NUR 445 Exam 2: Acute & Chronic Health Disruptions In
Adults III V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position. What is the
primary rationale for this intervention?
A. To increase the patient’s comfort level
B. To improve oxygenation by recruiting collapsed alveoli
C. To decrease the risk of aspiration pneumonia
D. To make it easier for family members to visit
Ans: B
Explanation: Prone positioning is utilized in ARDS to improve gas exchange and oxygenation. It works by
shifting the weight of the heart and abdomen away from the lungs. This allows for the recruitment of
alveoli in the dorsal lung regions that are often collapsed. Improved ventilation-perfusion matching is the
expected outcome of this specific maneuver. Nurses must carefully monitor the patient’s skin integrity
and tube security during this process.
2. Which assessment finding should the nurse prioritize in a patient suspected of having septic shock?
A. Increased urine output
B. Bradycardia and hypertension
C. Hypotension that does not respond to fluid resuscitation
D. Normal skin temperature and color
Ans: C
,Explanation: Septic shock is characterized by persistent hypotension despite adequate fluid
resuscitation efforts. This condition indicates severe systemic vasodilation and capillary leakage due to
infection. Other signs include an elevated serum lactate level and signs of end-organ dysfunction. The
nurse must initiate vasopressor therapy as ordered to maintain a mean arterial pressure above 65
mmHg. Early identification of these symptoms is critical for improving patient survival rates.
3. A patient sustains a full-thickness burn to the entire right arm and the anterior trunk. Using the Rule of
Nines, what is the estimated Total Body Surface Area (TBSA) affected?
A. 18%
B. 45%
C. 36%
D. 27%
Ans: D
Explanation: The Rule of Nines assigns 9% to the entire right arm and 18% to the anterior trunk. Adding
these two values together results in a total of 27% TBSA. Accurate estimation is vital for determining
fluid resuscitation needs in the emergent phase. Errors in calculation can lead to either fluid overload or
inadequate tissue perfusion. The nurse should use this standardized tool immediately upon the patient’s
arrival at the facility.
4. A patient is in the compensatory stage of shock. Which clinical manifestation is most likely to be
observed?
A. Cool, clammy skin and tachycardia
B. Decreased respiratory rate and lethargy
C. Hypotension and anuria
, D. Increased bowel sounds and hunger
Ans: A
Explanation: In the compensatory stage of shock, the body activates the sympathetic nervous system to
maintain perfusion. This results in an increased heart rate and peripheral vasoconstriction, leading to
cool and clammy skin. Blood is shunted away from non-essential organs to the heart and brain. The nurse
should monitor for subtle changes in vital signs during this stage. Prompt intervention at this level can
prevent progression to the progressive stage of shock.
5. What is the goal of Positive End-Expiratory Pressure (PEEP) in mechanical ventilation for a patient with
ARDS?
A. To decrease the work of breathing for the ventilator
B. To increase the respiratory rate of the patient
C. To prevent the alveoli from collapsing during expiration
D. To provide 100% oxygen delivery at all times
Ans: C
Explanation: PEEP provides a set amount of pressure at the end of expiration to keep the alveoli open.
This improves oxygenation by increasing the functional residual capacity of the lungs. It allows for a
lower fraction of inspired oxygen (FiO2) to be used, reducing oxygen toxicity risk. However, high levels of
PEEP can cause complications like barotrauma or decreased cardiac output. The nurse must assess the
patient’s hemodynamic status whenever PEEP levels are adjusted.
6. Which medication is typically the first-line vasopressor for a patient in septic shock?
A. Dopamine
B. Epinephrine
Adults III V1 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position. What is the
primary rationale for this intervention?
A. To increase the patient’s comfort level
B. To improve oxygenation by recruiting collapsed alveoli
C. To decrease the risk of aspiration pneumonia
D. To make it easier for family members to visit
Ans: B
Explanation: Prone positioning is utilized in ARDS to improve gas exchange and oxygenation. It works by
shifting the weight of the heart and abdomen away from the lungs. This allows for the recruitment of
alveoli in the dorsal lung regions that are often collapsed. Improved ventilation-perfusion matching is the
expected outcome of this specific maneuver. Nurses must carefully monitor the patient’s skin integrity
and tube security during this process.
2. Which assessment finding should the nurse prioritize in a patient suspected of having septic shock?
A. Increased urine output
B. Bradycardia and hypertension
C. Hypotension that does not respond to fluid resuscitation
D. Normal skin temperature and color
Ans: C
,Explanation: Septic shock is characterized by persistent hypotension despite adequate fluid
resuscitation efforts. This condition indicates severe systemic vasodilation and capillary leakage due to
infection. Other signs include an elevated serum lactate level and signs of end-organ dysfunction. The
nurse must initiate vasopressor therapy as ordered to maintain a mean arterial pressure above 65
mmHg. Early identification of these symptoms is critical for improving patient survival rates.
3. A patient sustains a full-thickness burn to the entire right arm and the anterior trunk. Using the Rule of
Nines, what is the estimated Total Body Surface Area (TBSA) affected?
A. 18%
B. 45%
C. 36%
D. 27%
Ans: D
Explanation: The Rule of Nines assigns 9% to the entire right arm and 18% to the anterior trunk. Adding
these two values together results in a total of 27% TBSA. Accurate estimation is vital for determining
fluid resuscitation needs in the emergent phase. Errors in calculation can lead to either fluid overload or
inadequate tissue perfusion. The nurse should use this standardized tool immediately upon the patient’s
arrival at the facility.
4. A patient is in the compensatory stage of shock. Which clinical manifestation is most likely to be
observed?
A. Cool, clammy skin and tachycardia
B. Decreased respiratory rate and lethargy
C. Hypotension and anuria
, D. Increased bowel sounds and hunger
Ans: A
Explanation: In the compensatory stage of shock, the body activates the sympathetic nervous system to
maintain perfusion. This results in an increased heart rate and peripheral vasoconstriction, leading to
cool and clammy skin. Blood is shunted away from non-essential organs to the heart and brain. The nurse
should monitor for subtle changes in vital signs during this stage. Prompt intervention at this level can
prevent progression to the progressive stage of shock.
5. What is the goal of Positive End-Expiratory Pressure (PEEP) in mechanical ventilation for a patient with
ARDS?
A. To decrease the work of breathing for the ventilator
B. To increase the respiratory rate of the patient
C. To prevent the alveoli from collapsing during expiration
D. To provide 100% oxygen delivery at all times
Ans: C
Explanation: PEEP provides a set amount of pressure at the end of expiration to keep the alveoli open.
This improves oxygenation by increasing the functional residual capacity of the lungs. It allows for a
lower fraction of inspired oxygen (FiO2) to be used, reducing oxygen toxicity risk. However, high levels of
PEEP can cause complications like barotrauma or decreased cardiac output. The nurse must assess the
patient’s hemodynamic status whenever PEEP levels are adjusted.
6. Which medication is typically the first-line vasopressor for a patient in septic shock?
A. Dopamine
B. Epinephrine
