NUR2790/NUR 2790 Exam 3 V2 |
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A patient’s arterial blood gas (ABG) results are: pH 7.26, PaCO2 54 mmHg, and HCO3 24
mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH level is below 7.35, which signifies that the patient is in an
acidotic state. The PaCO2 is elevated above the normal limit of 45 mmHg, indicating the
respiratory system is responsible for the imbalance. Because the bicarbonate level is within
the normal range, this is considered uncompensated respiratory acidosis.
2. An adult patient is admitted with partial-thickness burns to the entire left arm and the
entire front of the torso. Using the Rule of Nines, what is the total body surface area (TBSA)
burned?
A. 18%
,B. 36%
C. 27%
D. 45%
Correct Answer: C
Expert Explanation: According to the Rule of Nines, the entire arm accounts for 9% of the
body surface area. The anterior torso (chest and abdomen) accounts for 18% of the total
body surface area. Adding 9% and 18% results in a total of 27% TBSA burned for this
patient.
3. A patient weighing 70 kg has 40% TBSA burns. Using the Parkland formula
(4mL/kg/%TBSA), how much fluid should be administered in the first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Expert Explanation: The total 24-hour fluid requirement is calculated as 4 mL x 70 kg x
40, which equals 11,200 mL. The Parkland formula dictates that half of this total volume
must be given in the first 8 hours following the injury. Therefore, 11,200 mL divided by 2
equals 5,600 mL to be infused in the initial 8-hour window.
, 4. Which clinical manifestation is considered an early sign of hypovolemic shock?
A. Tachycardia
B. Bradypnea
C. Hypotension
D. Anuria
Correct Answer: A
Expert Explanation: Tachycardia is one of the earliest compensatory mechanisms the
body employs to maintain cardiac output during fluid loss. As stroke volume decreases, the
heart rate increases to compensate and maintain tissue perfusion. Hypotension is typically
a later sign indicating that compensatory mechanisms are failing.
5. A patient in septic shock has a blood pressure of 80/40 mmHg after receiving a 3L fluid
bolus. Which medication should the nurse anticipate administering next?
A. Atropine
B. Norepinephrine
C. Furosemide
D. Nitroprusside
Correct Answer: B
Expert Explanation: Norepinephrine is the first-line vasopressor used in septic shock
when fluid resuscitation fails to restore adequate blood pressure. It works by causing
Professional Nursing III / PN3 Q&A
with Rationale | Rasmussen
University
1. A patient’s arterial blood gas (ABG) results are: pH 7.26, PaCO2 54 mmHg, and HCO3 24
mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH level is below 7.35, which signifies that the patient is in an
acidotic state. The PaCO2 is elevated above the normal limit of 45 mmHg, indicating the
respiratory system is responsible for the imbalance. Because the bicarbonate level is within
the normal range, this is considered uncompensated respiratory acidosis.
2. An adult patient is admitted with partial-thickness burns to the entire left arm and the
entire front of the torso. Using the Rule of Nines, what is the total body surface area (TBSA)
burned?
A. 18%
,B. 36%
C. 27%
D. 45%
Correct Answer: C
Expert Explanation: According to the Rule of Nines, the entire arm accounts for 9% of the
body surface area. The anterior torso (chest and abdomen) accounts for 18% of the total
body surface area. Adding 9% and 18% results in a total of 27% TBSA burned for this
patient.
3. A patient weighing 70 kg has 40% TBSA burns. Using the Parkland formula
(4mL/kg/%TBSA), how much fluid should be administered in the first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Expert Explanation: The total 24-hour fluid requirement is calculated as 4 mL x 70 kg x
40, which equals 11,200 mL. The Parkland formula dictates that half of this total volume
must be given in the first 8 hours following the injury. Therefore, 11,200 mL divided by 2
equals 5,600 mL to be infused in the initial 8-hour window.
, 4. Which clinical manifestation is considered an early sign of hypovolemic shock?
A. Tachycardia
B. Bradypnea
C. Hypotension
D. Anuria
Correct Answer: A
Expert Explanation: Tachycardia is one of the earliest compensatory mechanisms the
body employs to maintain cardiac output during fluid loss. As stroke volume decreases, the
heart rate increases to compensate and maintain tissue perfusion. Hypotension is typically
a later sign indicating that compensatory mechanisms are failing.
5. A patient in septic shock has a blood pressure of 80/40 mmHg after receiving a 3L fluid
bolus. Which medication should the nurse anticipate administering next?
A. Atropine
B. Norepinephrine
C. Furosemide
D. Nitroprusside
Correct Answer: B
Expert Explanation: Norepinephrine is the first-line vasopressor used in septic shock
when fluid resuscitation fails to restore adequate blood pressure. It works by causing
