NUR 265 Advanced Medical-Surgical Nursing Exam 9 Study Guide 2026
|Galen College
1. In a mass casualty incident (MCI), which triage tag color is assigned to a
patient who has a sucking chest wound and is in respiratory distress?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
Rationale: The Red tag is for immediate life-threatening injuries that are treatable, such as
airway obstruction or sucking chest wounds.
2. A patient arrives with deep partial-thickness burns to the entire left arm and
the anterior trunk. Using the Rule of Nines, what is the estimated TBSA burned?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: Left arm (9%) + Anterior trunk (18%) = 27% TBSA.
,3. According to the Parkland Formula, how much fluid should a 70kg patient
with 50% TBSA burns receive in the first 8 hours?
A. 14,000 mL
B. 3,500 mL
C. 7,000 mL
D. 10,500 mL
Answer: C
Rationale: Parkland Formula: 4mL x kg x %TBSA. 4 x 70 x 50 = 14,000 mL total for 24h.
Half is given in the first 8 hours, which is 7,000 mL.
4. What is the primary goal of fluid resuscitation in the emergent phase of burn
management?
A. Maintain urine output of 30-50 mL/hr
B. Maintain a heart rate below 100 bpm
C. Prevent shivering
D. Decrease blood glucose levels
Answer: A
Rationale: Adequate urine output (0.5 mL/kg/hr or roughly 30-50 mL/hr) is the most
reliable indicator of successful fluid resuscitation in burn patients.
5. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR) in its early stages?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Answer: A
Rationale: Early septic shock (hyperdynamic phase) often presents with warm skin, high
CO, and vasodilation resulting in low SVR.
, 6. A patient in the ICU has a Mean Arterial Pressure (MAP) of 55 mmHg. Which
action should the nurse prioritize?
A. Document the finding and re-evaluate in 1 hour
B. Increase the IV fluid rate as per protocol
C. Administer a sedative to lower oxygen demand
D. Assess the patient’s temperature
Answer: B
Rationale: A MAP below 65 mmHg indicates inadequate organ perfusion; fluid
resuscitation or vasopressors are typically required.
7. Which clinical finding is a hallmark of the Progressive Stage of shock?
A. Mean Arterial Pressure (MAP) drop of 20 mmHg from baseline
B. Metabolic alkalosis
C. Slightly increased heart rate
D. Warm, flushed skin
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail, leading to a significant
drop in MAP, organ ischemia, and metabolic acidosis.
8. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Epinephrine
B. Diphenhydramine
C. Methylprednisolone
D. Albuterol
Answer: A
Rationale: Epinephrine is the drug of choice for anaphylaxis because it causes
bronchodilation and vasoconstriction.
|Galen College
1. In a mass casualty incident (MCI), which triage tag color is assigned to a
patient who has a sucking chest wound and is in respiratory distress?
A. Red
B. Yellow
C. Green
D. Black
Answer: A
Rationale: The Red tag is for immediate life-threatening injuries that are treatable, such as
airway obstruction or sucking chest wounds.
2. A patient arrives with deep partial-thickness burns to the entire left arm and
the anterior trunk. Using the Rule of Nines, what is the estimated TBSA burned?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: Left arm (9%) + Anterior trunk (18%) = 27% TBSA.
,3. According to the Parkland Formula, how much fluid should a 70kg patient
with 50% TBSA burns receive in the first 8 hours?
A. 14,000 mL
B. 3,500 mL
C. 7,000 mL
D. 10,500 mL
Answer: C
Rationale: Parkland Formula: 4mL x kg x %TBSA. 4 x 70 x 50 = 14,000 mL total for 24h.
Half is given in the first 8 hours, which is 7,000 mL.
4. What is the primary goal of fluid resuscitation in the emergent phase of burn
management?
A. Maintain urine output of 30-50 mL/hr
B. Maintain a heart rate below 100 bpm
C. Prevent shivering
D. Decrease blood glucose levels
Answer: A
Rationale: Adequate urine output (0.5 mL/kg/hr or roughly 30-50 mL/hr) is the most
reliable indicator of successful fluid resuscitation in burn patients.
5. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR) in its early stages?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Answer: A
Rationale: Early septic shock (hyperdynamic phase) often presents with warm skin, high
CO, and vasodilation resulting in low SVR.
, 6. A patient in the ICU has a Mean Arterial Pressure (MAP) of 55 mmHg. Which
action should the nurse prioritize?
A. Document the finding and re-evaluate in 1 hour
B. Increase the IV fluid rate as per protocol
C. Administer a sedative to lower oxygen demand
D. Assess the patient’s temperature
Answer: B
Rationale: A MAP below 65 mmHg indicates inadequate organ perfusion; fluid
resuscitation or vasopressors are typically required.
7. Which clinical finding is a hallmark of the Progressive Stage of shock?
A. Mean Arterial Pressure (MAP) drop of 20 mmHg from baseline
B. Metabolic alkalosis
C. Slightly increased heart rate
D. Warm, flushed skin
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail, leading to a significant
drop in MAP, organ ischemia, and metabolic acidosis.
8. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Epinephrine
B. Diphenhydramine
C. Methylprednisolone
D. Albuterol
Answer: A
Rationale: Epinephrine is the drug of choice for anaphylaxis because it causes
bronchodilation and vasoconstriction.
