NSG 3130 Exam 4 Prep 2026 | 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.
1. A patient in the intensive care unit is exhibiting signs of septic shock. Which of
the following hemodynamic profiles most accurately characterizes the
hyperdynamic (early) phase of septic shock?
A. High Systemic Vascular Resistance (SVR) and low Cardiac Output (CO).
B. Low Systemic Vascular Resistance (SVR) and high Cardiac Output (CO).
C. High Central Venous Pressure (CVP) and low Pulmonary Artery Wedge
Pressure (PAWP).
D. Low Cardiac Output (CO) and low Mixed Venous Oxygen Saturation (SvO2).
B. Low Systemic Vascular Resistance (SVR) and high Cardiac Output (CO).
Rationale: The early or hyperdynamic phase of septic shock is characterized by
massive vasodilation induced by inflammatory mediators, which drastically reduces
SVR. In response, the heart compensates by increasing heart rate and stroke volume,
resulting in an elevated or hyperdynamic Cardiac Output (CO).
2. The nurse is caring for a patient who sustained a high-level spinal cord injury
above the T6 level. The nurse notes a blood pressure of 82/40 mmHg and a
heart rate of 46 beats/minute. The nurse identifies this as neurogenic shock.
What is the primary pathophysiological mechanism causing this state?
A. Loss of parasympathetic nervous system tone leading to widespread
vasoconstriction.
B. Disruption of the sympathetic nervous system resulting in uninhibited
parasympathetic response and loss of vasomotor tone.
C. Severe intravascular volume depletion due to occult hemorrhage.
D. Direct mechanical injury to the myocardium resulting in cardiogenic pump
failure.
,B. Disruption of the sympathetic nervous system resulting in uninhibited
parasympathetic response and loss of vasomotor tone.
Rationale: Neurogenic shock occurs due to the loss of sympathetic vasomotor tone
caused by spinal cord injury above T6. This results in massive, uninhibited
parasympathetic stimulation, causing profound vasodilation (venous pooling) and
bradycardia, distinguishing it from other shock states where tachycardia is the rule.
3. Which of the following intravenous fluids is considered a colloid solution and is
utilized to expand intravascular volume rapidly by increasing oncotic pressure?
A. 0.9% Normal Saline
B. Lactated Ringer’s solution
C. 5% Albumin
D. 5% Dextrose in Water (D5W)
C. 5% Albumin
Rationale: Albumin is a colloid solution containing large molecules that cannot easily
cross the capillary membrane. It pulls fluid from the interstitial space into the
intravascular compartment by increasing plasma oncotic pressure, whereas Normal
Saline and Lactated Ringer's are crystalloids.
4. During the compensatory stage of hypovolemic shock, which physiological
compensatory mechanism is activated to maintain perfusion to vital organs?
A. Parasympathetic activation leading to decreased myocardial contractility.
B. Suppression of the renin-angiotensin-aldosterone system (RAAS) to promote
diuresis.
C. Activation of the sympathetic nervous system releasing epinephrine and
norepinephrine.
D. Vasodilation of splanchnic and cutaneous bed vessels.
C. Activation of the sympathetic nervous system releasing epinephrine and
norepinephrine.
Rationale: In the compensatory stage of shock, the drop in cardiac output triggers
baroreceptors to activate the sympathetic nervous system (SNS). The release of
catecholamines (epinephrine and norepinephrine) increases heart rate, enhances
myocardial contractility, and causes selective vasoconstriction to shunt blood to vital
organs.
5. A patient with severe cardiogenic shock is placed on an Intra-Aortic Balloon
Pump (IABP). What is the primary therapeutic benefit of counterpulsation
therapy?
, A. Inflation during systole to pull blood out of the left ventricle.
B. Deflation during diastole to maximize coronary artery perfusion.
C. Inflation during diastole to enhance coronary artery perfusion and deflation
right before systole to decrease afterload.
D. Continuous inflation to maintain a high mean arterial pressure throughout the
entire cardiac cycle.
C. Inflation during diastole to enhance coronary artery perfusion and deflation
right before systole to decrease afterload.
Rationale: The IABP inflates during diastole (matching the dicrotic notch) to retrograde-
flush blood into the aortic root, augmenting coronary artery perfusion. It deflates
immediately before systole, creating a vacuum effect that lowers intra-aortic pressure,
reducing left ventricular afterload and workload.
Section 2: Advanced Respiratory Care and Mechanical
Ventilation
6. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on
mechanical ventilation. The provider orders the use of positive end-expiratory
pressure (PEEP). What is the primary purpose of PEEP in ARDS?
A. To decrease the patient's respiratory rate and work of breathing.
B. To prevent alveolar collapse at the end of expiration and maximize gas
exchange.
C. To decrease the peak inspiratory pressure within the ventilator circuit.
D. To completely eliminate the need for sedation and paralytic agents.
B. To prevent alveolar collapse at the end of expiration and maximize gas
exchange.
