NSG 430 Adult Health Nursing II Guide Final Exam Actual
Exam 2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
SECTION 1: BURN INJURY MANAGEMENT (10-12 Questions)
Q1: A patient with 40% total body surface area (TBSA) thermal burns weighs 70 kg.
Using the Parkland formula, how many milliliters of lactated Ringer's solution should be
administered in the first 24 hours?
A. 4,200 mL
B. 8,400 mL
C. 11,200 mL
D. 16,800 mL
Correct Answer: C
Rationale: Correct because the Parkland formula is 4 mL × kg × % TBSA (4 × 70 × 40 =
11,200 mL). This matches GCU NSG430 curriculum for fluid resuscitation in burn injury.
Q2: Using the Parkland formula for a 70 kg patient with 40% TBSA burns, how should
the fluid be administered over the first 24 hours?
A. 5,600 mL in first 8 hours; 5,600 mL in next 16 hours
B. 5,600 mL in first 8 hours; 2,800 mL in second 8 hours; 2,800 mL in third 8 hours
C. 2,800 mL in first 8 hours; 5,600 mL in next 8 hours; 2,800 mL in final 8 hours
D. 11,200 mL infused continuously at 467 mL/hour for 24 hours
Correct Answer: B
Rationale: Correct because half the total volume is given in the first 8 hours from the
time of injury, and the remaining half is split equally between the second and third
8-hour periods. Guidelines recommend this schedule to prevent hypovolemic shock.
Q3: During the emergent phase of burn injury, which assessment finding is the best
indicator of adequate fluid resuscitation?
A. Central venous pressure of 2 mmHg
B. Urine output of 30-50 mL/hour
C. Heart rate of 120 beats/minute
D. Blood pressure of 90/60 mmHg
Correct Answer: B
,Rationale: Correct because urine output is the best clinical indicator of adequate tissue
perfusion and renal perfusion during burn resuscitation. The priority action is
maintaining 30-50 mL/hour in adults.
Q4: A patient sustained a chemical burn 48 hours ago. The nurse recognizes that tissue
damage continues for how long after a chemical burn?
A. 6 hours
B. 12 hours
C. 24 hours
D. 72 hours
Correct Answer: D
Rationale: Correct because chemical burns cause tissue damage that continues up to
72 hours after exposure, unlike thermal burns where damage is generally complete
within 24 hours.
Q5: Which description best characterizes a partial-thickness burn wound?
A. Brown/black eschar with leathery appearance and no pain
B. Mottled red appearance with moist skin and blisters
C. Dry, white appearance with minimal edema
D. Charred tissue with visible thrombosed vessels
Correct Answer: B
Rationale: Correct because partial-thickness burns involve the epidermis and part of the
dermis, presenting as mottled red, moist, blistered skin with severe pain. This matches
GCU NSG430 curriculum on burn classification.
Q6: A patient presents with a full-thickness burn covering the right hand. Which
assessment finding does the nurse expect?
A. Severe pain and blister formation
B. Mottled red appearance with weeping
C. Brown/black eschar with leathery appearance and little to no pain
D. Blanching erythema with mild edema
Correct Answer: C
Rationale: Correct because full-thickness burns destroy all layers of skin and nerve
endings, resulting in a leathery, charred eschar and little to no pain due to destroyed
nerve endings.
,Q7: When should enteral feedings be initiated for a patient with major burns covering
50% TBSA?
A. Immediately upon admission to the emergency department
B. After the emergent/resuscitative phase
C. When the patient begins oral intake independently
D. 72 hours after wound grafting is complete
Correct Answer: B
Rationale: Correct because enteral feedings for major burns should begin after the
emergent phase to prevent ileus and ensure hemodynamic stability. Guidelines
recommend early enteral nutrition once resuscitation is adequate.
Q8: During the acute/wound healing phase of burn recovery, which nutritional
intervention is most appropriate?
A. Low protein, low carbohydrate diet
B. High protein, high carbohydrate diet
C. Fat-restricted diet with normal protein
D. Clear liquid diet until grafting is complete
Correct Answer: B
Rationale: Correct because the acute phase requires high protein and high carbohydrate
intake to support wound healing, graft take, and meet hypermetabolic demands. This
matches GCU NSG430 curriculum.
