NSG 3160 ADVANCED INTEGRATIVE
NURSING CARE EXAM PREP
QUESTIONS & VERIFIED ANSWERS
2026/2027 UPDATE
1. A patient with SIADH is presenting with a serum sodium level of 118 mEq/L. Which nursing
intervention is the highest priority?
A. Implementing seizure precautions and monitoring neurological status
B. Administering a bolus of 0.9% Normal Saline
C. Increasing oral fluid intake to 2000 mL per day
D. Administering oral salt tablets with fruit juice
Answer: A
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) puts the patient at
high risk for cerebral edema, seizures, and coma. Fluid restriction, not increases, is
required for SIADH.
2. Which assessment finding in a patient with a chest tube requires immediate notification of
the provider?
A. Occasional bubbling in the suction control chamber
B. Tidaling in the water seal chamber during inspiration
,C. Drainage of 50 mL of serosanguinous fluid in 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 or the patient’s pleural space. Tidaling is normal, and small amounts of
drainage are expected.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium of 6.8 mEq/L. Which
medication should the nurse be prepared to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and D50W
D. Furosemide (Lasix)
Answer: B
Conceptual Explanation: While insulin and Kayexalate help lower potassium, Calcium
Gluconate is administered first to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
4. A patient is admitted with suspected Pheochromocytoma. Which action by the nurse is
contraindicated?
A. Monitoring blood pressure every 15 minutes
, B. Palpating the abdomen to check for masses
C. Collecting a 24-hour urine for catecholamines
D. Instructing the patient to avoid smoking and caffeine
Answer: B
Conceptual Explanation: Palpation of the abdomen in a patient with Pheochromocytoma
can trigger a sudden release of catecholamines, leading to a hypertensive crisis.
5. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin and metabolic acidosis
B. Generalized edema and crackles in the lungs
C. Urine output of less than 10 mL per hour
D. Increased heart rate and narrowed pulse pressure
Answer: D
Conceptual Explanation: In the compensatory stage, the body attempts to maintain CO
through SNS activation, resulting in tachycardia and vasoconstriction (narrowed pulse
pressure). Cold skin and acidosis occur in the progressive stage.
6. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and has a
blood pressure of 210/110 mmHg. What is the nurse’s first action?
A. Raise the head of the bed to 90 degrees
B. Notify the healthcare provider immediately
NURSING CARE EXAM PREP
QUESTIONS & VERIFIED ANSWERS
2026/2027 UPDATE
1. A patient with SIADH is presenting with a serum sodium level of 118 mEq/L. Which nursing
intervention is the highest priority?
A. Implementing seizure precautions and monitoring neurological status
B. Administering a bolus of 0.9% Normal Saline
C. Increasing oral fluid intake to 2000 mL per day
D. Administering oral salt tablets with fruit juice
Answer: A
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) puts the patient at
high risk for cerebral edema, seizures, and coma. Fluid restriction, not increases, is
required for SIADH.
2. Which assessment finding in a patient with a chest tube requires immediate notification of
the provider?
A. Occasional bubbling in the suction control chamber
B. Tidaling in the water seal chamber during inspiration
,C. Drainage of 50 mL of serosanguinous fluid in 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 or the patient’s pleural space. Tidaling is normal, and small amounts of
drainage are expected.
3. A patient with Chronic Kidney Disease (CKD) has a serum potassium of 6.8 mEq/L. Which
medication should the nurse be prepared to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and D50W
D. Furosemide (Lasix)
Answer: B
Conceptual Explanation: While insulin and Kayexalate help lower potassium, Calcium
Gluconate is administered first to stabilize the myocardial cell membrane and prevent life-
threatening arrhythmias.
4. A patient is admitted with suspected Pheochromocytoma. Which action by the nurse is
contraindicated?
A. Monitoring blood pressure every 15 minutes
, B. Palpating the abdomen to check for masses
C. Collecting a 24-hour urine for catecholamines
D. Instructing the patient to avoid smoking and caffeine
Answer: B
Conceptual Explanation: Palpation of the abdomen in a patient with Pheochromocytoma
can trigger a sudden release of catecholamines, leading to a hypertensive crisis.
5. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin and metabolic acidosis
B. Generalized edema and crackles in the lungs
C. Urine output of less than 10 mL per hour
D. Increased heart rate and narrowed pulse pressure
Answer: D
Conceptual Explanation: In the compensatory stage, the body attempts to maintain CO
through SNS activation, resulting in tachycardia and vasoconstriction (narrowed pulse
pressure). Cold skin and acidosis occur in the progressive stage.
6. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and has a
blood pressure of 210/110 mmHg. What is the nurse’s first action?
A. Raise the head of the bed to 90 degrees
B. Notify the healthcare provider immediately
