NSG 3250 EXAM 300 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE ALREADY GRADED A+
NEW!!!!!!!!!!!!!!!!!!!!!!!!!!!
This comprehensive set of 300 multiple-choice questions is meticulously
designed for nursing students preparing for the NSG 3250 Exam. The
questions thoroughly cover all core content areas including medical-surgical
nursing, pharmacology, critical care, neurological assessment, cardiovascular
and respiratory disorders, endocrine and renal conditions, gastrointestinal
and hepatic disorders, wound care, infection control, and perioperative
nursing. Each question is paired with a correct answer and a detailed
rationale that explains the underlying clinical principle, nursing intervention,
or pathophysiological concept. This resource ensures a deep and practical
understanding for exam success and reinforces critical nursing knowledge
required for safe and effective patient care in complex clinical environments.
1. A patient with heart failure is prescribed furosemide. Which finding requires
immediate intervention?
A) Weight loss of 1 kg in 24 hours
B) Blood pressure 110/70 mmHg
C) Potassium level 2.9 mEq/L
D) Urine output 1500 mL/day
Correct Answer: C) Potassium level 2.9 mEq/L.
Rationale: Hypokalemia is a serious side effect of loop diuretics like furosemide
and can lead to life-threatening cardiac dysrhythmias. A potassium level of 2.9
mEq/L is critically low and requires immediate correction. Weight loss of 1 kg in
24 hours indicates effective diuresis, a blood pressure of 110/70 mmHg may be
acceptable, and urine output of 1500 mL/day is within normal limits.
2. A nurse is caring for a patient with chest pain. Which action is the priority?
A) Obtain health history
B) Administer oxygen
C) Provide pain medication
,D) Perform ECG
Correct Answer: B) Administer oxygen.
Rationale: Airway, breathing, and oxygenation are always the priority when
managing chest pain to prevent myocardial ischemia and damage. Administering
oxygen ensures adequate perfusion to the heart muscle while other interventions
are initiated. Assessment, pain management, and ECG are important but secondary
to oxygenation.
3. A patient with COPD is receiving oxygen. Which finding indicates correct
oxygen therapy?
A) Respiratory rate 8/min
B) Oxygen saturation 90%
C) Oxygen saturation 100%
D) Respiratory alkalosis
Correct Answer: B) Oxygen saturation 90%.
Rationale: In COPD patients, the target oxygen saturation is typically 88% to 92%
to avoid suppressing the hypoxic drive. An SpO2 of 90% indicates appropriate
oxygen therapy. An SpO2 of 100% could lead to hypercapnia and respiratory
depression in COPD patients.
4. Which symptom is most concerning in a patient with increased intracranial
pressure?
A) Headache
B) Vomiting
C) Decreased level of consciousness
D) Blurred vision
Correct Answer: C) Decreased level of consciousness.
Rationale: Changes in level of consciousness are the earliest and most critical
indicator of worsening intracranial pressure. As ICP increases, cerebral perfusion
decreases, leading to altered LOC. Headache, vomiting, and blurred vision are also
signs of increased ICP, but they are later or less specific findings.
5. A patient with acute kidney injury has potassium 6.2 mEq/L. What is the priority
action?
A) Restrict fluids
B) Administer insulin and glucose
C) Monitor intake/output
,D) Encourage potassium-rich foods
Correct Answer: B) Administer insulin and glucose.
Rationale: Hyperkalemia of 6.2 mEq/L is life-threatening and requires immediate
intervention. Insulin and glucose work together to shift potassium from the
extracellular space into the cells, temporarily lowering serum potassium levels.
Fluid restriction and monitoring are appropriate but not the priority for acute
hyperkalemia.
6. Which assessment finding indicates appendicitis?
A) Left lower quadrant pain
B) Rebound tenderness in RLQ
C) Hyperactive bowel sounds
D) Pain radiating to the back
Correct Answer: B) Rebound tenderness in RLQ.
Rationale: Rebound tenderness in the right lower quadrant (McBurney's point) is a
classic sign of appendicitis, indicating peritoneal irritation. Pain is typically
localized to the right lower quadrant, not the left. Bowel sounds may be diminished
or absent, not hyperactive.
7. A patient with burns is at highest risk for which complication?
A) Hypothermia
B) Hyperkalemia
C) Infection
D) Fluid overload
Correct Answer: C) Infection.
