Galen NSG 3800 Exam 2 – Adult Health II (2026) Actual Q&A PDF, Exams of Nursing

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Galen NSG 3800 Exam 2 – Adult Health II

(2026) Actual Q&A PDF

1. A nurse is providing discharge teaching to a patient with heart failure. Which patient statement indicates a correct understanding of dietary modifications for managing their condition? A) “I should limit my daily fluid intake to 4 liters.” B) “I need to avoid canned soups and frozen dinners.” C) “Adding extra salt to my food will help with fluid balance.” D) “Reading food labels for sodium content is not necessary.” Correct Answer: B) “I need to avoid canned soups and frozen dinners.” Rationale: Processed foods like canned soups, frozen dinners, and deli meats are typically high in sodium. Heart failure patients must follow a low-sodium diet (usually <2,000 mg/day) to prevent fluid retention and worsening of symptoms. Patients should read labels and limit high-sodium items.
2. A patient with chronic heart failure presents with shortness of breath, crackles auscultated in the lung bases, and 3+ pitting edema in the lower extremities. Which nursing intervention should be implemented first? A) Encourage the patient to ambulate B) Administer the prescribed diuretic (furosemide) C) Restrict the patient’s fluid intake to 1 L/day D) Provide a high-sodium diet Correct Answer: B) Administer the prescribed diuretic (furosemide). Rationale: Crackles and edema indicate significant fluid overload, requiring rapid reduction of preload. Administering a loop diuretic is the priority intervention in acute decompensated heart failure with volume overload. Encouraging ambulation could worsen dyspnea, and fluid restriction is important but not the immediate priority.

B) Pneumonia C) Pulmonary embolism D) COPD exacerbation Correct Answer: C) Pulmonary embolism. Rationale: Pulmonary embolism often presents with sudden dyspnea, pleuritic chest pain, and clear lung sounds despite significant respiratory distress. Tachycardia and the feeling of impending doom are also common. Prompt recognition and intervention are critical.

1. A nurse is assessing a patient with pneumonia and has the patient repeat the letter “E” while auscultating. The nurse notes that the patient’s voice sounds are distorted and the letter “A” is audible instead of “E.” How should this finding be documented? A) Bronchophony B) Egophony C) Whispered pectoriloquy D) Sonorous wheezes Correct Answer: B) Egophony. Rationale: Egophony (E-to- A change) occurs when the patient says “E” and it sounds like “A” due to lung consolidation. Bronchophony is increased loudness of spoken words, and whispered pectoriloquy is the ability to hear whispered words clearly through the stethoscope.
2. A patient has been prescribed warfarin for the treatment of a deep vein thrombosis (DVT) and subsequent pulmonary embolism. Which patient statement indicates a need for further teaching about anticoagulant therapy? A) “I will need to have my blood drawn regularly to check my INR.” B) “I will continue to eat the same amount of green vegetables each week.” C) “I will take ibuprofen for my occasional headaches.” D) “I will report any unusual bleeding or bruising to my doctor.”

Correct Answer: C) “I will take ibuprofen for my occasional headaches.” Rationale: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that increases the risk of gastrointestinal bleeding when taken with warfarin. Patients should use acetaminophen instead and inform all providers about warfarin therapy.

1. The nurse is caring for a patient with a chest tube to water-seal drainage. The nurse notes that the water-seal chamber is no longer tidaling. What is the most likely cause? A) The lung has fully re-expanded B) There is an air leak C) The chest tube is obstructed D) The drainage system is at the wrong level Correct Answer: C) The chest tube is obstructed. Rationale: Tidaling (fluctuation) stops either when the lung has re-expanded (normal) or when the tube is obstructed (a problem). Pain on inspiration with loss of tidaling suggests an obstruction, which must be resolved. An air leak would cause continuous bubbling.
2. A patient is receiving continuous bladder irrigation (CBI) after a transurethral resection of the prostate (TURP). The nurse notes that the outflow is slower than the inflow. What is the priority nursing action? A) Increase the flow rate of the CBI B) Manually irrigate the catheter as ordered C) Clamp the catheter to allow the bladder to fill D) Check the drainage tubing for kinks or clots Correct Answer: D) Check the drainage tubing for kinks or clots. Rationale: Decreased outflow indicates a potential obstruction, typically from a blood clot. The first step is to inspect the drainage system for kinks, dependent loops, or clots that may be obstructing flow. Manual irrigation may be needed if simple troubleshooting fails.

