NUR 265 Advanced Medical-Surgical Nursing Exam 5 2026 |Galen
College
1. A nurse is caring for a patient in the compensatory stage of shock. Which
clinical finding should the nurse expect?
A. Heart rate 115 bpm with cool, clammy skin
B. Blood pressure 80/40 mmHg
C. Lethargy and unresponsiveness
D. Urine output of 10 mL/hr
E. Absent bowel sounds
Answer: A
Rationale: In the compensatory stage, the body activates the sympathetic nervous system,
leading to tachycardia and peripheral vasoconstriction (cool, clammy skin) to maintain
blood pressure.
2. The nurse is calculating the Mean Arterial Pressure (MAP) for a patient with a
blood pressure of 90/60 mmHg. What is the MAP?
A. 70 mmHg
B. 75 mmHg
C. 60 mmHg
D. 80 mmHg
Answer: A
Rationale: MAP = (SBP + 2DBP) / 3. So, (90 + 120) / 3 = 70 mmHg.
,3. A patient with septic shock has been prescribed a 30 mL/kg isotonic
crystalloid bolus. Which of the following is the primary goal of this therapy?
A. To decrease systemic vascular resistance
B. To increase heart rate
C. To treat the underlying infection
D. To restore intravascular volume and maintain organ perfusion
Answer: D
Rationale: Fluid resuscitation in septic shock is aimed at restoring the volume in the
vascular space to improve MAP and tissue perfusion.
4. Which hemodynamic parameter is uniquely associated with neurogenic shock
compared to other types of shock?
A. Bradycardia
B. Tachycardia
C. Increased Systemic Vascular Resistance (SVR)
D. High Central Venous Pressure (CVP)
Answer: A
Rationale: Neurogenic shock results from loss of sympathetic tone, leading to
parasympathetic dominance, which causes bradycardia. Other forms of shock typically
present with tachycardia.
5. A patient is diagnosed with Disseminated Intravascular Coagulation (DIC).
Which laboratory result is most diagnostic of this condition?
A. Decreased PTT
B. Elevated D-Dimer
C. Increased Platelet count
D. Decreased Fibrin Degradation Products (FDPs)
Answer: B
, Rationale: Elevated D-Dimer indicates the breakdown of fibrin clots, which is a hallmark
finding in DIC alongside prolonged clotting times and low platelets.
6. In the progressive stage of shock, what is the primary cause of metabolic
acidosis?
A. Hypoventilation
B. Renal retention of hydrogen ions
C. Excessive bicarbonate production
D. Anaerobic metabolism and lactic acid buildup
Answer: D
Rationale: As tissue perfusion fails, cells switch to anaerobic metabolism, which produces
lactic acid as a byproduct, leading to metabolic acidosis.
7. Which medication is considered the first-line vasopressor for a patient in
septic shock who remains hypotensive after fluid resuscitation?
A. Dopamine
B. Epinephrine
C. Dobutamine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine (Levophed) is the preferred first-choice vasopressor to
increase SVR in septic shock.
8. The nurse is caring for a patient in cardiogenic shock. Which treatment goal is
most appropriate for this patient?
A. Increase preload with rapid fluid boluses
B. Increase systemic vascular resistance
C. Reduce workload of the heart and improve cardiac output
D. Administer high-dose anticoagulants
Answer: C
College
1. A nurse is caring for a patient in the compensatory stage of shock. Which
clinical finding should the nurse expect?
A. Heart rate 115 bpm with cool, clammy skin
B. Blood pressure 80/40 mmHg
C. Lethargy and unresponsiveness
D. Urine output of 10 mL/hr
E. Absent bowel sounds
Answer: A
Rationale: In the compensatory stage, the body activates the sympathetic nervous system,
leading to tachycardia and peripheral vasoconstriction (cool, clammy skin) to maintain
blood pressure.
2. The nurse is calculating the Mean Arterial Pressure (MAP) for a patient with a
blood pressure of 90/60 mmHg. What is the MAP?
A. 70 mmHg
B. 75 mmHg
C. 60 mmHg
D. 80 mmHg
Answer: A
Rationale: MAP = (SBP + 2DBP) / 3. So, (90 + 120) / 3 = 70 mmHg.
,3. A patient with septic shock has been prescribed a 30 mL/kg isotonic
crystalloid bolus. Which of the following is the primary goal of this therapy?
A. To decrease systemic vascular resistance
B. To increase heart rate
C. To treat the underlying infection
D. To restore intravascular volume and maintain organ perfusion
Answer: D
Rationale: Fluid resuscitation in septic shock is aimed at restoring the volume in the
vascular space to improve MAP and tissue perfusion.
4. Which hemodynamic parameter is uniquely associated with neurogenic shock
compared to other types of shock?
A. Bradycardia
B. Tachycardia
C. Increased Systemic Vascular Resistance (SVR)
D. High Central Venous Pressure (CVP)
Answer: A
Rationale: Neurogenic shock results from loss of sympathetic tone, leading to
parasympathetic dominance, which causes bradycardia. Other forms of shock typically
present with tachycardia.
5. A patient is diagnosed with Disseminated Intravascular Coagulation (DIC).
Which laboratory result is most diagnostic of this condition?
A. Decreased PTT
B. Elevated D-Dimer
C. Increased Platelet count
D. Decreased Fibrin Degradation Products (FDPs)
Answer: B
, Rationale: Elevated D-Dimer indicates the breakdown of fibrin clots, which is a hallmark
finding in DIC alongside prolonged clotting times and low platelets.
6. In the progressive stage of shock, what is the primary cause of metabolic
acidosis?
A. Hypoventilation
B. Renal retention of hydrogen ions
C. Excessive bicarbonate production
D. Anaerobic metabolism and lactic acid buildup
Answer: D
Rationale: As tissue perfusion fails, cells switch to anaerobic metabolism, which produces
lactic acid as a byproduct, leading to metabolic acidosis.
7. Which medication is considered the first-line vasopressor for a patient in
septic shock who remains hypotensive after fluid resuscitation?
A. Dopamine
B. Epinephrine
C. Dobutamine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine (Levophed) is the preferred first-choice vasopressor to
increase SVR in septic shock.
8. The nurse is caring for a patient in cardiogenic shock. Which treatment goal is
most appropriate for this patient?
A. Increase preload with rapid fluid boluses
B. Increase systemic vascular resistance
C. Reduce workload of the heart and improve cardiac output
D. Administer high-dose anticoagulants
Answer: C
