NSG 3280 Exam 4 Mixed Comprehensive Practice Exam (100 Questions
and Answers with Detailed Rationales) | Complete NCLEX-Style Med-Surg
Nursing Review, Adult Health, Pharmacology, Emergency Care,
Cardiovascular, Respiratory, Neurological, and Critical Thinking Exam
Prep Guide |PDF
1. A nurse is assessing a client who reports sudden onset of crushing chest
discomfort radiating to the left arm and jaw area.
A. Musculoskeletal strain
B. Gastroesophageal reflux
C. Acute myocardial infarction
D. Anxiety attack
Rationale: Crushing chest pain radiating to the arm and jaw is highly suggestive of
myocardial infarction and requires immediate emergency intervention.
2. A nurse is caring for a client who suddenly develops severe shortness of breath,
cyanosis, and difficulty speaking in full sentences.
A. Asthma remission
B. Mild anxiety episode
C. Acute respiratory distress
D. Normal post-exercise response
Rationale: Severe dyspnea with cyanosis indicates impaired oxygenation and is a medical
emergency requiring immediate airway and oxygen support.
3. A diabetic client presents with confusion, diaphoresis, and a blood glucose level of
48 mg/dL during routine assessment.
A. Hyperglycemia crisis
B. Diabetic ketoacidosis
C. Hypoglycemic emergency
D. Hyperosmolar state
,Rationale: Blood glucose below 70 with neurological symptoms indicates hypoglycemia
requiring rapid glucose replacement.
4. A postoperative client suddenly reports sharp chest pain and difficulty breathing
while lying in bed.
A. Incisional discomfort
B. Anxiety-related symptoms
C. Pulmonary embolism
D. Acid reflux episode
Rationale: Sudden chest pain and dyspnea after surgery strongly suggest pulmonary
embolism, a life-threatening complication.
5. A nurse is monitoring a client with elevated temperature, stiff neck, and sensitivity
to light in a hospital unit.
A. Migraine headache
B. Sinus infection
C. Bacterial meningitis
D. Tension headache
Rationale: Fever, neck stiffness, and photophobia are classic signs of meningitis requiring
urgent evaluation.
6. A nurse is caring for a client who is receiving warfarin therapy for atrial fibrillation
management.
A. Platelet count
B. Blood glucose
C. International normalized ratio (INR)
D. Serum sodium
Rationale: INR is the primary lab used to monitor warfarin effectiveness and bleeding risk.
, 7. A nurse observes a client with chronic heart failure exhibiting bilateral lower
extremity swelling and crackles in lung bases.
A. Dehydration
B. Hypovolemia
C. Fluid volume overload
D. Acute anemia
Rationale: Edema and crackles indicate fluid retention and pulmonary congestion in heart
failure.
8. A nurse is prioritizing care for multiple clients in the emergency department during
a busy shift.
A. Stable diabetic client requesting education
B. Post-op client requesting pain medication
C. Client with airway obstruction and stridor
D. Client awaiting discharge paperwork
Rationale: Airway obstruction is life-threatening and always takes highest priority in nursing
care.
9. A nurse is teaching a client with chronic obstructive pulmonary disease about
breathing techniques to improve oxygenation.
A. Rapid shallow breathing
B. Breath holding techniques
C. Pursed-lip breathing strategy
D. Hyperventilation exercises
Rationale: Pursed-lip breathing helps maintain airway pressure and improves oxygen
exchange in COPD.
10. A nurse is assessing a client who presents with excessive thirst, frequent
urination, and fruity-smelling breath.
A. Hypoglycemia
B. Diabetes insipidus
and Answers with Detailed Rationales) | Complete NCLEX-Style Med-Surg
Nursing Review, Adult Health, Pharmacology, Emergency Care,
Cardiovascular, Respiratory, Neurological, and Critical Thinking Exam
Prep Guide |PDF
1. A nurse is assessing a client who reports sudden onset of crushing chest
discomfort radiating to the left arm and jaw area.
A. Musculoskeletal strain
B. Gastroesophageal reflux
C. Acute myocardial infarction
D. Anxiety attack
Rationale: Crushing chest pain radiating to the arm and jaw is highly suggestive of
myocardial infarction and requires immediate emergency intervention.
2. A nurse is caring for a client who suddenly develops severe shortness of breath,
cyanosis, and difficulty speaking in full sentences.
A. Asthma remission
B. Mild anxiety episode
C. Acute respiratory distress
D. Normal post-exercise response
Rationale: Severe dyspnea with cyanosis indicates impaired oxygenation and is a medical
emergency requiring immediate airway and oxygen support.
3. A diabetic client presents with confusion, diaphoresis, and a blood glucose level of
48 mg/dL during routine assessment.
A. Hyperglycemia crisis
B. Diabetic ketoacidosis
C. Hypoglycemic emergency
D. Hyperosmolar state
,Rationale: Blood glucose below 70 with neurological symptoms indicates hypoglycemia
requiring rapid glucose replacement.
4. A postoperative client suddenly reports sharp chest pain and difficulty breathing
while lying in bed.
A. Incisional discomfort
B. Anxiety-related symptoms
C. Pulmonary embolism
D. Acid reflux episode
Rationale: Sudden chest pain and dyspnea after surgery strongly suggest pulmonary
embolism, a life-threatening complication.
5. A nurse is monitoring a client with elevated temperature, stiff neck, and sensitivity
to light in a hospital unit.
A. Migraine headache
B. Sinus infection
C. Bacterial meningitis
D. Tension headache
Rationale: Fever, neck stiffness, and photophobia are classic signs of meningitis requiring
urgent evaluation.
6. A nurse is caring for a client who is receiving warfarin therapy for atrial fibrillation
management.
A. Platelet count
B. Blood glucose
C. International normalized ratio (INR)
D. Serum sodium
Rationale: INR is the primary lab used to monitor warfarin effectiveness and bleeding risk.
, 7. A nurse observes a client with chronic heart failure exhibiting bilateral lower
extremity swelling and crackles in lung bases.
A. Dehydration
B. Hypovolemia
C. Fluid volume overload
D. Acute anemia
Rationale: Edema and crackles indicate fluid retention and pulmonary congestion in heart
failure.
8. A nurse is prioritizing care for multiple clients in the emergency department during
a busy shift.
A. Stable diabetic client requesting education
B. Post-op client requesting pain medication
C. Client with airway obstruction and stridor
D. Client awaiting discharge paperwork
Rationale: Airway obstruction is life-threatening and always takes highest priority in nursing
care.
9. A nurse is teaching a client with chronic obstructive pulmonary disease about
breathing techniques to improve oxygenation.
A. Rapid shallow breathing
B. Breath holding techniques
C. Pursed-lip breathing strategy
D. Hyperventilation exercises
Rationale: Pursed-lip breathing helps maintain airway pressure and improves oxygen
exchange in COPD.
10. A nurse is assessing a client who presents with excessive thirst, frequent
urination, and fruity-smelling breath.
A. Hypoglycemia
B. Diabetes insipidus
