1|Page
NSG 3850 Exam 4 Galen College Of Nursing Actual Exam 2026-
2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a client who has a history of heart failure and is
receiving furosemide. Which finding indicates the client may be
experiencing fluid volume deficit?
A) Bilateral crackles in the lung bases
B) Jugular vein distention
C) Orthostatic hypotension
D) Weight gain of 2 kg in 24 hours
Answer: C) Orthostatic hypotension
Explanation: Orthostatic hypotension is a classic sign of fluid volume
deficit related to intravascular volume depletion. Furosemide is a
potent loop diuretic that can cause excessive fluid loss. Bilateral
crackles, jugular vein distention, and rapid weight gain are all indicators
of fluid volume excess, which is the opposite problem.
2. A client with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which clinical manifestation should the nurse anticipate?
A) Hypoactive deep tendon reflexes
B) Muscle weakness and cardiac dysrhythmias
,2|Page
C) Tetany and positive Chvostek's sign
D) Bone pain and pathological fractures
Answer: B) Muscle weakness and cardiac dysrhythmias
Explanation: A potassium level of 6.8 mEq/L indicates severe
hyperkalemia. Elevated extracellular potassium alters the resting
membrane potential of excitable cells, initially causing increased
excitability but progressing to muscle weakness, flaccid paralysis, and
life-threatening cardiac dysrhythmias such as ventricular fibrillation.
Tetany and Chvostek's sign are associated with hypocalcemia, while
bone pain relates to chronic kidney disease mineral bone disorder.
3. A nurse is teaching a client about the use of a 24-hour Holter
monitor. Which statement by the client indicates understanding of the
teaching?
A) "I will remove the electrodes when I shower."
B) "I should keep a diary of my activities and any symptoms I
experience."
C) "This device will alert me if I am about to have a heart attack."
D) "I need to stay in the hospital while wearing this monitor."
Answer: B) "I should keep a diary of my activities and any symptoms I
experience."
Explanation: A Holter monitor continuously records cardiac electrical
activity for 24 to 48 hours during normal daily activities. Keeping a diary
correlating activities and symptoms with recorded events allows the
provider to identify rhythm disturbances and their clinical significance.
,3|Page
Electrodes must remain dry and in place; the device does not provide
real-time alerts, and hospitalization is not required.
4. A client is admitted with a diagnosis of syndrome of inappropriate
antidiuretic hormone secretion (SIADH). Which serum laboratory value
should the nurse expect?
A) Sodium 152 mEq/L
B) Sodium 128 mEq/L
C) Potassium 5.8 mEq/L
D) Calcium 7.8 mg/dL
Answer: B) Sodium 128 mEq/L
Explanation: SIADH involves excessive release of antidiuretic hormone,
leading to renal water retention and dilutional hyponatremia. A serum
sodium of 128 mEq/L reflects this dilutional effect (normal range
approximately 135-145 mEq/L). Hypernatremia would indicate the
opposite condition, diabetes insipidus. Hyperkalemia and hypocalcemia
are not directly characteristic of SIADH.
5. A nurse is caring for a client who develops sudden-onset dyspnea,
pleuritic chest pain, and apprehension 3 days after a total hip
arthroplasty. Which condition should the nurse suspect?
A) Acute myocardial infarction
B) Pneumonia
C) Pulmonary embolism
D) Atelectasis
, 4|Page
Answer: C) Pulmonary embolism
Explanation: This presentation following major orthopedic surgery is
highly suggestive of pulmonary embolism. Virchow's triad of venous
stasis, endothelial injury, and hypercoagulability places postoperative
clients at significant risk for venous thromboembolism. Dyspnea,
pleuritic pain, and a sense of doom are classic symptoms of a
pulmonary embolus obstructing pulmonary vasculature.
6. A client is receiving a blood transfusion and develops chills, fever,
and low back pain. What is the priority nursing action?
A) Slow the transfusion rate and administer acetaminophen
B) Administer diphenhydramine and continue the transfusion
C) Stop the transfusion and infuse normal saline with new tubing
D) Notify the healthcare provider after the transfusion is complete
Answer: C) Stop the transfusion and infuse normal saline with new
tubing
Explanation: Chills, fever, and low back pain are signs of an acute
hemolytic transfusion reaction, a life-threatening emergency. The
immediate priority is to discontinue the transfusion, maintain IV access
with normal saline using new tubing to prevent infusing more
incompatible blood, monitor vital signs, and notify the provider.
Delaying action or continuing the infusion can result in acute kidney
injury and disseminated intravascular coagulation.
7. A nurse is assessing a client with left-sided heart failure. Which
finding is most characteristic of this condition?