Rationale: The loss of skin integrity in burn patients creates a significant portal of
entry for pathogens, making infection the leading cause of morbidity and mortality
in burn injuries. While hypothermia, hyperkalemia, and fluid shifts are also
concerns, infection is the most serious long-term complication.
8. A patient with anaphylaxis requires which medication first?
A) Diphenhydramine
B) Albuterol
C) Epinephrine
D) Corticosteroids
Correct Answer: C) Epinephrine.
, Rationale: Epinephrine is the first-line medication for anaphylaxis. It works rapidly
to reverse bronchospasm, hypotension, and angioedema. Other medications like
antihistamines, bronchodilators, and corticosteroids are adjunctive treatments that
may be given after epinephrine.
9. A patient post-cardiac arrest has a temperature of 34°C. What action is
appropriate?
A) Apply warming blankets
B) Initiate targeted temperature management
C) Administer antipyretics
D) Document as expected
Correct Answer: B) Initiate targeted temperature management.
Rationale: Targeted temperature management (therapeutic hypothermia) is a
standard intervention in post-cardiac arrest care to reduce the risk of neurological
injury. A temperature of 34°C may be intentional as part of this protocol. Warming
blankets would counteract this therapy.
10. A patient with severe burns has carbonaceous sputum. What is the priority?
A) Assess for smoke inhalation injury
B) Provide humidified oxygen
C) Administer antibiotics
D) Suction the airway
Correct Answer: A) Assess for smoke inhalation injury.
Rationale: Carbonaceous sputum is a hallmark sign of smoke inhalation injury,
which can lead to airway edema and compromise. The priority is to assess and
manage the airway. Humidified oxygen may be needed, but assessment is the first
step.
11. A patient in status epilepticus requires which medication first?
A) Oral phenytoin
B) IV lorazepam
C) IV phenobarbital
D) Oral diazepam
Correct Answer: B) IV lorazepam.
Rationale: Status epilepticus is a medical emergency requiring rapid termination of
seizure activity. Intravenous benzodiazepines, such as lorazepam or diazepam, are
the first-line medications because of their rapid onset of action.
ANSWERS WITH RATIONALE ALREADY GRADED A+
NEW!!!!!!!!!!!!!!!!!!!!!!!!!!!
This comprehensive set of 300 multiple-choice questions is meticulously
designed for nursing students preparing for the NSG 3250 Exam. The
questions thoroughly cover all core content areas including medical-surgical
nursing, pharmacology, critical care, neurological assessment, cardiovascular
and respiratory disorders, endocrine and renal conditions, gastrointestinal
and hepatic disorders, wound care, infection control, and perioperative
nursing. Each question is paired with a correct answer and a detailed
rationale that explains the underlying clinical principle, nursing intervention,
or pathophysiological concept. This resource ensures a deep and practical
understanding for exam success and reinforces critical nursing knowledge
required for safe and effective patient care in complex clinical environments.
1. A patient with heart failure is prescribed furosemide. Which finding requires
immediate intervention?
A) Weight loss of 1 kg in 24 hours
B) Blood pressure 110/70 mmHg
C) Potassium level 2.9 mEq/L
D) Urine output 1500 mL/day
Correct Answer: C) Potassium level 2.9 mEq/L.
Rationale: Hypokalemia is a serious side effect of loop diuretics like furosemide
and can lead to life-threatening cardiac dysrhythmias. A potassium level of 2.9
mEq/L is critically low and requires immediate correction. Weight loss of 1 kg in
24 hours indicates effective diuresis, a blood pressure of 110/70 mmHg may be
acceptable, and urine output of 1500 mL/day is within normal limits.
2. A nurse is caring for a patient with chest pain. Which action is the priority?
A) Obtain health history
B) Administer oxygen
C) Provide pain medication
,D) Perform ECG
Correct Answer: B) Administer oxygen.
Rationale: Airway, breathing, and oxygenation are always the priority when
managing chest pain to prevent myocardial ischemia and damage. Administering
oxygen ensures adequate perfusion to the heart muscle while other interventions
are initiated. Assessment, pain management, and ECG are important but secondary
to oxygenation.
3. A patient with COPD is receiving oxygen. Which finding indicates correct
oxygen therapy?
