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NUR2755 / NUR 2755 Exam 2 Study
Guide (2024/2025) – Multidimensional
Care IV / MDC 4
Questions
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a
pH of 7.30, PaCO2 of 68 mmHg, HCO3 of 28 mmol/L, and PaO2 of 60 mmHg.
How should the nurse interpret these arterial blood gas (ABG) results?
A. Metabolic acidosis, uncompensated
B. Respiratory acidosis, partially compensated
C. Metabolic alkalosis, fully compensated
D. Respiratory alkalosis, uncompensated
Correct Answer: B. Respiratory acidosis, partially compensated
Rationale: The pH is below 7.35, indicating acidosis. The elevated PaCO2 (normal: 35–45
mmHg) suggests a respiratory cause due to CO2 retention, common in COPD. The slightly
elevated HCO3 (normal: 22–26 mmol/L) indicates partial compensation by the kidneys.
2. A nurse is caring for a patient with diabetic ketoacidosis (DKA) who exhibits
Kussmaul respirations. What is the primary reason for this respiratory pattern?
A. To compensate for metabolic acidosis
B. To increase oxygen delivery to tissues
C. To reduce cerebral edema
D. To correct electrolyte imbalances
Correct Answer: A. To compensate for metabolic acidosis
Rationale: Kussmaul respirations are rapid, deep breaths that occur as the body attempts
to eliminate excess CO2 to compensate for the severe metabolic acidosis (low pH) seen in
DKA.
3. A patient with a 3-day history of nausea and vomiting presents with a
respiratory rate of 10 breaths/min. What ABG result would the nurse expect?
A. pH 7.48, PaCO2 48 mmHg
B. pH 7.32, PaCO2 50 mmHg
, 2
C. pH 7.30, PaCO2 30 mmHg
D. pH 7.42, PaCO2 40 mmHg
Correct Answer: B. pH 7.32, PaCO2 50 mmHg
Rationale: Prolonged vomiting leads to loss of stomach acid, causing metabolic alkalosis.
Hypoventilation (low respiratory rate) is a compensatory mechanism, increasing PaCO2 to
lower pH. The results show alkalosis (pH > 7.35) with elevated PaCO2.
4. What is the priority nursing intervention for a patient with a second-degree
burn covering 20% of their body surface area?
A. Administer analgesics as prescribed
B. Initiate fluid resuscitation
C. Apply antibiotic cream
D. Debride the wound immediately
Correct Answer: B. Initiate fluid resuscitation
Rationale: Fluid loss is a major concern in burns due to increased capillary permeability.
The priority is to restore fluid volume to prevent hypovolemic shock, using formulas like
the Parkland formula.
5. A nurse is preparing to administer silver sulfadiazine (Silvadene) to a burn
patient. What is the primary purpose of this medication?
A. Pain relief
B. Prevention of infection
C. Wound debridement
D. Promotion of granulation tissue
Correct Answer: B. Prevention of infection
Rationale: Silver sulfadiazine is a topical antimicrobial used to prevent and treat infections
in burn wounds by reducing bacterial growth.
6. A patient with a history of heart failure is admitted with pulmonary edema.
Which medication should the nurse anticipate administering?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Correct Answer: B. Furosemide
Rationale: Furosemide, a loop diuretic, is used to reduce fluid overload in pulmonary
edema by promoting diuresis, thus relieving pressure on the lungs.
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7. A patient with frostbite on their hands is admitted to the ED. What is the
priority nursing intervention?
A. Administer pain medication
B. Immerse hands in warm water
C. Apply dry, sterile dressings
D. Elevate the affected limbs
Correct Answer: B. Immerse hands in warm water
Rationale: Rewarming frostbitten tissue in warm water (40–42°C) is the priority to restore
circulation and prevent further tissue damage.
8. A nurse is caring for a patient with a heat stroke who begins to shiver. Why is
shivering problematic?
A. It increases oxygen demand
B. It raises body temperature
C. It causes muscle cramps
D. It leads to dehydration
Correct Answer: B. It raises body temperature
Rationale: Shivering generates heat, which can worsen hyperthermia in heat stroke.
Medications like chlorpromazine may be used to control shivering.
9. A patient with a spinal cord injury at T6 is at risk for which complication?
A. Autonomic dysreflexia
B. Respiratory failure
C. Deep vein thrombosis
D. Urinary incontinence
Correct Answer: A. Autonomic dysreflexia
Rationale: Autonomic dysreflexia is a life-threatening complication in spinal cord injuries
above T6, triggered by stimuli like bladder distension, leading to severe hypertension.
10. What is the hallmark symptom of autonomic dysreflexia in a patient with a
spinal cord injury?