C) The nurse notes purulent drainage and redness at the insertion site D) The dressing was last changed 7 days ago Correct Answer: C) The nurse notes purulent drainage and redness at the insertion site. Rationale: Purulent drainage and redness indicate a catheter-related bloodstream infection (CRBSI), which requires immediate intervention. The provider should be notified and cultures obtained. Mild discomfort is common, but purulence is always abnormal.

1. A patient is receiving a blood transfusion and develops acute shortness of breath, tachypnea, crackles in all lung fields, and frothy sputum. The blood pressure is 160/90 mm Hg. Which complication is most likely? A) Acute hemolytic reaction B) Anaphylactic reaction C) Febrile non-hemolytic reaction D) Transfusion-associated circulatory overload (TACO) Correct Answer: D) Transfusion-associated circulatory overload (TACO). Rationale: TACO is caused by fluid volume overload and presents with pulmonary edema (crackles, frothy sputum), hypertension, and an S3 heart sound. It is more common in clients with underlying cardiac or renal disease.
2. A patient is receiving total parenteral nutrition (TPN) through a central line. Which nursing action is most important to prevent a catheter-related bloodstream infection? A) Change the TPN solution every 48 hours B) Change the primary tubing for TPN every 24 hours C) Use a needleless connector and change it weekly D) Flush the catheter with 10 mL of sterile saline every shift Correct Answer: B) Change the primary tubing for TPN every 24 hours.

Rationale: TPN is a hypertonic solution and a rich medium for bacterial growth. To prevent catheter- related bloodstream infections, the administration set (tubing) must be changed every 24 hours. The solution itself is also typically changed every 24 hours.

1. A nurse is educating a patient with a new ileostomy about expected stool consistency. Which response is correct? A) “Your stool will be formed and brown, like a normal bowel movement.” B) “The output will be liquid to semi - liquid due to lack of col onic absorption.” C) “The stool will be thick and paste - like, similar to a colostomy.” D) “You will have no stool output, only gas, from your ileostomy.” Correct Answer: B) “The output will be liquid to semi - liquid due to lack of colonic absorption.” Rationale: An ileostomy is created from the ileum, where most water and nutrients are absorbed; the colon is not used. The output is therefore liquid to semi-liquid, not formed, and contains digestive enzymes and bile.
2. The nurse is caring for a patie nt with a new colostomy. The patient asks the nurse, “Will I ever be able to control when I have a bowel movement?” What is the best response? A) “No, you will wear a pouch at all times to collect the stool.” B) “Yes, you can use a procedure called colostomy irrigation to regulate your bowel movements.” C) “Yes, after about 6 months, your bowel will learn to hold the stool.” D) “No, but you can take medications to stop the stool from forming.” Correct Answer: B) “Yes, you can use a procedure called colostomy irrigation to regulate your bowel movements.” Rationale: Some clients with descending or sigmoid colostomies may be candidates for colostomy irrigation, which is performed daily to flush the colon and create a predictable period of evacuation. This allows for bowel regulation between irrigations.

D) Administer the injection into a site with visible bruising Correct Answer: C) Insert the needle at a 45- to 90-degree angle without aspirating. Rationale: For subcutaneous heparin, aspiration is not recommended because it can cause bleeding and tissue damage. The needle is inserted at a 45- to 90- degree angle depending on the patient’s body habitus, and the site should not be massaged to prevent bruising.

1. A patient has an indwelling urinary catheter. The nurse should obtain a sterile urine specimen by: A) Aspirating urine from the drainage bag B) Disconnecting the catheter from the drainage tube C) Using a syringe to withdraw urine from the catheter tubing port D) Draining urine from the collection bag directly into a cup Correct Answer: C) Using a syringe to withdraw urine from the catheter tubing port. Rationale: The appropriate method is to use a sterile syringe to aspirate urine from the catheter tubing port after cleaning it with an antiseptic swab. This maintains a closed system and reduces infection risk. Urine from the drainage bag may be contaminated.
2. Which of the following is the primary intracellular cation? A) Sodium (Na⁺) B) Calcium (Ca²⁺) C) Potassium (K⁺) D) Chloride (Cl⁻) Correct Answer: C) Potassium (K⁺). Rationale: Potassium is the primary intracellular cation, maintaining resting membrane potential and regulating cellular function. Sodium is the primary extracellular cation.

22. A nurse is caring for a patient with hyperkalemia (K⁺ 6.5 mEq/L). Which ECG change should the nurse expect? A) Flattened T waves B) Prominent U waves C) Tall peaked T waves D) Prolonged QT interval Correct Answer: C) Tall peaked T waves. Rationale: Hyperkalemia causes tall peaked (tented) T waves, PR prolongation, widening of QRS, and eventually a sine wave pattern and asystole. Flattened T waves and U waves are seen in hypokalemia.

