NSG4100 | NSG4100 Nursing Practice - Adult
Health III Exam 4 Version 1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient arrives in the emergency department with deep partial-thickness burns to
the front of both legs and the entire abdomen. Using the Rule of Nines, what is the
estimated total body surface area (TBSA) affected?
A. 27%
B. 45%
C. 36%
D. 18%
Correct Answer: C
Expert Explanation: The abdomen accounts for 18% of the TBSA and each leg
accounts for 18% total. Since only the front of both legs is involved, that contributes
9% per leg (18% total for both fronts). Adding the 18% from the abdomen to the
18% from the legs results in a total of 36%.
2. Which assessment finding in a patient with a tension pneumothorax requires
immediate intervention?
A. Crepitus around the chest tube insertion site
,B. Diminished breath sounds on the affected side
C. SpO2 of 92% on room air
D. Tracheal deviation toward the unaffected side
Correct Answer: D
Expert Explanation: Tracheal deviation is a late and life-threatening sign of a
tension pneumothorax indicating significant mediastinal shift. This shift can
compress the heart and great vessels, leading to cardiovascular collapse. Immediate
needle decompression or chest tube insertion is necessary to relieve the pressure.
3. A patient in the compensatory stage of shock exhibits which of the following
physiological responses?
A. Decreased urinary output and metabolic alkalosis
B. Increased heart rate and narrowed pulse pressure
C. Hypotension and bradycardia
D. Warm, flushed skin and increased capillary refill
Correct Answer: B
Expert Explanation: During the compensatory stage of shock, the body activates
the sympathetic nervous system to maintain cardiac output. This results in an
increased heart rate and peripheral vasoconstriction, which narrows the pulse
,pressure. Monitoring for these subtle changes is critical for early identification of
shock states.
4. The nurse is caring for a patient on mechanical ventilation with Positive End-
Expiratory Pressure (PEEP) set at 15 cm H2O. Which complication should the nurse
monitor for?
A. Hypoventilation
B. Respiratory acidosis
C. Increased cardiac output
D. Barotrauma
Correct Answer: D
Expert Explanation: High levels of PEEP increase the risk of barotrauma, such as
pneumothorax, due to the high pressure exerted on the alveoli. Additionally, high
PEEP can decrease venous return and subsequently lower cardiac output. The nurse
must frequently assess breath sounds and hemodynamic stability in these patients.
5. Which medication is considered the first-line treatment for a patient experiencing
anaphylactic shock?
A. Diphenhydramine
B. Epinephrine
, C. Hydrocortisone
D. Albuterol
Correct Answer: B
Expert Explanation: Epinephrine is the gold standard for treating anaphylaxis
because it causes bronchodilation and vasoconstriction. It rapidly reverses the life-
threatening airway obstruction and hypotension associated with the reaction. While
antihistamines and steroids are used, they are secondary and do not act fast enough
to save the patient’s life in the acute phase.
6. A patient with septic shock has a Mean Arterial Pressure (MAP) of 55 mmHg despite
fluid resuscitation. Which vasopressor is the preferred first choice for this patient?
A. Phenylephrine
B. Dopamine
C. Dobutamine
D. Norepinephrine
Correct Answer: D
Expert Explanation: Norepinephrine is the first-line vasopressor recommended by
the Surviving Sepsis Campaign for patients who remain hypotensive after fluid
resuscitation. It effectively increases MAP through its alpha-1 agonist properties
Health III Exam 4 Version 1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient arrives in the emergency department with deep partial-thickness burns to
the front of both legs and the entire abdomen. Using the Rule of Nines, what is the
estimated total body surface area (TBSA) affected?
A. 27%
B. 45%
C. 36%
D. 18%
Correct Answer: C
Expert Explanation: The abdomen accounts for 18% of the TBSA and each leg
accounts for 18% total. Since only the front of both legs is involved, that contributes
9% per leg (18% total for both fronts). Adding the 18% from the abdomen to the
18% from the legs results in a total of 36%.
2. Which assessment finding in a patient with a tension pneumothorax requires
immediate intervention?
A. Crepitus around the chest tube insertion site
,B. Diminished breath sounds on the affected side
C. SpO2 of 92% on room air
D. Tracheal deviation toward the unaffected side
Correct Answer: D
Expert Explanation: Tracheal deviation is a late and life-threatening sign of a
tension pneumothorax indicating significant mediastinal shift. This shift can
compress the heart and great vessels, leading to cardiovascular collapse. Immediate
needle decompression or chest tube insertion is necessary to relieve the pressure.
3. A patient in the compensatory stage of shock exhibits which of the following
physiological responses?
A. Decreased urinary output and metabolic alkalosis
B. Increased heart rate and narrowed pulse pressure
C. Hypotension and bradycardia
D. Warm, flushed skin and increased capillary refill
Correct Answer: B
Expert Explanation: During the compensatory stage of shock, the body activates
the sympathetic nervous system to maintain cardiac output. This results in an
increased heart rate and peripheral vasoconstriction, which narrows the pulse
,pressure. Monitoring for these subtle changes is critical for early identification of
shock states.
4. The nurse is caring for a patient on mechanical ventilation with Positive End-
Expiratory Pressure (PEEP) set at 15 cm H2O. Which complication should the nurse
monitor for?
A. Hypoventilation
B. Respiratory acidosis
C. Increased cardiac output
D. Barotrauma
Correct Answer: D
Expert Explanation: High levels of PEEP increase the risk of barotrauma, such as
pneumothorax, due to the high pressure exerted on the alveoli. Additionally, high
PEEP can decrease venous return and subsequently lower cardiac output. The nurse
must frequently assess breath sounds and hemodynamic stability in these patients.
5. Which medication is considered the first-line treatment for a patient experiencing
anaphylactic shock?
A. Diphenhydramine
B. Epinephrine
, C. Hydrocortisone
D. Albuterol
Correct Answer: B
Expert Explanation: Epinephrine is the gold standard for treating anaphylaxis
because it causes bronchodilation and vasoconstriction. It rapidly reverses the life-
threatening airway obstruction and hypotension associated with the reaction. While
antihistamines and steroids are used, they are secondary and do not act fast enough
to save the patient’s life in the acute phase.
6. A patient with septic shock has a Mean Arterial Pressure (MAP) of 55 mmHg despite
fluid resuscitation. Which vasopressor is the preferred first choice for this patient?
A. Phenylephrine
B. Dopamine
C. Dobutamine
D. Norepinephrine
Correct Answer: D
Expert Explanation: Norepinephrine is the first-line vasopressor recommended by
the Surviving Sepsis Campaign for patients who remain hypotensive after fluid
resuscitation. It effectively increases MAP through its alpha-1 agonist properties
