NUR 445 Exam 4: Acute & Chronic Health Disruptions In
Adults III V3 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient in septic shock has a MAP of 55 mmHg despite a 3L fluid bolus. Which medication should the
nurse anticipate administering first?
A. Dobutamine
B. Nitroprusside
C. Norepinephrine
D. Atropine
Ans: C
Explanation: The nurse must identify the priority action based on the patient’s clinical presentation.
Understanding the underlying pathophysiology allows for targeted nursing interventions.
Norepinephrine is the first-line vasopressor for fluid-refractory septic shock to maintain MAP.
Continuous assessment is necessary to evaluate the effectiveness of the chosen treatment. Patient safety
remains the primary focus during high-acuity health disruptions.
2. A burn patient weighs 70 kg and has 50% TBSA burns. Using the Parkland formula, how much fluid should
be given in the first 8 hours?
A. 7,000 mL
B. 3,500 mL
C. 14,000 mL
D. 5,250 mL
Ans: A
,Explanation: The Parkland formula calculates 4mL x weight in kg x percent TBSA burned. Half of the
total 24-hour volume is administered in the first 8 hours. This calculation is vital for preventing
hypovolemic shock in the emergent phase. Understanding the underlying pathophysiology allows for
targeted nursing interventions. Patient safety remains the primary focus during high-acuity health
disruptions.
3. Which laboratory finding is most indicative of Disseminated Intravascular Coagulation (DIC)?
A. Increased Fibrinogen
B. Elevated Fibrin Degradation Products (FDPs)
C. Decreased D-dimer
D. Increased Platelet Count
Ans: B
Explanation: Elevated FDPs indicate that the body is actively breaking down clots, which is a hallmark of
DIC. This question assesses the nurse’s ability to interpret complex lab data in critical care.
Understanding the underlying pathophysiology allows for targeted nursing interventions. This specific
intervention is supported by current clinical practice guidelines for critical care. Patient safety remains
the primary focus during high-acuity health disruptions.
4. A patient on a ventilator has a high-pressure alarm sounding. What is the nurse’s priority action?
A. Check for a leak in the circuit
B. Suction the patient’s airway
C. Increase the oxygen concentration
D. Silence the alarm and observe
Ans: B
, Explanation: High-pressure alarms are often caused by secretions or biting the tube, requiring
immediate suctioning or clearing. The nurse must identify the priority action based on the patient’s
clinical presentation. Understanding the underlying pathophysiology allows for targeted nursing
interventions. Continuous assessment is necessary to evaluate the effectiveness of the chosen treatment.
Patient safety remains the primary focus during high-acuity health disruptions.
5. What is the primary goal of PEEP in a patient with ARDS?
A. To prevent alveolar collapse at the end of expiration
B. To decrease the work of breathing
C. To decrease the risk of barotrauma
D. To increase the respiratory rate
Ans: A
Explanation: PEEP provides pressure at expiration to keep alveoli open and improve gas exchange. This
intervention is crucial for managing refractory hypoxemia in ARDS patients. Understanding the
underlying pathophysiology allows for targeted nursing interventions. Continuous assessment is
necessary to evaluate the effectiveness of the chosen treatment. Patient safety remains the primary focus
during high-acuity health disruptions.
6. A patient with a T6 spinal cord injury reports a severe headache and has a BP of 200/100. What is the first
action?
A. Assess the patient for bladder distension
B. Administer antihypertensive medication
C. Place the patient in a supine position
D. Notify the provider immediately
Adults III V3 - Arizona College Updated and Latest
Questions and Correct Answers with Rationale
1. A patient in septic shock has a MAP of 55 mmHg despite a 3L fluid bolus. Which medication should the
nurse anticipate administering first?
A. Dobutamine
B. Nitroprusside
C. Norepinephrine
D. Atropine
Ans: C
Explanation: The nurse must identify the priority action based on the patient’s clinical presentation.
Understanding the underlying pathophysiology allows for targeted nursing interventions.
Norepinephrine is the first-line vasopressor for fluid-refractory septic shock to maintain MAP.
Continuous assessment is necessary to evaluate the effectiveness of the chosen treatment. Patient safety
remains the primary focus during high-acuity health disruptions.
2. A burn patient weighs 70 kg and has 50% TBSA burns. Using the Parkland formula, how much fluid should
be given in the first 8 hours?
A. 7,000 mL
B. 3,500 mL
C. 14,000 mL
D. 5,250 mL
Ans: A
,Explanation: The Parkland formula calculates 4mL x weight in kg x percent TBSA burned. Half of the
total 24-hour volume is administered in the first 8 hours. This calculation is vital for preventing
hypovolemic shock in the emergent phase. Understanding the underlying pathophysiology allows for
targeted nursing interventions. Patient safety remains the primary focus during high-acuity health
disruptions.
3. Which laboratory finding is most indicative of Disseminated Intravascular Coagulation (DIC)?
A. Increased Fibrinogen
B. Elevated Fibrin Degradation Products (FDPs)
C. Decreased D-dimer
D. Increased Platelet Count
Ans: B
Explanation: Elevated FDPs indicate that the body is actively breaking down clots, which is a hallmark of
DIC. This question assesses the nurse’s ability to interpret complex lab data in critical care.
Understanding the underlying pathophysiology allows for targeted nursing interventions. This specific
intervention is supported by current clinical practice guidelines for critical care. Patient safety remains
the primary focus during high-acuity health disruptions.
4. A patient on a ventilator has a high-pressure alarm sounding. What is the nurse’s priority action?
A. Check for a leak in the circuit
B. Suction the patient’s airway
C. Increase the oxygen concentration
D. Silence the alarm and observe
Ans: B
, Explanation: High-pressure alarms are often caused by secretions or biting the tube, requiring
immediate suctioning or clearing. The nurse must identify the priority action based on the patient’s
clinical presentation. Understanding the underlying pathophysiology allows for targeted nursing
interventions. Continuous assessment is necessary to evaluate the effectiveness of the chosen treatment.
Patient safety remains the primary focus during high-acuity health disruptions.
5. What is the primary goal of PEEP in a patient with ARDS?
A. To prevent alveolar collapse at the end of expiration
B. To decrease the work of breathing
C. To decrease the risk of barotrauma
D. To increase the respiratory rate
Ans: A
Explanation: PEEP provides pressure at expiration to keep alveoli open and improve gas exchange. This
intervention is crucial for managing refractory hypoxemia in ARDS patients. Understanding the
underlying pathophysiology allows for targeted nursing interventions. Continuous assessment is
necessary to evaluate the effectiveness of the chosen treatment. Patient safety remains the primary focus
during high-acuity health disruptions.
6. A patient with a T6 spinal cord injury reports a severe headache and has a BP of 200/100. What is the first
action?
A. Assess the patient for bladder distension
B. Administer antihypertensive medication
C. Place the patient in a supine position
D. Notify the provider immediately