1. The nurse is caring for a patient with a nasogastric (NG) tube to low intermittent suction. Which electrolyte imbalance is most likely to occur? A) Hypernatremia B) Hypokalemia C) Hypercalcemia D) Hypermagnesemia Correct Answer: B) Hypokalemia. Rationale: NG suction removes gastric fluid containing potassium, leading to hypokalemia. Potassium replacement and monitoring are essential. Hypokalemia can cause cardiac arrhythmias and respiratory muscle weakness.
2. A patient with chronic kidney disease is receiving erythropoietin (Epogen). The nurse should evaluate the effectiveness of this therapy by monitoring which laboratory value? A) White blood cell count B) Serum potassium C) Hemoglobin and hematocrit

Correct Answer: C) “It’s normal to feel frustrated with a new diagnosis. Can you tell me more about what you’re feeling right now?” Rationale: This response validates the patient’s feelings, normalizes the emotional response to a new diagnosis, and uses an open-ended question to encourage expression of concerns. It promotes therapeutic communication.

1. The nurse is assessing a patient for a pulmonary embolism (PE). Which finding is most consistent with a PE? A) Normal breath sounds with sudden dyspnea B) Crackles in the lung bases C) Bronchial breath sounds with egophony D) Stridor Correct Answer: A) Normal breath sounds with sudden dyspnea. Rationale: Pulmonary embolism often presents with clear lung sounds despite severe dyspnea. Crackles suggest pneumonia or heart failure, bronchial breath sounds suggest consolidation, and stridor indicates upper airway obstruction. 28. A patient is receiving a blood transfusion. The nurse notes that the patient’s temperature has increased from 37.0°C to 38.5°C (98.6°F to 101.3°F). The patient is shivering. What is the priority nursing action? A) Apply a cooling blanket to reduce the fever B) Administer acetaminophen as ordered C) Stop the transfusion and notify the provider D) Slow the transfusion rate to 50 mL per hour Correct Answer: C) Stop the transfusion and notify the provider.

Rationale: Any fever or chills during a transfusion should be assumed to be a transfusion reaction. The transfusion must be stopped immediately to prevent a more serious reaction (e.g., febrile non- hemolytic or acute hemolytic reaction).

1. A patient has a serum potassium level of 2.9 mEq/L. The patient is receiving digoxin. What is the priority nursing action? A) Administer the scheduled dose of digoxin B) Withhol d the digoxin and assess the patient’s apical pulse C) Notify the healthcare provider and obtain an order for potassium replacement D) Increase the patient’s fluid intake to 3000 mL/day Correct Answer: C) Notify the healthcare provider and obtain an order for potassium replacement. Rationale: A potassium level of 2.9 mEq/L indicates severe hypokalemia. Hypokalemia increases the risk of digoxin toxicity, which can be fatal. The priority is to notify the provider and obtain an order for potassium replacement.
2. A patient with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which finding would cause the nurse to hold the medication and notify the provider? A) Serum potassium level of 3.8 mEq/L B) Blood pressure of 90/50 mm Hg C) Urine output of 50 mL in the last hour D) Weight gain of 1 kg in 24 hours Correct Answer: B) Blood pressure of 90/50 mm Hg. Rationale: Furosemide is a potent diuretic that can cause hypotension. A blood pressure of 90/50 mm Hg is below the normal range, and administering furosemide could further lower blood pressure and compromise renal perfusion.

D) Haemophilus influenzae Correct Answer: A) Escherichia coli. Rationale: Escherichia coli (E. coli) accounts for approximately 80% of community-acquired uncomplicated UTIs in women. It is a normal inhabitant of the intestinal tract that can ascend from the perineum to the urethra and bladder.

1. A nurse is teaching a female client about preventing urinary tract infections (UTIs). Which statement by the client indicates a need for further teaching? A) “I will wipe from front to back after using the toilet.” B) “I will drink at least 2 - 3 liters of water per day.” C) “I will urinate immediately after sexual intercourse.” D) “I will wear tight - fitting underwear and pantyhose.” Correct Answer: D) “I will wear tight - fitting underwear and pantyhos e.” Rationale: Tight-fitting clothing can trap moisture and warmth, promoting bacterial growth. Loose, cotton underwear is recommended. Wiping front to back, staying hydrated, and voiding after intercourse are all correct preventive measures.
2. A patient is admitted with acute cystitis. Which clinical manifestation is most characteristic of a lower urinary tract infection (UTI)? A) Costovertebral angle (CVA) tenderness and high fever B) Dysuria, urinary frequency, and suprapubic discomfort C) Nausea, vomiting, and severe flank pain D) Oliguria and periorbital edema Correct Answer: B) Dysuria, urinary frequency, and suprapubic discomfort.

