NUR 254 Final Exam Guide 2025/2026 | Galen
College of Nursing | Complete Exam Questions
with 100% Verified Correct Answers
NUR 254 Course | Adult Health Nursing II, Advanced Clinical Judgment, Complex Patient Care,
Pharmacology Applications, Fluid & Electrolyte Management, Acute & Chronic Disease
Interventions | Expert-Verified Q&A | Academic & Certification-Ready
Introduction
This document provides the complete and updated NUR 254 Final Exam Guide for the
2025/2026 academic cycle at Galen College of Nursing. It covers all essential topics including
critical thinking in adult health, advanced pharmacological principles, cardiovascular and
respiratory disorders, renal and endocrine management, and evidence-based interventions for
acute and chronic conditions. All answers have been thoroughly verified for accuracy, ensuring
full preparation for academic mastery and practical nursing application.
Answer Format
All correct answers are highlighted in bold and green, with concise rationales that strengthen
understanding of advanced adult health nursing concepts.
NUR 254 Final Exam Guide Q&A | Verified 2025/2026 Content | Exam-Aligned |
Prepared for Nursing Academic & Clinical Excellence
Question 1
A patient with acute myocardial infarction presents with ST elevation on ECG. What is the
priority intervention?
A) Administer aspirin
B) Prepare for percutaneous coronary intervention (PCI)
C) Start beta-blockers
D) Initiate thrombolytic therapy
B) Prepare for percutaneous coronary intervention (PCI)
Rationale: PCI is the gold standard for restoring blood flow in ST-elevation myocardial
infarction (STEMI) within 90 minutes.
Question 2
A patient with heart failure exhibits dyspnea and 3+ pitting edema. What medication should be
prioritized?
A) Furosemide
B) Metoprolol
, C) Digoxin
D) Nitroglycerin
A) Furosemide
Rationale: Furosemide, a loop diuretic, reduces fluid overload and alleviates edema in heart
failure.
Question 3
What is the primary assessment finding in a patient with pneumonia presenting with a
productive cough?
A) Bradycardia
B) Crackles on auscultation
C) Decreased respiratory rate
D) Clear lung fields
B) Crackles on auscultation
Rationale: Crackles indicate fluid or infection in the alveoli, common in pneumonia.
Question 4
A patient with chronic obstructive pulmonary disease (COPD) has a PaCO2 of 55 mmHg. What
does this indicate?
A) Hyperventilation
B) Respiratory alkalosis
C) Chronic hypercapnia
D) Hypoxemia
C) Chronic hypercapnia
Rationale: Elevated PaCO2 suggests chronic CO2 retention, typical in advanced COPD.
Question 5
What is the initial intervention for a patient with acute renal failure and oliguria?
A) Administer IV fluids
B) Insert a urinary catheter
C) Start dialysis
D) Restrict fluid intake
B) Insert a urinary catheter
Rationale: A catheter assesses urine output and rules out obstruction as a cause.
Question 6
A patient with diabetes mellitus type 1 has a blood glucose of 50 mg/dL. What is the priority
action?
A) Administer regular insulin
B) Provide 15 g of fast-acting carbohydrates
C) Start IV dextrose
D) Recheck in 1 hour
B) Provide 15 g of fast-acting carbohydrates
Rationale: Oral carbohydrates quickly raise blood glucose in mild hypoglycemia.
Question 7
What electrolyte imbalance is most critical to monitor in a patient with Addison’s disease?
College of Nursing | Complete Exam Questions
with 100% Verified Correct Answers
NUR 254 Course | Adult Health Nursing II, Advanced Clinical Judgment, Complex Patient Care,
Pharmacology Applications, Fluid & Electrolyte Management, Acute & Chronic Disease
Interventions | Expert-Verified Q&A | Academic & Certification-Ready
Introduction
This document provides the complete and updated NUR 254 Final Exam Guide for the
2025/2026 academic cycle at Galen College of Nursing. It covers all essential topics including
critical thinking in adult health, advanced pharmacological principles, cardiovascular and
respiratory disorders, renal and endocrine management, and evidence-based interventions for
acute and chronic conditions. All answers have been thoroughly verified for accuracy, ensuring
full preparation for academic mastery and practical nursing application.
Answer Format
All correct answers are highlighted in bold and green, with concise rationales that strengthen
understanding of advanced adult health nursing concepts.
NUR 254 Final Exam Guide Q&A | Verified 2025/2026 Content | Exam-Aligned |
Prepared for Nursing Academic & Clinical Excellence
Question 1
A patient with acute myocardial infarction presents with ST elevation on ECG. What is the
priority intervention?
A) Administer aspirin
B) Prepare for percutaneous coronary intervention (PCI)
C) Start beta-blockers
D) Initiate thrombolytic therapy
B) Prepare for percutaneous coronary intervention (PCI)
Rationale: PCI is the gold standard for restoring blood flow in ST-elevation myocardial
infarction (STEMI) within 90 minutes.
Question 2
A patient with heart failure exhibits dyspnea and 3+ pitting edema. What medication should be
prioritized?
A) Furosemide
B) Metoprolol
, C) Digoxin
D) Nitroglycerin
A) Furosemide
Rationale: Furosemide, a loop diuretic, reduces fluid overload and alleviates edema in heart
failure.
Question 3
What is the primary assessment finding in a patient with pneumonia presenting with a
productive cough?
A) Bradycardia
B) Crackles on auscultation
C) Decreased respiratory rate
D) Clear lung fields
B) Crackles on auscultation
Rationale: Crackles indicate fluid or infection in the alveoli, common in pneumonia.
Question 4
A patient with chronic obstructive pulmonary disease (COPD) has a PaCO2 of 55 mmHg. What
does this indicate?
A) Hyperventilation
B) Respiratory alkalosis
C) Chronic hypercapnia
D) Hypoxemia
C) Chronic hypercapnia
Rationale: Elevated PaCO2 suggests chronic CO2 retention, typical in advanced COPD.
Question 5
What is the initial intervention for a patient with acute renal failure and oliguria?
A) Administer IV fluids
B) Insert a urinary catheter
C) Start dialysis
D) Restrict fluid intake
B) Insert a urinary catheter
Rationale: A catheter assesses urine output and rules out obstruction as a cause.
Question 6
A patient with diabetes mellitus type 1 has a blood glucose of 50 mg/dL. What is the priority
action?
A) Administer regular insulin
B) Provide 15 g of fast-acting carbohydrates
C) Start IV dextrose
D) Recheck in 1 hour
B) Provide 15 g of fast-acting carbohydrates
Rationale: Oral carbohydrates quickly raise blood glucose in mild hypoglycemia.
Question 7
What electrolyte imbalance is most critical to monitor in a patient with Addison’s disease?
