NSG 3130 Exam 4 Prep 2026-2027 | Nursing Practice Test Questions
& Answers | Complete Study Guide
Prepare for NSG 3130 Exam 4 with this comprehensive study guide featuring practice questions,
verified answers, and detailed rationales designed to reinforce key nursing concepts. This exam
prep resource covers advanced patient assessment, clinical judgment, pharmacology, priority
nursing interventions, care planning, safety considerations, and evidence-based practice
commonly assessed in NSG 3130. Structured to improve knowledge retention and test-taking
confidence, the material helps students identify strengths and target areas for improvement
before exam day. Ideal for nursing students seeking a reliable and effective resource to prepare
for and excel on NSG 3130 Exam 4.
Question 1
A nurse is caring for a patient in the intensive care unit who is undergoing hemodynamic
monitoring. The patient’s central venous pressure (CVP) reads 1 mmHg. Which clinical
condition matches this parameter?
A) Right-sided heart failure.
B) B) Hypovolemia due to severe hemorrhage.
C) Fluid volume overload from excessive IV infusions.
D) Pulmonary hypertension.
Rationale: A normal CVP is 2–6 mmHg. A low CVP (<2 mmHg) directly indicates
reduced right-sided cardiac preload, which is caused by conditions that reduce
intravascular volume, such as hemorrhage, severe dehydration, or excessive diuresis.
Question 2
A patient in septic shock remains hypotensive despite receiving a 30 mL/kg bolus of
normal saline. The provider orders a continuous vasopressor infusion. Which
medication is considered the first-choice agent to restore systemic vascular resistance
(SVR)?
A) Epinephrine.
B) Atropine sulfate.
C) C) Norepinephrine.
D) Nitroprusside.
,Rationale: Norepinephrine is the first-line vasopressor used in septic shock to treat
fluid-refractory hypotension. It works primarily via alpha-1 adrenergic receptors to cause
potent vasoconstriction, thereby increasing SVR and blood pressure.
Question 3
A nurse is caring for a patient with acute respiratory distress syndrome (ARDS) who is
receiving mechanical ventilation. Which arterial blood gas finding is considered the
hallmark manifestation of ARDS?
A) Metabolic alkalosis with adequate oxygenation.
B) B) Severe hypoxemia that does not improve with increased fraction of inspired
oxygen (refractory hypoxemia).
C) Respiratory alkalosis with an elevated PaO2.
D) Normal PaO2 paired with elevated bicarbonate levels.
Rationale: Refractory hypoxemia—where the patient’s PaO2 remains critically low
despite escalating delivery of oxygen (FiO2)—is the clinical hallmark of ARDS. It is
caused by widespread intrapulmonary shunting from alveolar collapse and fluid
accumulation.
Question 4
The low-pressure alarm sounds on the mechanical ventilator of a patient who is
intubated and sedated. The nurse enters the room and notes the patient is in no
immediate distress. What is the most likely cause of this alarm?
A) The patient is biting down on the endotracheal tube.
B) Extensive mucus plugging within the main bronchus.
C) C) A total disconnection between the endotracheal tube and the ventilator
circuit.
D) Development of an acute tension pneumothorax.
Rationale: Low-pressure alarms are triggered by a loss of resistance or a drop in
expected airway pressure. This is caused by circuit disconnections, severe cuff leaks, or
accidental self-extubation. Biting, plugging, and pneumothoraces cause high-pressure
alarms.
,Question 5
A patient is admitted to the emergency department following a motor vehicle accident.
The nurse notes a spinal cord injury at the T3 level. The patient’s vital signs are blood
pressure 82/40 mmHg and heart rate 46 beats/minute. Which type of shock is this
patient experiencing?
A) Hypovolemic shock.
B) Cardiogenic shock.
C) C) Neurogenic shock.
D) Anaphylactic shock.
Rationale: Neurogenic shock occurs with spinal cord injuries above T6 due to the loss
of sympathetic nervous system tone. This leads to massive vasodilation (causing
hypotension) and unopposed vagal stimulation (causing bradycardia), making
bradycardia a unique identifier of neurogenic shock compared to other shock states.
Question 6
A nurse is evaluating the hemodynamic parameters of a patient in cardiogenic shock.
