NURS 4526 ACUTE CARE - WEEK 1
(ADULTS) QUESTIONS AND
ANSWERS (SOLVED) 100%
CORRECT.
EXAM
1. A patient is admitted with acute respiratory distress
syndrome (ARDS). Which ABG finding is expected in the early
phase?
✅ Answer: PaO₂ < 60 mmHg despite FiO₂ > 50%
📘 Rationale: Early ARDS shows refractory hypoxemia due to
shunting.
2. Which ventilator setting directly affects alveolar
ventilation?
✅ Answer: Tidal volume
📘 Rationale: Tidal volume × respiratory rate = minute ventilation,
which removes CO₂.
3. A patient on pressure support ventilation (PSV) has a
respiratory rate of 32 breaths/min. What does this suggest?
✅ Answer: Increased work of breathing or insufficient pressure
support
📘 Rationale: High RR on PSV indicates the patient is struggling to
achieve adequate tidal volume.
,4. Which finding is most indicative of decreased cardiac
output?
✅ Answer: Narrow pulse pressure
📘 Rationale: Narrow pulse pressure (e.g., 90/80) suggests low
stroke volume.
5. A post-op patient’s urine output is 20 mL over 2 hours.
What should the nurse do first?
✅ Answer: Check blood pressure and assess for hypovolemia
📘 Rationale: Oliguria often reflects prerenal cause; assess
perfusion before calling provider.
6. Which lab value is most concerning in a patient with sepsis?
✅ Answer: Lactate 4.2 mmol/L
📘 Rationale: Lactate >2 indicates tissue hypoperfusion; >4 severe
sepsis/septic shock.
7. A patient with heart failure has crackles, JVD, and S3.
Which medication is priority?
✅ Answer: Furosemide IV
📘 Rationale: Diuresis reduces preload and pulmonary congestion.
8. Which acid-base disturbance is expected in salicylate
overdose?
✅ Answer: Mixed respiratory alkalosis and metabolic acidosis
📘 Rationale: Salicylates directly stimulate respiratory center
(alkalosis) then cause metabolic acidosis.
9. A patient with chest tube drainage of 250 mL/hr of bloody
fluid post-op suggests:
✅ Answer: Active hemorrhage
, 📘 Rationale: >100–150 mL/hr is concerning; 250 mL/hr requires
immediate provider notification.
10. Which rhythm requires immediate defibrillation?
✅ Answer: Pulseless ventricular tachycardia
📘 Rationale: Defibrillation is definitive treatment for pulseless
VT/VF.
11. A patient with COPD has SpO₂ 88% on 2 L nasal cannula.
Next action?
✅ Answer: Increase to 3 L and reassess
📘 Rationale: Goal SpO₂ 88–92% in COPD; current is slightly low
but safe to increase.
12. Which finding indicates tension pneumothorax?
✅ Answer: Tracheal deviation and hypotension
📘 Rationale: Mediastinal shift → decreased venous return →
hypotension.
13. A patient receiving norepinephrine has extravasation.
What is the antidote?
✅ Answer: Phentolamine
📘 Rationale: Phentolamine is an alpha-blocker that prevents
ischemia from vasopressor extravasation.
14. Which potassium level is most dangerous in a patient on
digoxin?
✅ Answer: 3.1 mEq/L
📘 Rationale: Hypokalemia increases risk of digoxin toxicity and
dysrhythmias.
15. A patient with pancreatitis has a positive Cullen’s sign.
This indicates:
(ADULTS) QUESTIONS AND
ANSWERS (SOLVED) 100%
CORRECT.
EXAM
1. A patient is admitted with acute respiratory distress
syndrome (ARDS). Which ABG finding is expected in the early
phase?
✅ Answer: PaO₂ < 60 mmHg despite FiO₂ > 50%
📘 Rationale: Early ARDS shows refractory hypoxemia due to
shunting.
2. Which ventilator setting directly affects alveolar
ventilation?
✅ Answer: Tidal volume
📘 Rationale: Tidal volume × respiratory rate = minute ventilation,
which removes CO₂.
3. A patient on pressure support ventilation (PSV) has a
respiratory rate of 32 breaths/min. What does this suggest?
✅ Answer: Increased work of breathing or insufficient pressure
support
📘 Rationale: High RR on PSV indicates the patient is struggling to
achieve adequate tidal volume.
,4. Which finding is most indicative of decreased cardiac
output?
✅ Answer: Narrow pulse pressure
📘 Rationale: Narrow pulse pressure (e.g., 90/80) suggests low
stroke volume.
5. A post-op patient’s urine output is 20 mL over 2 hours.
What should the nurse do first?
✅ Answer: Check blood pressure and assess for hypovolemia
📘 Rationale: Oliguria often reflects prerenal cause; assess
perfusion before calling provider.
6. Which lab value is most concerning in a patient with sepsis?
✅ Answer: Lactate 4.2 mmol/L
📘 Rationale: Lactate >2 indicates tissue hypoperfusion; >4 severe
sepsis/septic shock.
7. A patient with heart failure has crackles, JVD, and S3.
Which medication is priority?
✅ Answer: Furosemide IV
📘 Rationale: Diuresis reduces preload and pulmonary congestion.
8. Which acid-base disturbance is expected in salicylate
overdose?
✅ Answer: Mixed respiratory alkalosis and metabolic acidosis
📘 Rationale: Salicylates directly stimulate respiratory center
(alkalosis) then cause metabolic acidosis.
9. A patient with chest tube drainage of 250 mL/hr of bloody
fluid post-op suggests:
✅ Answer: Active hemorrhage
, 📘 Rationale: >100–150 mL/hr is concerning; 250 mL/hr requires
immediate provider notification.
10. Which rhythm requires immediate defibrillation?
✅ Answer: Pulseless ventricular tachycardia
📘 Rationale: Defibrillation is definitive treatment for pulseless
VT/VF.
11. A patient with COPD has SpO₂ 88% on 2 L nasal cannula.
Next action?
✅ Answer: Increase to 3 L and reassess
📘 Rationale: Goal SpO₂ 88–92% in COPD; current is slightly low
but safe to increase.
12. Which finding indicates tension pneumothorax?
✅ Answer: Tracheal deviation and hypotension
📘 Rationale: Mediastinal shift → decreased venous return →
hypotension.
13. A patient receiving norepinephrine has extravasation.
What is the antidote?
✅ Answer: Phentolamine
📘 Rationale: Phentolamine is an alpha-blocker that prevents
ischemia from vasopressor extravasation.
14. Which potassium level is most dangerous in a patient on
digoxin?
✅ Answer: 3.1 mEq/L
📘 Rationale: Hypokalemia increases risk of digoxin toxicity and
dysrhythmias.
15. A patient with pancreatitis has a positive Cullen’s sign.
This indicates:
