Galen NSG 3800 Exam 1 – Adult Health II (2026) Actual Q&A PDF, Exams of Nursing

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Galen NSG 3800 Exam 1 – Adult Health II

(2026) Actual Q&A PDF

1. A nurse manager notices a persistent increase in medication errors on a unit. Using a systems- thinking approach, what is the first leadership action? A. Punish the staff responsible for the errors. B. Conduct a root cause analysis to identify underlying issues. C. Replace all nursing staff on the unit. D. Ignore the issue until the next audit cycle. Correct Answer: B Rationale: Effective leadership uses systems thinking. Root cause analysis identifies underlying systemic issues rather than blaming individuals, allowing for process improvements that prevent future errors. This approach aligns with quality improvement principles.
2. A charge nurse delegates tasks to an unlicensed assistive personnel (UAP). Which task is appropriate for delegation? A. Administering intravenous push medications. B. Assessing a patient’s pain level using a 0– 10 scale. C. Assisting a patient with bathing and oral hygiene. D. Interpreting a patient’s telemetry rhythm strip. Correct Answer: C Rationale: Basic, non‑technical care such as hygiene and activities of daily living can be delegated to UAPs within their scope of practice. Assessment, medication administration, and interpretation of diagnostic data require licensed nursing judgment.
3. Which form of leadership does a manager demonstrate when they gather the team to inform them of mandatory cross‑training for increased productivity?

Correct Answer: B Rationale: Transformational leadership promotes communication, teamwork, collaboration, and positive change. Facilitating open communication to resolve conflict empowers staff and builds a cohesive team environment.

1. An experienced nurse uses contingency theory when orienting a new graduate nurse. Which needs does the nurse address with the new graduate? Select all that apply. A. Coaching B. Discipline C. Counseling D. Developing Correct Answer: A, C, D Rationale: Contingency theory adapts leadership style to the individual and situation. Coaching, counseling, and developing are appropriate for a new graduate. Discipline is not a primary need during orientation.
2. A nurse educator has developed leadership skills through advanced education and shares positive changes within the department. Which transformational leadership characteristic is being demonstrated? A. Using positional power to enforce rules. B. Avoiding any change in the department. C. Creating a culture of dependency on the leader. D. Empowering others through shared vision. Correct Answer: D Rationale: Transformational leaders empower others, share vision, and promote positive change. The educator’s actions reflect empowerment and a commitment to advancing practice through shared learning.

1. Which competencies are important for a nurse leader to develop? Select all that apply. A. Diagnosing a situation accurately. B. Adapting to changing circumstances. C. Controlling all unit decisions without input. D. Communicating effectively with the team. Correct Answer: A, B, D Rationale: Effective nurse leaders must be able to diagnose situations, adapt to changes, and communicate skillfully. Controlling all decisions without input (C) is an autocratic approach, not a core competency.
2. Which behaviors are associated with effective leaders? Select all that apply. A. Problem‑solving skills B. Priority setting C. Self‑development D. Passive listening Correct Answer: A, B, C Rationale: Effective leaders demonstrate active problem‑solving, prioritize appropriately, and engage in continuous self‑development. Passive listening does not support effective leadership communication.
3. Which statement best describes the relationship between management and leadership? A. Management and leadership are identical processes. B. Leadership is a component of management and focuses on vision and inspiration. C. Managers always demonstrate stronger leadership skills than non‑managers. D. Leadership is only relevant for top executives.

1. Which statement about delegation is accurate? A. Delegation transfers accountability to the delegatee. B. The delegating nurse retains ultimate accountability for the task. C. Unlicensed personnel may independently assess patients after delegation. D. Delegation is not permitted for licensed practical/vocational nurses. Correct Answer: B Rationale: The nurse retains accountability for the delegated task, even though the task itself may be performed by another person. Responsibility may be shared, but accountability remains with the delegating nurse.
2. A unit manager observes a UAP consistently performing tasks outside their scope of practice. What is the most appropriate initial action? A. Immediately fire the UAP. B. Report the UAP to the state board. C. Provide reeducation about the UAP’s role and scope. D. Ignore the behavior if no patient harm occurred. Correct Answer: C Rationale: The manager should first address the issue through reeducation and clarification of role expectations. Progressive corrective action follows if the behavior persists.
3. W hich situation best demonstrates the manager’s function of “organizing”? A. Setting goals for the next fiscal year. B. Allocating staff to cover all shifts. C. Motivating staff to achieve unit goals. D. Comparing actual outcomes to expected outcomes.

Correct Answer: B Rationale: Organizing involves arranging resources (including staff) to achieve the organization’s goals. Allocating staff to shifts is a direct example of the management function of organizing.

1. A nurse leader wants to implement a change to improve patient safety. Which step should the leader take first according to change theory? A. Force the change through administrative mandate. B. Unfreeze the current system by creating awareness of the need for change. C. Immediately implement the new safety protocol. D. Refreeze the system after full implementation. Correct Answer: B Rationale: According to Lewin’s change theory, the first stage is “unfreezing,” which involves creating awareness that the current process is inadequate and that change is necessary.
2. A manager is evaluating a new quality improvement initiative. Which step is being performed? A. Planning B. Organizing C. Leading D. Controlling Correct Answer: D Rationale: Controlling is the management function that monitors performance, compares it to goals, and makes corrections as needed. Evaluating a quality initiative falls under controlling.

Correct Answer: B Rationale: AONL competencies include: communication and relationship building, knowledge of the healthcare environment, leadership, professionalism, and business skills. Knowledge of the healthcare environment is essential for effective leadership.

1. A nurse is planning care for a patient with hyponatremia (serum sodium 128 mEq/L). Which foods should the nurse recommend? Select all that apply. A. Canned soup B. Celery C. Ham D. Fresh apple slices Correct Answer: A, B, C Rationale: Hyponatremia requires increased sodium intake. Canned soup, celery, and ham are high in sodium. Fresh apple slices have low sodium and are not therapeutic for hyponatremia.
2. A patient with decreased serum calcium is admitted. Which foods should the nurse recommend? Select all that apply. A. Sardines B. Milk C. Cheese D. White bread Correct Answer: A, B, C Rationale: Hypocalcemia requires increased calcium intake. Sardines, milk, and cheese are excellent dietary sources of calcium. White bread contains minimal calcium.

1. The nurse is assessing a patient with a serum sodium of 130 mEq/L. Which signs and symptoms should the nurse monitor for? Select all that apply. A. Convulsions B. Decreased level of consciousness C. Dry skin D. Increased thirst Correct Answer: A, B Rationale: Hyponatremia (low sodium) can cause cerebral edema, leading to neurological changes such as decreased LOC, seizures, and coma. Dry skin and increased thirst are more characteristic of hypernatremia.
2. Which laboratory values help determine fluid status? Select all that apply. A. Blood urea nitrogen (BUN) B. Serum sodium (Na⁺) C. Creatinine D. Prothrombin time (PT) Correct Answer: A, B, C Rationale: BUN, serum sodium, and creatinine are key indicators of fluid balance. Elevated BUN and creatinine suggest dehydration or kidney dysfunction. PT is a coagulation test unrelated to fluid status.
3. The nurse is caring for a patient with a serum potassium of 5.2 mEq/L. Which signs and symptoms should the nurse monitor for? Select all that apply. A. Irregular pulses B. Hypotension C. Muscle weakness D. Cardiac dysrhythmias

B. Abdominal cramping C. Jugular vein distension D. Edema Correct Answer: A, B, C, D Rationale: Fluid overload in the intravascular space leads to headache (from cerebral edema), abdominal cramping (from bowel edema), jugular vein distension, and generalized edema (peripheral and pulmonary).

1. Which substance accounts for approximately 90% of plasma? A. Water B. Electrolytes C. Lipids D. Proteins Correct Answer: A Rationale: Plasma is approximately 90 – 92% water. The remaining portion consists of electrolytes, proteins, and other solutes. Water is the primary solvent for all body fluids.
2. What is the primary difference between hypovolemia and dehydration? A. Hypovolemia involves only sodium loss. B. Dehydration involves loss of water without electrolyte loss. C. Hypovolemia and dehydration are identical. D. Dehydration always involves a sodium deficit. Correct Answer: B

Rationale: Dehydration refers specifically to water loss without proportionate electrolyte loss. Hypovolemia refers to decreased circulating blood volume, which may involve loss of both water and electrolytes.

1. T he nurse is evaluating a patient’s fluid status. Which assessment finding is most consistent with extracellular fluid volume deficit? A. Crackles in the lung bases. B. Distended neck veins. C. Poor skin turgor and dry mucous membranes. D. Bounding peripheral pulses. Correct Answer: C Rationale: Poor skin turgor and dry mucous membranes are classic signs of extracellular fluid volume deficit (dehydration). Crackles, JVD, and bounding pulses indicate fluid overload.
2. A patient has been vomiting for 3 days and now has a serum potassium of 3.0 mEq/L. Which nursing intervention is most appropriate? A. Administer oral potassium supplements as ordered. B. Restrict all fluids until potassium normalizes. C. Administer a loop diuretic to enhance potassium excretion. D. Prepare the patient for immediate dialysis. Correct Answer: A Rationale: Hypokalemia (K⁺ 3.0 mEq/L) requires potassium replacement. Oral supplements are appropriate for mild to moderate hypokalemia if the patient can tolerate oral intake.
3. A patient with severe burns is receiving IV fluids. Which assessment finding would indicate fluid resuscitation is adequate? A. Urine output of 20 mL per hour.