Which set of findings aligns with the pathophysiology of this condition?
A) High cardiac output, low SVR, low PAWP.
B) B) Low cardiac output, high SVR, high pulmonary artery wedge pressure
(PAWP).
C) High cardiac output, high SVR, low CVP.
D) Low cardiac output, low SVR, low PAWP.
Rationale: In cardiogenic shock, the heart fails to pump effectively, lowering cardiac
output. The body compensates via vasoconstriction, which increases afterload (high
SVR). Fluid backs up into the lungs, increasing left ventricular end-diastolic pressure
(high PAWP).
Question 7
, Which mechanical ventilator setting is specifically adjusted to maintain a positive
pressure within the alveoli at the end of expiration, preventing micro-atelectasis in an
ARDS patient?
A) Tidal Volume (Vt).
B) Fraction of Inspired Oxygen (FiO2).
C) C) Positive End-Expiratory Pressure (PEEP).
D) Inspiratory Flow Rate.
Rationale: PEEP keeps the alveoli open at the end of exhalation. This prevents
alveolar collapse (atelectasis), increases the surface area for gas exchange, and helps
treat refractory hypoxemia in patients with ARDS.
Question 8
A patient in the coronary care unit develops ventricular fibrillation (V-Fib). The nurse
notes the patient is unresponsive and pulseless. Which intervention must be performed
first?
A) Administer a 1 mg IV bolus of Epinephrine.
B) B) Immediate defibrillation (unsynchronized shock).
C) Perform a synchronized cardioversion.
D) Insert an advanced airway tube.
Rationale: The definitive treatment for pulseless ventricular fibrillation is immediate
defibrillation. While CPR is performed until the defibrillator is ready, delivering an
unsynchronized shock takes priority over medications or airway placement.
Question 9
A nurse is assessing a patient who is post-operative from an abdominal aortic aneurysm
repair. The nurse notes a sudden drop in urine output to less than 15 mL/hour, a serum
creatinine of 2.8 mg/dL, and a blood urea nitrogen (BUN) of 45 mg/dL. Which phase of
Acute Kidney Injury (AKI) is this patient demonstrating?
A) Initiation phase.
B) B) Oliguric phase.
& Answers | Complete Study Guide
Prepare for NSG 3130 Exam 4 with this comprehensive study guide featuring practice questions,
verified answers, and detailed rationales designed to reinforce key nursing concepts. This exam
prep resource covers advanced patient assessment, clinical judgment, pharmacology, priority
nursing interventions, care planning, safety considerations, and evidence-based practice
commonly assessed in NSG 3130. Structured to improve knowledge retention and test-taking
confidence, the material helps students identify strengths and target areas for improvement
before exam day. Ideal for nursing students seeking a reliable and effective resource to prepare
for and excel on NSG 3130 Exam 4.
Question 1
A nurse is caring for a patient in the intensive care unit who is undergoing hemodynamic
monitoring. The patient’s central venous pressure (CVP) reads 1 mmHg. Which clinical
condition matches this parameter?
A) Right-sided heart failure.
B) B) Hypovolemia due to severe hemorrhage.
C) Fluid volume overload from excessive IV infusions.
D) Pulmonary hypertension.
Rationale: A normal CVP is 2–6 mmHg. A low CVP (<2 mmHg) directly indicates
reduced right-sided cardiac preload, which is caused by conditions that reduce
intravascular volume, such as hemorrhage, severe dehydration, or excessive diuresis.
Question 2
A patient in septic shock remains hypotensive despite receiving a 30 mL/kg bolus of
normal saline. The provider orders a continuous vasopressor infusion. Which
medication is considered the first-choice agent to restore systemic vascular resistance
(SVR)?
A) Epinephrine.
B) Atropine sulfate.
C) C) Norepinephrine.
D) Nitroprusside.
,Rationale: Norepinephrine is the first-line vasopressor used in septic shock to treat
fluid-refractory hypotension. It works primarily via alpha-1 adrenergic receptors to cause
potent vasoconstriction, thereby increasing SVR and blood pressure.
Question 3
A nurse is caring for a patient with acute respiratory distress syndrome (ARDS) who is
receiving mechanical ventilation. Which arterial blood gas finding is considered the
hallmark manifestation of ARDS?
