1|Page
NSG 430/ NSG430| Final Exam GCU | Adult Health
Nursing II | Questions & Answers with Rationale |
Grade A| 100% Correct | (NEW 2026)
Exam Structure:
Subject: Adult Health Nursing II - Trauma, Shock, & Critical Care
Source: Grand Canyon University, NSG430 Final Exam
Format: Q&A Guide with Rationale
1: A 23-year-old female sustained injuries after being thrown from a
vehicle in an MVA. Which lab test should the nurse ensure is collected
from this patient?
Options:
A. Pregnancy test
B. Serum electrolytes
C. CBC
D. Blood type and crossmatch
Correct Answer: A. Pregnancy test
Rationale:
1. A pregnancy test is essential for any female of childbearing age who
experiences trauma.
2. Management of injuries, medication administration, and diagnostic
imaging (X-rays, CT scans) must consider potential pregnancy to avoid
fetal harm.
3. Options B, C, and D are important trauma labs but do not take priority
over confirming pregnancy status before interventions that could harm
a fetus.
2: The nurse is administering blood to a trauma patient experiencing
shock. Which assessment findings best indicate a dangerous infusion
reaction? (Select all that apply.)
Options:
, 2|Page
A. Increasing dyspnea
B. Increasing BP
C. Vomiting
D. An increase in temp of 0.3°C
E. Facial flushing
Correct Answer: A, C, E
Rationale:
1. These are classic signs of an acute hemolytic or allergic transfusion
reaction.
2. These can progress to anaphylaxis, respiratory distress, and shock.
3. Immediate intervention (stopping the transfusion, notifying the
provider, supporting the airway) is required.
4. Option B is incorrect: Increasing BP is not a classic sign of a transfusion
reaction.
5. Option D is incorrect: A temperature increase of 0.3°C is within
expected variation and not a critical indicator alone.
3: A patient with traumatic injuries is experiencing widespread
vasodilation and decreased peripheral resistance. For which type of
shock should the nurse plan care?
Options:
A. Septic
B. Obstructive
C. Cardiogenic
D. Hypovolemic
Correct Answer: A. Septic
Rationale:
1. Widespread vasodilation and decreased systemic vascular resistance
(SVR) are hallmark pathophysiologic features of septic (distributive)
shock.
2. This is often due to a systemic inflammatory response.
3. Option B is incorrect: Obstructive shock is caused by physical
obstruction of blood flow.
4. Option C is incorrect: Cardiogenic shock results from pump failure.
5. Option D is incorrect: Hypovolemic shock is caused by decreased
intravascular volume.
, 3|Page
4: A victim of multiple traumatic injuries is bleeding profusely from
one arm and leg. What should the nurse use to help control bleeding?
Options:
A. Vessel clamps
B. Limb elevation
C. Vasopressor application
D. Direct pressure application
Correct Answer: D. Direct pressure application
Rationale:
1. Direct, firm pressure over the bleeding site is the first-line, most
effective method to control external hemorrhage.
2. Tourniquets may be used if direct pressure fails, but pressure is the
initial standard intervention.
3. Option A is incorrect: Vessel clamps are used in surgical settings, not
initial field or bedside hemorrhage control.
4. Option C is incorrect: Vasopressors are pharmacological, not topical,
hemorrhage control.
5: A patient is admitted with chest injuries from an MVA. For what
should the nurse assess to determine the patient's ultimate extent of
injuries?
Options:
A. Recreational activities
B. Preexisting health problems
C. Psychosocial status before trauma
D. Number and types of previous traumas
Correct Answer: B. Preexisting health problems
Rationale:
1. Underlying conditions (e.g., COPD, heart disease) significantly impact
recovery, complication risk, and tolerance to treatment.
2. This makes them critical to assess in trauma patients.
3. Options A, C, and D are less directly related to physiological recovery
potential.
6: One week after a trauma, the patient's Hgb drops and temperature
rises. The nurse should conduct assessment for which complication?
Options:
, 4|Page
A. Liver laceration
B. Intracranial bleed
C. GI hemorrhage
D. Postop internal bleed
Correct Answer: C. GI hemorrhage
Rationale:
1. A delayed drop in hemoglobin with fever suggests possible
gastrointestinal bleeding.
2. This is a common complication after major trauma due to stress ulcers
or pre-existing conditions exacerbated by physiological stress.
3. Options A, B, and D would typically present sooner than one week post-
trauma.
7: A patient experiencing cardiogenic shock is prescribed
nitroprusside. Which nursing interventions are indicated? (Select all
that apply.)
Options:
A. Monitor for thiocyanate poisoning
B. Report urine output of more than 150 mL/h
C. Do not mix with other meds
D. Assess IV access site and apply ice for infiltration
E. Report increased confusion
Correct Answer: A, C, E
Rationale:
1. Nitroprusside metabolizes to thiocyanate, which is toxic at high levels.
2. It is light-sensitive and should not be mixed with other medications.
3. Confusion can indicate cyanide toxicity, a rare but serious adverse
effect.
4. Option B is incorrect: Increased urine output is not a concerning
finding specific to nitroprusside.
5. Option D is incorrect: Ice is not applied for nitroprusside infiltration.
8: The nurse is caring for a patient recovering from surgery. Which
action should the nurse perform to prevent onset of hypovolemic
shock?
