NSG 3850 Exam Practice Questions
1. A nurse is caring for a client with heart failure who reports shortness of breath and
fatigue. Which laboratory value is most specific to confirm worsening heart failure?
A) Troponin I
B) Brain natriuretic peptide (BNP) ✅
C) D-dimer
D) C-reactive protein
2. The nurse is teaching a client with COPD about pursed-lip breathing. Which statement
indicates understanding?
A) “I will inhale quickly through my mouth.”
B) “I should exhale through pursed lips slowly.” ✅
C) “I should hold my breath for at least 10 seconds.”
D) “I will breathe in and out rapidly.”
3. When administering IV potassium chloride (KCl), the nurse should:
A) Infuse rapidly over 10 minutes.
B) Dilute in 50-100 mL of normal saline and infuse slowly. ✅
C) Administer undiluted as a bolus.
D) Mix with dextrose solution.
4. A client with a history of diabetes presents with confusion, diaphoresis, and tremors.
What is the nurse’s priority action?
A) Reassure the client.
B) Check the blood glucose level. ✅
C) Give 1 mg glucagon IM immediately.
D) Notify the provider.
5. A nurse is planning care for a client receiving total parenteral nutrition (TPN). What is
the priority nursing action?
A) Monitor for signs of infection at the catheter site. ✅
B) Weigh the client weekly.
C) Encourage oral fluids.
D) Limit glucose monitoring to once daily.
,6. A client with cirrhosis has asterixis and confusion. Which lab value does the nurse expect
to be elevated?
A) Serum albumin
B) Serum ammonia ✅
C) Bilirubin
D) Platelet count
7. Which intervention is appropriate for a client experiencing autonomic dysreflexia?
A) Place the client in Trendelenburg position.
B) Elevate the head of the bed to 90 degrees. ✅
C) Restrict fluids.
D) Apply warm compresses to lower extremities.
8. The nurse assesses a client post-thyroidectomy and notes hoarseness and stridor. What is
the priority action?
A) Reassess in 30 minutes.
B) Administer IV calcium gluconate.
C) Notify Rapid Response Team. ✅
D) Suction the airway.
9. A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates the need for further teaching?
A) “I will empty the pouch when it is one-third full.”
B) “I can use mild soap and water to clean the skin.”
C) “I will expect stool to be liquid and continuous.” ✅
D) “I should check the skin around the stoma regularly.”
10. A client reports severe chest pain unrelieved by rest or nitroglycerin. Which finding
requires immediate intervention?
A) Blood pressure 142/90 mm Hg
B) ST-segment elevation on ECG ✅
C) Heart rate 88 bpm
D) Oxygen saturation 96%
,11. Explain why beta-blockers are contraindicated in acute decompensated heart failure.
✅ Answer: Beta-blockers decrease myocardial contractility and can worsen heart failure
symptoms during acute decompensation.
12. Describe two priority interventions for a client experiencing hypoglycemia.
✅ Answer:
Administer 15 grams of a fast-acting carbohydrate (e.g., juice).
Recheck glucose in 15 minutes and repeat if needed.
13. State one key difference between ulcerative colitis and Crohn’s disease.
✅ Answer: Ulcerative colitis affects only the colon and rectum in a continuous pattern; Crohn’s
disease can affect any part of the GI tract in skip lesions.
14. List two signs of digoxin toxicity.
✅ Answer:
Nausea and vomiting
Visual disturbances (e.g., blurred vision, yellow halos)
15. What is the rationale for administering lactulose to a client with hepatic
encephalopathy?
✅ Answer: Lactulose reduces serum ammonia levels by trapping ammonia in the gut and
promoting its excretion.
16. A nurse is caring for a client with hypocalcemia. Which assessment finding requires
immediate intervention?
A) Positive Chvostek’s sign
B) Laryngospasm ✅
C) Numbness in fingers
D) Muscle twitching
17. When teaching a client newly diagnosed with hypertension about lifestyle changes,
which recommendation is appropriate?
, A) Limit alcohol to 4 drinks daily.
B) Engage in 30 minutes of aerobic exercise most days. ✅
C) Avoid all dairy products.
D) Reduce potassium intake.
18. A client is receiving vancomycin IV. The nurse notes redness and flushing of the neck
and upper torso. What should the nurse do?
A) Stop the infusion immediately.
B) Slow the infusion rate. ✅
C) Notify the provider of anaphylaxis.
D) Administer epinephrine.
19. Which ECG finding is consistent with hypokalemia?
A) Peaked T waves
B) U waves ✅
C) Widened QRS complexes
D) ST-segment elevation
20. The nurse prepares to administer morning insulin. The client’s blood glucose is 68
mg/dL. What is the appropriate action?
A) Administer the insulin as ordered.
B) Hold the insulin and notify the provider. ✅
C) Give 4 ounces of juice and recheck in 30 minutes.
D) Double-check the insulin dose with another nurse.
21. A nurse is caring for a client with acute pancreatitis. Which laboratory finding would
be elevated?
A) Amylase ✅
B) AST
C) Bilirubin
D) Hemoglobin
✅ 22. Which of the following assessment findings indicates neurogenic shock after spinal
cord injury?