A) Metabolic alkalosis with adequate oxygenation.
B) B) Severe hypoxemia that does not improve with increased fraction of inspired
oxygen (refractory hypoxemia).
C) Respiratory alkalosis with an elevated PaO2.
D) Normal PaO2 paired with elevated bicarbonate levels.
Rationale: Refractory hypoxemia—where the patient’s PaO2 remains critically low
despite escalating delivery of oxygen (FiO2)—is the clinical hallmark of ARDS. It is
caused by widespread intrapulmonary shunting from alveolar collapse and fluid
accumulation.
Question 4
The low-pressure alarm sounds on the mechanical ventilator of a patient who is
intubated and sedated. The nurse enters the room and notes the patient is in no
immediate distress. What is the most likely cause of this alarm?
A) The patient is biting down on the endotracheal tube.
B) Extensive mucus plugging within the main bronchus.
C) C) A total disconnection between the endotracheal tube and the ventilator
circuit.
D) Development of an acute tension pneumothorax.
Rationale: Low-pressure alarms are triggered by a loss of resistance or a drop in
expected airway pressure. This is caused by circuit disconnections, severe cuff leaks, or
accidental self-extubation. Biting, plugging, and pneumothoraces cause high-pressure
alarms.
,Question 5
A patient is admitted to the emergency department following a motor vehicle accident.
The nurse notes a spinal cord injury at the T3 level. The patient’s vital signs are blood
pressure 82/40 mmHg and heart rate 46 beats/minute. Which type of shock is this
patient experiencing?
A) Hypovolemic shock.
B) Cardiogenic shock.
C) C) Neurogenic shock.
D) Anaphylactic shock.
Rationale: Neurogenic shock occurs with spinal cord injuries above T6 due to the loss
of sympathetic nervous system tone. This leads to massive vasodilation (causing
hypotension) and unopposed vagal stimulation (causing bradycardia), making
bradycardia a unique identifier of neurogenic shock compared to other shock states.
Question 6
A nurse is evaluating the hemodynamic parameters of a patient in cardiogenic shock.
Which set of findings aligns with the pathophysiology of this condition?
A) High cardiac output, low SVR, low PAWP.
B) B) Low cardiac output, high SVR, high pulmonary artery wedge pressure
(PAWP).
C) High cardiac output, high SVR, low CVP.
D) Low cardiac output, low SVR, low PAWP.
Rationale: In cardiogenic shock, the heart fails to pump effectively, lowering cardiac
output. The body compensates via vasoconstriction, which increases afterload (high
SVR). Fluid backs up into the lungs, increasing left ventricular end-diastolic pressure
(high PAWP).
Question 7
, Which mechanical ventilator setting is specifically adjusted to maintain a positive
pressure within the alveoli at the end of expiration, preventing micro-atelectasis in an
ARDS patient?
A) Tidal Volume (Vt).
B) Fraction of Inspired Oxygen (FiO2).
C) C) Positive End-Expiratory Pressure (PEEP).
D) Inspiratory Flow Rate.
Rationale: PEEP keeps the alveoli open at the end of exhalation. This prevents
alveolar collapse (atelectasis), increases the surface area for gas exchange, and helps
treat refractory hypoxemia in patients with ARDS.
Question 8
A patient in the coronary care unit develops ventricular fibrillation (V-Fib). The nurse
notes the patient is unresponsive and pulseless. Which intervention must be performed
first?
A) Administer a 1 mg IV bolus of Epinephrine.
B) B) Immediate defibrillation (unsynchronized shock).
C) Perform a synchronized cardioversion.
D) Insert an advanced airway tube.
Rationale: The definitive treatment for pulseless ventricular fibrillation is immediate
defibrillation. While CPR is performed until the defibrillator is ready, delivering an
unsynchronized shock takes priority over medications or airway placement.
Question 9
A nurse is assessing a patient who is post-operative from an abdominal aortic aneurysm
repair. The nurse notes a sudden drop in urine output to less than 15 mL/hour, a serum
creatinine of 2.8 mg/dL, and a blood urea nitrogen (BUN) of 45 mg/dL. Which phase of
Acute Kidney Injury (AKI) is this patient demonstrating?
A) Initiation phase.
B) B) Oliguric phase.
