NUR2790/NUR 2790 Exam 3 V1 |
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A nurse is caring for a patient in the early stages of hypovolemic shock. Which
hemodynamic finding is the nurse most likely to observe?
A. Decreased Central Venous Pressure (CVP)
B. Increased Central Venous Pressure (CVP)
C. Increased Mean Arterial Pressure (MAP)
D. Decreased Systemic Vascular Resistance (SVR)
Correct Answer: A
Expert Explanation: In hypovolemic shock, the primary issue is a loss of intravascular
volume. This leads to a decrease in venous return to the right atrium, which manifests as a
low Central Venous Pressure. The body often attempts to compensate initially by
increasing SVR through vasoconstriction.
2. Using the Parkland formula, a patient weighing 70kg with 50% total body surface area
(TBSA) burns requires how much fluid in the first 8 hours?
A. 10,500 mL
,B. 14,000 mL
C. 3,500 mL
D. 7,000 mL
Correct Answer: D
Expert Explanation: The Parkland formula calculates total 24-hour fluid needs as 4mL x
kg x %TBSA. For this patient, the total is 4 x 70 x 50, which equals 14,000 mL. Since half of
this total must be administered in the first 8 hours, the nurse should give 7,000 mL.
3. Which laboratory value is the most sensitive indicator of tissue hypoperfusion in a patient
with suspected septic shock?
A. Hemoglobin level
B. White Blood Cell (WBC) count
C. Blood Urea Nitrogen (BUN)
D. Serum Lactate level
Correct Answer: D
Expert Explanation: Serum lactate is a byproduct of anaerobic metabolism, which occurs
when cells do not receive enough oxygen. Elevated levels signify significant tissue hypoxia
and are used to guide resuscitation in sepsis. Monitoring lactate levels helps clinicians
determine the severity of shock and the effectiveness of treatment.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation. Which setting is primarily used to prevent alveolar collapse at the end of
expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Respiratory Rate (RR)
D. Tidal Volume (VT)
Correct Answer: B
Expert Explanation: PEEP provides a small amount of pressure at the end of expiration to
keep the alveoli open. This improves gas exchange and prevents atelectasis in patients with
stiff lungs. However, high levels of PEEP can increase intrathoracic pressure and decrease
cardiac output.
5. The high-pressure alarm on a ventilator sounds for a patient with ARDS. Which action
should the nurse take first?
A. Assess the patient for a pneumothorax
B. Check the tubing for kinks or the patient biting the tube
C. Suction the patient to clear secretions
D. Manually ventilate the patient with an Ambu bag
Correct Answer: B
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A nurse is caring for a patient in the early stages of hypovolemic shock. Which
hemodynamic finding is the nurse most likely to observe?
A. Decreased Central Venous Pressure (CVP)
B. Increased Central Venous Pressure (CVP)
C. Increased Mean Arterial Pressure (MAP)
D. Decreased Systemic Vascular Resistance (SVR)
Correct Answer: A
Expert Explanation: In hypovolemic shock, the primary issue is a loss of intravascular
volume. This leads to a decrease in venous return to the right atrium, which manifests as a
low Central Venous Pressure. The body often attempts to compensate initially by
increasing SVR through vasoconstriction.
2. Using the Parkland formula, a patient weighing 70kg with 50% total body surface area
(TBSA) burns requires how much fluid in the first 8 hours?
A. 10,500 mL
,B. 14,000 mL
C. 3,500 mL
D. 7,000 mL
Correct Answer: D
Expert Explanation: The Parkland formula calculates total 24-hour fluid needs as 4mL x
kg x %TBSA. For this patient, the total is 4 x 70 x 50, which equals 14,000 mL. Since half of
this total must be administered in the first 8 hours, the nurse should give 7,000 mL.
3. Which laboratory value is the most sensitive indicator of tissue hypoperfusion in a patient
with suspected septic shock?
A. Hemoglobin level
B. White Blood Cell (WBC) count
C. Blood Urea Nitrogen (BUN)
D. Serum Lactate level
Correct Answer: D
Expert Explanation: Serum lactate is a byproduct of anaerobic metabolism, which occurs
when cells do not receive enough oxygen. Elevated levels signify significant tissue hypoxia
and are used to guide resuscitation in sepsis. Monitoring lactate levels helps clinicians
determine the severity of shock and the effectiveness of treatment.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation. Which setting is primarily used to prevent alveolar collapse at the end of
expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Respiratory Rate (RR)
D. Tidal Volume (VT)
Correct Answer: B
Expert Explanation: PEEP provides a small amount of pressure at the end of expiration to
keep the alveoli open. This improves gas exchange and prevents atelectasis in patients with
stiff lungs. However, high levels of PEEP can increase intrathoracic pressure and decrease
cardiac output.
5. The high-pressure alarm on a ventilator sounds for a patient with ARDS. Which action
should the nurse take first?
A. Assess the patient for a pneumothorax
B. Check the tubing for kinks or the patient biting the tube
C. Suction the patient to clear secretions
D. Manually ventilate the patient with an Ambu bag
Correct Answer: B