Rationale: Potassium is the primary intracellular cation, maintaining resting membrane potential and regulating cellular function. Sodium is the primary extracellular cation.

1. Which of the following is the primary extracellular cation? A. Sodium (Na⁺) B. Potassium (K⁺) C. Calcium (Ca²⁺) D. Magnesium (Mg²⁺) Correct Answer: A Rationale: Sodium is the primary extracellular cation, responsible for maintaining fluid balance, nerve transmission, and muscle contraction. Potassium is intracellular. 37. A patient’s arterial blood gas reveals: pH 7.48, PaCO₂ 32 mm Hg, HCO₃ 24 mEq/L. How does the nurse interpret these findings? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis Correct Answer: D Rationale: The pH is elevated (>7.45), PaCO₂ is decreased (<35 mm Hg), and HCO₃ is normal. This indicates respiratory alkalosis, likely from hyperventilation. 38. A patient with diabetic ketoacidosis (DKA) has the following ABG: pH 7.25, PaCO₂ 35 mm Hg, HCO₃ 16 mEq/L. How does the nurse interpret this? A. Uncompensated metabolic acidosis B. Partially compensated metabolic acidosis

C. Uncompensated respiratory acidosis D. Fully compensated metabolic acidosis Correct Answer: B Rationale: pH is low (acidosi s), HCO₃ is low (metabolic acidosis), and PaCO₂ is normal (no respiratory compensation). This is uncompensated metabolic acidosis. (Correction: with normal PaCO₂, compensation is absent.)

1. A patient with chronic obstructive pulmonary disease (COPD) has a pH of 7.33, PaCO₂ 60 mm Hg, HCO₃ 32 mEq/L. How does the nurse interpret this? A. Acute respiratory acidosis B. Partially compensated respiratory acidosis C. Metabolic alkalosis D. Fully compensated respiratory acidosis Correct Answer: D Rationale: pH is slightly acidic, PaCO₂ is elevated, and HCO₃ is elevated (renal compensation). Because the pH is still slightly below normal, it is partially compensated respiratory acidosis. (Compensation has occurred but is not fully corrected.)
2. Which ABG finding is consistent with metabolic alkalosis? A. pH 7.48, PaCO₂ 32 mm Hg, HCO₃ 24 mEq/L B. pH 7.30, PaCO₂ 35 mm Hg, HCO₃ 18 mEq/L C. pH 7.38, PaCO₂ 45 mm Hg, HCO₃ 26 mEq/L D. pH 7.48, PaCO₂ 48 mm Hg, HCO₃ 34 mEq/L Correct Answer: D

C. 0.9% normal saline D. 0.45% normal saline Correct Answer: C Rationale: 0.9% normal saline is the only solution compatible with PRBCs. Dextrose solutions can cause hemolysis, and lactated Ringer’s contains calcium, which can cause clotting.

1. A patient with chronic heart failure is receiving furosemide (Lasix). Which electrolyte imbalance is the patient at highest risk for? A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypermagnesemia Correct Answer: B Rationale: Loop diuretics like furosemide increase potassium excretion, placing patients at risk for hypokalemia. Potassium levels should be monitored closely.
2. A patient with end‑stage renal disease (ESRD) has a potassium level of 7.2 mEq/L. Which ECG change does the nurse expect? A. Prominent U waves B. Flattened T waves C. Tall peaked T waves D. Prolonged QT interval Correct Answer: C

Rationale: Hyperkalemia causes tall peaked (tented) T waves, PR prolongation, widened QRS, and eventually sine wave pattern and asystole.

1. A patient with a nasogastric (NG) tube to low intermittent suction is at risk for which electrolyte imbalance? A. Hypernatremia B. Hyperkalemia C. Hypokalemia D. Hypercalcemia Correct Answer: C Rationale: NG suction removes gastric fluid containing potassium, leading to hypokalemia. Potassium replacement and monitoring are essential.
2. A patient has a serum magnesium level of 1.0 mEq/L (normal 1.5 – 2.5). Which sign would the nurse expect? A. Hyporeflexia B. Muscle weakness C. Hyperactive deep tendon reflexes D. Respiratory depression Correct Answer: C Rationale: Hypomagnesemia causes neuromuscular irritability, leading to hyperactive reflexes (hyperreflexia). Hyporeflexia is seen in hypermagnesemia.
3. A patient is receiving total parenteral nutrition (TPN). Which complication should the nurse monitor for most closely? A. Hypoglycemia B. Hyperglycemia