NUR 521 EXAM 4 BLUEPRINT
PRACTICE EXAM QUESTIONS AND
ANSWERS 2026 VERIFIED.
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg
despite fluid resuscitation. Which medication should the nurse anticipate
administering first?
A. Dopamine
B. Furosemide
C. Nitroprusside
D. Norepinephrine
Answer: D
Conceptual Explanation: Norepinephrine is the first-line vasopressor for septic shock that
is unresponsive to fluid resuscitation to maintain a MAP of at least 65 mmHg.
2. In the rule of nines for burn assessment, what percentage is assigned to the
entire right arm?
A. 4.5%
B. 9%
C. 13.5%
D. 18%
Answer: B
Conceptual Explanation: The entire arm (front and back) is assigned 9% in the rule of
nines.
,3. Which phase of burn management begins with the start of fluid resuscitation
and ends when the patient is hemodynamically stable?
A. Pre-hospital phase
B. Acute phase
C. Rehabilitative phase
D. Emergent phase
Answer: D
Conceptual Explanation: The emergent (resuscitative) phase focuses on fluid
resuscitation and stabilizing the patient immediately after the burn injury.
4. What is the hallmark sign of the compensatory stage of shock?
A. Bradycardia
B. Hypotension
C. Narrowing pulse pressure
D. Anuria
Answer: C
Conceptual Explanation: In the compensatory stage, catecholamine release causes
vasoconstriction, which often results in a narrowing pulse pressure before a significant
drop in systolic blood pressure occurs.
5. A patient with a burn injury is receiving fluid resuscitation using the Parkland
formula. Which indicator is the most reliable for assessing the adequacy of fluid
replacement?
A. Daily weight
B. Urine output of 0.5 to 1 mL/kg/hr
C. Central venous pressure
D. Peripheral edema
Answer: B
, Conceptual Explanation: Urine output is the primary clinical parameter used to titrate
fluid resuscitation in burn patients.
6. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR)?
A. Cardiogenic shock
B. Septic shock
C. Hypovolemic shock
D. Obstructive shock
Answer: B
Conceptual Explanation: Septic shock, especially in the early (hyperdynamic) phase, is
associated with vasodilation (low SVR) and a compensatory increase in cardiac output.
7. A patient in the ICU has a Pulmonary Artery Wedge Pressure (PAWP) of 22
mmHg. Which condition does this finding most likely suggest?
A. Dehydration
B. Left-sided heart failure
C. Septic shock
D. Pulmonary embolism
Answer: B
Conceptual Explanation: Normal PAWP is 6-12 mmHg. An elevation indicates increased
left ventricular end-diastolic pressure, commonly seen in left-sided heart failure.
8. What is the primary goal of the ‘Surviving Sepsis Campaign’ 3-hour bundle?
A. Starting mechanical ventilation
B. Obtaining blood cultures before antibiotics
C. Initiating enteral nutrition
D. Administering low-dose steroids
Answer: B
PRACTICE EXAM QUESTIONS AND
ANSWERS 2026 VERIFIED.
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg
despite fluid resuscitation. Which medication should the nurse anticipate
administering first?
A. Dopamine
B. Furosemide
C. Nitroprusside
D. Norepinephrine
Answer: D
Conceptual Explanation: Norepinephrine is the first-line vasopressor for septic shock that
is unresponsive to fluid resuscitation to maintain a MAP of at least 65 mmHg.
2. In the rule of nines for burn assessment, what percentage is assigned to the
entire right arm?
A. 4.5%
B. 9%
C. 13.5%
D. 18%
Answer: B
Conceptual Explanation: The entire arm (front and back) is assigned 9% in the rule of
nines.
,3. Which phase of burn management begins with the start of fluid resuscitation
and ends when the patient is hemodynamically stable?
A. Pre-hospital phase
B. Acute phase
C. Rehabilitative phase
D. Emergent phase
Answer: D
Conceptual Explanation: The emergent (resuscitative) phase focuses on fluid
resuscitation and stabilizing the patient immediately after the burn injury.
4. What is the hallmark sign of the compensatory stage of shock?
A. Bradycardia
B. Hypotension
C. Narrowing pulse pressure
D. Anuria
Answer: C
Conceptual Explanation: In the compensatory stage, catecholamine release causes
vasoconstriction, which often results in a narrowing pulse pressure before a significant
drop in systolic blood pressure occurs.
5. A patient with a burn injury is receiving fluid resuscitation using the Parkland
formula. Which indicator is the most reliable for assessing the adequacy of fluid
replacement?
A. Daily weight
B. Urine output of 0.5 to 1 mL/kg/hr
C. Central venous pressure
D. Peripheral edema
Answer: B
, Conceptual Explanation: Urine output is the primary clinical parameter used to titrate
fluid resuscitation in burn patients.
6. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR)?
A. Cardiogenic shock
B. Septic shock
C. Hypovolemic shock
D. Obstructive shock
Answer: B
Conceptual Explanation: Septic shock, especially in the early (hyperdynamic) phase, is
associated with vasodilation (low SVR) and a compensatory increase in cardiac output.
7. A patient in the ICU has a Pulmonary Artery Wedge Pressure (PAWP) of 22
mmHg. Which condition does this finding most likely suggest?
A. Dehydration
B. Left-sided heart failure
C. Septic shock
D. Pulmonary embolism
Answer: B
Conceptual Explanation: Normal PAWP is 6-12 mmHg. An elevation indicates increased
left ventricular end-diastolic pressure, commonly seen in left-sided heart failure.
8. What is the primary goal of the ‘Surviving Sepsis Campaign’ 3-hour bundle?
A. Starting mechanical ventilation
B. Obtaining blood cultures before antibiotics
C. Initiating enteral nutrition
D. Administering low-dose steroids
Answer: B
