NSG 3250 Final Exam V1 | NSG 3250 Adult
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Final
Exam)
1. A nurse is caring for a patient who is 4 hours postoperative following abdominal surgery.
The patient’s blood pressure is 90/50 mmHg and heart rate is 115 bpm. What is the priority
nursing action?
A. Administer pain medication as prescribed
B. Increase the intravenous fluid infusion rate per protocol
C. Encourage the patient to use the incentive spirometer
D. Document the findings in the medical record
Answer: B
Rationale: The patient’s vital signs indicate potential hypovolemic shock, which is a critical
postoperative complication. Tachycardia and hypotension suggest a significant loss of fluid
or blood volume that requires immediate intervention. Increasing the IV infusion rate helps
to restore circulating volume and stabilize the patient’s hemodynamic status.
2. A client with a history of COPD presents with increased dyspnea and a pH of 7.30, PaCO2 of
52 mmHg, and HCO3 of 26 mEq/L. How should the nurse interpret these ABG results?
A. Metabolic Acidosis
,B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 indicates a
respiratory cause. Since the bicarbonate level is within or near the normal range, the
primary problem is the retention of carbon dioxide. This condition is common in patients
with obstructive lung diseases like COPD who cannot effectively exhale CO2.
3. The nurse is preparing to administer Lispro insulin to a client with Type 1 Diabetes. When
should the nurse instruct the client to begin eating?
A. Within 15 minutes of receiving the injection
B. Exactly 2 hours after the injection
C. 30 to 60 minutes after the injection
D. Immediately before the injection is given
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes.
Administering it too far in advance of a meal can lead to severe hypoglycemia. It is essential
for the nurse to ensure the food is available and the patient is ready to eat before the dose
is administered.
, 4. A nurse is providing discharge instructions to a client who had a thyroidectomy. Which
symptom should the nurse instruct the client to report immediately?
A. Mild soreness at the incision site
B. A slight decrease in appetite
C. Feeling tired and requiring frequent naps
D. Tingling in the fingers or around the mouth
Answer: D
Rationale: Tingling in the extremities or circumoral area is a sign of hypocalcemia, which
can occur if the parathyroid glands are accidentally damaged during a thyroidectomy. This
condition can lead to tetany and life-threatening respiratory distress if not treated. The
nurse must emphasize that this is a medical emergency requiring prompt intervention.
5. Which assessment finding in a client with an electrolyte imbalance is most indicative of
hypokalemia?
A. Muscle weakness and leg cramps
B. Positive Chvostek’s sign
C. Tall, peaked T-waves on an ECG
D. Hyperactive bowel sounds
Answer: A
Health I | Galen College of Nursing | Q&A
with Rationale (Galen NSG3250 Final
Exam)
1. A nurse is caring for a patient who is 4 hours postoperative following abdominal surgery.
The patient’s blood pressure is 90/50 mmHg and heart rate is 115 bpm. What is the priority
nursing action?
A. Administer pain medication as prescribed
B. Increase the intravenous fluid infusion rate per protocol
C. Encourage the patient to use the incentive spirometer
D. Document the findings in the medical record
Answer: B
Rationale: The patient’s vital signs indicate potential hypovolemic shock, which is a critical
postoperative complication. Tachycardia and hypotension suggest a significant loss of fluid
or blood volume that requires immediate intervention. Increasing the IV infusion rate helps
to restore circulating volume and stabilize the patient’s hemodynamic status.
2. A client with a history of COPD presents with increased dyspnea and a pH of 7.30, PaCO2 of
52 mmHg, and HCO3 of 26 mEq/L. How should the nurse interpret these ABG results?
A. Metabolic Acidosis
,B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 indicates a
respiratory cause. Since the bicarbonate level is within or near the normal range, the
primary problem is the retention of carbon dioxide. This condition is common in patients
with obstructive lung diseases like COPD who cannot effectively exhale CO2.
3. The nurse is preparing to administer Lispro insulin to a client with Type 1 Diabetes. When
should the nurse instruct the client to begin eating?
A. Within 15 minutes of receiving the injection
B. Exactly 2 hours after the injection
C. 30 to 60 minutes after the injection
D. Immediately before the injection is given
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes.
Administering it too far in advance of a meal can lead to severe hypoglycemia. It is essential
for the nurse to ensure the food is available and the patient is ready to eat before the dose
is administered.
, 4. A nurse is providing discharge instructions to a client who had a thyroidectomy. Which
symptom should the nurse instruct the client to report immediately?
A. Mild soreness at the incision site
B. A slight decrease in appetite
C. Feeling tired and requiring frequent naps
D. Tingling in the fingers or around the mouth
Answer: D
Rationale: Tingling in the extremities or circumoral area is a sign of hypocalcemia, which
can occur if the parathyroid glands are accidentally damaged during a thyroidectomy. This
condition can lead to tetany and life-threatening respiratory distress if not treated. The
nurse must emphasize that this is a medical emergency requiring prompt intervention.
5. Which assessment finding in a client with an electrolyte imbalance is most indicative of
hypokalemia?
A. Muscle weakness and leg cramps
B. Positive Chvostek’s sign
C. Tall, peaked T-waves on an ECG
D. Hyperactive bowel sounds
Answer: A
