NR 325 Adult Health III Exam 4 Practice 2026 |Chamberlain College
1. A patient is admitted with suspected hypovolemic shock. Which intravenous
fluid is most appropriate for initial volume replacement?
A. Lactated Ringer’s solution
B. 5% Dextrose in Water
C. 0.45% Normal Saline
D. 3% Sodium Chloride
Answer: A
Rationale: Isotonic crystalloids like Lactated Ringer’s or 0.9% Normal Saline are the fluids
of choice for initial resuscitation in hypovolemic shock because they expand the
intravascular volume.
2. Which clinical finding is a hallmark of the compensatory stage of shock?
A. Mean arterial pressure (MAP) below 60 mmHg
B. Narrowing pulse pressure
C. Decreased heart rate
D. Metabolic acidosis
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis.
Narrowing pulse pressure is an early sign of decreased stroke volume even if the systolic
blood pressure remains normal.
,3. A patient in septic shock has a MAP of 55 mmHg despite adequate fluid
resuscitation. Which medication should the nurse anticipate administering first?
A. Nitroglycerin
B. Norepinephrine
C. Furosemide
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock that is refractory
to fluid resuscitation to maintain a MAP of at least 65 mmHg.
4. During the emergent phase of a burn injury, what is the primary goal of care?
A. Physical therapy
B. Infection prevention
C. Wound grafting
D. Fluid resuscitation
Answer: D
Rationale: The emergent phase (first 24-48 hours) focuses on resolving immediate life-
threatening problems, with fluid resuscitation being the priority to prevent hypovolemic
shock.
5. Using the Parkland Formula, calculate the total fluid required in the first 24
hours for a 70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
Rationale: Parkland Formula: 4 mL x Weight (kg) x TBSA (%). Calculation: 4 x 70 x 40 =
11,200 mL.
, 6. A patient with neurogenic shock presents with a blood pressure of 80/40
mmHg. Which additional finding would the nurse expect?
A. Bradycardia
B. Hyperthermia
C. Tachycardia
D. Clammy skin
Answer: A
Rationale: Neurogenic shock is unique because the loss of sympathetic tone leads to
bradycardia and vasodilation, unlike other forms of shock which cause tachycardia.
7. An adult patient has burns on the entire left arm and the entire front of the
torso. According to the Rule of Nines, what is the TBSA percentage?
A. 18%
B. 9%
C. 36%
D. 27%
Answer: D
Rationale: Entire arm = 9%, Front of torso = 18%. Total = 9 + 18 = 27%.
8. Which laboratory value is most indicative of Systemic Inflammatory Response
Syndrome (SIRS) progression to Multiple Organ Dysfunction Syndrome (MODS)?
A. Decreased BUN
B. Increased hemoglobin
C. Decreased C-reactive protein
D. Increased serum creatinine
Answer: D
Rationale: A rising creatinine level indicates renal dysfunction, which is a common
component of organ failure in MODS.
1. A patient is admitted with suspected hypovolemic shock. Which intravenous
fluid is most appropriate for initial volume replacement?
A. Lactated Ringer’s solution
B. 5% Dextrose in Water
C. 0.45% Normal Saline
D. 3% Sodium Chloride
Answer: A
Rationale: Isotonic crystalloids like Lactated Ringer’s or 0.9% Normal Saline are the fluids
of choice for initial resuscitation in hypovolemic shock because they expand the
intravascular volume.
2. Which clinical finding is a hallmark of the compensatory stage of shock?
A. Mean arterial pressure (MAP) below 60 mmHg
B. Narrowing pulse pressure
C. Decreased heart rate
D. Metabolic acidosis
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis.
Narrowing pulse pressure is an early sign of decreased stroke volume even if the systolic
blood pressure remains normal.
,3. A patient in septic shock has a MAP of 55 mmHg despite adequate fluid
resuscitation. Which medication should the nurse anticipate administering first?
A. Nitroglycerin
B. Norepinephrine
C. Furosemide
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock that is refractory
to fluid resuscitation to maintain a MAP of at least 65 mmHg.
4. During the emergent phase of a burn injury, what is the primary goal of care?
A. Physical therapy
B. Infection prevention
C. Wound grafting
D. Fluid resuscitation
Answer: D
Rationale: The emergent phase (first 24-48 hours) focuses on resolving immediate life-
threatening problems, with fluid resuscitation being the priority to prevent hypovolemic
shock.
5. Using the Parkland Formula, calculate the total fluid required in the first 24
hours for a 70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
Rationale: Parkland Formula: 4 mL x Weight (kg) x TBSA (%). Calculation: 4 x 70 x 40 =
11,200 mL.
, 6. A patient with neurogenic shock presents with a blood pressure of 80/40
mmHg. Which additional finding would the nurse expect?
A. Bradycardia
B. Hyperthermia
C. Tachycardia
D. Clammy skin
Answer: A
Rationale: Neurogenic shock is unique because the loss of sympathetic tone leads to
bradycardia and vasodilation, unlike other forms of shock which cause tachycardia.
7. An adult patient has burns on the entire left arm and the entire front of the
torso. According to the Rule of Nines, what is the TBSA percentage?
A. 18%
B. 9%
C. 36%
D. 27%
Answer: D
Rationale: Entire arm = 9%, Front of torso = 18%. Total = 9 + 18 = 27%.
8. Which laboratory value is most indicative of Systemic Inflammatory Response
Syndrome (SIRS) progression to Multiple Organ Dysfunction Syndrome (MODS)?
A. Decreased BUN
B. Increased hemoglobin
C. Decreased C-reactive protein
D. Increased serum creatinine
Answer: D
Rationale: A rising creatinine level indicates renal dysfunction, which is a common
component of organ failure in MODS.
