1
NSG 3130 EXAM 5 2026/2027 | FUNDAMENTAL
CONCEPTS & SKILLS FOR NURSING PRACTICE II |
40 VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: COMPREHENSIVE INTEGRATION – Questions 1-10
Q1: Prioritization Across Multiple Patients
A nurse is caring for four patients at the start of the shift. Which patient should the nurse assess
first?
A. A postoperative patient reporting pain rated 7/10 after receiving analgesia two hours earlier
B. A patient with COPD whose oxygen saturation decreased from 94% to 86% while receiving 2 L/min
oxygen
C. A diabetic patient requesting assistance before eating
D. A patient scheduled for discharge who needs education about medications
Correct Answer: B
Rationale: Airway and breathing problems always receive the highest priority. A significant decrease
in oxygen saturation from 94% to 86% on oxygen therapy indicates a critical oxygenation problem
requiring immediate assessment and intervention. The postoperative patient with pain (A) is
important but not life-threatening. The diabetic patient (C) and discharge patient (D) have non-
urgent needs .
Q2: Clinical Judgment – Early Signs of Hypoxia
A nurse is assessing a client who is in the early stages of hypoxia. Which clinical manifestation should
the nurse expect to observe first?
A. Cyanosis
B. Restlessness and anxiety
C. Bradypnea
D. Bradycardia
Correct Answer: B
Rationale: Restlessness, anxiety, and tachycardia are classic early signs of hypoxia as the central
nervous system reacts to decreasing oxygen levels. Cyanosis (A), bradycardia (C), and bradypnea (D)
are late signs that indicate severe, prolonged oxygen deprivation .
Q3: Ventilator Alarm Interpretation
, 2
A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Increase the oxygen flow rate
B. Silence the alarm
C. Assess the patient and check for kinks in the tubing or secretions
D. Call the respiratory therapist
Correct Answer: C
Rationale: When a high-pressure alarm sounds, the nurse must first assess the patient and check for
common causes such as tubing kinks, secretions, or patient biting on the tube. Increasing oxygen (A)
or silencing the alarm (B) without assessment is unsafe. Calling respiratory therapy (D) may be
appropriate but assessment comes first.
Q4: ABG Interpretation
A patient's arterial blood gas results are: pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L. How should the
nurse interpret this?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Fully compensated respiratory acidosis
Correct Answer: A
Rationale: The pH is acidotic (7.30 < 7.35), and the PaCO2 is elevated (55 > 45), indicating respiratory
acidosis. The HCO3 is normal (26), indicating no metabolic compensation. Therefore, this is
uncompensated respiratory acidosis. Partially compensated (B) would have elevated HCO3.
Uncompensated metabolic acidosis (C) would have low HCO3. Fully compensated (D) would have a
normal pH.
Q5: Chest Tube Disconnection
A nurse walks into a client's room and notices the chest tube has become disconnected from the
drainage unit. Which immediate action should the nurse take?
A. Clamp the chest tube near the client's chest wall
B. Submerge the end of the tube in a bottle of sterile water
C. Apply a sterile occlusive dressing taped on three sides
D. Instruct the client to perform a Valsalva maneuver
Correct Answer: B
Rationale: Submerging the open end of the tube in 1 to 2 inches of sterile water immediately
establishes a temporary water seal. This prevents atmospheric air from rushing into the pleural
space and causing a tension pneumothorax. Clamping the chest tube (A) could lead to tension
pneumothorax if air cannot escape .
NSG 3130 EXAM 5 2026/2027 | FUNDAMENTAL
CONCEPTS & SKILLS FOR NURSING PRACTICE II |
40 VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: COMPREHENSIVE INTEGRATION – Questions 1-10
Q1: Prioritization Across Multiple Patients
A nurse is caring for four patients at the start of the shift. Which patient should the nurse assess
first?
A. A postoperative patient reporting pain rated 7/10 after receiving analgesia two hours earlier
B. A patient with COPD whose oxygen saturation decreased from 94% to 86% while receiving 2 L/min
oxygen
C. A diabetic patient requesting assistance before eating
D. A patient scheduled for discharge who needs education about medications
Correct Answer: B
Rationale: Airway and breathing problems always receive the highest priority. A significant decrease
in oxygen saturation from 94% to 86% on oxygen therapy indicates a critical oxygenation problem
requiring immediate assessment and intervention. The postoperative patient with pain (A) is
important but not life-threatening. The diabetic patient (C) and discharge patient (D) have non-
urgent needs .
Q2: Clinical Judgment – Early Signs of Hypoxia
A nurse is assessing a client who is in the early stages of hypoxia. Which clinical manifestation should
the nurse expect to observe first?
A. Cyanosis
B. Restlessness and anxiety
C. Bradypnea
D. Bradycardia
Correct Answer: B
Rationale: Restlessness, anxiety, and tachycardia are classic early signs of hypoxia as the central
nervous system reacts to decreasing oxygen levels. Cyanosis (A), bradycardia (C), and bradypnea (D)
are late signs that indicate severe, prolonged oxygen deprivation .
Q3: Ventilator Alarm Interpretation
, 2
A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Increase the oxygen flow rate
B. Silence the alarm
C. Assess the patient and check for kinks in the tubing or secretions
D. Call the respiratory therapist
Correct Answer: C
Rationale: When a high-pressure alarm sounds, the nurse must first assess the patient and check for
common causes such as tubing kinks, secretions, or patient biting on the tube. Increasing oxygen (A)
or silencing the alarm (B) without assessment is unsafe. Calling respiratory therapy (D) may be
appropriate but assessment comes first.
Q4: ABG Interpretation
A patient's arterial blood gas results are: pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L. How should the
nurse interpret this?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Fully compensated respiratory acidosis
Correct Answer: A
Rationale: The pH is acidotic (7.30 < 7.35), and the PaCO2 is elevated (55 > 45), indicating respiratory
acidosis. The HCO3 is normal (26), indicating no metabolic compensation. Therefore, this is
uncompensated respiratory acidosis. Partially compensated (B) would have elevated HCO3.
Uncompensated metabolic acidosis (C) would have low HCO3. Fully compensated (D) would have a
normal pH.
Q5: Chest Tube Disconnection
A nurse walks into a client's room and notices the chest tube has become disconnected from the
drainage unit. Which immediate action should the nurse take?
A. Clamp the chest tube near the client's chest wall
B. Submerge the end of the tube in a bottle of sterile water
C. Apply a sterile occlusive dressing taped on three sides
D. Instruct the client to perform a Valsalva maneuver
Correct Answer: B
Rationale: Submerging the open end of the tube in 1 to 2 inches of sterile water immediately
establishes a temporary water seal. This prevents atmospheric air from rushing into the pleural
space and causing a tension pneumothorax. Clamping the chest tube (A) could lead to tension
pneumothorax if air cannot escape .
