NR-341/NR341 Exam 1 V2 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg and a heart rate of 115
bpm. Which action should the nurse anticipate first?
A. Administering IV Furosemide
B. Starting a Norepinephrine infusion
C. Administering a 500 mL Normal Saline bolus
D. Placing the patient in High-Fowler’s position
Correct Answer: C
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia or fluid volume deficit. The tachycardia is a compensatory
mechanism to maintain cardiac output in the presence of low preload. Administering an
isotonic fluid bolus is the priority intervention to restore circulating volume and stabilize
hemodynamics.
2. A patient’s Mean Arterial Pressure (MAP) is 60 mmHg and the Intracranial Pressure (ICP) is
25 mmHg. What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 35 mmHg
B. 85 mmHg
,C. 50 mmHg
D. 1500 mmHg
Correct Answer: A
Expert Explanation: Cerebral Perfusion Pressure is calculated by subtracting the ICP from
the MAP (CPP = MAP - ICP). In this scenario, 60 minus 25 equals 35 mmHg, which is
significantly below the normal range of 60 to 100 mmHg. This low CPP indicates that the
brain is not receiving adequate blood flow, placing the patient at high risk for ischemic
injury.
3. The nurse is caring for a patient on mechanical ventilation with PEEP set at 15 cm H2O.
Which assessment finding should the nurse report immediately?
A. Respiratory rate of 18 breaths per minute
B. SpO2 of 94% on 40% FiO2
C. Diminished breath sounds on the right side
D. Tracheal secretions that are thin and clear
Correct Answer: C
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase the
risk of barotrauma, such as a tension pneumothorax. Diminished breath sounds on one side
suggest a collapsed lung or pleural complication that requires urgent intervention. The
nurse must monitor for decreased cardiac output and lung injury whenever PEEP exceeds
10 cm H2O.
,4. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.48, PaCO2 30, HCO3 22, PaO2 55
B. pH 7.35, PaCO2 45, HCO3 24, PaO2 90
C. pH 7.20, PaCO2 60, HCO3 28, PaO2 50
D. pH 7.38, PaCO2 40, HCO3 24, PaO2 95
Correct Answer: A
Expert Explanation: Early ARDS is characterized by respiratory alkalosis (high pH, low
CO2) due to hyperventilation and refractory hypoxemia (low PaO2). The patient breathes
faster to compensate for hypoxia, leading to the ‘blowing off’ of carbon dioxide. Despite
oxygen administration, the PaO2 remains low due to intrapulmonary shunting.
5. The nurse notes the cardiac monitor shows Ventricular Fibrillation (VF). What is the first
priority action?
A. Initiate high-quality CPR and prepare for defibrillation
B. Perform immediate synchronized cardioversion
C. Administer 1 mg of Epinephrine IV
D. Check the patient’s pulse for 10 seconds
Correct Answer: A
, Expert Explanation: Ventricular Fibrillation is a pulseless rhythm that requires immediate
unsynchronized defibrillation. While waiting for the defibrillator, the nurse must maintain
perfusion through high-quality chest compressions. Synchronized cardioversion is
inappropriate for VF because there is no R-wave to track.
6. A patient with septic shock has a MAP of 55 mmHg despite fluid resuscitation. Which
medication should the nurse anticipate?
A. Labetalol
B. Nitroprusside
C. Diltiazem
D. Norepinephrine
Correct Answer: D
Expert Explanation: Norepinephrine is the first-line vasopressor for septic shock when
fluid resuscitation fails to maintain a MAP of at least 65 mmHg. It works by causing
vasoconstriction through alpha-1 adrenergic stimulation to increase systemic vascular
resistance. Medications like Nitroprusside or Labetalol would further decrease blood
pressure and are contraindicated in shock.
7. Which clinical finding is part of the ‘Cushing’s Triad’ associated with increased intracranial
pressure?
A. Tachycardia, Hypotension, and Tachypnea
B. Bradycardia, Hypotension, and Cheyne-Stokes breathing
Health Q&A with Rationale | Chamberlain
University
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg and a heart rate of 115
bpm. Which action should the nurse anticipate first?
