NSG 430 Exam 4: (Latest 2026/2027 Update) Critical Care, Cardiology,
Infectious Disease, Burns, & Emergency Nursing | Q&A | Grade A | 100%
Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 Exam 4 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: SATA: Risk factors for bacterial infection include which of the following?
Correct Answer: Diabetes Mellitus, Atopic dermatitis, Moisture, Obesity, Skin neoplasms (All
options are risk factors).
1. DM impairs immune function and wound healing.
2. Atopic dermatitis compromises skin barrier integrity.
3. Moisture macerates skin, increasing infection risk.
2: SATA: Treatment for lower extremity cellulitis, what orders do you expect?
Correct Answer: Vancomycin 1000mls, Elevate the extremity, Heat packs.
1. Vancomycin provides coverage for MRSA and strep.
2. Elevation reduces edema and improves venous return.
3. Heat packs increase blood flow and promote healing.
3: Which data collected by the nurse caring for a patient who has cardiogenic shock
indicate that the patient may be developing multiple organ dysfunction syndrome?
Correct Answer: The patient's serum creatinine level is elevated.
1. Elevated creatinine indicates acute kidney injury (renal failure).
2. MODS involves failure of two or more organ systems.
3. Renal dysfunction is a common component of MODS.
4: INR/PT levels doubled, what are you giving?
Correct Answer: Fresh frozen plasma.
1. FFP provides clotting factors for immediate reversal.
2. Vitamin K also given but takes 6-24 hours to work.
3. For life-threatening bleeding, FFP is priority.
5: A patient recovering from heart surgery develops pericarditis and complains of level 6
(0 to 10 scale) chest pain with deep breathing. Which ordered PRN medication will be the
most appropriate for the nurse to give?
Correct Answer: Oral ibuprofen (Motrin) 600 mg.
1. NSAIDs are first-line for pericarditis pain and inflammation.
2. Ibuprofen 600 mg q8h is standard dosing.
3. Avoid in acute MI but safe post-cardiac surgery.
,6: Which assessment data collected by the nurse who is admitting a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
Correct Answer: The pain has lasted longer than 30 minutes.
1. Angina typically resolves within 15 minutes.
2. Pain lasting >20-30 minutes suggests myocardial infarction.
3. Prolonged ischemia leads to myocardial necrosis.
7: Which nursing action will be included in the plan of care for a patient who is being
treated for bleeding esophageal varices with balloon tamponade?
Correct Answer: Monitor the patient for shortness of breath.
1. Balloon can migrate and cause airway obstruction.
2. Monitor for respiratory distress (priority).
3. Keep scissors at bedside for emergency deflation.
8: When admitting a 42-year-old patient with a possible brain injury after a car accident
(MVA) to the emergency department (ED), the nurse obtains the following information.
Which finding is most important to report to the health care provider?
Correct Answer: Patient states they regularly take warfarin (Coumadin) regularly.
1. Warfarin increases risk of intracranial hemorrhage.
2. May need urgent reversal with vitamin K or FFP.
3. Anticoagulation worsens outcomes in head trauma.
9: During discharge teaching with a 68-year-old patient who had a mitral valve
replacement with a mechanical valve, the nurse instructs the patient on the?
Correct Answer: Need for frequent PTT/INR measurement; long term anticoagulants.
1. Mechanical valves require lifelong warfarin anticoagulation.
2. Target INR 2.5-3.5 for mechanical mitral valve.
3. Regular monitoring prevents thromboembolism.
10: Which assessment finding for a patient who has just been admitted with acute
pyelonephritis is most important for the nurse to report to the health care provider?
Correct Answer: Blood pressure 82/60 mm Hg.
1. Hypotension suggests sepsis or septic shock.
2. Pyelonephritis can progress to urosepsis.
3. Requires immediate fluid resuscitation and antibiotics.
11: Decorticate posture: what would you question?
Correct Answer: Consent for the lumbar puncture.
1. Decorticate posturing indicates severe brain injury/increased ICP.
2. LP contraindicated in increased ICP (risk of herniation).
3. Head CT needed before LP.
, 12: A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and
blurred vision. As the nurse, what is the priority?
Correct Answer: Checking the patient's blood glucose.
1. Symptoms suggest hyperglycemia.
2. Acute pancreatitis can cause insulin dysfunction.
3. May require insulin therapy.
13: What are early signs of hypoxemia with a patient with anemia?
Correct Answer: Restlessness.
1. CNS is highly sensitive to oxygen deprivation.
2. Early signs: restlessness, confusion, agitation.
3. Late signs: bradycardia, cyanosis.
14: The nurse preparing for the annual physical exam of a 50-year-old man will plan to
teach the patient about?
Correct Answer: Colonoscopy.
1. Colon cancer screening begins at age 45-50.
2. Colonoscopy is gold standard for screening.
3. Teach about bowel preparation.
15: Which finding indicates to the nurse that a patient's transjugular intrahepatic
portosystemic shunt (TIPS) placed 3 months ago has been effective?
Correct Answer: Fewer episodes of bleeding varices.
1. TIPS reduces portal hypertension.
2. Decreases risk of variceal rebleeding.
3. Monitor for hepatic encephalopathy (complication).
16: What is an expected lab value for someone with SIADH?
Correct Answer: The patient has a serum sodium level of 115 mEq/L.
1. SIADH causes dilutional hyponatremia.
2. Sodium <135 indicates hyponatremia.
3. Severe hyponatremia (<120) can cause seizures.
17: A 37-year-old female patient is hospitalized with acute kidney injury (AKI). Which
information will be most useful to the nurse in evaluating improvement in kidney
function?
Correct Answer: Glomerular filtration rate (GFR).
