NSG 300 NURSING FUNDAMENTALS
AND PROFESSIONAL PRACTICE FINAL
EXAM 2026/2027
1. A patient with a spinal cord injury at the T6 level reports a sudden, severe headache and
nasal congestion. The nurse notes the patient is diaphoretic above the level of injury and has
a blood pressure of 190/110 mmHg. What is the priority nursing action?
A. Administer the prescribed PRN antihypertensive medication.
B. Elevate the head of the bed to 90 degrees and check for bladder distension.
C. Perform a neurological assessment to check for signs of stroke.
D. Lower the head of the bed to a flat position to increase cerebral perfusion.
Answer: B
Conceptual Explanation: These are signs of autonomic dysreflexia. The priority is to sit
the patient upright to lower BP and identify/remove the stimulus, which is most commonly
a distended bladder.
,2. When utilizing the SBAR (Situation, Background, Assessment, Recommendation) tool for
communication, which statement represents the ‘Assessment’ phase?
A. The patient was admitted two days ago with a diagnosis of heart failure.
B. I am calling about Mrs. Jones in Room 402 who is experiencing new onset shortness of
breath.
C. The patient has bilateral crackles in the lung bases and an oxygen saturation of 88% on
room air.
D. I suggest that we obtain a chest X-ray and increase the patient’s diuretic dose.
Answer: C
Conceptual Explanation: Assessment in SBAR involves providing clinical findings and
data collected during the physical exam or vital signs check.
3. Which process describes the ‘first-pass effect’ in pharmacology?
A. The excretion of a drug through the kidneys in its unchanged form.
B. The initial rapid distribution of a drug to highly vascular organs like the brain.
C. The metabolism of a drug by the liver before it reaches the systemic circulation.
D. The binding of a drug to albumin, preventing its therapeutic action.
Answer: C
, Conceptual Explanation: The first-pass effect occurs when drugs taken orally are
absorbed from the GI tract and transported to the liver, where a significant portion may be
metabolized before reaching the heart and general circulation.
4. A nurse is caring for a patient who has been diagnosed with a terminal illness. The patient’s
family asks the nurse not to tell the patient the diagnosis. According to the principle of
autonomy, what should the nurse do?
A. Follow the family’s wishes to avoid causing the patient unnecessary distress.
B. Refer the family to the ethics committee for a final decision.
C. Support the patient’s right to know their diagnosis if they ask for information.
D. Ask the provider to explain the diagnosis to the family again.
Answer: C
Conceptual Explanation: Autonomy refers to the patient’s right to self-determination and
to make informed decisions about their own healthcare, including knowing their diagnosis.
5. Which arterial blood gas (ABG) result indicates partially compensated metabolic acidosis?
A. pH 7.48, PaCO2 48 mmHg, HCO3 30 mEq/L
B. pH 7.32, PaCO2 30 mmHg, HCO3 18 mEq/L
C. pH 7.35, PaCO2 35 mmHg, HCO3 24 mEq/L
D. pH 7.25, PaCO2 40 mmHg, HCO3 19 mEq/L
Answer: B
AND PROFESSIONAL PRACTICE FINAL
EXAM 2026/2027
1. A patient with a spinal cord injury at the T6 level reports a sudden, severe headache and
nasal congestion. The nurse notes the patient is diaphoretic above the level of injury and has
a blood pressure of 190/110 mmHg. What is the priority nursing action?
A. Administer the prescribed PRN antihypertensive medication.
B. Elevate the head of the bed to 90 degrees and check for bladder distension.
C. Perform a neurological assessment to check for signs of stroke.
D. Lower the head of the bed to a flat position to increase cerebral perfusion.
Answer: B
Conceptual Explanation: These are signs of autonomic dysreflexia. The priority is to sit
the patient upright to lower BP and identify/remove the stimulus, which is most commonly
a distended bladder.
,2. When utilizing the SBAR (Situation, Background, Assessment, Recommendation) tool for
communication, which statement represents the ‘Assessment’ phase?
A. The patient was admitted two days ago with a diagnosis of heart failure.
B. I am calling about Mrs. Jones in Room 402 who is experiencing new onset shortness of
breath.
C. The patient has bilateral crackles in the lung bases and an oxygen saturation of 88% on
room air.
D. I suggest that we obtain a chest X-ray and increase the patient’s diuretic dose.
Answer: C
Conceptual Explanation: Assessment in SBAR involves providing clinical findings and
data collected during the physical exam or vital signs check.
3. Which process describes the ‘first-pass effect’ in pharmacology?
A. The excretion of a drug through the kidneys in its unchanged form.
B. The initial rapid distribution of a drug to highly vascular organs like the brain.
C. The metabolism of a drug by the liver before it reaches the systemic circulation.
D. The binding of a drug to albumin, preventing its therapeutic action.
Answer: C
, Conceptual Explanation: The first-pass effect occurs when drugs taken orally are
absorbed from the GI tract and transported to the liver, where a significant portion may be
metabolized before reaching the heart and general circulation.
4. A nurse is caring for a patient who has been diagnosed with a terminal illness. The patient’s
family asks the nurse not to tell the patient the diagnosis. According to the principle of
autonomy, what should the nurse do?
A. Follow the family’s wishes to avoid causing the patient unnecessary distress.
B. Refer the family to the ethics committee for a final decision.
C. Support the patient’s right to know their diagnosis if they ask for information.
D. Ask the provider to explain the diagnosis to the family again.
Answer: C
Conceptual Explanation: Autonomy refers to the patient’s right to self-determination and
to make informed decisions about their own healthcare, including knowing their diagnosis.
5. Which arterial blood gas (ABG) result indicates partially compensated metabolic acidosis?
A. pH 7.48, PaCO2 48 mmHg, HCO3 30 mEq/L
B. pH 7.32, PaCO2 30 mmHg, HCO3 18 mEq/L
C. pH 7.35, PaCO2 35 mmHg, HCO3 24 mEq/L
D. pH 7.25, PaCO2 40 mmHg, HCO3 19 mEq/L
Answer: B