A. Administering IV Furosemide
B. Starting a Norepinephrine infusion
C. Administering a 500 mL Normal Saline bolus
D. Placing the patient in High-Fowler’s position
Correct Answer: C
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia or fluid volume deficit. The tachycardia is a compensatory
mechanism to maintain cardiac output in the presence of low preload. Administering an
isotonic fluid bolus is the priority intervention to restore circulating volume and stabilize
hemodynamics.
2. A patient’s Mean Arterial Pressure (MAP) is 60 mmHg and the Intracranial Pressure (ICP) is
25 mmHg. What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 35 mmHg
B. 85 mmHg
,C. 50 mmHg
D. 1500 mmHg
Correct Answer: A
Expert Explanation: Cerebral Perfusion Pressure is calculated by subtracting the ICP from
the MAP (CPP = MAP - ICP). In this scenario, 60 minus 25 equals 35 mmHg, which is
significantly below the normal range of 60 to 100 mmHg. This low CPP indicates that the
brain is not receiving adequate blood flow, placing the patient at high risk for ischemic
injury.
3. The nurse is caring for a patient on mechanical ventilation with PEEP set at 15 cm H2O.
Which assessment finding should the nurse report immediately?
A. Respiratory rate of 18 breaths per minute
B. SpO2 of 94% on 40% FiO2
C. Diminished breath sounds on the right side
D. Tracheal secretions that are thin and clear
Correct Answer: C
Expert Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase the
risk of barotrauma, such as a tension pneumothorax. Diminished breath sounds on one side
suggest a collapsed lung or pleural complication that requires urgent intervention. The
nurse must monitor for decreased cardiac output and lung injury whenever PEEP exceeds
10 cm H2O.
,4. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.48, PaCO2 30, HCO3 22, PaO2 55
B. pH 7.35, PaCO2 45, HCO3 24, PaO2 90
C. pH 7.20, PaCO2 60, HCO3 28, PaO2 50
D. pH 7.38, PaCO2 40, HCO3 24, PaO2 95
Correct Answer: A
Expert Explanation: Early ARDS is characterized by respiratory alkalosis (high pH, low
CO2) due to hyperventilation and refractory hypoxemia (low PaO2). The patient breathes
faster to compensate for hypoxia, leading to the ‘blowing off’ of carbon dioxide. Despite
oxygen administration, the PaO2 remains low due to intrapulmonary shunting.
5. The nurse notes the cardiac monitor shows Ventricular Fibrillation (VF). What is the first
priority action?
A. Initiate high-quality CPR and prepare for defibrillation
B. Perform immediate synchronized cardioversion
C. Administer 1 mg of Epinephrine IV
D. Check the patient’s pulse for 10 seconds
Correct Answer: A
, Expert Explanation: Ventricular Fibrillation is a pulseless rhythm that requires immediate
unsynchronized defibrillation. While waiting for the defibrillator, the nurse must maintain
perfusion through high-quality chest compressions. Synchronized cardioversion is
inappropriate for VF because there is no R-wave to track.
6. A patient with septic shock has a MAP of 55 mmHg despite fluid resuscitation. Which
medication should the nurse anticipate?
A. Labetalol
B. Nitroprusside
C. Diltiazem
D. Norepinephrine
Correct Answer: D
Expert Explanation: Norepinephrine is the first-line vasopressor for septic shock when
fluid resuscitation fails to maintain a MAP of at least 65 mmHg. It works by causing
vasoconstriction through alpha-1 adrenergic stimulation to increase systemic vascular
resistance. Medications like Nitroprusside or Labetalol would further decrease blood
pressure and are contraindicated in shock.
7. Which clinical finding is part of the ‘Cushing’s Triad’ associated with increased intracranial
pressure?
A. Tachycardia, Hypotension, and Tachypnea
B. Bradycardia, Hypotension, and Cheyne-Stokes breathing