1. GFR is best indicator of kidney function.
2. Increasing GFR indicates improvement.
3. Calculated from serum creatinine.
Infectious Disease, Burns, & Emergency Nursing | Q&A | Grade A | 100%
Correct (Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 Exam 4 – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: SATA: Risk factors for bacterial infection include which of the following?
Correct Answer: Diabetes Mellitus, Atopic dermatitis, Moisture, Obesity, Skin neoplasms (All
options are risk factors).
1. DM impairs immune function and wound healing.
2. Atopic dermatitis compromises skin barrier integrity.
3. Moisture macerates skin, increasing infection risk.
2: SATA: Treatment for lower extremity cellulitis, what orders do you expect?
Correct Answer: Vancomycin 1000mls, Elevate the extremity, Heat packs.
1. Vancomycin provides coverage for MRSA and strep.
2. Elevation reduces edema and improves venous return.
3. Heat packs increase blood flow and promote healing.
3: Which data collected by the nurse caring for a patient who has cardiogenic shock
indicate that the patient may be developing multiple organ dysfunction syndrome?
Correct Answer: The patient's serum creatinine level is elevated.
1. Elevated creatinine indicates acute kidney injury (renal failure).
2. MODS involves failure of two or more organ systems.
3. Renal dysfunction is a common component of MODS.
4: INR/PT levels doubled, what are you giving?
Correct Answer: Fresh frozen plasma.
1. FFP provides clotting factors for immediate reversal.
2. Vitamin K also given but takes 6-24 hours to work.
3. For life-threatening bleeding, FFP is priority.
5: A patient recovering from heart surgery develops pericarditis and complains of level 6
(0 to 10 scale) chest pain with deep breathing. Which ordered PRN medication will be the
most appropriate for the nurse to give?
Correct Answer: Oral ibuprofen (Motrin) 600 mg.
1. NSAIDs are first-line for pericarditis pain and inflammation.
2. Ibuprofen 600 mg q8h is standard dosing.
3. Avoid in acute MI but safe post-cardiac surgery.
,6: Which assessment data collected by the nurse who is admitting a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
Correct Answer: The pain has lasted longer than 30 minutes.
1. Angina typically resolves within 15 minutes.
2. Pain lasting >20-30 minutes suggests myocardial infarction.
3. Prolonged ischemia leads to myocardial necrosis.
7: Which nursing action will be included in the plan of care for a patient who is being
treated for bleeding esophageal varices with balloon tamponade?
Correct Answer: Monitor the patient for shortness of breath.
1. Balloon can migrate and cause airway obstruction.
2. Monitor for respiratory distress (priority).
3. Keep scissors at bedside for emergency deflation.
8: When admitting a 42-year-old patient with a possible brain injury after a car accident
(MVA) to the emergency department (ED), the nurse obtains the following information.
Which finding is most important to report to the health care provider?
Correct Answer: Patient states they regularly take warfarin (Coumadin) regularly.
1. Warfarin increases risk of intracranial hemorrhage.
2. May need urgent reversal with vitamin K or FFP.
3. Anticoagulation worsens outcomes in head trauma.
9: During discharge teaching with a 68-year-old patient who had a mitral valve
replacement with a mechanical valve, the nurse instructs the patient on the?
Correct Answer: Need for frequent PTT/INR measurement; long term anticoagulants.
1. Mechanical valves require lifelong warfarin anticoagulation.
2. Target INR 2.5-3.5 for mechanical mitral valve.
3. Regular monitoring prevents thromboembolism.
10: Which assessment finding for a patient who has just been admitted with acute
pyelonephritis is most important for the nurse to report to the health care provider?
Correct Answer: Blood pressure 82/60 mm Hg.
1. Hypotension suggests sepsis or septic shock.
2. Pyelonephritis can progress to urosepsis.
3. Requires immediate fluid resuscitation and antibiotics.
11: Decorticate posture: what would you question?
Correct Answer: Consent for the lumbar puncture.
1. Decorticate posturing indicates severe brain injury/increased ICP.
2. LP contraindicated in increased ICP (risk of herniation).
3. Head CT needed before LP.
, 12: A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and
blurred vision. As the nurse, what is the priority?
Correct Answer: Checking the patient's blood glucose.
1. Symptoms suggest hyperglycemia.
2. Acute pancreatitis can cause insulin dysfunction.
3. May require insulin therapy.
13: What are early signs of hypoxemia with a patient with anemia?
Correct Answer: Restlessness.
1. CNS is highly sensitive to oxygen deprivation.
2. Early signs: restlessness, confusion, agitation.
3. Late signs: bradycardia, cyanosis.
14: The nurse preparing for the annual physical exam of a 50-year-old man will plan to
teach the patient about?
Correct Answer: Colonoscopy.
1. Colon cancer screening begins at age 45-50.
2. Colonoscopy is gold standard for screening.
3. Teach about bowel preparation.
15: Which finding indicates to the nurse that a patient's transjugular intrahepatic
portosystemic shunt (TIPS) placed 3 months ago has been effective?
Correct Answer: Fewer episodes of bleeding varices.
1. TIPS reduces portal hypertension.
2. Decreases risk of variceal rebleeding.
3. Monitor for hepatic encephalopathy (complication).
16: What is an expected lab value for someone with SIADH?
Correct Answer: The patient has a serum sodium level of 115 mEq/L.
1. SIADH causes dilutional hyponatremia.
2. Sodium <135 indicates hyponatremia.
3. Severe hyponatremia (<120) can cause seizures.
17: A 37-year-old female patient is hospitalized with acute kidney injury (AKI). Which
information will be most useful to the nurse in evaluating improvement in kidney
function?
Correct Answer: Glomerular filtration rate (GFR).
1. GFR is best indicator of kidney function.
2. Increasing GFR indicates improvement.
3. Calculated from serum creatinine.
