NR 325 Adult Health III Exam 1 Practice Questions 2026 |Chamberlain
College
1. A patient in septic shock has a blood pressure of 70/40 mmHg and a heart
rate of 120 bpm. Which of the following is the priority intervention?
A. Administering broad-spectrum antibiotics
B. Starting a norepinephrine infusion at 2 mcg/min
C. Initiating rapid fluid resuscitation with 30 mL/kg of crystalloids
D. Inserting an indwelling urinary catheter
D. Inserting an indwelling urinary catheter
Answer: C
Rationale: The first-line treatment for hypotension in septic shock is fluid resuscitation to
restore intravascular volume before starting vasopressors.
2. Which assessment finding in a patient with a head injury should the nurse
report immediately as an early sign of increased intracranial pressure (ICP)?
A. Decerebrate posturing
B. Cushing’s triad
C. Fixed and dilated pupils
D. A change in the level of consciousness
Answer: D
Rationale: A change in the level of consciousness (LOC) is the most sensitive and earliest
indicator of increased ICP.
,3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). What
is the primary pathophysiological change occurring in the lungs?
A. Decrease in capillary permeability
B. Increased production of surfactant
C. Damage to the alveolar-capillary membrane
D. Localized infection of the lower lobes
Answer: C
Rationale: ARDS is characterized by non-cardiogenic pulmonary edema caused by damage
to the alveolar-capillary membrane, leading to severe hypoxemia.
4. The nurse is monitoring a patient’s Central Venous Pressure (CVP). A reading
of 2 mmHg most likely indicates:
A. Fluid volume overload
B. Right-sided heart failure
C. Hypovolemia
D. Pulmonary hypertension
Answer: C
Rationale: Normal CVP is 2 to 8 mmHg. A low CVP (like 2 or below) typically indicates
hypovolemia or reduced venous return.
5. A patient with a T6 spinal cord injury reports a severe headache and nasal
congestion. Their BP is 190/110. What is the nurse’s first action?
A. Administer PRN antihypertensives
B. Place the patient in a supine position
C. Check for a full bladder or fecal impaction
D. Call the physician for a STAT CT scan
Answer: C
Rationale: These are signs of Autonomic Dysreflexia. The priority is to sit the patient up
and then find/remove the noxious stimulus, such as a full bladder.
, 6. Which cardiac rhythm requires immediate defibrillation?
A. Asystole
B. Ventricular fibrillation
C. Atrial fibrillation
D. Pulseless electrical activity (PEA)
Answer: B
Rationale: Defibrillation is indicated for Ventricular Fibrillation (VF) and Pulseless
Ventricular Tachycardia (pVT). Asystole and PEA are treated with CPR and epinephrine.
7. A patient with a pulmonary embolism has a PaO2 of 58 mmHg. What is the
underlying cause of this hypoxemia?
A. Ventilation-perfusion (V/Q) mismatch
B. Alveolar hypoventilation
C. Reduced inspired oxygen concentration
D. Pulmonary shunting
Answer: A
Rationale: A PE blocks blood flow to ventilated alveoli, causing a V/Q mismatch where
there is ventilation but no perfusion (wasted ventilation).
8. During the compensatory stage of shock, the nurse expects to see which
clinical manifestation?
A. Lethargy and cold, clammy skin
B. Hypotension and bradycardia
C. Narrow pulse pressure and tachycardia
D. Respiratory acidosis
Answer: C
Rationale: In the compensatory stage, the body uses the sympathetic nervous system to
maintain cardiac output, leading to tachycardia and vasoconstriction.
College
1. A patient in septic shock has a blood pressure of 70/40 mmHg and a heart
rate of 120 bpm. Which of the following is the priority intervention?
A. Administering broad-spectrum antibiotics
B. Starting a norepinephrine infusion at 2 mcg/min
C. Initiating rapid fluid resuscitation with 30 mL/kg of crystalloids
D. Inserting an indwelling urinary catheter
D. Inserting an indwelling urinary catheter
Answer: C
Rationale: The first-line treatment for hypotension in septic shock is fluid resuscitation to
restore intravascular volume before starting vasopressors.
2. Which assessment finding in a patient with a head injury should the nurse
report immediately as an early sign of increased intracranial pressure (ICP)?
A. Decerebrate posturing
B. Cushing’s triad
C. Fixed and dilated pupils
D. A change in the level of consciousness
Answer: D
Rationale: A change in the level of consciousness (LOC) is the most sensitive and earliest
indicator of increased ICP.
,3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). What
is the primary pathophysiological change occurring in the lungs?
A. Decrease in capillary permeability
B. Increased production of surfactant
C. Damage to the alveolar-capillary membrane
D. Localized infection of the lower lobes
Answer: C
Rationale: ARDS is characterized by non-cardiogenic pulmonary edema caused by damage
to the alveolar-capillary membrane, leading to severe hypoxemia.
4. The nurse is monitoring a patient’s Central Venous Pressure (CVP). A reading
of 2 mmHg most likely indicates:
A. Fluid volume overload
B. Right-sided heart failure
C. Hypovolemia
D. Pulmonary hypertension
Answer: C
Rationale: Normal CVP is 2 to 8 mmHg. A low CVP (like 2 or below) typically indicates
hypovolemia or reduced venous return.
5. A patient with a T6 spinal cord injury reports a severe headache and nasal
congestion. Their BP is 190/110. What is the nurse’s first action?
A. Administer PRN antihypertensives
B. Place the patient in a supine position
C. Check for a full bladder or fecal impaction
D. Call the physician for a STAT CT scan
Answer: C
Rationale: These are signs of Autonomic Dysreflexia. The priority is to sit the patient up
and then find/remove the noxious stimulus, such as a full bladder.
, 6. Which cardiac rhythm requires immediate defibrillation?
A. Asystole
B. Ventricular fibrillation
C. Atrial fibrillation
D. Pulseless electrical activity (PEA)
Answer: B
Rationale: Defibrillation is indicated for Ventricular Fibrillation (VF) and Pulseless
Ventricular Tachycardia (pVT). Asystole and PEA are treated with CPR and epinephrine.
7. A patient with a pulmonary embolism has a PaO2 of 58 mmHg. What is the
underlying cause of this hypoxemia?
A. Ventilation-perfusion (V/Q) mismatch
B. Alveolar hypoventilation
C. Reduced inspired oxygen concentration
D. Pulmonary shunting
Answer: A
Rationale: A PE blocks blood flow to ventilated alveoli, causing a V/Q mismatch where
there is ventilation but no perfusion (wasted ventilation).
8. During the compensatory stage of shock, the nurse expects to see which
clinical manifestation?
A. Lethargy and cold, clammy skin
B. Hypotension and bradycardia
C. Narrow pulse pressure and tachycardia
D. Respiratory acidosis
Answer: C
Rationale: In the compensatory stage, the body uses the sympathetic nervous system to
maintain cardiac output, leading to tachycardia and vasoconstriction.
