NSG 3800 Actual Exams Binder 2026 – Galen College
of Nursing (U.S.) | Complete Course Review & Verified
Answers | Comprehensive Nursing Assessment |
Latest version
Q001: A 67-year-old client with COPD, heart failure, and newly diagnosed atrial
fibrillation is admitted for dyspnea. Home medications include metoprolol, digoxin,
prednisone, and warfarin. On auscultation, crackles are bilateral, and the apical pulse is
irregular at 110 bpm. Oxygen saturation is 86% on 2 L nasal cannula. Which action
should the nurse take first?
Options:
A. Increase oxygen to 6 L via simple mask
B. Obtain a stat chest X-ray
C. Check a stat digoxin level and basic metabolic panel
D. Administer IV furosemide 40 mg as ordered - CORRECT
(Correct Answer: D)
Q002: A 34-year-old postpartum client on magnesium sulfate for preeclampsia has a
respiratory rate of 10 breaths/min, absent patellar reflexes, and urine output 60 mL over
4 hours. Calcium gluconate is at bedside. Which priority intervention is required?
Options:
A. Stop the magnesium sulfate infusion - CORRECT
B. Encourage oral fluid intake
C. Prepare for immediate cesarean delivery
D. Increase the magnesium dose to achieve seizure control
(Correct Answer: A)
Q003: A 5-year-old with sickle cell disease presents with severe joint pain, fever 39.4 °C,
and a hemoglobin level of 6.2 g/dL. The nurse prepares to administer a unit of packed
RBCs. Which pre-transfusion check is most critical?
Options:
,A. Verify informed consent is on the chart
B. Ensure extended phenotype matching - CORRECT
C. Premedicate with acetaminophen only
D. Transfuse through a 22-gauge peripheral IV
(Correct Answer: B)
Q004: An alert 78-year-old client with diabetes and stage 4 chronic kidney disease has a
serum potassium of 6.3 mEq/L and ECG showing peaked T waves. Which prescribed
intervention should the nurse implement first?
Options:
A. Give 10 units regular insulin + 25 g dextrose IV - CORRECT
B. Administer oral sodium polystyrene sulfonate
C. Obtain a dialysis access chest X-ray
D. Restrict dietary potassium to 40 mEq/day
(Correct Answer: A)
Q005: A client with bipolar disorder on lithium and quetiapine reports severe nausea,
tremor, and diarrhea. Lithium level is 2.1 mEq/L (normal 0.6–1.2). Which immediate
nursing action is required?
Options:
A. Hold lithium and start IV hydration - CORRECT
B. Administer an antiemetic and continue lithium
C. Increase quetiapine for mood stabilization
D. Restrict sodium intake
(Correct Answer: A)
Q006: A 29-week-pregnant client in preterm labor is receiving betamethasone and
nifedipine. Fetal heart rate shows recurrent late decelerations. Which action should the
nurse take first?
Options:
A. Stop nifedipine immediately
B. Position client in left lateral tilt and give O₂ - CORRECT
C. Prepare for emergency cesarean delivery
D. Increase IV fluids to 125 mL/h
(Correct Answer: B)
,Q007: A client with a traumatic brain injury receiving mannitol has a serum osmolality of
320 mOsm/kg (upper limit 310). Urine output is 400 mL/h. Which prescribed
intervention is priority?
Options:
A. Stop mannitol and notify provider - CORRECT
B. Replace with 0.45% saline
C. Continue mannitol to reduce ICP
D. Begin desmopressin
(Correct Answer: A)
Q008: A 16-year-old with anorexia nervosa has a BMI of 14, heart rate 45 bpm, and BP
85/50 mmHg. The provider orders oral refeeding. Which nursing action is most
appropriate initially?
Options:
A. Start 3000 kcal/day oral diet immediately
B. Begin continuous cardiac monitoring - CORRECT
C. Allow unlimited exercise to stimulate appetite
D. Restrict fluids to prevent edema
(Correct Answer: B)
Q009: A client with leukemia develops rigors and a temperature of 38.9 °C during a
platelet transfusion. Blood pressure is stable at 110/70 mmHg. Which action should the
nurse take first?
