NR 325 Adult Health III Critical Care Nursing Practice Pack 2026
|Chamberlain College
1. Which of the following clinical findings is characteristic of the early stage of
hypovolemic shock?
A. Bradycardia and hypertension
B. Lethargy and decreased urine output
C. Tachycardia and narrowed pulse pressure
D. Hypotension and bradypnea
Answer: C
Rationale: In early hypovolemic shock, the body compensates by increasing the heart rate
(tachycardia) and vasoconstriction, which narrows the pulse pressure even before a
significant drop in systolic blood pressure occurs.
2. A patient with ARDS is on mechanical ventilation with high PEEP. What is the
primary risk associated with high PEEP levels?
A. Hyperventilation
B. Barotrauma and decreased cardiac output
C. Increased venous return
D. Respiratory alkalosis
Answer: B
Rationale: High Positive End-Expiratory Pressure (PEEP) increases intrathoracic pressure,
which can lead to alveolar rupture (barotrauma) and compressed vena cava, reducing
venous return and cardiac output.
,3. The nurse is caring for a patient with a Central Venous Pressure (CVP) of 1
mmHg. Which intervention should the nurse anticipate?
A. Administration of a loop diuretic
B. Administration of a beta-blocker
C. Continuous venovenous hemofiltration
D. Fluid bolus of Normal Saline
Answer: D
Rationale: A normal CVP is 2-8 mmHg. A CVP of 1 indicates hypovolemia or low fluid
volume, requiring fluid resuscitation.
4. Which heart rhythm is characterized by a lack of P waves and a ‘sawtooth’
appearance of the baseline?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrial Flutter
D. Third-degree Heart Block
Answer: C
Rationale: Atrial flutter is classically identified by sawtooth-shaped ‘F’ waves on an EKG
baseline.
5. What is the gold standard diagnostic test for determining the presence of a
pulmonary embolism?
A. Chest X-ray
B. CT Pulmonary Angiogram
C. D-dimer assay
D. Arterial Blood Gas
Answer: B
Rationale: CT Pulmonary Angiography (CTPA) is the preferred and most common
diagnostic test to visualize clots in the pulmonary vasculature.
, 6. A patient’s ABG results are: pH 7.31, PaCO2 52, HCO3 24. How should the
nurse interpret these results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory
cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
7. When assessing a patient for Beck’s Triad, which three signs is the nurse
looking for?
A. Muffled heart sounds, JVD, hypotension
B. Bradycardia, hypertension, irregular respirations
C. Tachycardia, hypotension, clear lung sounds
D. Elevated CVP, narrowed pulse pressure, bradycardia
Answer: A
Rationale: Beck’s Triad (muffled heart sounds, jugular venous distention, and
hypotension) is a classic indicator of cardiac tamponade.
8. A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation.
Which medication is the first-choice vasopressor?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: C
Rationale: Norepinephrine (Levophed) is the first-line vasopressor recommended by the
Surviving Sepsis Campaign for patients who remain hypotensive after fluid resuscitation.
|Chamberlain College
1. Which of the following clinical findings is characteristic of the early stage of
hypovolemic shock?
A. Bradycardia and hypertension
B. Lethargy and decreased urine output
C. Tachycardia and narrowed pulse pressure
D. Hypotension and bradypnea
Answer: C
Rationale: In early hypovolemic shock, the body compensates by increasing the heart rate
(tachycardia) and vasoconstriction, which narrows the pulse pressure even before a
significant drop in systolic blood pressure occurs.
2. A patient with ARDS is on mechanical ventilation with high PEEP. What is the
primary risk associated with high PEEP levels?
A. Hyperventilation
B. Barotrauma and decreased cardiac output
C. Increased venous return
D. Respiratory alkalosis
Answer: B
Rationale: High Positive End-Expiratory Pressure (PEEP) increases intrathoracic pressure,
which can lead to alveolar rupture (barotrauma) and compressed vena cava, reducing
venous return and cardiac output.
,3. The nurse is caring for a patient with a Central Venous Pressure (CVP) of 1
mmHg. Which intervention should the nurse anticipate?
A. Administration of a loop diuretic
B. Administration of a beta-blocker
C. Continuous venovenous hemofiltration
D. Fluid bolus of Normal Saline
Answer: D
Rationale: A normal CVP is 2-8 mmHg. A CVP of 1 indicates hypovolemia or low fluid
volume, requiring fluid resuscitation.
4. Which heart rhythm is characterized by a lack of P waves and a ‘sawtooth’
appearance of the baseline?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrial Flutter
D. Third-degree Heart Block
Answer: C
Rationale: Atrial flutter is classically identified by sawtooth-shaped ‘F’ waves on an EKG
baseline.
5. What is the gold standard diagnostic test for determining the presence of a
pulmonary embolism?
A. Chest X-ray
B. CT Pulmonary Angiogram
C. D-dimer assay
D. Arterial Blood Gas
Answer: B
Rationale: CT Pulmonary Angiography (CTPA) is the preferred and most common
diagnostic test to visualize clots in the pulmonary vasculature.
, 6. A patient’s ABG results are: pH 7.31, PaCO2 52, HCO3 24. How should the
nurse interpret these results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory
cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
7. When assessing a patient for Beck’s Triad, which three signs is the nurse
looking for?
A. Muffled heart sounds, JVD, hypotension
B. Bradycardia, hypertension, irregular respirations
C. Tachycardia, hypotension, clear lung sounds
D. Elevated CVP, narrowed pulse pressure, bradycardia
Answer: A
Rationale: Beck’s Triad (muffled heart sounds, jugular venous distention, and
hypotension) is a classic indicator of cardiac tamponade.
8. A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation.
Which medication is the first-choice vasopressor?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: C
Rationale: Norepinephrine (Levophed) is the first-line vasopressor recommended by the
Surviving Sepsis Campaign for patients who remain hypotensive after fluid resuscitation.