NSG 3850 Exam 4 Galen College Of Nursing Actual Exam 2026-
2027 BANK QUESTIONS WITH DETAILED VERIFIED
ANSWERS EXAM QUESTIONS WILL COME FROM HERE
(100% CORRECT ANSWERS A+ GRADED
1. A nurse is assessing a client who has a history of heart failure and is
receiving furosemide. Which finding indicates the client may be
experiencing fluid volume deficit?
A) Bilateral crackles in the lung bases
B) Jugular vein distention
C) Orthostatic hypotension
D) Weight gain of 2 kg in 24 hours
Answer: C) Orthostatic hypotension
Explanation: Orthostatic hypotension is a classic sign of fluid volume
deficit related to intravascular volume depletion. Furosemide is a
potent loop diuretic that can cause excessive fluid loss. Bilateral
crackles, jugular vein distention, and rapid weight gain are all indicators
of fluid volume excess, which is the opposite problem.
2. A client with chronic kidney disease has a serum potassium level of
6.8 mEq/L. Which clinical manifestation should the nurse anticipate?
A) Hypoactive deep tendon reflexes
B) Muscle weakness and cardiac dysrhythmias
,2|Page
C) Tetany and positive Chvostek's sign
D) Bone pain and pathological fractures
Answer: B) Muscle weakness and cardiac dysrhythmias
Explanation: A potassium level of 6.8 mEq/L indicates severe
hyperkalemia. Elevated extracellular potassium alters the resting
membrane potential of excitable cells, initially causing increased
excitability but progressing to muscle weakness, flaccid paralysis, and
life-threatening cardiac dysrhythmias such as ventricular fibrillation.
Tetany and Chvostek's sign are associated with hypocalcemia, while
bone pain relates to chronic kidney disease mineral bone disorder.
3. A nurse is teaching a client about the use of a 24-hour Holter
monitor. Which statement by the client indicates understanding of the
teaching?
A) "I will remove the electrodes when I shower."
B) "I should keep a diary of my activities and any symptoms I
experience."
C) "This device will alert me if I am about to have a heart attack."
D) "I need to stay in the hospital while wearing this monitor."
Answer: B) "I should keep a diary of my activities and any symptoms I
experience."
Explanation: A Holter monitor continuously records cardiac electrical
activity for 24 to 48 hours during normal daily activities. Keeping a diary
correlating activities and symptoms with recorded events allows the
provider to identify rhythm disturbances and their clinical significance.
,3|Page
Electrodes must remain dry and in place; the device does not provide
real-time alerts, and hospitalization is not required.
4. A client is admitted with a diagnosis of syndrome of inappropriate
antidiuretic hormone secretion (SIADH). Which serum laboratory value
should the nurse expect?
A) Sodium 152 mEq/L
B) Sodium 128 mEq/L
C) Potassium 5.8 mEq/L
D) Calcium 7.8 mg/dL
Answer: B) Sodium 128 mEq/L
Explanation: SIADH involves excessive release of antidiuretic hormone,
leading to renal water retention and dilutional hyponatremia. A serum
sodium of 128 mEq/L reflects this dilutional effect (normal range
approximately 135-145 mEq/L). Hypernatremia would indicate the
opposite condition, diabetes insipidus. Hyperkalemia and hypocalcemia
are not directly characteristic of SIADH.
5. A nurse is caring for a client who develops sudden-onset dyspnea,
pleuritic chest pain, and apprehension 3 days after a total hip
arthroplasty. Which condition should the nurse suspect?
A) Acute myocardial infarction
B) Pneumonia
C) Pulmonary embolism
D) Atelectasis
, 4|Page
Answer: C) Pulmonary embolism
Explanation: This presentation following major orthopedic surgery is
highly suggestive of pulmonary embolism. Virchow's triad of venous
stasis, endothelial injury, and hypercoagulability places postoperative
clients at significant risk for venous thromboembolism. Dyspnea,
pleuritic pain, and a sense of doom are classic symptoms of a
pulmonary embolus obstructing pulmonary vasculature.
6. A client is receiving a blood transfusion and develops chills, fever,
and low back pain. What is the priority nursing action?
A) Slow the transfusion rate and administer acetaminophen
B) Administer diphenhydramine and continue the transfusion
C) Stop the transfusion and infuse normal saline with new tubing
D) Notify the healthcare provider after the transfusion is complete
Answer: C) Stop the transfusion and infuse normal saline with new
tubing
Explanation: Chills, fever, and low back pain are signs of an acute
hemolytic transfusion reaction, a life-threatening emergency. The
immediate priority is to discontinue the transfusion, maintain IV access
with normal saline using new tubing to prevent infusing more
incompatible blood, monitor vital signs, and notify the provider.
Delaying action or continuing the infusion can result in acute kidney
injury and disseminated intravascular coagulation.
7. A nurse is assessing a client with left-sided heart failure. Which
finding is most characteristic of this condition?
