NUR 2790 Professional Nursing III (PN3) Exam 1 - Comprehensive
Review Questions and Verified Answers and Rationales | Latest
Update
1. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS).
Which clinical finding is a hallmark sign of this condition?
A. Improved oxygenation with high-flow oxygen administration
B. Decreased pulmonary artery wedge pressure
C. Refractory hypoxemia
D. Respiratory alkalosis in the late stages
Answer: C
Rationale: Refractory hypoxemia, where the patient’s oxygen levels do not improve even
with high concentrations of oxygen, is a classic hallmark of ARDS due to significant
shunting.
2. When using the Parkland Formula for a patient with 50% Total Body Surface
Area (TBSA) burns weighing 80kg, how much fluid should be given in the first 8
hours?
A. 16,000 mL
B. 4,000 mL
C. 8,000 mL
D. 12,000 mL
,Answer: C
Rationale: Parkland Formula: 4mL x kg x %TBSA. Total = 4 x 80 x 50 = 16,000 mL. Half is
given in the first 8 hours (8,000 mL).
3. In the START triage system, which tag would a nurse assign to a patient who
is walking and has minor lacerations?
A. Red (Immediate)
B. Yellow (Delayed)
C. Black (Deceased)
D. Green (Minor)
Answer: D
Rationale: The ‘walking wounded’ are classified as Green (Minor) in the START triage
system.
4. A patient on a mechanical ventilator has a ‘High Pressure’ alarm sounding.
What is the most likely cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. Self-extubation by the patient
D. Cuff leak in the ET tube
Answer: B
,Rationale: High-pressure alarms are caused by increased resistance, such as biting the
tube, secretions, or kinking. Low-pressure alarms are usually caused by leaks or
disconnection.
5. Which type of shock is characterized by bradycardia instead of tachycardia?
A. Septic shock
B. Neurogenic shock
C. Hypovolemic shock
D. Cardiogenic shock
Answer: B
Rationale: Neurogenic shock results in the loss of sympathetic tone, leading to the triad of
hypotension, bradycardia, and poikilothermia.
6. A nurse is caring for a patient in the emergent phase of a burn injury. Which
electrolyte imbalance is most likely?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Rationale: In the emergent phase, cell destruction releases potassium into the
extracellular fluid, causing hyperkalemia.
, 7. What is the primary goal of Positive End-Expiratory Pressure (PEEP) in a
patient with ARDS?
A. To increase the fraction of inspired oxygen (FiO2)
B. To increase the respiratory rate
C. To decrease the risk of barotrauma
D. To prevent alveolar collapse at the end of expiration
Answer: D
Rationale: PEEP keeps alveoli open at the end of expiration, improving gas exchange and
increasing Functional Residual Capacity (FRC).
8. A patient with a suspected C6 spinal cord injury is experiencing a sudden BP
of 200/110, a severe headache, and flushing above the level of injury. What is
the priority nursing action?
A. Administer an antihypertensive
B. Sit the patient upright
C. Check for bladder distention
D. Notify the physician
Answer: B
Rationale: This is Autonomic Dysreflexia. The first action is to sit the patient upright to
lower BP via orthostatic effect, followed by identifying the cause.
Review Questions and Verified Answers and Rationales | Latest
Update
1. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS).
Which clinical finding is a hallmark sign of this condition?
A. Improved oxygenation with high-flow oxygen administration
B. Decreased pulmonary artery wedge pressure
C. Refractory hypoxemia
D. Respiratory alkalosis in the late stages
Answer: C
Rationale: Refractory hypoxemia, where the patient’s oxygen levels do not improve even
with high concentrations of oxygen, is a classic hallmark of ARDS due to significant
shunting.
2. When using the Parkland Formula for a patient with 50% Total Body Surface
Area (TBSA) burns weighing 80kg, how much fluid should be given in the first 8
hours?
A. 16,000 mL
B. 4,000 mL
C. 8,000 mL
D. 12,000 mL
,Answer: C
Rationale: Parkland Formula: 4mL x kg x %TBSA. Total = 4 x 80 x 50 = 16,000 mL. Half is
given in the first 8 hours (8,000 mL).
3. In the START triage system, which tag would a nurse assign to a patient who
is walking and has minor lacerations?
A. Red (Immediate)
B. Yellow (Delayed)
C. Black (Deceased)
D. Green (Minor)
Answer: D
Rationale: The ‘walking wounded’ are classified as Green (Minor) in the START triage
system.
4. A patient on a mechanical ventilator has a ‘High Pressure’ alarm sounding.
What is the most likely cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. Self-extubation by the patient
D. Cuff leak in the ET tube
Answer: B
,Rationale: High-pressure alarms are caused by increased resistance, such as biting the
tube, secretions, or kinking. Low-pressure alarms are usually caused by leaks or
disconnection.
5. Which type of shock is characterized by bradycardia instead of tachycardia?
A. Septic shock
B. Neurogenic shock
C. Hypovolemic shock
D. Cardiogenic shock
Answer: B
Rationale: Neurogenic shock results in the loss of sympathetic tone, leading to the triad of
hypotension, bradycardia, and poikilothermia.
6. A nurse is caring for a patient in the emergent phase of a burn injury. Which
electrolyte imbalance is most likely?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Rationale: In the emergent phase, cell destruction releases potassium into the
extracellular fluid, causing hyperkalemia.
, 7. What is the primary goal of Positive End-Expiratory Pressure (PEEP) in a
patient with ARDS?
A. To increase the fraction of inspired oxygen (FiO2)
B. To increase the respiratory rate
C. To decrease the risk of barotrauma
D. To prevent alveolar collapse at the end of expiration
Answer: D
Rationale: PEEP keeps alveoli open at the end of expiration, improving gas exchange and
increasing Functional Residual Capacity (FRC).
8. A patient with a suspected C6 spinal cord injury is experiencing a sudden BP
of 200/110, a severe headache, and flushing above the level of injury. What is
the priority nursing action?
A. Administer an antihypertensive
B. Sit the patient upright
C. Check for bladder distention
D. Notify the physician
Answer: B
Rationale: This is Autonomic Dysreflexia. The first action is to sit the patient upright to
lower BP via orthostatic effect, followed by identifying the cause.
