NSG 4100 (ADULT HEALTH III) EXAM 3
PRACTICE QUESTIONS | 200 MULTIPLE-
CHOICE QUESTIONS WITH ANSWERS &
DETAILED EXPLANATIONS (ITALICIZED) |
COMPLETE NURSING STUDY GUIDE
• 200 exam-style multiple-choice questions for NSG 4100 Adult Health III, each with
five answer options (A–E), a clearly marked correct answer, and a detailed EXPERT
RATIONALE — all displayed here in plain chat text.
• Read through each question actively, attempt an answer before checking, then
study the EXPERT RATIONALE beneath the correct option to reinforce the clinical
reasoning behind each concept.
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted
with an exacerbation. Which finding is most expected?
A. PaO2 of 95 mmHg
B. pH of 7.50
C. PaCO2 of 30 mmHg
D. PaCO2 of 55 mmHg ✓
EXPERT RATIONALE: In COPD exacerbations, air trapping and hypoventilation lead to
CO2 retention (hypercapnia). PaCO2 above 45 mmHg indicates respiratory acidosis,
which is a hallmark finding. PaO2 is typically reduced, not elevated.
E. Respiratory alkalosis
2. A nurse is caring for a patient with asthma who is experiencing a severe
attack. Which medication should be administered first?
A. Inhaled corticosteroid (budesonide)
B. Oral prednisone
C. Intravenous aminophylline
,D. Short-acting beta-2 agonist (albuterol) ✓
EXPERT RATIONALE: Short-acting beta-2 agonists such as albuterol are the first-line
rescue medications for acute asthma attacks due to their rapid bronchodilatory effect.
Corticosteroids are used for inflammation but take longer to act.
E. Ipratropium bromide alone
3. Which assessment finding in a patient with pneumonia requires immediate
intervention?
A. Temperature of 38.2°C
B. Productive cough with yellow sputum
C. SpO2 of 88% on room air ✓
EXPERT RATIONALE: An oxygen saturation below 90% indicates hypoxemia requiring
immediate oxygen supplementation and intervention. A temperature and productive
cough are expected findings in pneumonia but are not immediately life-threatening.
D. Respiratory rate of 20 breaths/min
E. Dullness to percussion over the right lower lobe
4. A patient is diagnosed with a pulmonary embolism. Which clinical
manifestation is most commonly associated with this condition?
A. Gradual onset of dyspnea over several days
B. Productive cough with green sputum
C. Sudden onset of pleuritic chest pain and dyspnea ✓
EXPERT RATIONALE: Pulmonary embolism classically presents with sudden onset of
pleuritic chest pain (sharp pain worsening with breathing), dyspnea, and tachycardia.
The sudden onset distinguishes it from other respiratory conditions.
D. Bilateral crackles in the lower lobes
,E. Fever above 39°C
5. Which intervention is the priority for a patient experiencing a tension
pneumothorax?
A. Administer supplemental oxygen via nasal cannula
B. Obtain an emergency chest X-ray
C. Prepare for needle decompression ✓
EXPERT RATIONALE: Tension pneumothorax is a life-threatening emergency where air
accumulates under pressure in the pleural space, shifting the mediastinum and
compressing the heart and great vessels. Immediate needle decompression at the
second intercostal space is required.
D. Place the patient in the prone position
E. Administer intravenous morphine for pain relief
6. A patient with heart failure is admitted with worsening dyspnea and
bilateral leg edema. Which drug class is most appropriate to relieve fluid
overload?
A. Beta-blockers
B. ACE inhibitors
C. Loop diuretics ✓
EXPERT RATIONALE: Loop diuretics such as furosemide promote rapid fluid excretion by
inhibiting sodium and chloride reabsorption in the loop of Henle. They are the
cornerstone of acute decompensated heart failure management to reduce preload and
relieve pulmonary and peripheral congestion.
D. Calcium channel blockers
E. Digoxin
, 7. Which finding indicates that a patient's heart failure treatment with
furosemide is effective?
A. Increased blood pressure
B. Decreased urine output
C. Reduction in daily weight and peripheral edema ✓
EXPERT RATIONALE: Effective diuresis results in weight loss (fluid loss) and reduction in
dependent edema. Daily weight measurement is the most reliable method of monitoring
fluid balance in heart failure patients.
D. Elevated serum potassium
E. Increased central venous pressure
8. A patient with acute myocardial infarction (MI) is prescribed aspirin. What
is the primary EXPERT RATIONALE?
A. To reduce fever associated with inflammation
B. To provide analgesia for chest pain
C. To inhibit platelet aggregation and prevent further clot formation ✓
EXPERT RATIONALE: Aspirin irreversibly inhibits cyclooxygenase (COX), reducing
thromboxane A2-mediated platelet aggregation. In acute MI, this reduces thrombus
propagation and improves coronary artery patency, reducing mortality.
D. To decrease myocardial oxygen demand
E. To lower serum cholesterol
9. A nurse assessing a patient with left-sided heart failure expects which
clinical finding?
