NSG 3250 ADULT HEALTH 1 EXAM 3 & EXAM 4 EACH EXAM
CONTAINS COMPLETE ACCURATE QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH DETAILED RATIONALES
(A NEW UPDATED VERSION 2026 EDITION) |GUARANTEED
PASS A+ (BRAND NEW!) FULL REVISED NSG 3250 ADULT
HEALTH 1 ACTUAL EXAM 3 & EXAM 4
NSG 3250 ADULT HEALTH 1 EXAM 3
1. A nurse is assessing a client with suspected left-sided heart failure. Which
finding is most consistent with this condition?
A. Jugular vein distention
B. CORRECT ANSWER: Crackles in the lung bases
C. Hepatojugular reflux
D. Peripheral edema
Rationale: Left-sided heart failure leads to increased pulmonary pressure and fluid
transudation into the alveoli, causing crackles (rales) typically first heard in the
lung bases. Jugular vein distention, hepatojugular reflux, and peripheral edema are
signs of right-sided heart failure, where systemic venous congestion predominates.
2. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) result: pH 7.32, PaCO2 58 mm Hg, HCO3- 30 me/L. The nurse
interprets these findings as:
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic alkalosis
C. CORRECT ANSWER: Partially compensated respiratory acidosis
D. Fully compensated metabolic acidosis
,Rationale: The pH is acidic (7.32 < 7.35), indicating acidosis. PaCO2 is elevated
(58 > 45), indicating a respiratory cause. HCO3- is elevated (30 > 26), suggesting
the kidneys are attempting compensation. Because pH is still abnormal,
compensation is partial, not full.
3. A nurse is caring for a client receiving furosemide for heart failure. Which
laboratory value requires immediate intervention?
A. Serum sodium 135 me/L
B. CORRECT ANSWER: Serum potassium 2.9 me/L
C. Serum chloride 100 me/L
D. Serum magnesium 2.0 mg/ld.
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A potassium
level of 2.9 me/L is critically low, increasing the risk of cardiac dysrhythmias.
Normal sodium is 135–145, chloride 98–106, magnesium 1.8–2.6 mg/ld.; those
values are acceptable.
4. A client presents with sudden onset of sharp, pleuritic chest pain and shortness
of breath after a long car ride. Vital signs: HR 110, RR 26, BP 130/85, SpO2 90%
on room air. Which diagnostic test should the nurse anticipate first?
A. Chest X-ray
B. CORRECT ANSWER: CT pulmonary angiography
C. D-dimer blood test
D. Ventilation-perfusion (V/Q) scan
Rationale: The presentation is highly suspicious for pulmonary embolism (PE)
given the risk factor (prolonged immobilization) and symptoms. CT pulmonary
angiography is the gold standard for confirming PE. While D-dimer is sensitive but
not specific, CT angiography is usually performed emergently when clinical
suspicion is high.
,5. A nurse is teaching a client with newly diagnosed hypertension about dietary
modifications. Which statement indicates a correct understanding of the DASH
diet?
A. "I should eat more red meat to increase my protein intake."
B. "I will limit my daily sodium intake to less than 5 grams."
C. CORRECT ANSWER: "I need to eat at least 4 to 5 servings of fruits and
vegetables daily."
D. "I can continue drinking 3 cups of coffee per day without affecting my blood
pressure."
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, lean
proteins, and low-fat dairy. The recommended sodium limit is 1.5–2.3 grams daily,
not 5 grams. Red meat is limited. Caffeine can transiently increase BP; moderation
is advised.
6. A client with pneumonia is receiving supplemental oxygen at 4 L/min via nasal
cannula. The nurse notes the client’s respiratory rate has decreased from 28 to 10
breaths/min and they are difficult to arouse. Which action is most appropriate?
A. Increase oxygen to 6 L/min
B. CORRECT ANSWER: Prepare for possible intubation and mechanical
ventilation
C. Administer naloxone
D. Decrease oxygen to 2 L/min
Rationale: The client is showing signs of hypercapnia and respiratory depression,
likely due to loss of hypoxic drive (uncommon but possible in severe COPD) or
worsening respiratory failure. Decreasing oxygen could worsen hypoxemia. The
decreased respiratory rate and altered mental status indicate impending respiratory
arrest; intubation may be needed.
, 7. A nurse assesses a client with a history of myocardial infarction (MI) who
reports chest pain that is relieved by nitroglycerin. The pain is described as
pressure-like, radiating to the left arm. Which type of angina is most likely?
A. Unstable angina
B. CORRECT ANSWER: Stable angina
C. Variant (Prinzmetal) angina
D. Microvascular angina
Rationale: Stable angina is predictable, occurs with exertion or stress, and is
relieved by rest or nitroglycerin. Unstable angina occurs at rest or with minimal
exertion and is not easily relieved. Variant angina is caused by coronary vasospasm
and often occurs at rest. Microvascular angina involves small vessels.
8. A client with heart failure has an order for digoxin. Before administering, the
nurse checks the apical pulse and finds it to be 52 beats/min. Which action should
the nurse take?
A. Administer the digoxin as ordered
B. CORRECT ANSWER: Hold the digoxin and notify the healthcare provider
C. Give the digoxin and then recheck the pulse in 30 minutes
D. Administer atropine to increase the heart rate
Rationale: Digoxin is withheld if the apical pulse is <60 beats/min in adults (or <70
in children) due to risk of bradycardia and digoxin toxicity. The nurse should
notify the provider. Atropine is not indicated without a prescription.
9. A nurse is providing discharge teaching to a client with chronic kidney disease
(CKD) stage 4. Which dietary instruction is most important?
