NSG 3130 Exam 4 V2 | NSG 3130
Fundamental Concepts & Skills for
Nursing Practice II | Actual Q&A with
Rationale (NSG3130 Exam 4) | Galen
College of Nursing
1. A nurse is preparing a patient for surgery. The patient states, ‘I signed the consent form,
but I don’t really understand what the surgeon is going to do.’ Which action should the nurse
take first?
A. Explain the risks and benefits of the procedure to the patient.
B. Document that the patient has signed the consent form.
C. Notify the surgeon that the patient needs further clarification.
D. Proceed with the preoperative checklist as planned.
Answer: C
Rationale: The nurse’s role in informed consent is to witness the signature and ensure the
patient is competent. If the patient expresses a lack of understanding, the nurse is
responsible for notifying the provider to explain the procedure further. It is outside the
nurse’s legal scope of practice to provide the primary explanation of surgical risks and
benefits.
2. Which electrolyte imbalance is most likely to cause a positive Chvostek’s sign?
A. Hyperkalemia
,B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Hypocalcemia increases neuromuscular irritability, leading to signs like
Chvostek’s (facial twitching) and Trousseau’s (carpal spasm). This condition requires
monitoring for tetany and potential respiratory distress. The nurse should assess the
patient’s ionized calcium levels and prepare for calcium replacement therapy.
3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mm Hg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 above 45 mm Hg
indicates a respiratory cause. Since the bicarbonate level is within the normal range, the
compensation has not yet occurred. This state is common in patients with hypoventilation
or chronic obstructive pulmonary disease (COPD).
, 4. Which oxygen delivery device provides the most precise concentration of oxygen?
A. Nasal Cannula
B. Simple Face Mask
C. Venturi Mask
D. Non-rebreather Mask
Answer: C
Rationale: The Venturi mask is specifically designed to deliver a precise FiO2 by using
different sized adapters. It is the preferred method for patients with COPD who require
specific, low-level oxygen concentrations. Other masks like the nasal cannula provide
variable concentrations based on the patient’s breathing pattern.
5. When assessing a surgical wound, the nurse notes the protrusion of internal organs
through the incision. Which term should the nurse use to document this finding?
A. Dehiscence
B. Fistula
C. Evisceration
D. Exudate
Answer: C
Rationale: Evisceration is a medical emergency where the wound layers separate and
abdominal organs protrude. Dehiscence is the separation of wound edges without organ
Fundamental Concepts & Skills for
Nursing Practice II | Actual Q&A with
Rationale (NSG3130 Exam 4) | Galen
College of Nursing
1. A nurse is preparing a patient for surgery. The patient states, ‘I signed the consent form,
but I don’t really understand what the surgeon is going to do.’ Which action should the nurse
take first?
A. Explain the risks and benefits of the procedure to the patient.
B. Document that the patient has signed the consent form.
C. Notify the surgeon that the patient needs further clarification.
D. Proceed with the preoperative checklist as planned.
Answer: C
Rationale: The nurse’s role in informed consent is to witness the signature and ensure the
patient is competent. If the patient expresses a lack of understanding, the nurse is
responsible for notifying the provider to explain the procedure further. It is outside the
nurse’s legal scope of practice to provide the primary explanation of surgical risks and
benefits.
2. Which electrolyte imbalance is most likely to cause a positive Chvostek’s sign?
A. Hyperkalemia
,B. Hyponatremia
C. Hypocalcemia
D. Hypermagnesemia
Answer: C
Rationale: Hypocalcemia increases neuromuscular irritability, leading to signs like
Chvostek’s (facial twitching) and Trousseau’s (carpal spasm). This condition requires
monitoring for tetany and potential respiratory distress. The nurse should assess the
patient’s ionized calcium levels and prepare for calcium replacement therapy.
3. A patient’s arterial blood gas (ABG) results are: pH 7.30, PaCO2 55 mm Hg, and HCO3 24
mEq/L. How should the nurse interpret these findings?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis, and an elevated PaCO2 above 45 mm Hg
indicates a respiratory cause. Since the bicarbonate level is within the normal range, the
compensation has not yet occurred. This state is common in patients with hypoventilation
or chronic obstructive pulmonary disease (COPD).
, 4. Which oxygen delivery device provides the most precise concentration of oxygen?
A. Nasal Cannula
B. Simple Face Mask
C. Venturi Mask
D. Non-rebreather Mask
Answer: C
Rationale: The Venturi mask is specifically designed to deliver a precise FiO2 by using
different sized adapters. It is the preferred method for patients with COPD who require
specific, low-level oxygen concentrations. Other masks like the nasal cannula provide
variable concentrations based on the patient’s breathing pattern.
5. When assessing a surgical wound, the nurse notes the protrusion of internal organs
through the incision. Which term should the nurse use to document this finding?
A. Dehiscence
B. Fistula
C. Evisceration
D. Exudate
Answer: C
Rationale: Evisceration is a medical emergency where the wound layers separate and
abdominal organs protrude. Dehiscence is the separation of wound edges without organ
