NR 325 Adult Health III Exam 1 Study Guide 2026 |Chamberlain
College
1. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect to observe?
A. Decreased heart rate
B. Narrowing pulse pressure
C. Metabolic alkalosis
D. Increased urinary output
Answer: B
Rationale: In the compensatory stage of shock, the body attempts to maintain cardiac
output. A narrowing pulse pressure is an early indicator of decreased stroke volume, even
if the systolic BP remains normal.
2. Which intravenous fluid is the most appropriate initial choice for rapid
volume expansion in a patient with hypovolemic shock?
A. 0.45% Normal Saline
B. 5% Dextrose in Water
C. 3% Normal Saline
D. Lactated Ringer’s
Answer: D
Rationale: Isotonic crystalloids like Lactated Ringer’s or 0.9% Normal Saline are the
preferred initial fluids for volume resuscitation because they expand the extracellular fluid
volume.
,3. A patient with neurogenic shock is characterized by which of the following
hemodynamic changes?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Tachycardia and hypotension
D. Bradycardia and hypertension
Answer: A
Rationale: Neurogenic shock results in a loss of sympathetic tone, leading to massive
vasodilation (hypotension) and a lack of compensatory tachycardia (bradycardia).
4. What is the primary goal of using a positive inotropic agent like Dobutamine
in a patient with cardiogenic shock?
A. To decrease heart rate
B. To reduce preload
C. To cause peripheral vasoconstriction
D. To increase myocardial contractility
Answer: D
Rationale: Dobutamine increases the force of myocardial contraction (inotropy), which
helps improve cardiac output in patients with a failing heart.
5. Which assessment finding is a hallmark of the progressive stage of shock?
A. Anasarca and weak peripheral pulses
B. Warm, dry skin
C. Mean arterial pressure (MAP) > 65 mmHg
D. Respiratory alkalosis
Answer: A
Rationale: In the progressive stage, capillary permeability increases, leading to systemic
edema (anasarca) and decreased peripheral perfusion.
, 6. A patient is suspected of having Septic Shock. Which lab value is most
indicative of tissue hypoperfusion?
A. Serum Lactate of 5.0 mmol/L
B. White Blood Cell count of 12,000
C. Creatinine of 1.1 mg/dL
D. Glucose of 140 mg/dL
Answer: A
Rationale: An elevated serum lactate level (typically > 2 mmol/L) is a key indicator of
anaerobic metabolism due to tissue hypoperfusion in sepsis.
7. When administering Norepinephrine for septic shock, what is the nurse’s
primary titration goal?
A. Keep Heart Rate < 100 bpm
B. Maintain Systolic BP ≥ 140 mmHg
C. Maintain MAP ≥ 65 mmHg
D. Ensure CVP is between 2-5 mmHg
Answer: C
Rationale: The standard goal for vasopressor therapy in septic shock is to maintain a Mean
Arterial Pressure (MAP) of at least 65 mmHg to ensure vital organ perfusion.
8. A patient with ARDS is being mechanically ventilated. Why is Positive End-
Expiratory Pressure (PEEP) utilized?
A. To keep alveoli open and improve oxygenation
B. To decrease functional residual capacity
C. To prevent pneumothorax
D. To decrease the work of breathing during expiration
Answer: A
Rationale: PEEP prevents alveolar collapse at the end of expiration, increasing the surface
area for gas exchange and improving oxygenation (PaO2).
College
1. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect to observe?
A. Decreased heart rate
B. Narrowing pulse pressure
C. Metabolic alkalosis
D. Increased urinary output
Answer: B
Rationale: In the compensatory stage of shock, the body attempts to maintain cardiac
output. A narrowing pulse pressure is an early indicator of decreased stroke volume, even
if the systolic BP remains normal.
2. Which intravenous fluid is the most appropriate initial choice for rapid
volume expansion in a patient with hypovolemic shock?
A. 0.45% Normal Saline
B. 5% Dextrose in Water
C. 3% Normal Saline
D. Lactated Ringer’s
Answer: D
Rationale: Isotonic crystalloids like Lactated Ringer’s or 0.9% Normal Saline are the
preferred initial fluids for volume resuscitation because they expand the extracellular fluid
volume.
,3. A patient with neurogenic shock is characterized by which of the following
hemodynamic changes?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Tachycardia and hypotension
D. Bradycardia and hypertension
Answer: A
Rationale: Neurogenic shock results in a loss of sympathetic tone, leading to massive
vasodilation (hypotension) and a lack of compensatory tachycardia (bradycardia).
4. What is the primary goal of using a positive inotropic agent like Dobutamine
in a patient with cardiogenic shock?
A. To decrease heart rate
B. To reduce preload
C. To cause peripheral vasoconstriction
D. To increase myocardial contractility
Answer: D
Rationale: Dobutamine increases the force of myocardial contraction (inotropy), which
helps improve cardiac output in patients with a failing heart.
5. Which assessment finding is a hallmark of the progressive stage of shock?
A. Anasarca and weak peripheral pulses
B. Warm, dry skin
C. Mean arterial pressure (MAP) > 65 mmHg
D. Respiratory alkalosis
Answer: A
Rationale: In the progressive stage, capillary permeability increases, leading to systemic
edema (anasarca) and decreased peripheral perfusion.
, 6. A patient is suspected of having Septic Shock. Which lab value is most
indicative of tissue hypoperfusion?
A. Serum Lactate of 5.0 mmol/L
B. White Blood Cell count of 12,000
C. Creatinine of 1.1 mg/dL
D. Glucose of 140 mg/dL
Answer: A
Rationale: An elevated serum lactate level (typically > 2 mmol/L) is a key indicator of
anaerobic metabolism due to tissue hypoperfusion in sepsis.
7. When administering Norepinephrine for septic shock, what is the nurse’s
primary titration goal?
A. Keep Heart Rate < 100 bpm
B. Maintain Systolic BP ≥ 140 mmHg
C. Maintain MAP ≥ 65 mmHg
D. Ensure CVP is between 2-5 mmHg
Answer: C
Rationale: The standard goal for vasopressor therapy in septic shock is to maintain a Mean
Arterial Pressure (MAP) of at least 65 mmHg to ensure vital organ perfusion.
8. A patient with ARDS is being mechanically ventilated. Why is Positive End-
Expiratory Pressure (PEEP) utilized?
A. To keep alveoli open and improve oxygenation
B. To decrease functional residual capacity
C. To prevent pneumothorax
D. To decrease the work of breathing during expiration
Answer: A
Rationale: PEEP prevents alveolar collapse at the end of expiration, increasing the surface
area for gas exchange and improving oxygenation (PaO2).
