
3 Gastrointestinal Disorders 15 Q39 – Q53
4 Renal & Genitourinary Disorders 15 Q54 – Q68
5 Endocrine Disorders 15 Q69 – Q83
6 Neurological Disorders 15 Q84 – Q98
7 Musculoskeletal & Integumentary Disorders 12 Q99 – Q110
8 Pharmacology & Medication Management 10 Q111 – Q120
TOTAL 120
Section 1: Cardiovascular Disorders
Q1: The nurse is caring for four assigned clients. Which client should the nurse assess FIRST?
A. A client with hypertension reporting a mild headache.
B. A client with heart failure reporting dyspnea after walking to the bathroom.
C. A client with angina reporting chest pain unrelieved by 3 nitroglycerin tablets over 15 minutes. *[CORRECT]*
D. A client with a deep vein thrombosis receiving heparin with an aPTT of 70 seconds.
Correct Answer: C. A client with angina reporting chest pain unrelieved by 3 nitroglycerin tablets over 15 minutes.
Rationale: Chest pain unrelieved by 3 nitroglycerin tablets suggests acute myocardial infarction requiring immediate
intervention (NCLEX-RN: Management of Care, Prioritization). The client with angina is at highest risk for cardiac ischemia
and potential cardiac arrest. The other clients are stable or have expected findings: aPTT of 70 seconds is within therapeutic
range for heparin (1.5-2 times control). NSG 3250 prioritization follows the ABC and acute vs. chronic framework.
,Q2: A client is prescribed lisinopril 10 mg daily for hypertension. Which finding should the nurse report to the
provider IMMEDIATELY?
A. Blood pressure 124/76 mmHg.
B. Serum potassium 5.8 mEq/L. *[CORRECT]*
C. Dry, persistent cough.
D. Serum sodium 138 mEq/L.
Correct Answer: B. Serum potassium 5.8 mEq/L.
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by inhibiting aldosterone secretion. A potassium of 5.8
mEq/L is critically elevated (normal 3.5-5.0 mEq/L) and risks life-threatening dysrhythmias. The dry cough is a common side
effect requiring medication change but not an emergency. BP of 124/76 indicates effective therapy. NSG 3250 pharmacology
emphasizes monitoring ACE inhibitor adverse effects per QSEN Safety competencies.
Q3: A client with coronary artery disease is prescribed a low-sodium diet. Which client statement indicates
teaching has been effective?
A. "I will season my food with soy sauce instead of salt."
B. "I can eat canned soups as long as I rinse them first."
C. "I will choose fresh fruits and vegetables and avoid processed foods." *[CORRECT]*
D. "I should use sea salt instead of table salt because it has less sodium."
Correct Answer: C. "I will choose fresh fruits and vegetables and avoid processed foods."
Rationale: Fresh fruits and vegetables are naturally low in sodium, while processed foods are the primary source of dietary
sodium. Soy sauce is extremely high in sodium. Rinsing canned soups does not significantly reduce sodium content. Sea salt
contains the same amount of sodium as table salt by weight. NSG 3250 nutrition therapy aligns with AHA guidelines for CAD
management.
Q4: A client presents to the emergency department with chest pain. The client took 1 nitroglycerin tablet
sublingually 5 minutes ago with no relief. What is the nurse's PRIORITY action?
A. Administer a second nitroglycerin tablet sublingually. *[CORRECT]*
B. Apply oxygen at 2 L/min via nasal cannula.
C. Obtain a 12-lead ECG.
D. Administer morphine 2 mg IV.
Correct Answer: A. Administer a second nitroglycerin tablet sublingually.
Rationale: Nitroglycerin protocol allows for one tablet every 5 minutes for up to 3 doses (NCLEX-RN: Pharmacology). If chest
pain is unrelieved after 1 dose, the next priority is administering the second dose while continuing to monitor vitals. Oxygen is
only indicated if SpO2 is <90%. An ECG is needed but pain relief takes priority. Morphine is reserved for pain unrelieved by 3
nitroglycerin doses. NSG 3250 follows ACS protocol.
,Q5: A client is admitted with suspected acute myocardial infarction. Which cardiac enzyme is MOST specific for
myocardial damage?
A. Creatine kinase (CK-MB).
B. Myoglobin.
C. Troponin I. *[CORRECT]*
D. Lactate dehydrogenase (LDH).
Correct Answer: C. Troponin I.
Rationale: Troponin I is the most specific and sensitive cardiac biomarker for myocardial injury, elevating within 3-4 hours
and persisting for 7-10 days (NCLEX-RN: Reduction of Risk Potential). CK-MB is less specific and returns to normal within
48-72 hours. Myoglobin elevates early but lacks cardiac specificity. LDH is no longer used clinically for MI diagnosis. NSG
3250 cardiac diagnostics emphasize troponin as the gold standard.
Q6: The nurse is caring for four clients with heart failure. Which client requires IMMEDIATE intervention?
A. A client with bilateral crackles in lung bases and 1+ pitting edema.
B. A client with a 2-pound weight gain over 24 hours and mild dyspnea.
C. A client with pink, frothy sputum and severe dyspnea. *[CORRECT]*
D. A client reporting fatigue and needing to sleep with two pillows.
Correct Answer: C. A client with pink, frothy sputum and severe dyspnea.