Options:
A. Elevate HOB
NSG 430/ NSG430| Final Exam GCU | Adult Health
Nursing II | Questions & Answers with Rationale |
Grade A| 100% Correct | (NEW 2026)
Exam Structure:
Subject: Adult Health Nursing II - Trauma, Shock, & Critical Care
Source: Grand Canyon University, NSG430 Final Exam
Format: Q&A Guide with Rationale
1: A 23-year-old female sustained injuries after being thrown from a
vehicle in an MVA. Which lab test should the nurse ensure is collected
from this patient?
Options:
A. Pregnancy test
B. Serum electrolytes
C. CBC
D. Blood type and crossmatch
Correct Answer: A. Pregnancy test
Rationale:
1. A pregnancy test is essential for any female of childbearing age who
experiences trauma.
2. Management of injuries, medication administration, and diagnostic
imaging (X-rays, CT scans) must consider potential pregnancy to avoid
fetal harm.
3. Options B, C, and D are important trauma labs but do not take priority
over confirming pregnancy status before interventions that could harm
a fetus.
2: The nurse is administering blood to a trauma patient experiencing
shock. Which assessment findings best indicate a dangerous infusion
reaction? (Select all that apply.)
Options:
, 2|Page
A. Increasing dyspnea
B. Increasing BP
C. Vomiting
D. An increase in temp of 0.3°C
E. Facial flushing
Correct Answer: A, C, E
Rationale:
1. These are classic signs of an acute hemolytic or allergic transfusion
reaction.
2. These can progress to anaphylaxis, respiratory distress, and shock.
3. Immediate intervention (stopping the transfusion, notifying the
provider, supporting the airway) is required.
4. Option B is incorrect: Increasing BP is not a classic sign of a transfusion
reaction.
5. Option D is incorrect: A temperature increase of 0.3°C is within
expected variation and not a critical indicator alone.
3: A patient with traumatic injuries is experiencing widespread
vasodilation and decreased peripheral resistance. For which type of
shock should the nurse plan care?
Options:
A. Septic
B. Obstructive
C. Cardiogenic
D. Hypovolemic
Correct Answer: A. Septic
Rationale:
1. Widespread vasodilation and decreased systemic vascular resistance
(SVR) are hallmark pathophysiologic features of septic (distributive)
shock.
2. This is often due to a systemic inflammatory response.
3. Option B is incorrect: Obstructive shock is caused by physical
obstruction of blood flow.
4. Option C is incorrect: Cardiogenic shock results from pump failure.
5. Option D is incorrect: Hypovolemic shock is caused by decreased
intravascular volume.
, 3|Page
4: A victim of multiple traumatic injuries is bleeding profusely from
one arm and leg. What should the nurse use to help control bleeding?
Options:
A. Vessel clamps
B. Limb elevation
C. Vasopressor application
D. Direct pressure application
Correct Answer: D. Direct pressure application
Rationale:
1. Direct, firm pressure over the bleeding site is the first-line, most
effective method to control external hemorrhage.
2. Tourniquets may be used if direct pressure fails, but pressure is the
initial standard intervention.
3. Option A is incorrect: Vessel clamps are used in surgical settings, not
initial field or bedside hemorrhage control.
4. Option C is incorrect: Vasopressors are pharmacological, not topical,
hemorrhage control.
5: A patient is admitted with chest injuries from an MVA. For what
should the nurse assess to determine the patient's ultimate extent of
injuries?
Options:
A. Recreational activities
B. Preexisting health problems
C. Psychosocial status before trauma
D. Number and types of previous traumas
Correct Answer: B. Preexisting health problems
Rationale:
1. Underlying conditions (e.g., COPD, heart disease) significantly impact
recovery, complication risk, and tolerance to treatment.
2. This makes them critical to assess in trauma patients.
3. Options A, C, and D are less directly related to physiological recovery
potential.
6: One week after a trauma, the patient's Hgb drops and temperature
rises. The nurse should conduct assessment for which complication?
Options:
, 4|Page
A. Liver laceration
B. Intracranial bleed
C. GI hemorrhage
D. Postop internal bleed
Correct Answer: C. GI hemorrhage
Rationale:
1. A delayed drop in hemoglobin with fever suggests possible
gastrointestinal bleeding.
2. This is a common complication after major trauma due to stress ulcers
or pre-existing conditions exacerbated by physiological stress.
3. Options A, B, and D would typically present sooner than one week post-
trauma.
7: A patient experiencing cardiogenic shock is prescribed
nitroprusside. Which nursing interventions are indicated? (Select all
that apply.)
Options:
A. Monitor for thiocyanate poisoning
B. Report urine output of more than 150 mL/h
C. Do not mix with other meds
D. Assess IV access site and apply ice for infiltration
E. Report increased confusion
Correct Answer: A, C, E
Rationale:
1. Nitroprusside metabolizes to thiocyanate, which is toxic at high levels.
2. It is light-sensitive and should not be mixed with other medications.
3. Confusion can indicate cyanide toxicity, a rare but serious adverse
effect.
4. Option B is incorrect: Increased urine output is not a concerning
finding specific to nitroprusside.
5. Option D is incorrect: Ice is not applied for nitroprusside infiltration.
8: The nurse is caring for a patient recovering from surgery. Which
action should the nurse perform to prevent onset of hypovolemic
shock?
Options:
A. Elevate HOB