A. Hypotension
B. Severe headache
NUR2755 / NUR 2755 Exam 2 Study
Guide (2024/2025) – Multidimensional
Care IV / MDC 4
Questions
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a
pH of 7.30, PaCO2 of 68 mmHg, HCO3 of 28 mmol/L, and PaO2 of 60 mmHg.
How should the nurse interpret these arterial blood gas (ABG) results?
A. Metabolic acidosis, uncompensated
B. Respiratory acidosis, partially compensated
C. Metabolic alkalosis, fully compensated
D. Respiratory alkalosis, uncompensated
Correct Answer: B. Respiratory acidosis, partially compensated
Rationale: The pH is below 7.35, indicating acidosis. The elevated PaCO2 (normal: 35–45
mmHg) suggests a respiratory cause due to CO2 retention, common in COPD. The slightly
elevated HCO3 (normal: 22–26 mmol/L) indicates partial compensation by the kidneys.
2. A nurse is caring for a patient with diabetic ketoacidosis (DKA) who exhibits
Kussmaul respirations. What is the primary reason for this respiratory pattern?
A. To compensate for metabolic acidosis
B. To increase oxygen delivery to tissues
C. To reduce cerebral edema
D. To correct electrolyte imbalances
Correct Answer: A. To compensate for metabolic acidosis
Rationale: Kussmaul respirations are rapid, deep breaths that occur as the body attempts
to eliminate excess CO2 to compensate for the severe metabolic acidosis (low pH) seen in
DKA.
3. A patient with a 3-day history of nausea and vomiting presents with a
respiratory rate of 10 breaths/min. What ABG result would the nurse expect?
A. pH 7.48, PaCO2 48 mmHg
B. pH 7.32, PaCO2 50 mmHg
, 2
C. pH 7.30, PaCO2 30 mmHg
D. pH 7.42, PaCO2 40 mmHg
Correct Answer: B. pH 7.32, PaCO2 50 mmHg
Rationale: Prolonged vomiting leads to loss of stomach acid, causing metabolic alkalosis.
Hypoventilation (low respiratory rate) is a compensatory mechanism, increasing PaCO2 to
lower pH. The results show alkalosis (pH > 7.35) with elevated PaCO2.
4. What is the priority nursing intervention for a patient with a second-degree
burn covering 20% of their body surface area?
A. Administer analgesics as prescribed
B. Initiate fluid resuscitation
C. Apply antibiotic cream
D. Debride the wound immediately
Correct Answer: B. Initiate fluid resuscitation
Rationale: Fluid loss is a major concern in burns due to increased capillary permeability.
The priority is to restore fluid volume to prevent hypovolemic shock, using formulas like
the Parkland formula.
5. A nurse is preparing to administer silver sulfadiazine (Silvadene) to a burn
patient. What is the primary purpose of this medication?
A. Pain relief
B. Prevention of infection
C. Wound debridement
D. Promotion of granulation tissue
Correct Answer: B. Prevention of infection
Rationale: Silver sulfadiazine is a topical antimicrobial used to prevent and treat infections
in burn wounds by reducing bacterial growth.
6. A patient with a history of heart failure is admitted with pulmonary edema.
Which medication should the nurse anticipate administering?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
Correct Answer: B. Furosemide
Rationale: Furosemide, a loop diuretic, is used to reduce fluid overload in pulmonary
edema by promoting diuresis, thus relieving pressure on the lungs.
, 3
7. A patient with frostbite on their hands is admitted to the ED. What is the
priority nursing intervention?
A. Administer pain medication
B. Immerse hands in warm water
C. Apply dry, sterile dressings
D. Elevate the affected limbs
Correct Answer: B. Immerse hands in warm water
Rationale: Rewarming frostbitten tissue in warm water (40–42°C) is the priority to restore
circulation and prevent further tissue damage.
8. A nurse is caring for a patient with a heat stroke who begins to shiver. Why is
shivering problematic?
A. It increases oxygen demand
B. It raises body temperature
C. It causes muscle cramps
D. It leads to dehydration
Correct Answer: B. It raises body temperature
Rationale: Shivering generates heat, which can worsen hyperthermia in heat stroke.
Medications like chlorpromazine may be used to control shivering.
9. A patient with a spinal cord injury at T6 is at risk for which complication?
A. Autonomic dysreflexia
B. Respiratory failure
C. Deep vein thrombosis
D. Urinary incontinence
Correct Answer: A. Autonomic dysreflexia
Rationale: Autonomic dysreflexia is a life-threatening complication in spinal cord injuries
above T6, triggered by stimuli like bladder distension, leading to severe hypertension.
10. What is the hallmark symptom of autonomic dysreflexia in a patient with a
spinal cord injury?
A. Hypotension
B. Severe headache
