NSG430/ NSG 430 Exam 1 (2026/2027 Update) | Complete Exam Questions with Verified Answers and Detailed Rationales | Critical Care, Endocrine Emergencies, Respiratory Failure, Hemodynamic Monitoring | A+ Graded

INSTANT PDF DOWNLOAD This comprehensive EXAM resource for the NSG 430 Adult Health Nursing II Exam 1 at Grand Canyon University covers essential critical care and end-of-life topics for the 2026/2027 academic year . It features exam-style questions with verified answers and detailed rationales . Exam 1 Blueprint Topics: End-of-Life & Palliative Care (18%) - hospice vs palliative, physical manifestations of dying, brain death criteria, postmortem care, ethical principles Endocrine Emergencies (36-38%) - DKA, HHS, thyroid storm, myxedema coma, Addisonian crisis, SIADH, Diabetes Insipidus, Cushing's syndrome Respiratory Disorders & Hemodynamic Monitoring (36-40%) - ARDS, acute respiratory failure, tension pneumothorax, chest tubes, mechanical ventilation, ABG interpretation, preload/afterload, CVP, PAWP Dosage Calculations - 4 math questions integrated into exam SATA Questions - 4 questions integrated into all topics END-OF-LIFE & PALLIATIVE CARE Q1. What is palliative care? Correct Answer: Care or treatment focusing on reducing the severity of symptoms; curative treatment can still be involved Rationale: Palliative care focuses on symptom management and quality of life regardless of prognosis. It can be provided concurrently with curative treatment . Q2. What is hospice care? Correct Answer: Treatment of the terminally ill with the goal of helping them die comfortably without pain; curative care is forgone Rationale: Hospice care requires physician certification that life expectancy is 6 months or less. It focuses on comfort measures only, not curative treatment . Q3. What are the physical manifestations of end of life - respiratory? Correct Answer: Cheyne-Stokes respirations, death rattle, terminal secretions, loss of gag reflex (risk for aspiration) Rationale: Cheyne-Stokes respirations involve alternating periods of apnea and deep, rapid breathing. These changes occur as the body begins to shut down, with respirations generally ceasing first . Q4. What are the physical manifestations of end of life - integumentary? Correct Answer: Mottling (purple and white leopard skin appearance), cyanosis in nail beds, cold/clammy skin, and waxlike skin very near death Rationale: These changes result from decreased peripheral perfusion and reduced cardiac output as death approaches. Hearing is typically the last sense to disappear . Q5. What is decisional capacity? Correct Answer: The ability to consent to or refuse care Rationale: Patients must demonstrate understanding, appreciation, reasoning, and ability to express a choice to have decisional capacity . Q6. What guides nursing care at end of life? (Select all that apply) Correct Answers: Code of Ethics (relieve suffering), Principle of Beneficence (care is provided to benefit), Standard of Care (define nursing acts required for safe and competent care) Rationale: These ethical and professional guidelines direct nurses in providing compassionate end-of-life care. The moral obligation of a nurse at end of life is to relieve suffering . Q7. What are common fears at end of life? (Select all that apply) Correct Answers: Fear of pain, fear of dyspnea (air hunger), fear of loneliness/abandonment, fear of meaninglessness Rationale: Patients fear the sensation of air hunger, which causes anxiety. Presence of people provides comfort and a sense of security. Life review through photo albums may help address meaninglessness . Q8. What is the doctrine of double effect? Correct Answer: Ethical principle that allows administration of pain medication that may hasten death when the primary intent is to relieve suffering Rationale: This principle guides palliative sedation and pain management at end of life when the goal is comfort, not hastening death. Q9. What assessments are appropriate in the last hours of life? Correct Answer: Limit to comfort measures; concerns about pain and respiratory status should be addressed; provide emotional/comfort support Rationale: Frequent vital signs and invasive assessments are discontinued. Focus shifts to symptom management and family support. Pain level and respiratory status may be most important during this time . Q10. What is postmortem care? Correct Answer: Close patient's eyes, replace dentures, wash and position body, allow family privacy Rationale: Never refer to the deceased as "the body" . Postmortem care should be performed with dignity and respect, allowing family time to say goodbye. Remove lines and dressings and clean the body . DIABETIC KETOACIDOSIS (DKA) Q11. What is the classic triad of DKA? Correct Answer: Hyperglycemia (250 mg/dL), ketones, and metabolic acidosis (pH 7.30) Rationale: DKA results from absolute insulin deficiency causing hyperglycemia, ketone production, and metabolic acidosis. It develops over HOURS to 1-2 days and is more common in Type 1 diabetes . Q12. What are the manifestations of DKA? (Select all that apply) Correct Answers: Profound dehydration, tachycardia, polyuria, ketonuria, hot/dry skin, Kussmaul respirations, fruity breath (acetone), nausea/vomiting, abdominal pain, BG 250, pH 7.30 Rationale: Dehydration occurs from osmotic diuresis. Kussmaul respirations are compensatory for metabolic acidosis. Abdominal pain can be severe and mimics acute abdomen . Q13. What is the treatment for DKA?