NSG4100 | NSG4100 Nursing Practice - Adult
Health III Exam 1 Version 1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation with high Positive End-Expiratory Pressure (PEEP). Which assessment
finding should the nurse prioritize?
A. Oxygen saturation of 94%
B. Blood pressure of 88/46 mmHg
C. Heart rate of 92 beats per minute
D. Respiratory rate of 18 breaths per minute
Correct Answer: B
Expert Explanation: High PEEP levels increase intrathoracic pressure which can
lead to decreased venous return and subsequent hypotension. This drop in cardiac
output is a significant risk for patients on high ventilator settings. The nurse must
monitor hemodynamics closely to ensure vital organ perfusion is maintained.
2. When calculating the fluid resuscitation needs for a burn patient using the Parkland
Formula, which fluid is most commonly used?
A. 0.45% Normal Saline
,B. 5% Dextrose in Water
C. Lactated Ringer’s
D. 3% Hypertonic Saline
Correct Answer: C
Expert Explanation: Lactated Ringer’s is the fluid of choice because its composition
most closely resembles human plasma and helps buffer metabolic acidosis. Using
isotonic crystalloids is essential for replacing volume lost during the first 24 hours
of burn care. This prevents hypovolemic shock and supports renal function.
3. A patient is admitted with suspected Septic Shock. Which laboratory result is most
indicative of tissue hypoxia and anaerobic metabolism?
A. Serum Creatinine 1.2 mg/dL
B. Lactate level 5.2 mmol/L
C. White blood cell count 12,000/mm3
D. Blood Urea Nitrogen 20 mg/dL
Correct Answer: B
Expert Explanation: Elevated lactate levels signify that the body has shifted to
anaerobic metabolism due to inadequate oxygen delivery at the cellular level. A level
greater than 2 mmol/L is a critical marker in the sepsis bundle for identifying shock.
,Early identification of high lactate allows for rapid intervention with fluids and
vasopressors.
4. The nurse is caring for a patient with a Glasgow Coma Scale (GCS) score of 7. Which
intervention is the highest priority for this patient?
A. Monitoring urine output hourly
B. Preparing for endotracheal intubation
C. Assessing the patient’s nutritional status
D. Administering prophylactic antibiotics
Correct Answer: B
Expert Explanation: A GCS score of 8 or less is generally considered an indication
that the patient cannot protect their own airway. Intubation is necessary to prevent
aspiration and ensure adequate ventilation in neurologically compromised patients.
This is a foundational ‘Airway’ priority in emergency and critical care nursing.
5. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. What does the
nurse anticipate the primary intervention will be?
A. Rapid infusion of intravenous fluids
B. Administration of a loop diuretic
C. Application of a cooling blanket
, D. Titrating down the vasopressor infusion
Correct Answer: A
Expert Explanation: A normal CVP ranges from 2 to 8 mmHg, and a value of 1
indicates hypovolemia or low preload. The nurse should anticipate fluid
resuscitation to increase the circulating volume and improve cardiac output.
Monitoring CVP trends helps determine the effectiveness of the fluid boluses.
6. Which clinical manifestation is a late sign of increased intracranial pressure (ICP)
known as Cushing’s Triad?
A. Tachycardia, hypotension, and tachypnea
B. Hypotension, bradycardia, and Cheyne-Stokes breathing
C. Bradycardia, widened pulse pressure, and irregular respirations
D. Hypertension, tachycardia, and increased pupil reactivity
Correct Answer: C
Expert Explanation: Cushing’s Triad consists of bradycardia, hypertension with a
widening pulse pressure, and irregular respiratory patterns. This triad indicates
significant brainstem compression and is considered a medical emergency. The
nurse must recognize these signs quickly to prevent herniation and death.
Health III Exam 1 Version 1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation with high Positive End-Expiratory Pressure (PEEP). Which assessment
finding should the nurse prioritize?
A. Oxygen saturation of 94%
B. Blood pressure of 88/46 mmHg
C. Heart rate of 92 beats per minute
D. Respiratory rate of 18 breaths per minute
Correct Answer: B
Expert Explanation: High PEEP levels increase intrathoracic pressure which can
lead to decreased venous return and subsequent hypotension. This drop in cardiac
output is a significant risk for patients on high ventilator settings. The nurse must
monitor hemodynamics closely to ensure vital organ perfusion is maintained.
2. When calculating the fluid resuscitation needs for a burn patient using the Parkland
Formula, which fluid is most commonly used?
A. 0.45% Normal Saline
,B. 5% Dextrose in Water
C. Lactated Ringer’s
D. 3% Hypertonic Saline
Correct Answer: C
Expert Explanation: Lactated Ringer’s is the fluid of choice because its composition
most closely resembles human plasma and helps buffer metabolic acidosis. Using
isotonic crystalloids is essential for replacing volume lost during the first 24 hours
of burn care. This prevents hypovolemic shock and supports renal function.
3. A patient is admitted with suspected Septic Shock. Which laboratory result is most
indicative of tissue hypoxia and anaerobic metabolism?
A. Serum Creatinine 1.2 mg/dL
B. Lactate level 5.2 mmol/L
C. White blood cell count 12,000/mm3
D. Blood Urea Nitrogen 20 mg/dL
Correct Answer: B
Expert Explanation: Elevated lactate levels signify that the body has shifted to
anaerobic metabolism due to inadequate oxygen delivery at the cellular level. A level
greater than 2 mmol/L is a critical marker in the sepsis bundle for identifying shock.
,Early identification of high lactate allows for rapid intervention with fluids and
vasopressors.
4. The nurse is caring for a patient with a Glasgow Coma Scale (GCS) score of 7. Which
intervention is the highest priority for this patient?
A. Monitoring urine output hourly
B. Preparing for endotracheal intubation
C. Assessing the patient’s nutritional status
D. Administering prophylactic antibiotics
Correct Answer: B
Expert Explanation: A GCS score of 8 or less is generally considered an indication
that the patient cannot protect their own airway. Intubation is necessary to prevent
aspiration and ensure adequate ventilation in neurologically compromised patients.
This is a foundational ‘Airway’ priority in emergency and critical care nursing.
5. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. What does the
nurse anticipate the primary intervention will be?
A. Rapid infusion of intravenous fluids
B. Administration of a loop diuretic
C. Application of a cooling blanket
, D. Titrating down the vasopressor infusion
Correct Answer: A
Expert Explanation: A normal CVP ranges from 2 to 8 mmHg, and a value of 1
indicates hypovolemia or low preload. The nurse should anticipate fluid
resuscitation to increase the circulating volume and improve cardiac output.
Monitoring CVP trends helps determine the effectiveness of the fluid boluses.
6. Which clinical manifestation is a late sign of increased intracranial pressure (ICP)
known as Cushing’s Triad?
A. Tachycardia, hypotension, and tachypnea
B. Hypotension, bradycardia, and Cheyne-Stokes breathing
C. Bradycardia, widened pulse pressure, and irregular respirations
D. Hypertension, tachycardia, and increased pupil reactivity
Correct Answer: C
Expert Explanation: Cushing’s Triad consists of bradycardia, hypertension with a
widening pulse pressure, and irregular respiratory patterns. This triad indicates
significant brainstem compression and is considered a medical emergency. The
nurse must recognize these signs quickly to prevent herniation and death.
