Page | 1
Final Exam NSG430 Questions with
Detailed Verified Answers
Question: The nurse is caring for a patient with an arterial monitoring system.
The nurse asses the patient's noninvasive cuff blood pressure to be 70/40 mm
Hg. The arterial blood pressure measurement via an intra-arterial catheter in
the same arm is assessed by the nurse to be 108/70 mm Hg. What is the best
action by the nurse?
Select one:
a. Frequent oropharyngeal suctioning
b. Side to side position changes
c. Range-of-motion to extremities
d. Frequent neurological assessments
Ans: d. Frequent neurological assessments
Question: The nurse is caring for a burn-injured patient who weighs 154
pounds, and the burn injury covers 40% of his body surface area. The nurse
calculates the fluid needs for the first 24 hours after a burn injury using a
standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV)
fluid for the first 24 hours. The nurse plans to administer what amount of fluid
in the first 24 hours?
Select one:
a. 14000 ml
For academic expert services contact me at
, Page | 2
b. 2800 ml
c. 7000 ml
d. 11200 ml
Ans: a. 14000 ml
Question: For patients with major burns, when should you start enteral
feedings?
Select one:
a. A few hours after the injury has occurred
b. Not until bowel sounds have returned
c. After the emergent phase of the injury
d. 2 to 3 days after the injury
Ans: c. After the emergent phase of the injury
Question: After receiving the handoff report from the day shift charge nurse,
which patient should the evening charge nurse assess first?
Select one:
a. Patient with meningitis complaining of photophobia
b. A patient with bacterial meningitis on droplet precautions
c. Mechanically ventilated patient with a GCS of 6
d. A patient with an intracranial pressure ICP of 20 mm Hg and an oral
temperature of 104°F
Ans: d. A patient with an intracranial pressure ICP of 20 mm Hg and an oral
temperature of 104°F
For academic expert services contact me at
, Page | 3
Question: The charge nurse assigns patients based on their acuity and the
level of experience of the critical care nurses on duty. This is an example of
implementation of:
Select one:
a. Healthy work environment
b. National patient safety goals
c. SBAR communication
d. Synergy model
Ans: d. Synergy model
Question: While caring for a patient with a basilar skull fracture, the nurse
assesses clear drainage from the patient's left naris. What is the best nursing
action?
Select one:
a. Insert bilateral cotton nasal packing.
b. Have the patient blow the nose until clear.
c. Place a nasal drip pad under the nose.
d. Suction the left nares until the drainage clears.
Ans: c. Place a nasal drip pad under the nose.
Question: The nurse is caring for a patient who was hit on the head with a
hammer. The patient was unconscious at the scene briefly but is now
conscious upon arrival at the emergency department with a GCS score of 15.
One hour later, the nurse assesses a GCS score of 3. What is the priority
nursing action?
Select one:
For academic expert services contact me at
, Page | 4
a. stimulate the patient hourly.
b. Notify the provider immediately.
c. Elevate the head of the bed.
d. Continue to monitor the patient.
Ans: b. Notify the provider immediately.
Question: The nurse is caring for a patient who has a diminished level of
consciousness and who is mechanically ventilated. While performing
endotracheal suctioning, the patient's hands clench and pull into the chest.
What is the best interpretation by the nurse?
Select one:
a. The patient is exhibiting purposeful movement.
b. The patient is exhibiting flexion posturing.
c. The patient is exhibiting extension posturing.
d. The patient is exhibiting decorticate posturing.
Ans: d. The patient is exhibiting decorticate posturing.
Question: (9) Which of the following would be seen in a patient with
myxedema coma?
Select one:
a. Decreased reflexes
b. Hyperthermia
c. Tachycardia
d. Hyperventilation
For academic expert services contact me at
Final Exam NSG430 Questions with
Detailed Verified Answers
Question: The nurse is caring for a patient with an arterial monitoring system.
The nurse asses the patient's noninvasive cuff blood pressure to be 70/40 mm
Hg. The arterial blood pressure measurement via an intra-arterial catheter in
the same arm is assessed by the nurse to be 108/70 mm Hg. What is the best
action by the nurse?
Select one:
a. Frequent oropharyngeal suctioning
b. Side to side position changes
c. Range-of-motion to extremities
d. Frequent neurological assessments
Ans: d. Frequent neurological assessments
Question: The nurse is caring for a burn-injured patient who weighs 154
pounds, and the burn injury covers 40% of his body surface area. The nurse
calculates the fluid needs for the first 24 hours after a burn injury using a
standard fluid resuscitation formula of 4 mL/kg/% burn of intravenous (IV)
fluid for the first 24 hours. The nurse plans to administer what amount of fluid
in the first 24 hours?
Select one:
a. 14000 ml
For academic expert services contact me at
, Page | 2
b. 2800 ml
c. 7000 ml
d. 11200 ml
Ans: a. 14000 ml
Question: For patients with major burns, when should you start enteral
feedings?
Select one:
a. A few hours after the injury has occurred
b. Not until bowel sounds have returned
c. After the emergent phase of the injury
d. 2 to 3 days after the injury
Ans: c. After the emergent phase of the injury
Question: After receiving the handoff report from the day shift charge nurse,
which patient should the evening charge nurse assess first?
Select one:
a. Patient with meningitis complaining of photophobia
b. A patient with bacterial meningitis on droplet precautions
c. Mechanically ventilated patient with a GCS of 6
d. A patient with an intracranial pressure ICP of 20 mm Hg and an oral
temperature of 104°F
Ans: d. A patient with an intracranial pressure ICP of 20 mm Hg and an oral
temperature of 104°F
For academic expert services contact me at
, Page | 3
Question: The charge nurse assigns patients based on their acuity and the
level of experience of the critical care nurses on duty. This is an example of
implementation of:
Select one:
a. Healthy work environment
b. National patient safety goals
c. SBAR communication
d. Synergy model
Ans: d. Synergy model
Question: While caring for a patient with a basilar skull fracture, the nurse
assesses clear drainage from the patient's left naris. What is the best nursing
action?
Select one:
a. Insert bilateral cotton nasal packing.
b. Have the patient blow the nose until clear.
c. Place a nasal drip pad under the nose.
d. Suction the left nares until the drainage clears.
Ans: c. Place a nasal drip pad under the nose.
Question: The nurse is caring for a patient who was hit on the head with a
hammer. The patient was unconscious at the scene briefly but is now
conscious upon arrival at the emergency department with a GCS score of 15.
One hour later, the nurse assesses a GCS score of 3. What is the priority
nursing action?
Select one:
For academic expert services contact me at
, Page | 4
a. stimulate the patient hourly.
b. Notify the provider immediately.
c. Elevate the head of the bed.
d. Continue to monitor the patient.
Ans: b. Notify the provider immediately.
Question: The nurse is caring for a patient who has a diminished level of
consciousness and who is mechanically ventilated. While performing
endotracheal suctioning, the patient's hands clench and pull into the chest.
What is the best interpretation by the nurse?
Select one:
a. The patient is exhibiting purposeful movement.
b. The patient is exhibiting flexion posturing.
c. The patient is exhibiting extension posturing.
d. The patient is exhibiting decorticate posturing.
Ans: d. The patient is exhibiting decorticate posturing.
Question: (9) Which of the following would be seen in a patient with
myxedema coma?
Select one:
a. Decreased reflexes
b. Hyperthermia
c. Tachycardia
d. Hyperventilation
For academic expert services contact me at