A. Increase intake of high-phosphorus foods
CONTAINS COMPLETE ACCURATE QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH DETAILED RATIONALES
(A NEW UPDATED VERSION 2026 EDITION) |GUARANTEED
PASS A+ (BRAND NEW!) FULL REVISED NSG 3250 ADULT
HEALTH 1 ACTUAL EXAM 3 & EXAM 4
NSG 3250 ADULT HEALTH 1 EXAM 3
1. A nurse is assessing a client with suspected left-sided heart failure. Which
finding is most consistent with this condition?
A. Jugular vein distention
B. CORRECT ANSWER: Crackles in the lung bases
C. Hepatojugular reflux
D. Peripheral edema
Rationale: Left-sided heart failure leads to increased pulmonary pressure and fluid
transudation into the alveoli, causing crackles (rales) typically first heard in the
lung bases. Jugular vein distention, hepatojugular reflux, and peripheral edema are
signs of right-sided heart failure, where systemic venous congestion predominates.
2. A client with chronic obstructive pulmonary disease (COPD) has an arterial
blood gas (ABG) result: pH 7.32, PaCO2 58 mm Hg, HCO3- 30 me/L. The nurse
interprets these findings as:
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic alkalosis
C. CORRECT ANSWER: Partially compensated respiratory acidosis
D. Fully compensated metabolic acidosis
,Rationale: The pH is acidic (7.32 < 7.35), indicating acidosis. PaCO2 is elevated
(58 > 45), indicating a respiratory cause. HCO3- is elevated (30 > 26), suggesting
the kidneys are attempting compensation. Because pH is still abnormal,
compensation is partial, not full.
3. A nurse is caring for a client receiving furosemide for heart failure. Which
laboratory value requires immediate intervention?
A. Serum sodium 135 me/L
B. CORRECT ANSWER: Serum potassium 2.9 me/L
C. Serum chloride 100 me/L
D. Serum magnesium 2.0 mg/ld.
Rationale: Furosemide is a loop diuretic that can cause hypokalemia. A potassium
level of 2.9 me/L is critically low, increasing the risk of cardiac dysrhythmias.
Normal sodium is 135–145, chloride 98–106, magnesium 1.8–2.6 mg/ld.; those
values are acceptable.
4. A client presents with sudden onset of sharp, pleuritic chest pain and shortness
of breath after a long car ride. Vital signs: HR 110, RR 26, BP 130/85, SpO2 90%
on room air. Which diagnostic test should the nurse anticipate first?
A. Chest X-ray
B. CORRECT ANSWER: CT pulmonary angiography
C. D-dimer blood test
D. Ventilation-perfusion (V/Q) scan
Rationale: The presentation is highly suspicious for pulmonary embolism (PE)
given the risk factor (prolonged immobilization) and symptoms. CT pulmonary
angiography is the gold standard for confirming PE. While D-dimer is sensitive but
not specific, CT angiography is usually performed emergently when clinical
suspicion is high.
,5. A nurse is teaching a client with newly diagnosed hypertension about dietary
modifications. Which statement indicates a correct understanding of the DASH
diet?
A. "I should eat more red meat to increase my protein intake."
B. "I will limit my daily sodium intake to less than 5 grams."
C. CORRECT ANSWER: "I need to eat at least 4 to 5 servings of fruits and
vegetables daily."
D. "I can continue drinking 3 cups of coffee per day without affecting my blood
pressure."
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, lean
proteins, and low-fat dairy. The recommended sodium limit is 1.5–2.3 grams daily,
not 5 grams. Red meat is limited. Caffeine can transiently increase BP; moderation
is advised.
6. A client with pneumonia is receiving supplemental oxygen at 4 L/min via nasal
cannula. The nurse notes the client’s respiratory rate has decreased from 28 to 10
breaths/min and they are difficult to arouse. Which action is most appropriate?
A. Increase oxygen to 6 L/min
B. CORRECT ANSWER: Prepare for possible intubation and mechanical
ventilation
C. Administer naloxone
D. Decrease oxygen to 2 L/min
Rationale: The client is showing signs of hypercapnia and respiratory depression,
likely due to loss of hypoxic drive (uncommon but possible in severe COPD) or
worsening respiratory failure. Decreasing oxygen could worsen hypoxemia. The
decreased respiratory rate and altered mental status indicate impending respiratory
arrest; intubation may be needed.
, 7. A nurse assesses a client with a history of myocardial infarction (MI) who
reports chest pain that is relieved by nitroglycerin. The pain is described as
pressure-like, radiating to the left arm. Which type of angina is most likely?
A. Unstable angina
B. CORRECT ANSWER: Stable angina
C. Variant (Prinzmetal) angina
D. Microvascular angina
Rationale: Stable angina is predictable, occurs with exertion or stress, and is
relieved by rest or nitroglycerin. Unstable angina occurs at rest or with minimal
exertion and is not easily relieved. Variant angina is caused by coronary vasospasm
and often occurs at rest. Microvascular angina involves small vessels.
8. A client with heart failure has an order for digoxin. Before administering, the
nurse checks the apical pulse and finds it to be 52 beats/min. Which action should
the nurse take?
A. Administer the digoxin as ordered
B. CORRECT ANSWER: Hold the digoxin and notify the healthcare provider
C. Give the digoxin and then recheck the pulse in 30 minutes
D. Administer atropine to increase the heart rate
Rationale: Digoxin is withheld if the apical pulse is <60 beats/min in adults (or <70
in children) due to risk of bradycardia and digoxin toxicity. The nurse should
notify the provider. Atropine is not indicated without a prescription.
9. A nurse is providing discharge teaching to a client with chronic kidney disease
(CKD) stage 4. Which dietary instruction is most important?
A. Increase intake of high-phosphorus foods