A) Bradycardia ✅
B) Hypertension
C) Cool, clammy skin
D) Increased cardiac output
1. A nurse is caring for a client with heart failure who reports shortness of breath and
fatigue. Which laboratory value is most specific to confirm worsening heart failure?
A) Troponin I
B) Brain natriuretic peptide (BNP) ✅
C) D-dimer
D) C-reactive protein
2. The nurse is teaching a client with COPD about pursed-lip breathing. Which statement
indicates understanding?
A) “I will inhale quickly through my mouth.”
B) “I should exhale through pursed lips slowly.” ✅
C) “I should hold my breath for at least 10 seconds.”
D) “I will breathe in and out rapidly.”
3. When administering IV potassium chloride (KCl), the nurse should:
A) Infuse rapidly over 10 minutes.
B) Dilute in 50-100 mL of normal saline and infuse slowly. ✅
C) Administer undiluted as a bolus.
D) Mix with dextrose solution.
4. A client with a history of diabetes presents with confusion, diaphoresis, and tremors.
What is the nurse’s priority action?
A) Reassure the client.
B) Check the blood glucose level. ✅
C) Give 1 mg glucagon IM immediately.
D) Notify the provider.
5. A nurse is planning care for a client receiving total parenteral nutrition (TPN). What is
the priority nursing action?
A) Monitor for signs of infection at the catheter site. ✅
B) Weigh the client weekly.
C) Encourage oral fluids.
D) Limit glucose monitoring to once daily.
,6. A client with cirrhosis has asterixis and confusion. Which lab value does the nurse expect
to be elevated?
A) Serum albumin
B) Serum ammonia ✅
C) Bilirubin
D) Platelet count
7. Which intervention is appropriate for a client experiencing autonomic dysreflexia?
A) Place the client in Trendelenburg position.
B) Elevate the head of the bed to 90 degrees. ✅
C) Restrict fluids.
D) Apply warm compresses to lower extremities.
8. The nurse assesses a client post-thyroidectomy and notes hoarseness and stridor. What is
the priority action?
A) Reassess in 30 minutes.
B) Administer IV calcium gluconate.
C) Notify Rapid Response Team. ✅
D) Suction the airway.
9. A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates the need for further teaching?
A) “I will empty the pouch when it is one-third full.”
B) “I can use mild soap and water to clean the skin.”
C) “I will expect stool to be liquid and continuous.” ✅
D) “I should check the skin around the stoma regularly.”
10. A client reports severe chest pain unrelieved by rest or nitroglycerin. Which finding
requires immediate intervention?
A) Blood pressure 142/90 mm Hg
B) ST-segment elevation on ECG ✅
C) Heart rate 88 bpm
D) Oxygen saturation 96%
,11. Explain why beta-blockers are contraindicated in acute decompensated heart failure.
✅ Answer: Beta-blockers decrease myocardial contractility and can worsen heart failure
symptoms during acute decompensation.
12. Describe two priority interventions for a client experiencing hypoglycemia.
✅ Answer:
Administer 15 grams of a fast-acting carbohydrate (e.g., juice).
Recheck glucose in 15 minutes and repeat if needed.
13. State one key difference between ulcerative colitis and Crohn’s disease.
✅ Answer: Ulcerative colitis affects only the colon and rectum in a continuous pattern; Crohn’s
disease can affect any part of the GI tract in skip lesions.
14. List two signs of digoxin toxicity.
✅ Answer:
Nausea and vomiting
Visual disturbances (e.g., blurred vision, yellow halos)
15. What is the rationale for administering lactulose to a client with hepatic
encephalopathy?
✅ Answer: Lactulose reduces serum ammonia levels by trapping ammonia in the gut and
promoting its excretion.
16. A nurse is caring for a client with hypocalcemia. Which assessment finding requires
immediate intervention?
A) Positive Chvostek’s sign
B) Laryngospasm ✅
C) Numbness in fingers
D) Muscle twitching
17. When teaching a client newly diagnosed with hypertension about lifestyle changes,
which recommendation is appropriate?
, A) Limit alcohol to 4 drinks daily.
B) Engage in 30 minutes of aerobic exercise most days. ✅
C) Avoid all dairy products.
D) Reduce potassium intake.
18. A client is receiving vancomycin IV. The nurse notes redness and flushing of the neck
and upper torso. What should the nurse do?
A) Stop the infusion immediately.
B) Slow the infusion rate. ✅
C) Notify the provider of anaphylaxis.
D) Administer epinephrine.
19. Which ECG finding is consistent with hypokalemia?
A) Peaked T waves
B) U waves ✅
C) Widened QRS complexes
D) ST-segment elevation
20. The nurse prepares to administer morning insulin. The client’s blood glucose is 68
mg/dL. What is the appropriate action?
A) Administer the insulin as ordered.
B) Hold the insulin and notify the provider. ✅
C) Give 4 ounces of juice and recheck in 30 minutes.
D) Double-check the insulin dose with another nurse.
21. A nurse is caring for a client with acute pancreatitis. Which laboratory finding would
be elevated?
A) Amylase ✅
B) AST
C) Bilirubin
D) Hemoglobin
✅ 22. Which of the following assessment findings indicates neurogenic shock after spinal
cord injury?
A) Bradycardia ✅
B) Hypertension
C) Cool, clammy skin
D) Increased cardiac output
