NR 324 Adult Health II Comprehensive Study Guide 2026
|Chamberlain College
1. A patient with septic shock is receiving aggressive fluid resuscitation. Which
finding indicates that the therapy is effective?
A. Blood pressure of 90/50 mmHg
B. Heart rate of 115 beats per minute
C. Urine output of 15 mL/hr
D. Mean arterial pressure (MAP) of 68 mmHg
Answer: D
Rationale: Effective fluid resuscitation in shock is indicated by a MAP of at least 65 mmHg,
ensuring adequate tissue perfusion.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of
shock?
A. Decreased heart rate
B. Cold, cyanotic skin
C. Lethargy and confusion
D. Increased respiratory rate
Answer: D
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
tachycardia and increased respiratory rate to improve oxygenation.
,3. A patient is admitted with a spinal cord injury at the T4 level. The nurse notes
a sudden increase in BP, bradycardia, and a severe headache. What is the
priority action?
A. Elevate the head of the bed to 45 degrees
B. Perform a digital rectal exam to check for stool
C. Administer an analgesic for the headache
D. Check the urinary catheter for kinks
Answer: A
Rationale: The symptoms indicate autonomic dysreflexia. The first priority is to sit the
patient up to help lower blood pressure through orthostatic changes.
4. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Serum lipase
B. Serum amylase
C. Serum calcium
D. WBC count
Answer: A
Rationale: Lipase is more specific than amylase for the diagnosis of acute pancreatitis as it
stays elevated longer and is not affected by as many non-pancreatic conditions.
5. A patient is on a mechanical ventilator. The ‘High Pressure’ alarm sounds.
What is a possible cause?
A. A leak in the cuff of the endotracheal tube
B. The patient has disconnected from the ventilator
C. The patient is biting the endotracheal tube
D. There is a large air leak in the chest tube
Answer: C
Rationale: High pressure alarms are triggered by resistance, such as the patient biting the
tube, secretions, or kinking. Low pressure alarms indicate leaks or disconnections.
, 6. What is the primary goal of administering Lactulose to a patient with hepatic
encephalopathy?
A. To reduce portal hypertension
B. To decrease serum potassium levels
C. To prevent gastrointestinal bleeding
D. To promote the excretion of ammonia in the stool
Answer: D
Rationale: Lactulose acidifies the colon contents, converting ammonia into ammonium
which is then excreted via bowel movements.
7. A nurse is caring for a patient with a burn injury using the Parkland Formula.
If the patient weighs 70kg and has a 50% TBSA burn, how much fluid should be
given in the first 8 hours?
A. 7,000 mL
B. 14,000 mL
C. 3,500 mL
D. 10,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x kg x TBSA. 4 x 70 x 50 = 14,000 mL total for 24 hours.
Half (7,000 mL) is given in the first 8 hours.
8. Which cardiac rhythm is characterized by a ‘sawtooth’ pattern on the ECG?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. First-degree AV block
D. Atrial Flutter
Answer: D
Rationale: Atrial flutter is defined by regular, sawtooth-shaped flutter waves (F waves)
instead of P waves.
|Chamberlain College
1. A patient with septic shock is receiving aggressive fluid resuscitation. Which
finding indicates that the therapy is effective?
A. Blood pressure of 90/50 mmHg
B. Heart rate of 115 beats per minute
C. Urine output of 15 mL/hr
D. Mean arterial pressure (MAP) of 68 mmHg
Answer: D
Rationale: Effective fluid resuscitation in shock is indicated by a MAP of at least 65 mmHg,
ensuring adequate tissue perfusion.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of
shock?
A. Decreased heart rate
B. Cold, cyanotic skin
C. Lethargy and confusion
D. Increased respiratory rate
Answer: D
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
tachycardia and increased respiratory rate to improve oxygenation.
,3. A patient is admitted with a spinal cord injury at the T4 level. The nurse notes
a sudden increase in BP, bradycardia, and a severe headache. What is the
priority action?
A. Elevate the head of the bed to 45 degrees
B. Perform a digital rectal exam to check for stool
C. Administer an analgesic for the headache
D. Check the urinary catheter for kinks
Answer: A
Rationale: The symptoms indicate autonomic dysreflexia. The first priority is to sit the
patient up to help lower blood pressure through orthostatic changes.
4. Which laboratory value is the most specific indicator of acute pancreatitis?
A. Serum lipase
B. Serum amylase
C. Serum calcium
D. WBC count
Answer: A
Rationale: Lipase is more specific than amylase for the diagnosis of acute pancreatitis as it
stays elevated longer and is not affected by as many non-pancreatic conditions.
5. A patient is on a mechanical ventilator. The ‘High Pressure’ alarm sounds.
What is a possible cause?
A. A leak in the cuff of the endotracheal tube
B. The patient has disconnected from the ventilator
C. The patient is biting the endotracheal tube
D. There is a large air leak in the chest tube
Answer: C
Rationale: High pressure alarms are triggered by resistance, such as the patient biting the
tube, secretions, or kinking. Low pressure alarms indicate leaks or disconnections.
, 6. What is the primary goal of administering Lactulose to a patient with hepatic
encephalopathy?
A. To reduce portal hypertension
B. To decrease serum potassium levels
C. To prevent gastrointestinal bleeding
D. To promote the excretion of ammonia in the stool
Answer: D
Rationale: Lactulose acidifies the colon contents, converting ammonia into ammonium
which is then excreted via bowel movements.
7. A nurse is caring for a patient with a burn injury using the Parkland Formula.
If the patient weighs 70kg and has a 50% TBSA burn, how much fluid should be
given in the first 8 hours?
A. 7,000 mL
B. 14,000 mL
C. 3,500 mL
D. 10,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x kg x TBSA. 4 x 70 x 50 = 14,000 mL total for 24 hours.
Half (7,000 mL) is given in the first 8 hours.
8. Which cardiac rhythm is characterized by a ‘sawtooth’ pattern on the ECG?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. First-degree AV block
D. Atrial Flutter
Answer: D
Rationale: Atrial flutter is defined by regular, sawtooth-shaped flutter waves (F waves)
instead of P waves.
