1
NSG 4100 EXAM 3 REAL TEST WITH QUESTIONS
AND ANSWERS
2026-27 LATEST VERSION
Practice Examination (RN / BSN Level)
Format: Multiple Choice
Total Questions: 100
Focus: Advanced Adult Health Nursing, Clinical Judgment,
Application & Analysis
Question 1
A nurse is caring for a patient with chronic obstructive
pulmonary disease (COPD). Which finding indicates chronic CO₂
retention?
A. Respiratory alkalosis
B. Elevated PaCO₂ with normal pH
C. Decreased bicarbonate level
D. Metabolic acidosis
Correct Answer: B
Rationale:
• B is correct: Patients with chronic COPD retain CO₂ and
develop renal compensation, resulting in near-normal pH
despite elevated PaCO₂.
,2
• A: Acute hyperventilation causes respiratory alkalosis.
• C: Bicarbonate is usually increased, not decreased.
• D: COPD causes respiratory, not metabolic, acidosis.
Question 2
A patient with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Correct Answer: C
Rationale:
• C is correct: Loop diuretics cause potassium loss,
increasing the risk of dysrhythmias.
• A: Sodium may be affected but is less critical.
• B: Calcium is less affected by furosemide.
• D: Magnesium is important but secondary to potassium.
Question 3
,3
Which assessment finding is most concerning in a patient with
increased intracranial pressure (ICP)?
A. Headache
B. Nausea
C. Unequal pupils
D. Photophobia
Correct Answer: C
Rationale:
• C is correct: Unequal pupils suggest brain herniation and
are a medical emergency.
• A, B, D: Common early signs but not immediately life-
threatening.
Question 4
A patient with diabetes reports shakiness and sweating. Which
action should the nurse take first?
A. Administer insulin
B. Check blood glucose
C. Call the provider
D. Give oral hypoglycemic medication
Correct Answer: B
Rationale:
, 4
• B is correct: Symptoms suggest hypoglycemia; blood
glucose must be verified immediately.
• A & D: Would worsen hypoglycemia.
• C: Assessment comes before notification.
Question 5
Which finding indicates effective treatment for pneumonia?
A. Increased white blood cell count
B. Decreased oxygen saturation
C. Clear lung sounds
D. Productive cough with green sputum
Correct Answer: C
Rationale:
• C is correct: Clear lung sounds indicate resolution of
infection.
• A: Elevated WBC suggests infection.
• B: Low SpO₂ indicates worsening.
• D: Purulent sputum suggests active infection.
Question 6
NSG 4100 EXAM 3 REAL TEST WITH QUESTIONS
AND ANSWERS
2026-27 LATEST VERSION
Practice Examination (RN / BSN Level)
Format: Multiple Choice
Total Questions: 100
Focus: Advanced Adult Health Nursing, Clinical Judgment,
Application & Analysis
Question 1
A nurse is caring for a patient with chronic obstructive
pulmonary disease (COPD). Which finding indicates chronic CO₂
retention?
A. Respiratory alkalosis
B. Elevated PaCO₂ with normal pH
C. Decreased bicarbonate level
D. Metabolic acidosis
Correct Answer: B
Rationale:
• B is correct: Patients with chronic COPD retain CO₂ and
develop renal compensation, resulting in near-normal pH
despite elevated PaCO₂.
,2
• A: Acute hyperventilation causes respiratory alkalosis.
• C: Bicarbonate is usually increased, not decreased.
• D: COPD causes respiratory, not metabolic, acidosis.
Question 2
A patient with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Correct Answer: C
Rationale:
• C is correct: Loop diuretics cause potassium loss,
increasing the risk of dysrhythmias.
• A: Sodium may be affected but is less critical.
• B: Calcium is less affected by furosemide.
• D: Magnesium is important but secondary to potassium.
Question 3
,3
Which assessment finding is most concerning in a patient with
increased intracranial pressure (ICP)?
A. Headache
B. Nausea
C. Unequal pupils
D. Photophobia
Correct Answer: C
Rationale:
• C is correct: Unequal pupils suggest brain herniation and
are a medical emergency.
• A, B, D: Common early signs but not immediately life-
threatening.
Question 4
A patient with diabetes reports shakiness and sweating. Which
action should the nurse take first?
A. Administer insulin
B. Check blood glucose
C. Call the provider
D. Give oral hypoglycemic medication
Correct Answer: B
Rationale:
, 4
• B is correct: Symptoms suggest hypoglycemia; blood
glucose must be verified immediately.
• A & D: Would worsen hypoglycemia.
• C: Assessment comes before notification.
Question 5
Which finding indicates effective treatment for pneumonia?
A. Increased white blood cell count
B. Decreased oxygen saturation
C. Clear lung sounds
D. Productive cough with green sputum
Correct Answer: C
Rationale:
• C is correct: Clear lung sounds indicate resolution of
infection.
• A: Elevated WBC suggests infection.
• B: Low SpO₂ indicates worsening.
• D: Purulent sputum suggests active infection.
Question 6
