NSG4100 | NSG4100 Nursing Practice - Adult
Health III Exam 1 Version 3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient arrives in the emergency department with a deep partial-thickness burn
to the entire left arm and left leg. Using the Rule of Nines, what is the estimated
percentage of Total Body Surface Area (TBSA) burned?
A. 18%
B. 27%
C. 36%
D. 45%
Correct Answer: B
Expert Explanation: The Rule of Nines assigns 9% to the entire arm and 18% to the
entire leg. Adding 9% and 18% results in a total of 27% TBSA. Accurate calculation
of TBSA is critical for determining the volume of fluid resuscitation needed in the
emergent phase.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin
B. Hypotension
,C. Metabolic acidosis
D. Increased heart rate
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis through the activation of the sympathetic nervous system. An
increased heart rate is one of the earliest signs as the body tries to maintain cardiac
output. Blood pressure may remain within normal limits during this initial phase
due to vasoconstriction.
3. A nurse is caring for a patient in septic shock. Which laboratory value should the
nurse prioritize as an indicator of tissue perfusion?
A. Serum Potassium
B. White Blood Cell count
C. Serum Lactate
D. Blood Urea Nitrogen
Correct Answer: C
Expert Explanation: Serum lactate is a key biomarker used to assess tissue hypoxia
and anaerobic metabolism in shock states. Elevated lactate levels indicate
,inadequate oxygen delivery to the tissues. Monitoring lactate trends helps clinicians
evaluate the effectiveness of resuscitation efforts.
4. During the emergent phase of burn injury, which electrolyte imbalance is most
commonly expected?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: During the emergent phase, massive cell destruction occurs,
which releases intracellular potassium into the extracellular space. This results in
hyperkalemia, which poses a significant risk for cardiac arrhythmias. The nurse
must monitor ECG changes and serum potassium levels closely during this period.
5. A patient with cardiogenic shock is prescribed Dobutamine. What is the primary
therapeutic goal of this medication?
A. To increase myocardial contractility
B. To decrease heart rate
C. To cause systemic vasodilation
, D. To decrease urine output
Correct Answer: A
Expert Explanation: Dobutamine is an inotropic agent used to improve cardiac
output by increasing the force of myocardial contraction. In cardiogenic shock, the
heart fails as a pump, so improving contractility is vital. The nurse should monitor
for side effects such as tachycardia or ectopy.
6. A patient has suffered an electrical burn. What is the primary nursing priority
following the assessment of airway and breathing?
A. Administering pain medication
B. Obtaining an electrocardiogram (ECG)
C. Checking for an exit wound
D. Applying topical antibiotics
Correct Answer: B
Expert Explanation: Electrical burns can cause significant internal damage and
disrupt the heart’s electrical conduction system. An ECG is a priority to assess for
life-threatening arrhythmias that may not be immediately apparent. Continuous
cardiac monitoring is usually required for at least 24 hours post-injury.
Health III Exam 1 Version 3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Galen
1. A patient arrives in the emergency department with a deep partial-thickness burn
to the entire left arm and left leg. Using the Rule of Nines, what is the estimated
percentage of Total Body Surface Area (TBSA) burned?
A. 18%
B. 27%
C. 36%
D. 45%
Correct Answer: B
Expert Explanation: The Rule of Nines assigns 9% to the entire arm and 18% to the
entire leg. Adding 9% and 18% results in a total of 27% TBSA. Accurate calculation
of TBSA is critical for determining the volume of fluid resuscitation needed in the
emergent phase.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin
B. Hypotension
,C. Metabolic acidosis
D. Increased heart rate
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis through the activation of the sympathetic nervous system. An
increased heart rate is one of the earliest signs as the body tries to maintain cardiac
output. Blood pressure may remain within normal limits during this initial phase
due to vasoconstriction.
3. A nurse is caring for a patient in septic shock. Which laboratory value should the
nurse prioritize as an indicator of tissue perfusion?
A. Serum Potassium
B. White Blood Cell count
C. Serum Lactate
D. Blood Urea Nitrogen
Correct Answer: C
Expert Explanation: Serum lactate is a key biomarker used to assess tissue hypoxia
and anaerobic metabolism in shock states. Elevated lactate levels indicate
,inadequate oxygen delivery to the tissues. Monitoring lactate trends helps clinicians
evaluate the effectiveness of resuscitation efforts.
4. During the emergent phase of burn injury, which electrolyte imbalance is most
commonly expected?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: During the emergent phase, massive cell destruction occurs,
which releases intracellular potassium into the extracellular space. This results in
hyperkalemia, which poses a significant risk for cardiac arrhythmias. The nurse
must monitor ECG changes and serum potassium levels closely during this period.
5. A patient with cardiogenic shock is prescribed Dobutamine. What is the primary
therapeutic goal of this medication?
A. To increase myocardial contractility
B. To decrease heart rate
C. To cause systemic vasodilation
, D. To decrease urine output
Correct Answer: A
Expert Explanation: Dobutamine is an inotropic agent used to improve cardiac
output by increasing the force of myocardial contraction. In cardiogenic shock, the
heart fails as a pump, so improving contractility is vital. The nurse should monitor
for side effects such as tachycardia or ectopy.
6. A patient has suffered an electrical burn. What is the primary nursing priority
following the assessment of airway and breathing?
A. Administering pain medication
B. Obtaining an electrocardiogram (ECG)
C. Checking for an exit wound
D. Applying topical antibiotics
Correct Answer: B
Expert Explanation: Electrical burns can cause significant internal damage and
disrupt the heart’s electrical conduction system. An ECG is a priority to assess for
life-threatening arrhythmias that may not be immediately apparent. Continuous
cardiac monitoring is usually required for at least 24 hours post-injury.
