NSG 123 TEST #3: (Latest 2026/2027 Update) Hypertension, Cardiovascular
Disorders, Mental Health & Maternal Health | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: NSG 123 – Medical-Surgical & Mental Health Nursing
Source: NSG 123 TEST #3 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the mechanism of action of magnesium sulfate (MgSO₄) in pre-eclampsia?
Correct Answer: Anticonvulsant — prevents and controls seizures. Relaxes skeletal muscle (decreased
reflexes), smooth muscle (relaxes uterus, slows contractions), cardiac muscle (slows heart activity).
Depresses CNS to prevent overstimulation. Antidote: calcium gluconate IV slow.
1. Therapeutic level: 4-8 mg/dL; monitor BP, RR, DTRs, urine output, LOC.
2. Toxicity: decreased reflexes, respiratory depression, oliguria, hypothermia, coma.
3. Magnesium crosses placenta; may cause neonatal hypotonia, respiratory depression.
2. What are the DSM-5 diagnostic criteria for major depressive disorder (MDD)?
Correct Answer: At least 5 of the following symptoms occurring most of the day, nearly every day for
at least 2 weeks: depressed mood, anhedonia, weight change (±5% in 1 month), sleep disturbance,
psychomotor changes, fatigue, worthlessness/guilt, indecisiveness/concentration difficulty, suicidal
ideation.
1. One symptom must be depressed mood or anhedonia.
2. Women are more likely to develop MDD than men.
3. Must cause clinically significant distress or functional impairment.
3. What are the stages of blood pressure according to ACC/AHA guidelines?
Correct Answer: Normal: <120/80; Elevated: 120-129/<80; Stage 1: 130-139/80-89; Stage 2: ≥140/
≥90; Hypertensive crisis: >180/>120.
1. Hypertensive urgency: BP >180/>120 without kidney damage.
2. Hypertensive emergency: BP >180/>120 with target organ damage.
3. Diagnosis based on 2 or more accurate BP measurements on separate occasions.
4. What is the mechanism of action of beta-blockers (e.g., metoprolol, propranolol)?
Correct Answer: Blocks beta-1 receptors in the heart → vasodilation, decreased heart contractility,
decreased oxygen demand. Decreases renin release → vasodilation and increased renal blood flow.
1. Hold if BP <100 and HR <60.
2. Do NOT stop abruptly (risk of rebound HTN, angina, MI).
3. Side effects: bronchospasm, bradycardia, fatigue, sexual dysfunction, hypoglycemia masking.
, 5. What are the clinical manifestations of peripheral artery disease (PAD)?
Correct Answer: Dry, scaly, mottled skin; ulcers on toes/feet (red, yellow, black sores); gangrene; no or
weak pedal pulses; intermittent claudication (leg pain with walking that improves with rest, worse when
legs elevated, relieved when lowered).
1. Education: rest when walking hurts, exercise legs, don't cross legs, keep legs down (not
elevated), no heating pads, check feet daily, report sores immediately.
6. What is the DSM-5 criterion for generalized anxiety disorder (GAD) in adults?
Correct Answer: At least 3 of 6 symptoms: restlessness/feeling on edge, easily fatigued, difficulty
concentrating or mind going blank, irritability, muscle tension, sleep disturbance. Symptoms occur more
days than not for at least 6 months.
1. For children, only 1 symptom is needed.
2. Symptoms cause clinically significant distress or impairment.
3. Women are more prevalent affected; onset often under age 45.
7. What is the mechanism of action of ACE inhibitors (lisinopril, enalapril)?
Correct Answer: Blocks RAAS — inhibits conversion of angiotensin I to angiotensin II → decreased
aldosterone → excretion of sodium/water (potassium retained) → vasodilation. Indicated for HTN and
heart failure.
1. Side effects: cough, hyperkalemia, angioedema (skin swelling of face/lips), neutropenia, renal
failure.
2. Avoid potassium supplements and salt substitutes.
3. Contraindicated in pregnancy.
8. What are the 6-Ps of total artery occlusion (acute limb ischemia)?
Correct Answer: Pain (constant, not relieved by rest); Pallor (pale or mottled); Pulselessness
(diminished or absent); Paresthesia (numbness, tingling, burning); Paralysis (limited mobility — serious
sign, may indicate nerve death); Poikilothermia (cool to touch, not matching other side).
1. Acute limb ischemia is medical emergency — urgent revascularization needed within 6-12
hours.
2. Paralysis and sensory loss are late signs; irreversible damage occurs rapidly.
3. Compare findings with contralateral limb.
9. What are the stages of anxiety (mild, moderate, severe, panic)?
Correct Answer: Mild: enhanced focus, sharpened senses, irritability, restlessness. Moderate: reduced
attention span, muscle tension, diaphoresis, pounding pulse. Severe: cannot function, cannot solve
problems, ritualistic behavior, hyperventilation, tachycardia. Panic: loss of reality, distorted perceptions,
can't communicate, may bolt or freeze.