A. Jugular vein distension
B. Peripheral pitting edema
PRACTICE QUESTIONS | 200 MULTIPLE-
CHOICE QUESTIONS WITH ANSWERS &
DETAILED EXPLANATIONS (ITALICIZED) |
COMPLETE NURSING STUDY GUIDE
• 200 exam-style multiple-choice questions for NSG 4100 Adult Health III, each with
five answer options (A–E), a clearly marked correct answer, and a detailed EXPERT
RATIONALE — all displayed here in plain chat text.
• Read through each question actively, attempt an answer before checking, then
study the EXPERT RATIONALE beneath the correct option to reinforce the clinical
reasoning behind each concept.
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted
with an exacerbation. Which finding is most expected?
A. PaO2 of 95 mmHg
B. pH of 7.50
C. PaCO2 of 30 mmHg
D. PaCO2 of 55 mmHg ✓
EXPERT RATIONALE: In COPD exacerbations, air trapping and hypoventilation lead to
CO2 retention (hypercapnia). PaCO2 above 45 mmHg indicates respiratory acidosis,
which is a hallmark finding. PaO2 is typically reduced, not elevated.
E. Respiratory alkalosis
2. A nurse is caring for a patient with asthma who is experiencing a severe
attack. Which medication should be administered first?
A. Inhaled corticosteroid (budesonide)
B. Oral prednisone
C. Intravenous aminophylline
,D. Short-acting beta-2 agonist (albuterol) ✓
EXPERT RATIONALE: Short-acting beta-2 agonists such as albuterol are the first-line
rescue medications for acute asthma attacks due to their rapid bronchodilatory effect.
Corticosteroids are used for inflammation but take longer to act.
E. Ipratropium bromide alone
3. Which assessment finding in a patient with pneumonia requires immediate
intervention?
A. Temperature of 38.2°C
B. Productive cough with yellow sputum
C. SpO2 of 88% on room air ✓
EXPERT RATIONALE: An oxygen saturation below 90% indicates hypoxemia requiring
immediate oxygen supplementation and intervention. A temperature and productive
cough are expected findings in pneumonia but are not immediately life-threatening.
D. Respiratory rate of 20 breaths/min
E. Dullness to percussion over the right lower lobe
4. A patient is diagnosed with a pulmonary embolism. Which clinical
manifestation is most commonly associated with this condition?
A. Gradual onset of dyspnea over several days
B. Productive cough with green sputum
C. Sudden onset of pleuritic chest pain and dyspnea ✓
EXPERT RATIONALE: Pulmonary embolism classically presents with sudden onset of
pleuritic chest pain (sharp pain worsening with breathing), dyspnea, and tachycardia.
The sudden onset distinguishes it from other respiratory conditions.
D. Bilateral crackles in the lower lobes
,E. Fever above 39°C
5. Which intervention is the priority for a patient experiencing a tension
pneumothorax?
A. Administer supplemental oxygen via nasal cannula
B. Obtain an emergency chest X-ray
C. Prepare for needle decompression ✓
EXPERT RATIONALE: Tension pneumothorax is a life-threatening emergency where air
accumulates under pressure in the pleural space, shifting the mediastinum and
compressing the heart and great vessels. Immediate needle decompression at the
second intercostal space is required.
D. Place the patient in the prone position
E. Administer intravenous morphine for pain relief
6. A patient with heart failure is admitted with worsening dyspnea and
bilateral leg edema. Which drug class is most appropriate to relieve fluid
overload?
A. Beta-blockers
B. ACE inhibitors
C. Loop diuretics ✓
EXPERT RATIONALE: Loop diuretics such as furosemide promote rapid fluid excretion by
inhibiting sodium and chloride reabsorption in the loop of Henle. They are the
cornerstone of acute decompensated heart failure management to reduce preload and
relieve pulmonary and peripheral congestion.
D. Calcium channel blockers
E. Digoxin
, 7. Which finding indicates that a patient's heart failure treatment with
furosemide is effective?
A. Increased blood pressure
B. Decreased urine output
C. Reduction in daily weight and peripheral edema ✓
EXPERT RATIONALE: Effective diuresis results in weight loss (fluid loss) and reduction in
dependent edema. Daily weight measurement is the most reliable method of monitoring
fluid balance in heart failure patients.
D. Elevated serum potassium
E. Increased central venous pressure
8. A patient with acute myocardial infarction (MI) is prescribed aspirin. What
is the primary EXPERT RATIONALE?
A. To reduce fever associated with inflammation
B. To provide analgesia for chest pain
C. To inhibit platelet aggregation and prevent further clot formation ✓
EXPERT RATIONALE: Aspirin irreversibly inhibits cyclooxygenase (COX), reducing
thromboxane A2-mediated platelet aggregation. In acute MI, this reduces thrombus
propagation and improves coronary artery patency, reducing mortality.
D. To decrease myocardial oxygen demand
E. To lower serum cholesterol
9. A nurse assessing a patient with left-sided heart failure expects which
clinical finding?
A. Jugular vein distension
B. Peripheral pitting edema