Rationale: Acute cystitis is an infection of the bladder. Its hallmark symptoms are lower urinary tract symptoms: dysuria (painful urination), frequency, urgency, and suprapubic heaviness or pain.

1. The nurse is caring for a patient with a new nephrostomy tube. Which finding requires immediate action? A) The tube has drained 200 mL of clear yellow urine in the past 4 hours B) The patient reports mild discomfort at the insertion site C) The tube stops draining and the patient reports flank pain D) The drainage system has a small air bubble in the tubing Correct Answer: C) The tube stops draining and the patient reports flank pain. Rationale: Cessation of drainage with flank pain suggests obstruction or dislodgement of the nephrostomy tube, which can cause urinary backup and kidney damage. This is an emergency. Mild discomfort and small air bubbles are expected.
2. A patient is diagnosed with chronic kidney disease (CKD) and has a potassium level of 6.8 mEq/L. Which medication should the nurse anticipate administering? A) Furosemide (Lasix) B) Sodium polystyrene sulfonate (Kayexalate) C) Spironolactone (Aldactone) D) IV dextrose and regular insulin Correct Answer: B) Sodium polystyrene sulfonate (Kayexalate). Rationale: A potassium level of 6.8 mEq/L indicates severe hyperkalemia. Sodium polystyrene sulfonate (Kayexalate) is a potassium-binding resin that works in the gut to exchange sodium for potassium, which is then eliminated in the stool.
3. A patient with chronic kidney disease (CKD) is being discharged. The nurse is teaching about managing anemia related to decreased erythropoietin production. Which instruction is most appropriate?

Correct Answer: B) Screen the patient for any metal in the body. Rationale: The MRI machine uses a strong magnetic field. Any ferromagnetic metal in the body can move, heat up, or cause injury. Screening for metal (implants, pacemakers, aneurysm clips, shrapnel) is essential for safety.

1. A patient has a positive Psoas sign. How is this maneuver performed? A) The patient flexes the right hip and knee while the examiner internally rotates the leg. B) The patient lies supine while the examiner lifts the right leg straight up against resistance. C) The patient lies on the left side while the examiner extends the right leg at the hip. D) The patient lies supine while the examiner presses deeply into the left lower quadrant. Correct Answer: C) The patient lies on the left side while the examiner extends the right leg at the hip. Rationale: The psoas sign is elicited with the patient lying on their side (left side) and the examiner extending the right leg at the hip, stretching the iliopsoas muscle. Pain indicates irritation of the psoas muscle, often due to appendicitis.
2. A client is diagnosed with a kidney stone (renal calculi). The priority nursing intervention is to: A) Strain all urine to capture the stone for analysis B) Encourage oral fluid intake of 3-4 L/day C) Administer prescribed opioid analgesics for pain D) Assess the client’s pain level and location Correct Answer: D) Assess the client’s pain level and location. Rationale: Renal colic from a kidney stone can cause excruciating pain. A focused pain assessment is the priority to determine the severity and guide the immediate need for pain medication. Managing pain is the most urgent need.

1. The nurse is caring for a patient who is receiving a continuous heparin infusion and has an aPTT value of 120 seconds. The patient has no signs of active bleeding. What is the priority nursing action? A) Continue the infusion at the same rate. B) Decrease the infusion rate by 2 mL/hour. C) Stop the infusion and prepare to administer vitamin K. D) Notify the healthcare provider and prepare to administer protamine sulfate. Correct Answer: D) Notify the healthcare provider and prepare to administer protamine sulfate. Rationale: An aPTT of 120 seconds is significantly above the therapeutic range and indicates a high risk for bleeding. The provider should be notified, and protamine sulfate may be ordered to reverse the heparin effect.
2. A patient with a deep vein thrombosis (DVT) is being transitioned from enoxaparin to warfarin. The nurse knows that enoxaparin should be continued for how long after initiating warfarin? A) 24 hours B) 48 hours C) 5-7 days D) 2 weeks Correct Answer: C) 5-7 days. Rationale: Enoxaparin and other parenteral anticoagulants should be continued for at least 5 days and until the INR is therapeutic (2.0-3.0) for two consecutive days. This ensures adequate anticoagulation during the delay in warfarin’s effect.
3. The nurse is teaching a patient with a new colostomy about odor control. Which food should the patient be encouraged to eat? A) Eggs B) Asparagus C) Yogurt