Rationale: ARDS is characterized by diffuse alveolar damage, surfactant depletion, and
atelectasis. PEEP maintains positive pressure in the lungs at the end of expiration,
keeping alveoli open (recruitment), increasing functional residual capacity, and
improving oxygenation while reducing the risk of oxygen toxicity.
7. While evaluating a patient on mechanical ventilation, the low-pressure alarm
sounds on the ventilator. Which of the following issues should the nurse
troubleshoot as the most likely cause?
A. The patient is biting down forcefully on the endotracheal tube.
B. Excess condensation or water is pooling within the ventilator tubing circuit.
, C. The patient's endotracheal tube cuff has leaked or the tubing has become
disconnected.
D. The patient is experiencing severe bronchospasms or a mucous plug.
C. The patient's endotracheal tube cuff has leaked or the tubing has become
disconnected.
Rationale: Low-pressure alarms are triggered by a drop in expected airway resistance,
typically caused by a total circuit disconnection, a leak in the endotracheal tube cuff, or
a dislodged tube. Biting, pooling water, and bronchospasms increase resistance and
trigger high-pressure alarms.
8. A patient is being ventilated in Assist-Control (AC) mode. The nurse understands
that this mode is defined by which of the following parameters?
A. The ventilator allows the patient to breathe spontaneously between sets
without any pressure support.
B. The ventilator delivers a preset tidal volume or pressure with every breath,
whether initiated by the ventilator or the patient.
C. The patient dictates all tidal volumes independently, and the machine only
controls the respiratory rate.
D. The ventilator only functions when the patient experiences apnea for more
than 20 seconds.
B. The ventilator delivers a preset tidal volume or pressure with every breath,
whether initiated by the ventilator or the patient.
Rationale: In Assist-Control (AC) mode, a preset tidal volume or pressure and a
minimum respiratory rate are established. If the patient initiates a spontaneous breath
above the set rate, the ventilator assists by delivering the full, preset tidal volume or
pressure for that breath.
9. The intensive care nurse notes that a patient ventilated for ARDS is being placed
in the prone position. What is the physiological rationale behind prone positioning
in severe ARDS?
A. To reduce intracranial pressure and maximize systemic venous return.
B. To improve recruitment of collapsed dependent posterior alveoli and optimize
ventilation-perfusion (V/Q) matching.
C. To prevent the occurrence of ventilator-associated pneumonia (VAP).
D. To facilitate easier suctioning of secretions from the upper airway.
B. To improve recruitment of collapsed dependent posterior alveoli and optimize
ventilation-perfusion (V/Q) matching.
Rationale: In a supine patient, the weight of the heart and abdominal contents
compresses the posterior (dependent) lung zones. Turning the patient prone relieves
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.
1. A patient in the intensive care unit is exhibiting signs of septic shock. Which of
the following hemodynamic profiles most accurately characterizes the
hyperdynamic (early) phase of septic shock?
A. High Systemic Vascular Resistance (SVR) and low Cardiac Output (CO).
B. Low Systemic Vascular Resistance (SVR) and high Cardiac Output (CO).
C. High Central Venous Pressure (CVP) and low Pulmonary Artery Wedge
Pressure (PAWP).
D. Low Cardiac Output (CO) and low Mixed Venous Oxygen Saturation (SvO2).
B. Low Systemic Vascular Resistance (SVR) and high Cardiac Output (CO).
Rationale: The early or hyperdynamic phase of septic shock is characterized by
massive vasodilation induced by inflammatory mediators, which drastically reduces
SVR. In response, the heart compensates by increasing heart rate and stroke volume,
resulting in an elevated or hyperdynamic Cardiac Output (CO).
2. The nurse is caring for a patient who sustained a high-level spinal cord injury
above the T6 level. The nurse notes a blood pressure of 82/40 mmHg and a
heart rate of 46 beats/minute. The nurse identifies this as neurogenic shock.
What is the primary pathophysiological mechanism causing this state?
A. Loss of parasympathetic nervous system tone leading to widespread
vasoconstriction.
B. Disruption of the sympathetic nervous system resulting in uninhibited
parasympathetic response and loss of vasomotor tone.
C. Severe intravascular volume depletion due to occult hemorrhage.
D. Direct mechanical injury to the myocardium resulting in cardiogenic pump
failure.
,B. Disruption of the sympathetic nervous system resulting in uninhibited
parasympathetic response and loss of vasomotor tone.
Rationale: Neurogenic shock occurs due to the loss of sympathetic vasomotor tone
caused by spinal cord injury above T6. This results in massive, uninhibited
parasympathetic stimulation, causing profound vasodilation (venous pooling) and
bradycardia, distinguishing it from other shock states where tachycardia is the rule.
3. Which of the following intravenous fluids is considered a colloid solution and is
utilized to expand intravascular volume rapidly by increasing oncotic pressure?
A. 0.9% Normal Saline
B. Lactated Ringer’s solution
C. 5% Albumin
D. 5% Dextrose in Water (D5W)
C. 5% Albumin
Rationale: Albumin is a colloid solution containing large molecules that cannot easily
cross the capillary membrane. It pulls fluid from the interstitial space into the
intravascular compartment by increasing plasma oncotic pressure, whereas Normal
Saline and Lactated Ringer's are crystalloids.
