NR 325 Adult Health III Comprehensive Exam Study Guide 2026
|Chamberlain College
1. A patient is admitted with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45 mmHg with a
normal HCO3 confirms the cause is respiratory in nature.
2. Which clinical manifestation is considered a component of Cushing’s Triad,
indicating increased intracranial pressure (ICP)?
A. Tachycardia
B. Widened pulse pressure
C. Hypotension
D. Increased respiratory rate
Answer: B
Rationale: Cushing’s Triad consists of bradycardia, irregular respirations (Cheyne-Stokes),
and hypertension with a widened pulse pressure.
,3. Using the Parkland Formula, calculate the total fluid resuscitation needed in
the first 24 hours for a 70kg patient with 40% Total Body Surface Area (TBSA)
burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 14,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x weight(kg) x TBSA. 4 x 70 x 40 = 11,200 mL.
4. A patient in the ICU has a central venous pressure (CVP) of 1 mmHg. Which
intervention should the nurse anticipate?
A. Administration of a bolus of IV fluids
B. Administration of a loop diuretic
C. Decreasing the IV infusion rate
D. Administering a vasodilator
Answer: A
Rationale: A low CVP (normal 2-8 mmHg) indicates hypovolemia or low fluid volume,
requiring fluid resuscitation.
5. In the water-seal chamber of a chest tube drainage system, what does
continuous bubbling typically indicate?
A. High suction pressure
B. Normal functioning during expiration
C. The lung has fully re-expanded
D. An air leak in the system
Answer: D
, Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is normal in patients with a pneumothorax during coughing or
expiration.
6. Which of the following is the hallmark clinical sign of Acute Respiratory
Distress Syndrome (ARDS)?
A. Refractory hypoxemia
B. Bradypnea
C. Respiratory alkalosis
D. Increased lung compliance
Answer: A
Rationale: Refractory hypoxemia is hypoxemia that does not improve even with high
concentrations of supplemental oxygen, a classic sign of ARDS.
7. A nurse is caring for a patient with liver cirrhosis and hepatic encephalopathy.
What is the primary purpose of administering lactulose?
A. To prevent gastrointestinal bleeding
B. To decrease bilirubin levels
C. To increase serum potassium
D. To reduce serum ammonia levels
Answer: D
Rationale: Lactulose promotes the excretion of ammonia through the stool to improve
neurological status in hepatic encephalopathy.
|Chamberlain College
1. A patient is admitted with a pH of 7.25, PaCO2 of 55 mmHg, and HCO3 of 24
mEq/L. Which acid-base imbalance is occurring?
A. Respiratory Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Metabolic Acidosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45 mmHg with a
normal HCO3 confirms the cause is respiratory in nature.
2. Which clinical manifestation is considered a component of Cushing’s Triad,
indicating increased intracranial pressure (ICP)?
A. Tachycardia
B. Widened pulse pressure
C. Hypotension
D. Increased respiratory rate
Answer: B
Rationale: Cushing’s Triad consists of bradycardia, irregular respirations (Cheyne-Stokes),
and hypertension with a widened pulse pressure.
,3. Using the Parkland Formula, calculate the total fluid resuscitation needed in
the first 24 hours for a 70kg patient with 40% Total Body Surface Area (TBSA)
burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 14,000 mL
Answer: A
Rationale: Parkland Formula: 4mL x weight(kg) x TBSA. 4 x 70 x 40 = 11,200 mL.
4. A patient in the ICU has a central venous pressure (CVP) of 1 mmHg. Which
intervention should the nurse anticipate?
A. Administration of a bolus of IV fluids
B. Administration of a loop diuretic
C. Decreasing the IV infusion rate
D. Administering a vasodilator
Answer: A
Rationale: A low CVP (normal 2-8 mmHg) indicates hypovolemia or low fluid volume,
requiring fluid resuscitation.
5. In the water-seal chamber of a chest tube drainage system, what does
continuous bubbling typically indicate?
A. High suction pressure
B. Normal functioning during expiration
C. The lung has fully re-expanded
D. An air leak in the system
Answer: D
, Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is normal in patients with a pneumothorax during coughing or
expiration.
6. Which of the following is the hallmark clinical sign of Acute Respiratory
Distress Syndrome (ARDS)?
A. Refractory hypoxemia
B. Bradypnea
C. Respiratory alkalosis
D. Increased lung compliance
Answer: A
Rationale: Refractory hypoxemia is hypoxemia that does not improve even with high
concentrations of supplemental oxygen, a classic sign of ARDS.
7. A nurse is caring for a patient with liver cirrhosis and hepatic encephalopathy.
What is the primary purpose of administering lactulose?
A. To prevent gastrointestinal bleeding
B. To decrease bilirubin levels
C. To increase serum potassium
D. To reduce serum ammonia levels
Answer: D
Rationale: Lactulose promotes the excretion of ammonia through the stool to improve
neurological status in hepatic encephalopathy.
