NUR 2790 Professional Nursing III - Exam 2 Questions and Verified
Answers and Rationales | Latest Update
1. A patient is in the early stages of septic shock. Which clinical manifestation
should the nurse expect to find?
A. Warm, flushed skin
B. Decreased heart rate
C. Cool, clammy skin
D. Increased urinary output
Answer: A
Rationale: In the early (hyperdynamic) phase of septic shock, vasodilation causes the skin
to feel warm and flushed. As shock progresses to the cold phase, the skin becomes cool and
clammy.
2. Which hemodynamic parameter is the most sensitive indicator of fluid
volume status in a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Central Venous Pressure (CVP)
C. Heart Rate
D. Systemic Vascular Resistance (SVR)
Answer: B
,Rationale: Central Venous Pressure (CVP) reflects the filling pressure of the right ventricle
and is a key indicator of fluid volume status and venous return.
3. A patient with ARDS is being mechanically ventilated with high levels of PEEP.
Which complication is the nurse most concerned about?
A. Increased cardiac output
B. Metabolic alkalosis
C. Pneumothorax
D. Pulmonary hypertension
Answer: C
Rationale: High Positive End-Expiratory Pressure (PEEP) can cause barotrauma, leading to
complications such as pneumothorax or subcutaneous emphysema.
4. Using the Parkland formula, calculate the total fluid volume needed in the
first 24 hours for a 70kg patient with 40% TBSA burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Rationale: Parkland Formula: 4mL x kg x %TBSA. Calculation: 4 x 70 x 40 = 11,200 mL.
,5. An ICU nurse is caring for a patient with a Pulmonary Artery Catheter. The
Pulmonary Artery Wedge Pressure (PAWP) is 22 mmHg. What does this
indicate?
A. Hypovolemia
B. Right-sided heart failure
C. Left-sided heart failure
D. Normal cardiac function
Answer: C
Rationale: Normal PAWP is 4-12 mmHg. An elevated PAWP (22 mmHg) indicates left
ventricular failure, fluid overload, or mitral regurgitation.
6. Which acid-base imbalance is most commonly seen in the initial stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: D
Rationale: Initial hyperventilation in ARDS leads to a decrease in CO2 levels, resulting in
respiratory alkalosis before the patient tires and progresses to acidosis.
, 7. A nurse is caring for a patient who has just returned from a kidney transplant.
What is the priority nursing assessment?
A. Auscultating bowel sounds
B. Monitoring hourly urine output
C. Checking the surgical dressing
D. Assessing level of consciousness
Answer: B
Rationale: Hourly urine output is the most critical indicator of the new kidney’s function
and the success of the transplant.
8. Which type of shock is characterized by a loss of sympathetic tone leading to
massive vasodilation?
A. Anaphylactic shock
B. Septic shock
C. Neurogenic shock
D. Cardiogenic shock
Answer: C
Rationale: Neurogenic shock occurs due to spinal cord injury or anesthesia, causing a loss
of sympathetic nervous system signals, resulting in vasodilation and bradycardia.
Answers and Rationales | Latest Update
1. A patient is in the early stages of septic shock. Which clinical manifestation
should the nurse expect to find?
A. Warm, flushed skin
B. Decreased heart rate
C. Cool, clammy skin
D. Increased urinary output
Answer: A
Rationale: In the early (hyperdynamic) phase of septic shock, vasodilation causes the skin
to feel warm and flushed. As shock progresses to the cold phase, the skin becomes cool and
clammy.
2. Which hemodynamic parameter is the most sensitive indicator of fluid
volume status in a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Central Venous Pressure (CVP)
C. Heart Rate
D. Systemic Vascular Resistance (SVR)
Answer: B
,Rationale: Central Venous Pressure (CVP) reflects the filling pressure of the right ventricle
and is a key indicator of fluid volume status and venous return.
3. A patient with ARDS is being mechanically ventilated with high levels of PEEP.
Which complication is the nurse most concerned about?
A. Increased cardiac output
B. Metabolic alkalosis
C. Pneumothorax
D. Pulmonary hypertension
Answer: C
Rationale: High Positive End-Expiratory Pressure (PEEP) can cause barotrauma, leading to
complications such as pneumothorax or subcutaneous emphysema.
4. Using the Parkland formula, calculate the total fluid volume needed in the
first 24 hours for a 70kg patient with 40% TBSA burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Rationale: Parkland Formula: 4mL x kg x %TBSA. Calculation: 4 x 70 x 40 = 11,200 mL.
,5. An ICU nurse is caring for a patient with a Pulmonary Artery Catheter. The
Pulmonary Artery Wedge Pressure (PAWP) is 22 mmHg. What does this
indicate?
A. Hypovolemia
B. Right-sided heart failure
C. Left-sided heart failure
D. Normal cardiac function
Answer: C
Rationale: Normal PAWP is 4-12 mmHg. An elevated PAWP (22 mmHg) indicates left
ventricular failure, fluid overload, or mitral regurgitation.
6. Which acid-base imbalance is most commonly seen in the initial stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: D
Rationale: Initial hyperventilation in ARDS leads to a decrease in CO2 levels, resulting in
respiratory alkalosis before the patient tires and progresses to acidosis.
, 7. A nurse is caring for a patient who has just returned from a kidney transplant.
What is the priority nursing assessment?
A. Auscultating bowel sounds
B. Monitoring hourly urine output
C. Checking the surgical dressing
D. Assessing level of consciousness
Answer: B
Rationale: Hourly urine output is the most critical indicator of the new kidney’s function
and the success of the transplant.
8. Which type of shock is characterized by a loss of sympathetic tone leading to
massive vasodilation?
A. Anaphylactic shock
B. Septic shock
C. Neurogenic shock
D. Cardiogenic shock
Answer: C
Rationale: Neurogenic shock occurs due to spinal cord injury or anesthesia, causing a loss
of sympathetic nervous system signals, resulting in vasodilation and bradycardia.