Q9: A burn patient in the rehabilitative phase asks about returning home. Which nursing
intervention is most appropriate?
A. Arrange for skilled nursing facility placement permanently
B. Teach wound dressing skills and coordinate PT/OT services
C. Restrict all activity until grafting is 100% healed
D. Recommend complete bed rest for 6 weeks
Correct Answer: B
Rationale: Correct because the rehabilitative phase focuses on restoring function,
teaching self-care including wound dressing, and coordinating physical and
occupational therapy.
Q10: A patient with 30% TBSA burns reports severe pain during dressing changes.
Which medication is most appropriate for procedural pain management?
A. Oral acetaminophen
, B. Intravenous hydromorphone
C. Topical lidocaine only
D. Oral ibuprofen
Correct Answer: B
Rationale: Correct because hydromorphone is the opioid of choice for severe burn pain
and procedural pain management due to its potency and effectiveness. The priority
action is adequate analgesia during wound care.
Q11: A patient with electrical burns is being assessed. The nurse recognizes that tissue
damage continues for how long after the injury?
A. 6-12 hours
B. 24 hours
C. 48 hours
D. 72 hours
Correct Answer: B
Rationale: Correct because electrical burns cause tissue damage that continues for up
to 24 hours after injury, requiring ongoing monitoring for compartment syndrome and
rhabdomyolysis.
Q12: Which action is the priority during the emergent phase of burn injury?
A. Apply topical antimicrobial ointment
B. Prevent hypovolemic shock and control edema
C. Begin aggressive physical therapy
D. Schedule excision and grafting
Correct Answer: B
Rationale: Correct because the emergent/resuscitative phase priority is preventing
hypovolemic shock and managing edema through aggressive fluid resuscitation and
hemodynamic monitoring.
SECTION 2: SHOCK SYNDROMES (12-15 Questions)
Q13: A patient with a T6 spinal cord injury presents with hypotension, bradycardia, and
warm, dry skin. Which type of shock is most likely?
A. Hypovolemic shock
B. Neurogenic shock
Exam 2026/2027 | Complete Exam-Style Questions with
Detailed Rationales | Pass Guaranteed – A+ Graded
SECTION 1: BURN INJURY MANAGEMENT (10-12 Questions)
Q1: A patient with 40% total body surface area (TBSA) thermal burns weighs 70 kg.
Using the Parkland formula, how many milliliters of lactated Ringer's solution should be
administered in the first 24 hours?
A. 4,200 mL
B. 8,400 mL
C. 11,200 mL
D. 16,800 mL
Correct Answer: C
Rationale: Correct because the Parkland formula is 4 mL × kg × % TBSA (4 × 70 × 40 =
11,200 mL). This matches GCU NSG430 curriculum for fluid resuscitation in burn injury.
Q2: Using the Parkland formula for a 70 kg patient with 40% TBSA burns, how should
the fluid be administered over the first 24 hours?
A. 5,600 mL in first 8 hours; 5,600 mL in next 16 hours
B. 5,600 mL in first 8 hours; 2,800 mL in second 8 hours; 2,800 mL in third 8 hours
C. 2,800 mL in first 8 hours; 5,600 mL in next 8 hours; 2,800 mL in final 8 hours
D. 11,200 mL infused continuously at 467 mL/hour for 24 hours
Correct Answer: B
Rationale: Correct because half the total volume is given in the first 8 hours from the
time of injury, and the remaining half is split equally between the second and third
8-hour periods. Guidelines recommend this schedule to prevent hypovolemic shock.
Q3: During the emergent phase of burn injury, which assessment finding is the best
indicator of adequate fluid resuscitation?
A. Central venous pressure of 2 mmHg
B. Urine output of 30-50 mL/hour
C. Heart rate of 120 beats/minute
D. Blood pressure of 90/60 mmHg
Correct Answer: B
,Rationale: Correct because urine output is the best clinical indicator of adequate tissue
perfusion and renal perfusion during burn resuscitation. The priority action is
maintaining 30-50 mL/hour in adults.
Q4: A patient sustained a chemical burn 48 hours ago. The nurse recognizes that tissue
damage continues for how long after a chemical burn?