4. During the compensatory stage of hypovolemic shock, which physiological
compensatory mechanism is activated to maintain perfusion to vital organs?
A. Parasympathetic activation leading to decreased myocardial contractility.
B. Suppression of the renin-angiotensin-aldosterone system (RAAS) to promote
diuresis.
C. Activation of the sympathetic nervous system releasing epinephrine and
norepinephrine.
D. Vasodilation of splanchnic and cutaneous bed vessels.
C. Activation of the sympathetic nervous system releasing epinephrine and
norepinephrine.
Rationale: In the compensatory stage of shock, the drop in cardiac output triggers
baroreceptors to activate the sympathetic nervous system (SNS). The release of
catecholamines (epinephrine and norepinephrine) increases heart rate, enhances
myocardial contractility, and causes selective vasoconstriction to shunt blood to vital
organs.
5. A patient with severe cardiogenic shock is placed on an Intra-Aortic Balloon
Pump (IABP). What is the primary therapeutic benefit of counterpulsation
therapy?
, A. Inflation during systole to pull blood out of the left ventricle.
B. Deflation during diastole to maximize coronary artery perfusion.
C. Inflation during diastole to enhance coronary artery perfusion and deflation
right before systole to decrease afterload.
D. Continuous inflation to maintain a high mean arterial pressure throughout the
entire cardiac cycle.
C. Inflation during diastole to enhance coronary artery perfusion and deflation
right before systole to decrease afterload.
Rationale: The IABP inflates during diastole (matching the dicrotic notch) to retrograde-
flush blood into the aortic root, augmenting coronary artery perfusion. It deflates
immediately before systole, creating a vacuum effect that lowers intra-aortic pressure,
reducing left ventricular afterload and workload.
Section 2: Advanced Respiratory Care and Mechanical
Ventilation
6. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on
mechanical ventilation. The provider orders the use of positive end-expiratory
pressure (PEEP). What is the primary purpose of PEEP in ARDS?
A. To decrease the patient's respiratory rate and work of breathing.
B. To prevent alveolar collapse at the end of expiration and maximize gas
exchange.
C. To decrease the peak inspiratory pressure within the ventilator circuit.
D. To completely eliminate the need for sedation and paralytic agents.
B. To prevent alveolar collapse at the end of expiration and maximize gas
exchange.
Rationale: ARDS is characterized by diffuse alveolar damage, surfactant depletion, and
atelectasis. PEEP maintains positive pressure in the lungs at the end of expiration,
keeping alveoli open (recruitment), increasing functional residual capacity, and
improving oxygenation while reducing the risk of oxygen toxicity.
7. While evaluating a patient on mechanical ventilation, the low-pressure alarm
sounds on the ventilator. Which of the following issues should the nurse
troubleshoot as the most likely cause?
A. The patient is biting down forcefully on the endotracheal tube.
B. Excess condensation or water is pooling within the ventilator tubing circuit.
, C. The patient's endotracheal tube cuff has leaked or the tubing has become
disconnected.
D. The patient is experiencing severe bronchospasms or a mucous plug.
C. The patient's endotracheal tube cuff has leaked or the tubing has become
disconnected.
Rationale: Low-pressure alarms are triggered by a drop in expected airway resistance,
typically caused by a total circuit disconnection, a leak in the endotracheal tube cuff, or
a dislodged tube. Biting, pooling water, and bronchospasms increase resistance and
trigger high-pressure alarms.
8. A patient is being ventilated in Assist-Control (AC) mode. The nurse understands
that this mode is defined by which of the following parameters?
A. The ventilator allows the patient to breathe spontaneously between sets
without any pressure support.
B. The ventilator delivers a preset tidal volume or pressure with every breath,
whether initiated by the ventilator or the patient.
C. The patient dictates all tidal volumes independently, and the machine only
controls the respiratory rate.
D. The ventilator only functions when the patient experiences apnea for more
than 20 seconds.
B. The ventilator delivers a preset tidal volume or pressure with every breath,
whether initiated by the ventilator or the patient.
Rationale: In Assist-Control (AC) mode, a preset tidal volume or pressure and a
minimum respiratory rate are established. If the patient initiates a spontaneous breath
above the set rate, the ventilator assists by delivering the full, preset tidal volume or
pressure for that breath.
9. The intensive care nurse notes that a patient ventilated for ARDS is being placed
in the prone position. What is the physiological rationale behind prone positioning
in severe ARDS?
A. To reduce intracranial pressure and maximize systemic venous return.
B. To improve recruitment of collapsed dependent posterior alveoli and optimize
ventilation-perfusion (V/Q) matching.
C. To prevent the occurrence of ventilator-associated pneumonia (VAP).
D. To facilitate easier suctioning of secretions from the upper airway.
B. To improve recruitment of collapsed dependent posterior alveoli and optimize
ventilation-perfusion (V/Q) matching.
Rationale: In a supine patient, the weight of the heart and abdominal contents
compresses the posterior (dependent) lung zones. Turning the patient prone relieves
