Exam 4: NSG3130 / NSG 3130 (New 2025/ 2026 Update) Fundamental Concepts & Skills for Nursing Practice II Review| Questions with Verified Answers & Detailed Rationale | Grade A| 100% Correct- Galen.

Exam 4: NSG3130 / NSG 3130 (New 2025/ 2026
Update) Fundamental Concepts & Skills for Nursing
Practice II Review| Questions with Verified Answers &
Detailed Rationale | Grade A| 100% Correct- Galen.


Question:
The nurse is caring for a patient with a chest tube who was transported to
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radiology for testing. When the patient returns to the nursing unit, the
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transporter shows the nurse the patient's chest tube collection device,
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which was badly damaged after being caught in the elevator door. What
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is the priority action of the nurse?
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a. Clamp the chest tube until the collection device is replaced.
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b. Cover the insertion site with a new occlusive dressing.
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c. Ensure that there is gentle bubbling in the water seal chamber.
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d. Check the patient's lung sounds and pulse oximetry.?
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Answer:
a. Clamp the chest tube until the collection device is replaced.
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The broken collection device may no longer be used to collect chest tube
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drainage. Clamping the chest tube until the collection device is replaced
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will prevent air from entering the lung space until the new collection
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device is attached. i,- i,-

,Question:

The nurse is caring for a patient who is hospitalized for pneumonia. Which
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nursing diagnosis has the highest priority?
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a. Activity intolerance r/t generalized weakness and hypoxemia
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b. Impaired nutritional intake r/t poor appetite and increased metabolic
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needs

c. Impaired airway clearance r/t thick secretions in trachea and bronchi
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d. Lack of knowledge r/t use of nebulizer and inhaled bronchodilators?
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Answer:

c. Impaired airway clearance r/t thick secretions in trachea and bronchi.
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Airway maintenance and patency is the highest priority for all patients,
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especially patients with respiratory disorders. Oxygenation is the most
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important human need. The other diagnoses can apply once the patient's
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airway is kept patent. i,- i,- i,-




Question:

The nurse is caring for a patient who developed a pulmonary embolism
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after surgery. Which goal statement is the highest priority for the nurse to
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include in the patient's care plan for the diagnosis impaired gas exchange
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r/t impaired pulmonary blood flow from embolus?
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, a. The patient will maintain pulse oximetry values of at least 95% on room
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air.

b. The patient will verbalize understanding of ordered anticoagulants.
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c. The patient will report chest pain of no greater than 3 on a 1 to 10 scale.
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d. The patient will ambulate 50 feet in hallway without shortness of
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breath.?

Answer:

a. The patient will maintain pulse oximetry values of at least 95% on room
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air.



Oxygenation is the most important human need, so adequate
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oxygenation of tissues as evidenced by pulse oximetry values of at least
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95% on room air is the highest priority goal. The other goals may be
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addressed once the oxygenation goal has been met.
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Question:
The nurse is caring for a patient with severe COPD who is becoming
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increasingly confused and disoriented. What is the priority action of the
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nurse?



a. Obtain an arterial blood gas to check for carbon dioxide retention.
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b. Increase the patient's oxygen until the pulse oximetry is greater than
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98%.

c. Lower the head of the patient's bed and insert a nasal airway.
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