NSG 4800 MIDTERM EXAM | ACTUAL EXAM QUESTIONS
AND ACCURATE ANSWERS PLUS RATIONALES (100%
VERIFIED ANSWERS) | 2026 NEWEST VERSION
|ALREADY GRADED A+
The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign,
if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute - ANSWER ✔✔- B, During the
fourth stage of labor, the maternal blood pressure, pulse, and respiration should be checked every
15 minutes during the first hour. An increasing pulse is an early sign of excessive blood loss because
the heart pumps faster to compensate for reduced blood volume. A slight increase in temperature is
normal. The blood pressure decreases as the blood volume diminishes, but a decreased blood
pressure would not be the earliest sign of hemorrhage. The respiratory rate is slightly increased
from normal.
The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for
the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to
include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1 week." - ANSWER ✔✔-
3, Cryotherapy involves the local application of liquid nitrogen to the lesion; this causes cell death
and tissue destruction. Tissue freezing is followed in 1 to 2 days by hemorrhagic blister formation;
therefore, ice is not applied to the site. The application of a warm, damp washcloth intermittently to
the site will provide relief of any discomfort. The nurse instructs the client to clean the site with the
1|Page
,prescribed solution to prevent secondary infection. A topical antibiotic also may be prescribed.
Alcohol would cause irritation to the skin. There is no reason for the client to avoid showering or
bathing.
The registered nurse is caring for the following clients. It would be a priority for the nurse to initiate a
multidisciplinary conference for the client who is
A.12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and is employed
as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non threatening voices. -
ANSWER ✔✔- B
A client with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which
test(s) before administering the first dose of this medication to the client?
a. Liver function tests
b. Renal function tests
c. Pancreatic enzyme studies
d. Complete blood cell count - ANSWER ✔✔- D. Carbamazepine may be used to treat a
seizure disorder. It can cause leukopenia, anemia, thrombocytopenia, and, very rarely, fatal
aplastic anemia. To reduce the risk of serious hematological effects, a complete blood cell
count should be done before treatment and periodically thereafter. This medication should
be avoided in clients with preexisting hematological abnormalities. The client also is told to
report the occurrence of fever, sore throat, pallor, weakness, infection, easy bruising, and
2|Page
, petechiae. The results of the remaining tests listed in the options are not associated with the
use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood
glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin
is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to
240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures - ANSWER ✔✔- C. Emergency management of DKA
focuses on correcting fluid and electrolyte imbalances and normalizing the serum glucose level. If
the corrections occur too quickly, serious consequences, including hypoglycemia and cerebral
edema, can occur. During management of DKA, when the blood glucose level falls to 250 to 300
mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is reduced and a dextrose solution is added to
maintain a blood glucose level of about 250 mg/dL (14.2 mmol/L), or until the client recovers from
ketosis. Fifty percent dextrose is used to treat hypoglycemia. NPH insulin is not used to treat DKA.
Phenytoin is not a usual treatment measure for DKA.
A client is being discharged from the emergency department after an evaluation for a concussion. The
nurse reinforces teaching regarding follow-up should the client develop complications. Which of the
following complications, if listed by the client, would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening - ANSWER ✔✔- 2; all others responses would indicate IICP and needs to
go to the ER
3|Page
AND ACCURATE ANSWERS PLUS RATIONALES (100%
VERIFIED ANSWERS) | 2026 NEWEST VERSION
|ALREADY GRADED A+
The nurse is monitoring a client in the immediate postpartum period for signs of hemorrhage. Which sign,
if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute - ANSWER ✔✔- B, During the
fourth stage of labor, the maternal blood pressure, pulse, and respiration should be checked every
15 minutes during the first hour. An increasing pulse is an early sign of excessive blood loss because
the heart pumps faster to compensate for reduced blood volume. A slight increase in temperature is
normal. The blood pressure decreases as the blood volume diminishes, but a decreased blood
pressure would not be the earliest sign of hemorrhage. The respiratory rate is slightly increased
from normal.
The nurse in the ambulatory care unit is providing home care instructions to a client after cryotherapy for
the treatment of malignant skin lesions. Which statement would be most appropriate for the nurse to
include in the home care instructions for this client?
"Apply ice to the site to prevent swelling."
"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1 week." - ANSWER ✔✔-
3, Cryotherapy involves the local application of liquid nitrogen to the lesion; this causes cell death
and tissue destruction. Tissue freezing is followed in 1 to 2 days by hemorrhagic blister formation;
therefore, ice is not applied to the site. The application of a warm, damp washcloth intermittently to
the site will provide relief of any discomfort. The nurse instructs the client to clean the site with the
1|Page
,prescribed solution to prevent secondary infection. A topical antibiotic also may be prescribed.
Alcohol would cause irritation to the skin. There is no reason for the client to avoid showering or
bathing.
The registered nurse is caring for the following clients. It would be a priority for the nurse to initiate a
multidisciplinary conference for the client who is
A.12 years old with Autism who is starting a new school and recently had a URI (upper respiratory tract
infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon (pyridostigmine) and is employed
as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non threatening voices. -
ANSWER ✔✔- B
A client with uncontrolled Diabetes Mellitus would require the greatest number of disciplines
(multidisciplinary) to manage their care i.e. Medicine, Nursing, Social Work, Nutritionist; the other
choices do not require as many providers of care to meet their needs.
A client is scheduled to begin therapy with carbamazepine. The nurse should assess the results of which
test(s) before administering the first dose of this medication to the client?
a. Liver function tests
b. Renal function tests
c. Pancreatic enzyme studies
d. Complete blood cell count - ANSWER ✔✔- D. Carbamazepine may be used to treat a
seizure disorder. It can cause leukopenia, anemia, thrombocytopenia, and, very rarely, fatal
aplastic anemia. To reduce the risk of serious hematological effects, a complete blood cell
count should be done before treatment and periodically thereafter. This medication should
be avoided in clients with preexisting hematological abnormalities. The client also is told to
report the occurrence of fever, sore throat, pallor, weakness, infection, easy bruising, and
2|Page
, petechiae. The results of the remaining tests listed in the options are not associated with the
use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood
glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin
is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to
240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures - ANSWER ✔✔- C. Emergency management of DKA
focuses on correcting fluid and electrolyte imbalances and normalizing the serum glucose level. If
the corrections occur too quickly, serious consequences, including hypoglycemia and cerebral
edema, can occur. During management of DKA, when the blood glucose level falls to 250 to 300
mg/dL (14.2 to 17.1 mmol/L), the IV infusion rate is reduced and a dextrose solution is added to
maintain a blood glucose level of about 250 mg/dL (14.2 mmol/L), or until the client recovers from
ketosis. Fifty percent dextrose is used to treat hypoglycemia. NPH insulin is not used to treat DKA.
Phenytoin is not a usual treatment measure for DKA.
A client is being discharged from the emergency department after an evaluation for a concussion. The
nurse reinforces teaching regarding follow-up should the client develop complications. Which of the
following complications, if listed by the client, would require further instruction?
1.Vomiting
2.Minor headache
3.Difficulty speaking
4.Difficulty awakening - ANSWER ✔✔- 2; all others responses would indicate IICP and needs to
go to the ER
3|Page