A) Respiratory rate 8/min
B) Oxygen saturation 90%
C) Oxygen saturation 100%
D) Respiratory alkalosis
Correct Answer: B) Oxygen saturation 90%.
Rationale: In COPD patients, the target oxygen saturation is typically 88% to 92%
to avoid suppressing the hypoxic drive. An SpO2 of 90% indicates appropriate
oxygen therapy. An SpO2 of 100% could lead to hypercapnia and respiratory
depression in COPD patients.
4. Which symptom is most concerning in a patient with increased intracranial
pressure?
A) Headache
B) Vomiting
C) Decreased level of consciousness
D) Blurred vision
Correct Answer: C) Decreased level of consciousness.
Rationale: Changes in level of consciousness are the earliest and most critical
indicator of worsening intracranial pressure. As ICP increases, cerebral perfusion
decreases, leading to altered LOC. Headache, vomiting, and blurred vision are also
signs of increased ICP, but they are later or less specific findings.
5. A patient with acute kidney injury has potassium 6.2 mEq/L. What is the priority
action?
A) Restrict fluids
B) Administer insulin and glucose
C) Monitor intake/output
,D) Encourage potassium-rich foods
Correct Answer: B) Administer insulin and glucose.
Rationale: Hyperkalemia of 6.2 mEq/L is life-threatening and requires immediate
intervention. Insulin and glucose work together to shift potassium from the
extracellular space into the cells, temporarily lowering serum potassium levels.
Fluid restriction and monitoring are appropriate but not the priority for acute
hyperkalemia.
6. Which assessment finding indicates appendicitis?
A) Left lower quadrant pain
B) Rebound tenderness in RLQ
C) Hyperactive bowel sounds
D) Pain radiating to the back
Correct Answer: B) Rebound tenderness in RLQ.
Rationale: Rebound tenderness in the right lower quadrant (McBurney's point) is a
classic sign of appendicitis, indicating peritoneal irritation. Pain is typically
localized to the right lower quadrant, not the left. Bowel sounds may be diminished
or absent, not hyperactive.
7. A patient with burns is at highest risk for which complication?
A) Hypothermia
B) Hyperkalemia
C) Infection
D) Fluid overload
Correct Answer: C) Infection.
Rationale: The loss of skin integrity in burn patients creates a significant portal of
entry for pathogens, making infection the leading cause of morbidity and mortality
in burn injuries. While hypothermia, hyperkalemia, and fluid shifts are also
concerns, infection is the most serious long-term complication.
8. A patient with anaphylaxis requires which medication first?
A) Diphenhydramine
B) Albuterol
C) Epinephrine
D) Corticosteroids
Correct Answer: C) Epinephrine.
, Rationale: Epinephrine is the first-line medication for anaphylaxis. It works rapidly
to reverse bronchospasm, hypotension, and angioedema. Other medications like
antihistamines, bronchodilators, and corticosteroids are adjunctive treatments that
may be given after epinephrine.
9. A patient post-cardiac arrest has a temperature of 34°C. What action is
appropriate?
A) Apply warming blankets
B) Initiate targeted temperature management
C) Administer antipyretics
D) Document as expected
Correct Answer: B) Initiate targeted temperature management.
Rationale: Targeted temperature management (therapeutic hypothermia) is a
standard intervention in post-cardiac arrest care to reduce the risk of neurological
injury. A temperature of 34°C may be intentional as part of this protocol. Warming
blankets would counteract this therapy.
10. A patient with severe burns has carbonaceous sputum. What is the priority?
A) Assess for smoke inhalation injury
B) Provide humidified oxygen
C) Administer antibiotics
D) Suction the airway
Correct Answer: A) Assess for smoke inhalation injury.
Rationale: Carbonaceous sputum is a hallmark sign of smoke inhalation injury,
which can lead to airway edema and compromise. The priority is to assess and
manage the airway. Humidified oxygen may be needed, but assessment is the first
step.
11. A patient in status epilepticus requires which medication first?
A) Oral phenytoin
B) IV lorazepam
C) IV phenobarbital
D) Oral diazepam
Correct Answer: B) IV lorazepam.
Rationale: Status epilepticus is a medical emergency requiring rapid termination of
seizure activity. Intravenous benzodiazepines, such as lorazepam or diazepam, are
the first-line medications because of their rapid onset of action.