Options:
A. Stop the transfusion immediately - CORRECT
B. Give acetaminophen and continue slowly
C. Obtain a fungal blood culture
D. Draw a type and screen for new units
(Correct Answer: A)
Q010: A client with a pulmonary artery catheter has a wedge pressure of 18 mmHg and
cardiac output 3.2 L/min (CI 1.9). Which intervention should the nurse anticipate?
Options:
A. Administer IV diuretic - CORRECT
B. Start dobutamine infusion
C. Increase afterload with vasopressin
D. Decrease FiO₂ to 0.21
(Correct Answer: A)
, Q011: A 2-day-old neonate has bilious vomiting, abdominal distention, and failure to
pass meconium. An abdominal X-ray shows dilated bowel loops and a "soap-bubble"
appearance. Which condition should the nurse suspect?
Options:
A. Hirschsprung disease
B. Meconium ileus - CORRECT
C. Intussusception
D. Pyloric stenosis
(Correct Answer: B)
Q012: A client with rheumatoid arthritis on methotrexate and prednisone develops a
cough, fever, and nodular chest infiltrates. LDH is elevated. Which opportunistic
infection is most likely?
Options:
A. Pneumocystis jirovecii pneumonia - CORRECT
B. Tuberculosis
C. Histoplasmosis
D. Aspergillosis
(Correct Answer: A)
Q013: A client with a spinal cord injury at T6 develops pounding headache, flushing, and
BP 210/110 mmHg during bladder catheterization. Which immediate nursing action is
priority?
Options:
A. Sit the client upright and loosen clothing - CORRECT
B. Administer sublingual nifedipine
C. Rapidly empty the bladder
D. Apply abdominal binder
(Correct Answer: A)
Q014: A client with acute pancreatitis has a nasogastric tube to suction, severe
epigastric pain, and a serum calcium of 7.2 mg/dL. Which nursing intervention is most
appropriate?
Options:
A. Administer IV calcium gluconate as ordered - CORRECT
B. Discontinue the NG suction
C. Increase suction to continuous
D. Provide oral calcium supplements
of Nursing (U.S.) | Complete Course Review & Verified
Answers | Comprehensive Nursing Assessment |
Latest version
Q001: A 67-year-old client with COPD, heart failure, and newly diagnosed atrial
fibrillation is admitted for dyspnea. Home medications include metoprolol, digoxin,
prednisone, and warfarin. On auscultation, crackles are bilateral, and the apical pulse is
irregular at 110 bpm. Oxygen saturation is 86% on 2 L nasal cannula. Which action
should the nurse take first?
Options:
A. Increase oxygen to 6 L via simple mask
B. Obtain a stat chest X-ray
C. Check a stat digoxin level and basic metabolic panel
D. Administer IV furosemide 40 mg as ordered - CORRECT
(Correct Answer: D)
Q002: A 34-year-old postpartum client on magnesium sulfate for preeclampsia has a
respiratory rate of 10 breaths/min, absent patellar reflexes, and urine output 60 mL over
4 hours. Calcium gluconate is at bedside. Which priority intervention is required?
Options:
A. Stop the magnesium sulfate infusion - CORRECT
B. Encourage oral fluid intake
C. Prepare for immediate cesarean delivery
D. Increase the magnesium dose to achieve seizure control
(Correct Answer: A)
Q003: A 5-year-old with sickle cell disease presents with severe joint pain, fever 39.4 °C,
and a hemoglobin level of 6.2 g/dL. The nurse prepares to administer a unit of packed
RBCs. Which pre-transfusion check is most critical?
Options:
,A. Verify informed consent is on the chart
B. Ensure extended phenotype matching - CORRECT
C. Premedicate with acetaminophen only
D. Transfuse through a 22-gauge peripheral IV
(Correct Answer: B)
Q004: An alert 78-year-old client with diabetes and stage 4 chronic kidney disease has a
serum potassium of 6.3 mEq/L and ECG showing peaked T waves. Which prescribed
intervention should the nurse implement first?