1. Mild to moderate anxiety can be adaptive (improves performance).
2. Severe and panic anxiety impair functioning and may require medication (benzodiazepines).
3. Nursing interventions: calm environment, grounding techniques, breathing exercises.
Disorders, Mental Health & Maternal Health | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: NSG 123 – Medical-Surgical & Mental Health Nursing
Source: NSG 123 TEST #3 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What is the mechanism of action of magnesium sulfate (MgSO₄) in pre-eclampsia?
Correct Answer: Anticonvulsant — prevents and controls seizures. Relaxes skeletal muscle (decreased
reflexes), smooth muscle (relaxes uterus, slows contractions), cardiac muscle (slows heart activity).
Depresses CNS to prevent overstimulation. Antidote: calcium gluconate IV slow.
1. Therapeutic level: 4-8 mg/dL; monitor BP, RR, DTRs, urine output, LOC.
2. Toxicity: decreased reflexes, respiratory depression, oliguria, hypothermia, coma.
3. Magnesium crosses placenta; may cause neonatal hypotonia, respiratory depression.
2. What are the DSM-5 diagnostic criteria for major depressive disorder (MDD)?
Correct Answer: At least 5 of the following symptoms occurring most of the day, nearly every day for
at least 2 weeks: depressed mood, anhedonia, weight change (±5% in 1 month), sleep disturbance,
psychomotor changes, fatigue, worthlessness/guilt, indecisiveness/concentration difficulty, suicidal
ideation.
1. One symptom must be depressed mood or anhedonia.
2. Women are more likely to develop MDD than men.
3. Must cause clinically significant distress or functional impairment.
3. What are the stages of blood pressure according to ACC/AHA guidelines?
Correct Answer: Normal: <120/80; Elevated: 120-129/<80; Stage 1: 130-139/80-89; Stage 2: ≥140/
≥90; Hypertensive crisis: >180/>120.
1. Hypertensive urgency: BP >180/>120 without kidney damage.
2. Hypertensive emergency: BP >180/>120 with target organ damage.
3. Diagnosis based on 2 or more accurate BP measurements on separate occasions.
4. What is the mechanism of action of beta-blockers (e.g., metoprolol, propranolol)?
Correct Answer: Blocks beta-1 receptors in the heart → vasodilation, decreased heart contractility,
decreased oxygen demand. Decreases renin release → vasodilation and increased renal blood flow.
1. Hold if BP <100 and HR <60.
2. Do NOT stop abruptly (risk of rebound HTN, angina, MI).
3. Side effects: bronchospasm, bradycardia, fatigue, sexual dysfunction, hypoglycemia masking.
, 5. What are the clinical manifestations of peripheral artery disease (PAD)?
Correct Answer: Dry, scaly, mottled skin; ulcers on toes/feet (red, yellow, black sores); gangrene; no or
weak pedal pulses; intermittent claudication (leg pain with walking that improves with rest, worse when
legs elevated, relieved when lowered).
1. Education: rest when walking hurts, exercise legs, don't cross legs, keep legs down (not
elevated), no heating pads, check feet daily, report sores immediately.
6. What is the DSM-5 criterion for generalized anxiety disorder (GAD) in adults?
Correct Answer: At least 3 of 6 symptoms: restlessness/feeling on edge, easily fatigued, difficulty
concentrating or mind going blank, irritability, muscle tension, sleep disturbance. Symptoms occur more
days than not for at least 6 months.
1. For children, only 1 symptom is needed.
2. Symptoms cause clinically significant distress or impairment.
3. Women are more prevalent affected; onset often under age 45.
7. What is the mechanism of action of ACE inhibitors (lisinopril, enalapril)?
Correct Answer: Blocks RAAS — inhibits conversion of angiotensin I to angiotensin II → decreased
aldosterone → excretion of sodium/water (potassium retained) → vasodilation. Indicated for HTN and
heart failure.
1. Side effects: cough, hyperkalemia, angioedema (skin swelling of face/lips), neutropenia, renal
failure.
2. Avoid potassium supplements and salt substitutes.
3. Contraindicated in pregnancy.
8. What are the 6-Ps of total artery occlusion (acute limb ischemia)?
Correct Answer: Pain (constant, not relieved by rest); Pallor (pale or mottled); Pulselessness
(diminished or absent); Paresthesia (numbness, tingling, burning); Paralysis (limited mobility — serious
sign, may indicate nerve death); Poikilothermia (cool to touch, not matching other side).
1. Acute limb ischemia is medical emergency — urgent revascularization needed within 6-12
hours.
2. Paralysis and sensory loss are late signs; irreversible damage occurs rapidly.
3. Compare findings with contralateral limb.
9. What are the stages of anxiety (mild, moderate, severe, panic)?
Correct Answer: Mild: enhanced focus, sharpened senses, irritability, restlessness. Moderate: reduced
attention span, muscle tension, diaphoresis, pounding pulse. Severe: cannot function, cannot solve
problems, ritualistic behavior, hyperventilation, tachycardia. Panic: loss of reality, distorted perceptions,
can't communicate, may bolt or freeze.
1. Mild to moderate anxiety can be adaptive (improves performance).
2. Severe and panic anxiety impair functioning and may require medication (benzodiazepines).
3. Nursing interventions: calm environment, grounding techniques, breathing exercises.
