NR 324 | Adult Health II | Week 9 Study Guide 2026/2027
|Chamberlain College
1. A nurse is monitoring a patient with a Central Venous Pressure (CVP) of 2
mmHg. Which intervention should the nurse anticipate?
A. Administration of an intravenous fluid bolus
B. Administration of a loop diuretic
C. Decrease in the current IV infusion rate
D. Preparation for immediate dialysis
Answer: A
Rationale: A CVP of 2 mmHg is low (normal is 2-8 mmHg), indicating hypovolemia. The
nurse should anticipate fluid resuscitation.
2. Which arterial blood gas (ABG) result is most indicative of respiratory failure
in a patient with COPD?
A. pH 7.28, PaCO2 60, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 24
D. pH 7.38, PaCO2 40, HCO3 24
Answer: A
Rationale: Respiratory failure in COPD is characterized by respiratory acidosis (low pH
and high PaCO2) and hypoxemia.
,3. The nurse is caring for a patient on a mechanical ventilator with Positive End-
Expiratory Pressure (PEEP). What is the primary purpose of PEEP?
A. To increase the fraction of inspired oxygen
B. To reduce the risk of barotrauma
C. To prevent alveolar collapse at the end of expiration
D. To provide a set number of breaths per minute
Answer: C
Rationale: PEEP maintains pressure in the lungs at the end of expiration to keep alveoli
open, improving oxygenation.
4. Which laboratory finding is characteristic of Disseminated Intravascular
Coagulation (DIC)?
A. Prolonged Prothrombin Time (PT)
B. Increased fibrinogen levels
C. Decreased D-dimer levels
D. Increased platelet count
Answer: A
Rationale: In DIC, clotting factors are consumed, leading to prolonged PT/PTT, decreased
platelets, and increased D-dimer.
5. A patient in hypovolemic shock is receiving large volumes of isotonic
crystalloids. Which assessment finding indicates improved tissue perfusion?
A. Urine output of 0.5 mL/kg/hr
B. Increased heart rate
C. Decrease in Mean Arterial Pressure (MAP)
D. Capillary refill of 5 seconds
Answer: A
Rationale: Adequate urine output is a sensitive indicator of renal perfusion and overall
tissue perfusion in shock states.
, 6. In the management of Septic Shock, which is the priority action within the
first hour of recognition?
A. Wait for the lactate level before starting fluids
B. Administer a sedative for comfort
C. Obtain blood cultures and then start broad-spectrum antibiotics
D. Place an indwelling urinary catheter
Answer: C
Rationale: The sepsis bundle prioritizes obtaining cultures and administering antibiotics
early to treat the underlying infection.
7. A patient with Cardiogenic Shock is prescribed Dobutamine. What is the
intended effect of this medication?
A. To decrease heart rate
B. To increase myocardial contractility
C. To cause peripheral vasoconstriction
D. To reduce circulating blood volume
Answer: B
Rationale: Dobutamine is an inotrope that increases cardiac output by enhancing the
strength of myocardial contractions.
8. Using the Parkland Formula, calculate the total fluid volume for the first 24
hours for a 70kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
|Chamberlain College
1. A nurse is monitoring a patient with a Central Venous Pressure (CVP) of 2
mmHg. Which intervention should the nurse anticipate?
A. Administration of an intravenous fluid bolus
B. Administration of a loop diuretic
C. Decrease in the current IV infusion rate
D. Preparation for immediate dialysis
Answer: A
Rationale: A CVP of 2 mmHg is low (normal is 2-8 mmHg), indicating hypovolemia. The
nurse should anticipate fluid resuscitation.
2. Which arterial blood gas (ABG) result is most indicative of respiratory failure
in a patient with COPD?
A. pH 7.28, PaCO2 60, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 24
D. pH 7.38, PaCO2 40, HCO3 24
Answer: A
Rationale: Respiratory failure in COPD is characterized by respiratory acidosis (low pH
and high PaCO2) and hypoxemia.
,3. The nurse is caring for a patient on a mechanical ventilator with Positive End-
Expiratory Pressure (PEEP). What is the primary purpose of PEEP?
A. To increase the fraction of inspired oxygen
B. To reduce the risk of barotrauma
C. To prevent alveolar collapse at the end of expiration
D. To provide a set number of breaths per minute
Answer: C
Rationale: PEEP maintains pressure in the lungs at the end of expiration to keep alveoli
open, improving oxygenation.
4. Which laboratory finding is characteristic of Disseminated Intravascular
Coagulation (DIC)?
A. Prolonged Prothrombin Time (PT)
B. Increased fibrinogen levels
C. Decreased D-dimer levels
D. Increased platelet count
Answer: A
Rationale: In DIC, clotting factors are consumed, leading to prolonged PT/PTT, decreased
platelets, and increased D-dimer.
5. A patient in hypovolemic shock is receiving large volumes of isotonic
crystalloids. Which assessment finding indicates improved tissue perfusion?
A. Urine output of 0.5 mL/kg/hr
B. Increased heart rate
C. Decrease in Mean Arterial Pressure (MAP)
D. Capillary refill of 5 seconds
Answer: A
Rationale: Adequate urine output is a sensitive indicator of renal perfusion and overall
tissue perfusion in shock states.
, 6. In the management of Septic Shock, which is the priority action within the
first hour of recognition?
A. Wait for the lactate level before starting fluids
B. Administer a sedative for comfort
C. Obtain blood cultures and then start broad-spectrum antibiotics
D. Place an indwelling urinary catheter
Answer: C
Rationale: The sepsis bundle prioritizes obtaining cultures and administering antibiotics
early to treat the underlying infection.
7. A patient with Cardiogenic Shock is prescribed Dobutamine. What is the
intended effect of this medication?
A. To decrease heart rate
B. To increase myocardial contractility
C. To cause peripheral vasoconstriction
D. To reduce circulating blood volume
Answer: B
Rationale: Dobutamine is an inotrope that increases cardiac output by enhancing the
strength of myocardial contractions.
8. Using the Parkland Formula, calculate the total fluid volume for the first 24
hours for a 70kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
