NUR 205 | NUR 205 Med Surg Exam 2 Version 3 |
Questions with Correct Answers and Expert
Explanation for Each Question | Saint Paul’s School
of Nursing
1. A patient is admitted with hypovolemic shock due to severe dehydration. Which of
the following intravenous fluids should the nurse expect to administer first for rapid
volume expansion?
A. 0.45% Normal Saline
B. 5% Dextrose in Water (D5W)
C. 0.9% Normal Saline
D. 3% Hypertonic Saline
Correct Answer: C
Expert Explanation: Isotonic solutions like 0.9% Normal Saline are the first-line
choice for rapid volume expansion in hypovolemic shock. These solutions stay in the
intravascular space longer than hypotonic solutions to support blood pressure. The
nurse must monitor for signs of fluid volume overload during rapid administration.
Using D5W is inappropriate because it becomes hypotonic once the glucose is
metabolized. Assessing urine output and lung sounds is vital to evaluate the
effectiveness and safety of the resuscitation.
,2. A patient in the early stages of septic shock is exhibiting a ‘warm’ phase. Which
clinical manifestation is most characteristic of this stage?
A. Cold, clammy skin
B. Bradycardia
C. Hypotension with pale extremities
D. Hyperdynamic state with flushed skin
Correct Answer: D
Expert Explanation: Septic shock often begins with a hyperdynamic or ‘warm’
phase characterized by vasodilation. During this stage, the patient typically has
warm, flushed skin and a high cardiac output. Peripheral resistance decreases, but
the heart compensates by increasing its rate and stroke volume. Nurses should
recognize this as an early warning sign before the patient progresses to the ‘cold’
stage. Prompt antibiotic therapy and fluid resuscitation are critical at this juncture.
3. The nurse is caring for a patient with peripheral artery disease (PAD) who complains
of pain while walking that is relieved by rest. What is the correct term for this
symptom?
A. Rest pain
B. Neuropathic ache
,C. Intermittent claudication
D. Dependent rubor
Correct Answer: C
Expert Explanation: Intermittent claudication is the classic symptom of peripheral
artery disease caused by muscle ischemia during exercise. The pain occurs because
the narrowed arteries cannot supply enough oxygenated blood to meeting the
metabolic demands of the muscles. It is typically relieved within minutes of stopping
the activity. The nurse should assess the distance the patient can walk before the
pain starts. Patient teaching focuses on a structured exercise program and smoking
cessation to improve collateral circulation.
4. A patient is suspected of having a Pulmonary Embolism (PE). Which of the following
is the priority nursing intervention when the patient suddenly develops shortness of
breath?
A. Applying supplemental oxygen via nasal cannula
B. Obtaining a STAT chest X-ray
C. Administering a bolus of IV fluids
D. Starting a Heparin drip
Correct Answer: A
, Expert Explanation: Recognizing hypoxia and ensuring adequate oxygenation is
the highest priority when a PE is suspected. Applying oxygen helps alleviate
respiratory distress and maintains tissue perfusion. The nurse should then notify
the rapid response team or the healthcare provider for further diagnostic orders.
While Heparin is used for treatment, it does not address the immediate airway and
breathing needs. Close monitoring of oxygen saturation and respiratory rate is
essential.
5. A patient is being treated for cardiogenic shock. Which medication would the nurse
expect to be ordered to increase cardiac contractility without significantly increasing
heart rate?
A. Epinephrine
B. Atropine
C. Dobutamine
D. Amiodarone
Correct Answer: C
Expert Explanation: Dobutamine is a positive inotrope commonly used in
cardiogenic shock to improve myocardial contractility. It acts on Beta-1 receptors to
increase the strength of the heart’s contraction. This helps improve cardiac output
and overall hemodynamic stability. Unlike epinephrine, it has a less pronounced
Questions with Correct Answers and Expert
Explanation for Each Question | Saint Paul’s School
of Nursing
1. A patient is admitted with hypovolemic shock due to severe dehydration. Which of
the following intravenous fluids should the nurse expect to administer first for rapid
volume expansion?
A. 0.45% Normal Saline
B. 5% Dextrose in Water (D5W)
C. 0.9% Normal Saline
D. 3% Hypertonic Saline
Correct Answer: C
Expert Explanation: Isotonic solutions like 0.9% Normal Saline are the first-line
choice for rapid volume expansion in hypovolemic shock. These solutions stay in the
intravascular space longer than hypotonic solutions to support blood pressure. The
nurse must monitor for signs of fluid volume overload during rapid administration.
Using D5W is inappropriate because it becomes hypotonic once the glucose is
metabolized. Assessing urine output and lung sounds is vital to evaluate the
effectiveness and safety of the resuscitation.
,2. A patient in the early stages of septic shock is exhibiting a ‘warm’ phase. Which
clinical manifestation is most characteristic of this stage?
A. Cold, clammy skin
B. Bradycardia
C. Hypotension with pale extremities
D. Hyperdynamic state with flushed skin
Correct Answer: D
Expert Explanation: Septic shock often begins with a hyperdynamic or ‘warm’
phase characterized by vasodilation. During this stage, the patient typically has
warm, flushed skin and a high cardiac output. Peripheral resistance decreases, but
the heart compensates by increasing its rate and stroke volume. Nurses should
recognize this as an early warning sign before the patient progresses to the ‘cold’
stage. Prompt antibiotic therapy and fluid resuscitation are critical at this juncture.
3. The nurse is caring for a patient with peripheral artery disease (PAD) who complains
of pain while walking that is relieved by rest. What is the correct term for this
symptom?
A. Rest pain
B. Neuropathic ache
,C. Intermittent claudication
D. Dependent rubor
Correct Answer: C
Expert Explanation: Intermittent claudication is the classic symptom of peripheral
artery disease caused by muscle ischemia during exercise. The pain occurs because
the narrowed arteries cannot supply enough oxygenated blood to meeting the
metabolic demands of the muscles. It is typically relieved within minutes of stopping
the activity. The nurse should assess the distance the patient can walk before the
pain starts. Patient teaching focuses on a structured exercise program and smoking
cessation to improve collateral circulation.
4. A patient is suspected of having a Pulmonary Embolism (PE). Which of the following
is the priority nursing intervention when the patient suddenly develops shortness of
breath?
A. Applying supplemental oxygen via nasal cannula
B. Obtaining a STAT chest X-ray
C. Administering a bolus of IV fluids
D. Starting a Heparin drip
Correct Answer: A
, Expert Explanation: Recognizing hypoxia and ensuring adequate oxygenation is
the highest priority when a PE is suspected. Applying oxygen helps alleviate
respiratory distress and maintains tissue perfusion. The nurse should then notify
the rapid response team or the healthcare provider for further diagnostic orders.
While Heparin is used for treatment, it does not address the immediate airway and
breathing needs. Close monitoring of oxygen saturation and respiratory rate is
essential.
5. A patient is being treated for cardiogenic shock. Which medication would the nurse
expect to be ordered to increase cardiac contractility without significantly increasing
heart rate?
A. Epinephrine
B. Atropine
C. Dobutamine
D. Amiodarone
Correct Answer: C
Expert Explanation: Dobutamine is a positive inotrope commonly used in
cardiogenic shock to improve myocardial contractility. It acts on Beta-1 receptors to
increase the strength of the heart’s contraction. This helps improve cardiac output
and overall hemodynamic stability. Unlike epinephrine, it has a less pronounced