A. 6 hours
B. 12 hours
C. 24 hours
D. 72 hours
Correct Answer: D
Rationale: Correct because chemical burns cause tissue damage that continues up to
72 hours after exposure, unlike thermal burns where damage is generally complete
within 24 hours.
Q5: Which description best characterizes a partial-thickness burn wound?
A. Brown/black eschar with leathery appearance and no pain
B. Mottled red appearance with moist skin and blisters
C. Dry, white appearance with minimal edema
D. Charred tissue with visible thrombosed vessels
Correct Answer: B
Rationale: Correct because partial-thickness burns involve the epidermis and part of the
dermis, presenting as mottled red, moist, blistered skin with severe pain. This matches
GCU NSG430 curriculum on burn classification.
Q6: A patient presents with a full-thickness burn covering the right hand. Which
assessment finding does the nurse expect?
A. Severe pain and blister formation
B. Mottled red appearance with weeping
C. Brown/black eschar with leathery appearance and little to no pain
D. Blanching erythema with mild edema
Correct Answer: C
Rationale: Correct because full-thickness burns destroy all layers of skin and nerve
endings, resulting in a leathery, charred eschar and little to no pain due to destroyed
nerve endings.
,Q7: When should enteral feedings be initiated for a patient with major burns covering
50% TBSA?
A. Immediately upon admission to the emergency department
B. After the emergent/resuscitative phase
C. When the patient begins oral intake independently
D. 72 hours after wound grafting is complete
Correct Answer: B
Rationale: Correct because enteral feedings for major burns should begin after the
emergent phase to prevent ileus and ensure hemodynamic stability. Guidelines
recommend early enteral nutrition once resuscitation is adequate.
Q8: During the acute/wound healing phase of burn recovery, which nutritional
intervention is most appropriate?
A. Low protein, low carbohydrate diet
B. High protein, high carbohydrate diet
C. Fat-restricted diet with normal protein
D. Clear liquid diet until grafting is complete
Correct Answer: B
Rationale: Correct because the acute phase requires high protein and high carbohydrate
intake to support wound healing, graft take, and meet hypermetabolic demands. This
matches GCU NSG430 curriculum.
Q9: A burn patient in the rehabilitative phase asks about returning home. Which nursing
intervention is most appropriate?
A. Arrange for skilled nursing facility placement permanently
B. Teach wound dressing skills and coordinate PT/OT services
C. Restrict all activity until grafting is 100% healed
D. Recommend complete bed rest for 6 weeks
Correct Answer: B
Rationale: Correct because the rehabilitative phase focuses on restoring function,
teaching self-care including wound dressing, and coordinating physical and
occupational therapy.
Q10: A patient with 30% TBSA burns reports severe pain during dressing changes.
Which medication is most appropriate for procedural pain management?
A. Oral acetaminophen
, B. Intravenous hydromorphone
C. Topical lidocaine only
D. Oral ibuprofen
Correct Answer: B
Rationale: Correct because hydromorphone is the opioid of choice for severe burn pain
and procedural pain management due to its potency and effectiveness. The priority
action is adequate analgesia during wound care.
Q11: A patient with electrical burns is being assessed. The nurse recognizes that tissue
damage continues for how long after the injury?
A. 6-12 hours
B. 24 hours
C. 48 hours
D. 72 hours
Correct Answer: B
Rationale: Correct because electrical burns cause tissue damage that continues for up
to 24 hours after injury, requiring ongoing monitoring for compartment syndrome and
rhabdomyolysis.
Q12: Which action is the priority during the emergent phase of burn injury?
A. Apply topical antimicrobial ointment
B. Prevent hypovolemic shock and control edema
C. Begin aggressive physical therapy
D. Schedule excision and grafting
Correct Answer: B
Rationale: Correct because the emergent/resuscitative phase priority is preventing
hypovolemic shock and managing edema through aggressive fluid resuscitation and
hemodynamic monitoring.
SECTION 2: SHOCK SYNDROMES (12-15 Questions)
Q13: A patient with a T6 spinal cord injury presents with hypotension, bradycardia, and
warm, dry skin. Which type of shock is most likely?
A. Hypovolemic shock
B. Neurogenic shock
