,Galen NSG 3250 Exam 4 | Adult Health I
Nursing Practice (2026) Actual Q&A PDF
1. A client with left‑sided heart failure is admitted with dyspnea and orthopnea.
The nurse expects to auscultate which lung sound?
A) Bilateral crackles at the lung bases
B) Expiratory wheezing
C) Pleural friction rub
D) Rhonchi that clear with cough
Correct Answer: Bilateral crackles at the lung bases
Rationale: Left‑sided failure causes blood to back up into the pulmonary
circulation, leading to fluid in the alveoli and crackles. Wheezes suggest airway
narrowing, and a friction rub indicates pleural inflammation.
2. The nurse is monitoring a patient after a myocardial infarction. Which cardiac
biomarker is most specific for myocardial injury?
A) CK‑MB
B) Troponin I
C) Myoglobin
D) BNP
Correct Answer: Troponin I
,Rationale: Cardiac troponins are the most specific and sensitive markers for
myocardial necrosis. CK‑MB is less specific, myoglobin rises early but is not
cardiac‑specific, and BNP indicates heart failure stretch.
3. A patient with hypertension asks why smoking cessation is important. The
nurse’s response is based on the fact that nicotine:
A) Increases HDL cholesterol
B) Decreases heart rate and blood pressure
C) Causes vasoconstriction and increases cardiac workload
D) Reduces the risk of atherosclerosis
Correct Answer: Causes vasoconstriction and increases cardiac workload
Rationale: Nicotine stimulates the sympathetic nervous system, causing
vasoconstriction, elevated blood pressure, and increased myocardial oxygen
demand. It does not lower risk or increase protective HDL.
4. The nurse is teaching a patient with chronic stable angina about sublingual
nitroglycerin. Which statement by the patient indicates understanding?
A) “I will swallow the tablet with a full glass of water.”
B) “I can take up to five doses 5 minutes apart.”
C) “I should call 911 if the pain is not relieved after three doses 5 minutes
apart.”
D) “I will take nitroglycerin only once a week.”
Correct Answer: “I should call 911 if the pain is not relieved after three doses 5
minutes apart.”
, Rationale: The standard regimen is one tablet sublingually every 5 minutes, up
to 3 doses. If pain persists, emergency medical services must be activated
because the patient may be having an MI.
5. A patient with COPD is receiving oxygen via nasal cannula. The nurse should
maintain the oxygen flow rate at:
A) 1–2 L/min and monitor for signs of carbon dioxide retention
B) 4–6 L/min to keep saturation above 95%
C) 10–15 L/min via non‑rebreather mask
D) 2–4 L/min and titrate to keep SpO₂ at 98%
Correct Answer: 1–2 L/min and monitor for signs of carbon dioxide retention
Rationale: COPD patients may rely on hypoxic drive; excessive oxygen can
suppress respiratory effort and cause hypercapnia. The target SpO₂ is often 88–
92%. Higher flow rates are avoided unless hypoxemia is severe.
6. The nurse is assessing a patient in status asthmaticus. Which finding is most
alarming?
A) Loud expiratory wheezing
B) Absence of wheezing (silent chest)
C) Cough with thick sputum
D) Respiratory rate of 28 breaths/min
Correct Answer: Absence of wheezing (silent chest)
Nursing Practice (2026) Actual Q&A PDF
1. A client with left‑sided heart failure is admitted with dyspnea and orthopnea.
The nurse expects to auscultate which lung sound?
A) Bilateral crackles at the lung bases
B) Expiratory wheezing
C) Pleural friction rub
D) Rhonchi that clear with cough
Correct Answer: Bilateral crackles at the lung bases
Rationale: Left‑sided failure causes blood to back up into the pulmonary
circulation, leading to fluid in the alveoli and crackles. Wheezes suggest airway
narrowing, and a friction rub indicates pleural inflammation.
2. The nurse is monitoring a patient after a myocardial infarction. Which cardiac
biomarker is most specific for myocardial injury?
A) CK‑MB
B) Troponin I
C) Myoglobin
D) BNP
Correct Answer: Troponin I
,Rationale: Cardiac troponins are the most specific and sensitive markers for
myocardial necrosis. CK‑MB is less specific, myoglobin rises early but is not
cardiac‑specific, and BNP indicates heart failure stretch.
3. A patient with hypertension asks why smoking cessation is important. The
nurse’s response is based on the fact that nicotine:
A) Increases HDL cholesterol
B) Decreases heart rate and blood pressure
C) Causes vasoconstriction and increases cardiac workload
D) Reduces the risk of atherosclerosis
Correct Answer: Causes vasoconstriction and increases cardiac workload
Rationale: Nicotine stimulates the sympathetic nervous system, causing
vasoconstriction, elevated blood pressure, and increased myocardial oxygen
demand. It does not lower risk or increase protective HDL.
4. The nurse is teaching a patient with chronic stable angina about sublingual
nitroglycerin. Which statement by the patient indicates understanding?
A) “I will swallow the tablet with a full glass of water.”
B) “I can take up to five doses 5 minutes apart.”
C) “I should call 911 if the pain is not relieved after three doses 5 minutes
apart.”
D) “I will take nitroglycerin only once a week.”
Correct Answer: “I should call 911 if the pain is not relieved after three doses 5
minutes apart.”
, Rationale: The standard regimen is one tablet sublingually every 5 minutes, up
to 3 doses. If pain persists, emergency medical services must be activated
because the patient may be having an MI.
5. A patient with COPD is receiving oxygen via nasal cannula. The nurse should
maintain the oxygen flow rate at:
A) 1–2 L/min and monitor for signs of carbon dioxide retention
B) 4–6 L/min to keep saturation above 95%
C) 10–15 L/min via non‑rebreather mask
D) 2–4 L/min and titrate to keep SpO₂ at 98%
Correct Answer: 1–2 L/min and monitor for signs of carbon dioxide retention
Rationale: COPD patients may rely on hypoxic drive; excessive oxygen can
suppress respiratory effort and cause hypercapnia. The target SpO₂ is often 88–
92%. Higher flow rates are avoided unless hypoxemia is severe.
6. The nurse is assessing a patient in status asthmaticus. Which finding is most
alarming?
A) Loud expiratory wheezing
B) Absence of wheezing (silent chest)
C) Cough with thick sputum
D) Respiratory rate of 28 breaths/min
Correct Answer: Absence of wheezing (silent chest)
