NSG 3800 All Exams Binder 2026 – Galen College of
Nursing (U.S.) | Complete Course Review & Verified
Answers | Comprehensive Nursing Assessment
Q001: A 67-year-old with COPD, heart failure, and newly diagnosed atrial fibrillation is
admitted with shortness of breath and bilateral crackles. Home medications include
metoprolol, digoxin, and warfarin. Vital signs: BP 92/58, HR 104 irregular, RR 28, SpO₂
86% on 2 L NC, temp 37°C. Which nursing action is priority?
Options:
A. Increase O₂ to 4 L NC
B. Obtain PT/INR and digoxin level - CORRECT
C. Administer IV diuretic push
D. Apply restraints for safety
(Correct Answer: B)
Q002: A 29-year-old G2P1 at 38 weeks gestation arrives with severe headache, visual
changes, and epigastric pain. BP 168/112, proteinuria +3, DTRs 3+ with clonus. Fetal
heart rate 160 with minimal variability. Which intervention should the nurse implement
first?
Options:
A. Start oxytocin induction
B. Administer IV hydralazine
C. Place left lateral position and start magnesium sulfate - CORRECT
D. Prepare for immediate vaginal delivery
(Correct Answer: C)
Q003: A 5-year-old with new-onset type 1 diabetes presents with fruity breath, Kussmaul
respirations, and glucose 488 mg/dL. Arterial pH 7.18, HCO₃ 12 mEq/L. Which order
should the nurse verify first?
Options:
A. Regular insulin 0.1 units/kg/hr IV - CORRECT
B. Sodium bicarbonate 1 mEq/kg IV
C. D5½NS at maintenance rate
, D. Oral glucose 15 g
(Correct Answer: A)
Q004: A 72-hour post-MI patient on heparin and aspirin suddenly reports severe back
pain and hypotension (BP 70/40). Abdominal ultrasound shows free fluid. Which action
is most urgent?
Options:
A. Increase heparin drip rate
B. Administer morphine sulfate 4 mg IV
C. Type and cross-match 6 units PRBC and call surgery - CORRECT
D. Obtain CT abdomen with contrast
(Correct Answer: C)
Q005: A 16-year-old is admitted after a suicide attempt by overdose. The patient is now
medically stable but refuses to speak and will not make eye contact. Which nursing
approach is most appropriate initially?
Options:
A. Ask parents to leave so the teen can speak privately
B. Sit silently at bedside to convey presence - CORRECT
C. Immediately begin cognitive behavioral therapy
D. Inform the teen that refusal to talk will prolong hospitalization
(Correct Answer: B)
Q006: A 42-year-old with major depressive disorder has been on sertraline 100 mg for 6
weeks and reports increasing suicidal ideation. The psychiatrist orders lithium 600 mg
daily. Which baseline lab is essential before the first dose?
Options:
A. Serum sodium
B. Creatinine and TSH - CORRECT
C. ALT and albumin
D. Hemoglobin A1c
(Correct Answer: B)
Q007: A 3-day-old infant develops jaundice with total bilirubin 18 mg/dL (308 µmol/L),
hemoglobin 12 g/dL, and reticulocyte count 8%. The mother is O+, baby B+. Which
treatment should the nurse prepare first?
Options:
A. Phototherapy and possible exchange transfusion - CORRECT
Nursing (U.S.) | Complete Course Review & Verified
Answers | Comprehensive Nursing Assessment
Q001: A 67-year-old with COPD, heart failure, and newly diagnosed atrial fibrillation is
admitted with shortness of breath and bilateral crackles. Home medications include
metoprolol, digoxin, and warfarin. Vital signs: BP 92/58, HR 104 irregular, RR 28, SpO₂
86% on 2 L NC, temp 37°C. Which nursing action is priority?
Options:
A. Increase O₂ to 4 L NC
B. Obtain PT/INR and digoxin level - CORRECT
C. Administer IV diuretic push
D. Apply restraints for safety
(Correct Answer: B)
Q002: A 29-year-old G2P1 at 38 weeks gestation arrives with severe headache, visual
changes, and epigastric pain. BP 168/112, proteinuria +3, DTRs 3+ with clonus. Fetal
heart rate 160 with minimal variability. Which intervention should the nurse implement
first?
Options:
A. Start oxytocin induction
B. Administer IV hydralazine
C. Place left lateral position and start magnesium sulfate - CORRECT
D. Prepare for immediate vaginal delivery
(Correct Answer: C)
Q003: A 5-year-old with new-onset type 1 diabetes presents with fruity breath, Kussmaul
respirations, and glucose 488 mg/dL. Arterial pH 7.18, HCO₃ 12 mEq/L. Which order
should the nurse verify first?
Options:
A. Regular insulin 0.1 units/kg/hr IV - CORRECT
B. Sodium bicarbonate 1 mEq/kg IV
C. D5½NS at maintenance rate
, D. Oral glucose 15 g
(Correct Answer: A)
Q004: A 72-hour post-MI patient on heparin and aspirin suddenly reports severe back
pain and hypotension (BP 70/40). Abdominal ultrasound shows free fluid. Which action
is most urgent?
Options:
A. Increase heparin drip rate
B. Administer morphine sulfate 4 mg IV
C. Type and cross-match 6 units PRBC and call surgery - CORRECT
D. Obtain CT abdomen with contrast
(Correct Answer: C)
Q005: A 16-year-old is admitted after a suicide attempt by overdose. The patient is now
medically stable but refuses to speak and will not make eye contact. Which nursing
approach is most appropriate initially?
Options:
A. Ask parents to leave so the teen can speak privately
B. Sit silently at bedside to convey presence - CORRECT
C. Immediately begin cognitive behavioral therapy
D. Inform the teen that refusal to talk will prolong hospitalization
(Correct Answer: B)
Q006: A 42-year-old with major depressive disorder has been on sertraline 100 mg for 6
weeks and reports increasing suicidal ideation. The psychiatrist orders lithium 600 mg
daily. Which baseline lab is essential before the first dose?
Options:
A. Serum sodium
B. Creatinine and TSH - CORRECT
C. ALT and albumin
D. Hemoglobin A1c
(Correct Answer: B)
Q007: A 3-day-old infant develops jaundice with total bilirubin 18 mg/dL (308 µmol/L),
hemoglobin 12 g/dL, and reticulocyte count 8%. The mother is O+, baby B+. Which
treatment should the nurse prepare first?
Options:
A. Phototherapy and possible exchange transfusion - CORRECT
