NUR 265 Advanced Medical-Surgical Nursing - Week 3 Comprehensive
Study Guide 2026 |Galen College
1. During a mass casualty incident, which color tag is assigned to a patient with
a sucking chest wound and stable vitals who requires immediate intervention?
A. Green
B. Yellow
C. Black
D. Red
Answer: D
Rationale: Red tags are for immediate life-threatening injuries that are survivable with
rapid intervention, such as airway obstruction or an open pneumothorax.
2. In the primary survey of a trauma patient, what is the ‘A’ in the ABCDE
mnemonic?
A. Assessment of injury
B. Ambulation status
C. Airway and cervical spine stabilization
D. Arterial blood gas analysis
Answer: C
Rationale: The primary survey begins with Airway maintenance while ensuring Cervical
spine stabilization to prevent further injury.
,3. Which stage of shock is characterized by a MAP decrease of 10-15 mmHg
from baseline and activation of the renin-angiotensin-aldosterone system?
A. Initial stage
B. Refractory stage
C. Progressive stage
D. Compensatory stage
Answer: D
Rationale: In the compensatory stage, the body initiates homeostatic mechanisms (like
RAAS) to maintain cardiac output and blood pressure.
4. A patient arrives with heatstroke. Which clinical finding distinguishes
heatstroke from heat exhaustion?
A. Altered mental status
B. Tachycardia
C. Profuse diaphoresis
D. Nausea and vomiting
Answer: A
Rationale: Heatstroke is a medical emergency characterized by a body temperature often
above 104F and neurological dysfunction, unlike heat exhaustion where mental status is
usually intact.
5. Using the Parkland Formula, calculate the total fluid resuscitation for a 70kg
patient with 40% TBSA burns over 24 hours.
A. 11,200 mL
B. 5,600 mL
C. 8,400 mL
D. 14,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x kg x %TBSA. So, 4 x 70 x 40 = 11,200 mL.
, 6. Which electrolyte imbalance is most commonly seen in the first 24 hours
(emergent phase) of a major burn injury?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: During the emergent phase, cell destruction releases potassium into the
extracellular fluid, leading to hyperkalemia.
7. A patient is in neurogenic shock. Which vital sign finding is unique to this type
of distributive shock?
A. Tachycardia
B. Bradycardia
C. Hypertension
D. Tachypnea
Answer: B
Rationale: Neurogenic shock causes a loss of sympathetic tone, leading to vasodilation and
a paradoxical bradycardia.
8. In the ‘Sepsis Six’ or 1-hour bundle, what is the recommended initial fluid
bolus for a patient with hypotension or lactate >4 mmol/L?
A. 10 mL/kg
B. 30 mL/kg
C. 20 mL/kg
D. 50 mL/kg
Answer: B
Rationale: The current Surviving Sepsis guidelines recommend a 30 mL/kg rapid
crystalloid bolus for sepsis-induced hypotension or high lactate.
Study Guide 2026 |Galen College
1. During a mass casualty incident, which color tag is assigned to a patient with
a sucking chest wound and stable vitals who requires immediate intervention?
A. Green
B. Yellow
C. Black
D. Red
Answer: D
Rationale: Red tags are for immediate life-threatening injuries that are survivable with
rapid intervention, such as airway obstruction or an open pneumothorax.
2. In the primary survey of a trauma patient, what is the ‘A’ in the ABCDE
mnemonic?
A. Assessment of injury
B. Ambulation status
C. Airway and cervical spine stabilization
D. Arterial blood gas analysis
Answer: C
Rationale: The primary survey begins with Airway maintenance while ensuring Cervical
spine stabilization to prevent further injury.
,3. Which stage of shock is characterized by a MAP decrease of 10-15 mmHg
from baseline and activation of the renin-angiotensin-aldosterone system?
A. Initial stage
B. Refractory stage
C. Progressive stage
D. Compensatory stage
Answer: D
Rationale: In the compensatory stage, the body initiates homeostatic mechanisms (like
RAAS) to maintain cardiac output and blood pressure.
4. A patient arrives with heatstroke. Which clinical finding distinguishes
heatstroke from heat exhaustion?
A. Altered mental status
B. Tachycardia
C. Profuse diaphoresis
D. Nausea and vomiting
Answer: A
Rationale: Heatstroke is a medical emergency characterized by a body temperature often
above 104F and neurological dysfunction, unlike heat exhaustion where mental status is
usually intact.
5. Using the Parkland Formula, calculate the total fluid resuscitation for a 70kg
patient with 40% TBSA burns over 24 hours.
A. 11,200 mL
B. 5,600 mL
C. 8,400 mL
D. 14,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x kg x %TBSA. So, 4 x 70 x 40 = 11,200 mL.
, 6. Which electrolyte imbalance is most commonly seen in the first 24 hours
(emergent phase) of a major burn injury?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: During the emergent phase, cell destruction releases potassium into the
extracellular fluid, leading to hyperkalemia.
7. A patient is in neurogenic shock. Which vital sign finding is unique to this type
of distributive shock?
A. Tachycardia
B. Bradycardia
C. Hypertension
D. Tachypnea
Answer: B
Rationale: Neurogenic shock causes a loss of sympathetic tone, leading to vasodilation and
a paradoxical bradycardia.
8. In the ‘Sepsis Six’ or 1-hour bundle, what is the recommended initial fluid
bolus for a patient with hypotension or lactate >4 mmol/L?
A. 10 mL/kg
B. 30 mL/kg
C. 20 mL/kg
D. 50 mL/kg
Answer: B
Rationale: The current Surviving Sepsis guidelines recommend a 30 mL/kg rapid
crystalloid bolus for sepsis-induced hypotension or high lactate.
