NSG4100 | NSG4100 Nursing Practice - Adult
Health III Exam 1 Version 2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A nurse is caring for a patient in the ICU with a suspected pulmonary embolism.
Which diagnostic test is considered the gold standard for confirming this diagnosis?
A. Pulmonary Angiography
B. Chest X-ray
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Correct Answer: A
Expert Explanation: Pulmonary angiography is considered the definitive gold
standard for diagnosing a pulmonary embolism because it provides direct
visualization of the pulmonary vasculature. While CT pulmonary angiography
(CTPA) is more commonly used in clinical practice due to its non-invasive nature,
traditional angiography remains the most accurate. Tests like D-dimer are useful for
screening but cannot confirm the diagnosis alone.
2. Which hemodynamic parameter should the nurse monitor to evaluate the preload
of the right side of the heart?
A. Systemic Vascular Resistance (SVR)
,B. Central Venous Pressure (CVP)
C. Pulmonary Artery Wedge Pressure (PAWP)
D. Cardiac Output (CO)
Correct Answer: B
Expert Explanation: Central Venous Pressure (CVP) reflects the filling pressure of
the right atrium and is the primary indicator of right-sided heart preload.
Pulmonary Artery Wedge Pressure (PAWP) reflects left-sided heart preload instead.
Monitoring these pressures is essential for managing fluid volume status in critically
ill patients.
3. A patient is admitted with a Mean Arterial Pressure (MAP) of 55 mmHg. Which
action should the nurse prioritize?
A. Increase the IV fluid rate as ordered
B. Administer an oral antihypertensive
C. Check the patient’s temperature
D. Recheck the blood pressure in 4 hours
Correct Answer: A
Expert Explanation: A MAP of at least 60 to 65 mmHg is required to maintain
adequate perfusion to vital organs such as the kidneys and brain. A MAP of 55
,mmHg indicates inadequate perfusion, necessitating immediate intervention such as
fluid resuscitation or vasopressors. Failure to restore adequate MAP can lead to
organ ischemia and multisystem organ failure.
4. During the care of a patient with an endotracheal tube, the high-pressure alarm on
the ventilator sounds. What is the most appropriate initial nursing action?
A. Increase the oxygen concentration to 100%
B. Check for a disconnected circuit
C. Suction the patient’s airway
D. Call the physician immediately
Correct Answer: C
Expert Explanation: High-pressure alarms are often triggered by secretions in the
airway, biting the tube, or kinking of the ventilator tubing. Suctioning the patient
addresses the common issue of airway obstruction due to mucus plugs. If suctioning
does not resolve the alarm, the nurse should further assess for tube displacement or
tension pneumothorax.
5. A patient presents with signs of cardiogenic shock. Which medication would the
nurse expect to be ordered to improve cardiac contractility?
A. Dobutamine
B. Dopamine
, C. Furosemide
D. Amiodarone
Correct Answer: A
Expert Explanation: Dobutamine is a positive inotrope that increases myocardial
contractility and cardiac output, which is crucial in cardiogenic shock. Unlike
dopamine, it has less effect on heart rate and peripheral resistance at moderate
doses. It helps the failing heart pump more effectively to maintain systemic
perfusion.
6. The nurse identifies that a patient is in the compensatory stage of shock. Which
clinical finding supports this conclusion?
A. Respiratory alkalosis
B. Decrease in blood pressure
C. Increased urinary output
D. Cool, clammy skin
Correct Answer: A
Expert Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis through the activation of the sympathetic nervous system.
Hyperventilation occurs to increase oxygenation, which often results in respiratory
Health III Exam 1 Version 2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A nurse is caring for a patient in the ICU with a suspected pulmonary embolism.
Which diagnostic test is considered the gold standard for confirming this diagnosis?
A. Pulmonary Angiography
B. Chest X-ray
C. D-dimer assay
D. Arterial Blood Gas (ABG)
Correct Answer: A
Expert Explanation: Pulmonary angiography is considered the definitive gold
standard for diagnosing a pulmonary embolism because it provides direct
visualization of the pulmonary vasculature. While CT pulmonary angiography
(CTPA) is more commonly used in clinical practice due to its non-invasive nature,
traditional angiography remains the most accurate. Tests like D-dimer are useful for
screening but cannot confirm the diagnosis alone.
2. Which hemodynamic parameter should the nurse monitor to evaluate the preload
of the right side of the heart?
A. Systemic Vascular Resistance (SVR)
,B. Central Venous Pressure (CVP)
C. Pulmonary Artery Wedge Pressure (PAWP)
D. Cardiac Output (CO)
Correct Answer: B
Expert Explanation: Central Venous Pressure (CVP) reflects the filling pressure of
the right atrium and is the primary indicator of right-sided heart preload.
Pulmonary Artery Wedge Pressure (PAWP) reflects left-sided heart preload instead.
Monitoring these pressures is essential for managing fluid volume status in critically
ill patients.
3. A patient is admitted with a Mean Arterial Pressure (MAP) of 55 mmHg. Which
action should the nurse prioritize?
A. Increase the IV fluid rate as ordered
B. Administer an oral antihypertensive
C. Check the patient’s temperature
D. Recheck the blood pressure in 4 hours
Correct Answer: A
Expert Explanation: A MAP of at least 60 to 65 mmHg is required to maintain
adequate perfusion to vital organs such as the kidneys and brain. A MAP of 55
,mmHg indicates inadequate perfusion, necessitating immediate intervention such as
fluid resuscitation or vasopressors. Failure to restore adequate MAP can lead to
organ ischemia and multisystem organ failure.
4. During the care of a patient with an endotracheal tube, the high-pressure alarm on
the ventilator sounds. What is the most appropriate initial nursing action?
A. Increase the oxygen concentration to 100%
B. Check for a disconnected circuit
C. Suction the patient’s airway
D. Call the physician immediately
Correct Answer: C
Expert Explanation: High-pressure alarms are often triggered by secretions in the
airway, biting the tube, or kinking of the ventilator tubing. Suctioning the patient
addresses the common issue of airway obstruction due to mucus plugs. If suctioning
does not resolve the alarm, the nurse should further assess for tube displacement or
tension pneumothorax.
5. A patient presents with signs of cardiogenic shock. Which medication would the
nurse expect to be ordered to improve cardiac contractility?
A. Dobutamine
B. Dopamine
, C. Furosemide
D. Amiodarone
Correct Answer: A
Expert Explanation: Dobutamine is a positive inotrope that increases myocardial
contractility and cardiac output, which is crucial in cardiogenic shock. Unlike
dopamine, it has less effect on heart rate and peripheral resistance at moderate
doses. It helps the failing heart pump more effectively to maintain systemic
perfusion.
6. The nurse identifies that a patient is in the compensatory stage of shock. Which
clinical finding supports this conclusion?
A. Respiratory alkalosis
B. Decrease in blood pressure
C. Increased urinary output
D. Cool, clammy skin
Correct Answer: A
Expert Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis through the activation of the sympathetic nervous system.
Hyperventilation occurs to increase oxygenation, which often results in respiratory