Rationale: Pink, frothy sputum with severe dyspnea indicates acute pulmonary edema, a life-threatening complication of heart
failure requiring immediate intervention (NCLEX-RN: Physiological Adaptation). This client shows signs of severe left-sided
heart failure with fluid backing into the alveoli. The other clients have stable or expected manifestations of chronic HF. NSG
3250 prioritization applies ABC and acute vs. chronic.
Q7: A client with heart failure is being discharged with furosemide 40 mg daily. Which client statement indicates
understanding of the medication?
A. "I will take this medication at bedtime to prevent waking at night."
B. "I should eat more bananas and sweet potatoes while taking this medication." *[CORRECT]*
C. "I will weigh myself once a week at the same time of day."
D. "I can stop taking this medication when my swelling goes down."
Correct Answer: B. "I should eat more bananas and sweet potatoes while taking this medication."
Rationale: Furosemide is a loop diuretic that causes potassium loss; consuming potassium-rich foods like bananas and sweet
potatoes helps prevent hypokalemia (NCLEX-RN: Pharmacology). The medication should be taken in the morning to prevent
nocturia. Daily weights are essential for HF management. The medication should never be stopped without provider approval.
NSG 3250 HF teaching aligns with AHA guidelines.
Q8: A client with atrial fibrillation is prescribed warfarin 5 mg daily. The client's INR is 3.5. What is the nurse's BEST
action?
A. Administer the warfarin as prescribed.
B. Hold the warfarin and notify the provider. *[CORRECT]*
C. Administer vitamin K intravenously.
D. Administer protamine sulfate.
Correct Answer: B. Hold the warfarin and notify the provider.
Rationale: For a client with atrial fibrillation, the therapeutic INR range is 2.0-3.0. An INR of 3.5 is elevated and increases
bleeding risk; the nurse should hold the dose and notify the provider (NCLEX-RN: Pharmacology, Lab Values). Vitamin K is
the antidote but is reserved for severe elevation or active bleeding. Protamine sulfate is the antidote for heparin, not warfarin.
NSG 3250 anticoagulation therapy follows evidence-based protocols.
, Q9: The nurse notes the client's cardiac monitor shows an irregular rhythm with no discernible P waves and an
irregular R-R interval. The client's apical pulse is 92 beats/minute. What is the nurse's interpretation?
A. Sinus arrhythmia.
B. Atrial fibrillation. *[CORRECT]*
C. Ventricular tachycardia.
D. First-degree AV block.
Correct Answer: B. Atrial fibrillation.
Rationale: Atrial fibrillation is characterized by absent P waves, irregular R-R intervals, and an irregularly irregular rhythm
(NCLEX-RN: Physiological Adaptation). The lack of organized atrial contraction produces no P waves. Sinus arrhythmia has
P waves. Ventricular tachycardia has wide QRS complexes. First-degree AV block has a prolonged PR interval. NSG 3250
dysrhythmia interpretation follows AHA guidelines.
Q10: A client with aortic stenosis is being assessed. Which finding is the nurse MOST likely to observe?
A. Bounding peripheral pulses.
B. Systolic murmur heard at the second intercostal space, right sternal border. *[CORRECT]*
C. Diastolic murmur heard at the apex.
D. Wide pulse pressure.
Correct Answer: B. Systolic murmur heard at the second intercostal space, right sternal border.
Rationale: Aortic stenosis produces a systolic ejection murmur best heard at the second intercostal space, right sternal border
(aortic area), radiating to the carotids (NCLEX-RN: Physiological Adaptation). The narrowed valve obstructs outflow,
producing a systolic murmur. Pulse pressure narrows rather than widens. Pulses are weak and delayed (pulsus parvus et
tardus). NSG 3250 valvular assessment differentiates stenosis from regurgitation.
Q11: A client with peripheral vascular disease reports leg pain that occurs when walking and resolves with rest.
The nurse documents this finding as:
A. Rest pain.
B. Intermittent claudication. *[CORRECT]*
C. Deep vein thrombosis.
D. Compartment syndrome.
Correct Answer: B. Intermittent claudication.
Rationale: Intermittent claudication is the classic manifestation of peripheral arterial disease, characterized by reproducible
pain with activity that resolves with rest (NCLEX-RN: Physiological Adaptation). It results from inadequate blood flow during
exercise. Rest pain indicates severe disease. DVT presents with unilateral edema and warmth, not activity-related pain. NSG
3250 PVD assessment emphasizes the location and pattern of pain.
Q12: The nurse is assessing a client with suspected deep vein thrombosis (DVT) in the left leg. Which finding
requires the MOST immediate intervention?
A. Calf tenderness and 1 cm difference in calf circumference.
B. Sudden onset of chest pain and dyspnea. *[CORRECT]*
C. Erythema and warmth along the inner thigh.
D. Positive Homans' sign.
Correct Answer: B. Sudden onset of chest pain and dyspnea.
Rationale: Sudden chest pain and dyspnea in a client with DVT suggests pulmonary embolism, a life-threatening complication
requiring immediate intervention (NCLEX-RN: Physiological Adaptation, Prioritization). The priority is to stabilize the client
and administer oxygen. Homans' sign is unreliable and no longer recommended for DVT diagnosis. Calf tenderness and
erythema are expected findings of DVT itself. NSG 3250 DVT complications follow PE protocols.