Options:
A. Give 10 units regular insulin + 25 g dextrose IV - CORRECT
B. Administer oral sodium polystyrene sulfonate
C. Obtain a dialysis access chest X-ray
D. Restrict dietary potassium to 40 mEq/day
(Correct Answer: A)
Q005: A client with bipolar disorder on lithium and quetiapine reports severe nausea,
tremor, and diarrhea. Lithium level is 2.1 mEq/L (normal 0.6–1.2). Which immediate
nursing action is required?
Options:
A. Hold lithium and start IV hydration - CORRECT
B. Administer an antiemetic and continue lithium
C. Increase quetiapine for mood stabilization
D. Restrict sodium intake
(Correct Answer: A)
Q006: A 29-week-pregnant client in preterm labor is receiving betamethasone and
nifedipine. Fetal heart rate shows recurrent late decelerations. Which action should the
nurse take first?
Options:
A. Stop nifedipine immediately
B. Position client in left lateral tilt and give O₂ - CORRECT
C. Prepare for emergency cesarean delivery
D. Increase IV fluids to 125 mL/h
(Correct Answer: B)
,Q007: A client with a traumatic brain injury receiving mannitol has a serum osmolality of
320 mOsm/kg (upper limit 310). Urine output is 400 mL/h. Which prescribed
intervention is priority?
Options:
A. Stop mannitol and notify provider - CORRECT
B. Replace with 0.45% saline
C. Continue mannitol to reduce ICP
D. Begin desmopressin
(Correct Answer: A)
Q008: A 16-year-old with anorexia nervosa has a BMI of 14, heart rate 45 bpm, and BP
85/50 mmHg. The provider orders oral refeeding. Which nursing action is most
appropriate initially?
Options:
A. Start 3000 kcal/day oral diet immediately
B. Begin continuous cardiac monitoring - CORRECT
C. Allow unlimited exercise to stimulate appetite
D. Restrict fluids to prevent edema
(Correct Answer: B)
Q009: A client with leukemia develops rigors and a temperature of 38.9 °C during a
platelet transfusion. Blood pressure is stable at 110/70 mmHg. Which action should the
nurse take first?
Options:
A. Stop the transfusion immediately - CORRECT
B. Give acetaminophen and continue slowly
C. Obtain a fungal blood culture
D. Draw a type and screen for new units
(Correct Answer: A)
Q010: A client with a pulmonary artery catheter has a wedge pressure of 18 mmHg and
cardiac output 3.2 L/min (CI 1.9). Which intervention should the nurse anticipate?
Options:
A. Administer IV diuretic - CORRECT
B. Start dobutamine infusion
C. Increase afterload with vasopressin
D. Decrease FiO₂ to 0.21
(Correct Answer: A)
, Q011: A 2-day-old neonate has bilious vomiting, abdominal distention, and failure to
pass meconium. An abdominal X-ray shows dilated bowel loops and a "soap-bubble"
appearance. Which condition should the nurse suspect?
Options:
A. Hirschsprung disease
B. Meconium ileus - CORRECT
C. Intussusception
D. Pyloric stenosis
(Correct Answer: B)
Q012: A client with rheumatoid arthritis on methotrexate and prednisone develops a
cough, fever, and nodular chest infiltrates. LDH is elevated. Which opportunistic
infection is most likely?
Options:
A. Pneumocystis jirovecii pneumonia - CORRECT
B. Tuberculosis
C. Histoplasmosis
D. Aspergillosis
(Correct Answer: A)
Q013: A client with a spinal cord injury at T6 develops pounding headache, flushing, and
BP 210/110 mmHg during bladder catheterization. Which immediate nursing action is
priority?
Options:
A. Sit the client upright and loosen clothing - CORRECT
B. Administer sublingual nifedipine
C. Rapidly empty the bladder
D. Apply abdominal binder
(Correct Answer: A)
Q014: A client with acute pancreatitis has a nasogastric tube to suction, severe
epigastric pain, and a serum calcium of 7.2 mg/dL. Which nursing intervention is most
appropriate?
Options:
A. Administer IV calcium gluconate as ordered - CORRECT
B. Discontinue the NG suction
C. Increase suction to continuous
D. Provide oral calcium supplements
