NSG 320 ADULT HEALTH NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A client is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
clinical finding most strongly supports this diagnosis?
A. Improved oxygenation with increased FiO2
B. Decreased heart rate and blood pressure
C. Increased pulmonary capillary wedge pressure
D. Hypoxemia refractory to supplemental oxygen
Answer: D
Conceptual Explanation: Refractory hypoxemia, where arterial oxygen levels remain low
despite high concentrations of inspired oxygen, is a hallmark of ARDS.
2. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect to see?
A. Tall, peaked T waves
B. Prolonged ST segment
,C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia typically causes peaked T waves, widened QRS
complexes, and prolonged PR intervals.
3. Following a thyroidectomy, a client develops muscle tremors and a positive Chvostek’s
sign. Which medication should the nurse anticipate administering?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: Muscle tremors and a positive Chvostek’s sign indicate
hypocalcemia, often due to accidental parathyroid gland removal during thyroidectomy. IV
calcium gluconate is the treatment.
4. A client with a history of atrial fibrillation is prescribed Warfarin. Which lab value indicates
the therapy is within the therapeutic range?
A. INR of 2.5
B. PTT of 60 seconds
, C. Platelets of 150,000
D. Hgb of 14 g/dL
Answer: A
Conceptual Explanation: For most conditions like atrial fibrillation, a therapeutic INR for
Warfarin therapy is between 2.0 and 3.0.
5. Which assessment finding in a client with a chest tube requires immediate intervention?
A. Occasional bubbling in the water seal chamber
B. Tidaling in the water seal chamber with respiration
C. Drainage of 50 mL in the last 2 hours
D. Continuous bubbling in the water seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate troubleshooting.
6. A patient is presenting with symptoms of autonomic dysreflexia. What is the priority
nursing action?
A. Administer an antihypertensive medication
B. Check the patient’s bladder for distension
C. Place the patient in a supine position
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A client is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
clinical finding most strongly supports this diagnosis?
A. Improved oxygenation with increased FiO2
B. Decreased heart rate and blood pressure
C. Increased pulmonary capillary wedge pressure
D. Hypoxemia refractory to supplemental oxygen
Answer: D
Conceptual Explanation: Refractory hypoxemia, where arterial oxygen levels remain low
despite high concentrations of inspired oxygen, is a hallmark of ARDS.
2. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect to see?
A. Tall, peaked T waves
B. Prolonged ST segment
,C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia typically causes peaked T waves, widened QRS
complexes, and prolonged PR intervals.
3. Following a thyroidectomy, a client develops muscle tremors and a positive Chvostek’s
sign. Which medication should the nurse anticipate administering?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
Answer: B
Conceptual Explanation: Muscle tremors and a positive Chvostek’s sign indicate
hypocalcemia, often due to accidental parathyroid gland removal during thyroidectomy. IV
calcium gluconate is the treatment.
4. A client with a history of atrial fibrillation is prescribed Warfarin. Which lab value indicates
the therapy is within the therapeutic range?
A. INR of 2.5
B. PTT of 60 seconds
, C. Platelets of 150,000
D. Hgb of 14 g/dL
Answer: A
Conceptual Explanation: For most conditions like atrial fibrillation, a therapeutic INR for
Warfarin therapy is between 2.0 and 3.0.
5. Which assessment finding in a client with a chest tube requires immediate intervention?
A. Occasional bubbling in the water seal chamber
B. Tidaling in the water seal chamber with respiration
C. Drainage of 50 mL in the last 2 hours
D. Continuous bubbling in the water seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak in the system, which requires immediate troubleshooting.
6. A patient is presenting with symptoms of autonomic dysreflexia. What is the priority
nursing action?
A. Administer an antihypertensive medication
B. Check the patient’s bladder for distension
C. Place the patient in a supine position
