NR341/NR 341 Final Exam V1 | Complex
Adult Health Q&A with Rationale |
Chamberlain University
1. A patient with a suspected myocardial infarction is admitted to the emergency
department. Which cardiac biomarker is most specific for myocardial injury and typically
remains elevated for up to two weeks?
A. Myoglobin
B. Creatine Kinase-MB (CK-MB)
C. Troponin T
D. Lactate Dehydrogenase (LDH)
Correct Answer: C
Expert Explanation: Troponin T is a highly specific marker for cardiac muscle damage and
can be detected in the blood for a prolonged period. This characteristic makes it superior to
CK-MB for late diagnosis of myocardial infarction. The nurse should monitor these levels to
evaluate the extent of myocardial damage over time.
2. A client is in the compensatory stage of shock. Which clinical manifestation should the
nurse expect to observe?
A. Decreased heart rate and increased urine output
B. Lethargy and metabolic acidosis
,C. Increased heart rate and narrowed pulse pressure
D. Cold, clammy skin and absent bowel sounds
Correct Answer: C
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain perfusion. An increased heart rate and narrowed
pulse pressure are classic signs of the body’s attempt to stabilize blood pressure. The nurse
must recognize these early compensatory mechanisms to prevent progression to the
progressive stage.
3. The nurse is caring for a patient on mechanical ventilation who begins to fight the
ventilator. The high-pressure alarm is sounding. Which action should the nurse take first?
A. Increase the sedation levels as prescribed
B. Check for kinks in the tubing or the patient biting the tube
C. Disconnect the patient and use a manual resuscitation bag
D. Call the respiratory therapist to recalibrate the machine
Correct Answer: B
Expert Explanation: High-pressure alarms are often caused by increased resistance, such
as a kink in the tubing or a patient biting the endotracheal tube. The nurse should first
assess for simple mechanical obstructions that can be quickly rectified. If the cause is not
immediately found and the patient is distressed, manual ventilation would then be
appropriate.
,4. A patient with acute respiratory distress syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. Decreased workload of the heart
B. Improved recruitment of posterior alveolar units
C. Reduced risk of ventilator-associated pneumonia
D. Enhanced secretion clearance from the upper airways
Correct Answer: B
Expert Explanation: Prone positioning improves oxygenation by redistributing
pulmonary blood flow and opening up collapsed alveoli in the dorsal lung regions. This
technique helps to equalize the pressure across the lung tissue, leading to more uniform
ventilation. Nurses must monitor the patient closely for complications like pressure ulcers
and tube displacement while in this position.
5. A client has sustained deep partial-thickness burns to 40% of the body. According to the
Parkland Formula, how much of the calculated 24-hour fluid volume should be administered
in the first 8 hours post-injury?
A. One-half of the total volume
B. One-quarter of the total volume
C. Three-quarters of the total volume
D. The entire volume
, Correct Answer: A
Expert Explanation: The Parkland Formula mandates that 50% of the calculated fluid
volume be administered within the first 8 hours after the burn injury occurs. The
remaining 50% is distributed over the next 16 hours to maintain adequate renal perfusion
and organ function. Accurate timing is essential because the 8-hour window starts from the
time of injury, not the time of arrival at the hospital.
6. When interpreting an arterial blood gas (ABG) for a patient with diabetic ketoacidosis
(DKA), which results are most consistent with this condition?
A. pH 7.28, PaCO2 32, HCO3 16
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 50, HCO3 24
D. pH 7.45, PaCO2 40, HCO3 28
Correct Answer: A
Expert Explanation: Diabetic ketoacidosis typically presents as metabolic acidosis with a
low pH and low bicarbonate level. The PaCO2 may also be low as the body attempts to
compensate through Kussmaul respirations. These ABG results reflect a partially
compensated metabolic acidosis, which is characteristic of severe DKA.
Adult Health Q&A with Rationale |
Chamberlain University
1. A patient with a suspected myocardial infarction is admitted to the emergency
department. Which cardiac biomarker is most specific for myocardial injury and typically
remains elevated for up to two weeks?
A. Myoglobin
B. Creatine Kinase-MB (CK-MB)
C. Troponin T
D. Lactate Dehydrogenase (LDH)
Correct Answer: C
Expert Explanation: Troponin T is a highly specific marker for cardiac muscle damage and
can be detected in the blood for a prolonged period. This characteristic makes it superior to
CK-MB for late diagnosis of myocardial infarction. The nurse should monitor these levels to
evaluate the extent of myocardial damage over time.
2. A client is in the compensatory stage of shock. Which clinical manifestation should the
nurse expect to observe?
A. Decreased heart rate and increased urine output
B. Lethargy and metabolic acidosis
,C. Increased heart rate and narrowed pulse pressure
D. Cold, clammy skin and absent bowel sounds
Correct Answer: C
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain perfusion. An increased heart rate and narrowed
pulse pressure are classic signs of the body’s attempt to stabilize blood pressure. The nurse
must recognize these early compensatory mechanisms to prevent progression to the
progressive stage.
3. The nurse is caring for a patient on mechanical ventilation who begins to fight the
ventilator. The high-pressure alarm is sounding. Which action should the nurse take first?
A. Increase the sedation levels as prescribed
B. Check for kinks in the tubing or the patient biting the tube
C. Disconnect the patient and use a manual resuscitation bag
D. Call the respiratory therapist to recalibrate the machine
Correct Answer: B
Expert Explanation: High-pressure alarms are often caused by increased resistance, such
as a kink in the tubing or a patient biting the endotracheal tube. The nurse should first
assess for simple mechanical obstructions that can be quickly rectified. If the cause is not
immediately found and the patient is distressed, manual ventilation would then be
appropriate.
,4. A patient with acute respiratory distress syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. Decreased workload of the heart
B. Improved recruitment of posterior alveolar units
C. Reduced risk of ventilator-associated pneumonia
D. Enhanced secretion clearance from the upper airways
Correct Answer: B
Expert Explanation: Prone positioning improves oxygenation by redistributing
pulmonary blood flow and opening up collapsed alveoli in the dorsal lung regions. This
technique helps to equalize the pressure across the lung tissue, leading to more uniform
ventilation. Nurses must monitor the patient closely for complications like pressure ulcers
and tube displacement while in this position.
5. A client has sustained deep partial-thickness burns to 40% of the body. According to the
Parkland Formula, how much of the calculated 24-hour fluid volume should be administered
in the first 8 hours post-injury?
A. One-half of the total volume
B. One-quarter of the total volume
C. Three-quarters of the total volume
D. The entire volume
, Correct Answer: A
Expert Explanation: The Parkland Formula mandates that 50% of the calculated fluid
volume be administered within the first 8 hours after the burn injury occurs. The
remaining 50% is distributed over the next 16 hours to maintain adequate renal perfusion
and organ function. Accurate timing is essential because the 8-hour window starts from the
time of injury, not the time of arrival at the hospital.
6. When interpreting an arterial blood gas (ABG) for a patient with diabetic ketoacidosis
(DKA), which results are most consistent with this condition?
A. pH 7.28, PaCO2 32, HCO3 16
B. pH 7.50, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 50, HCO3 24
D. pH 7.45, PaCO2 40, HCO3 28
Correct Answer: A
Expert Explanation: Diabetic ketoacidosis typically presents as metabolic acidosis with a
low pH and low bicarbonate level. The PaCO2 may also be low as the body attempts to
compensate through Kussmaul respirations. These ABG results reflect a partially
compensated metabolic acidosis, which is characteristic of severe DKA.
