BSN 346 Exam 1: Concepts of Nursing III
Updated and Verified Questions and
Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving
mechanical ventilation. Which setting is specifically used to keep the alveoli
open at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
C. Tidal Volume (VT)
D. Inspiratory Rate
Answer: A
Explanation: PEEP provides positive pressure at the end of expiration to prevent alveolar
collapse and improve oxygenation in patients with ARDS.
2. The nurse is caring for a patient in the emergent phase of a major burn injury.
Which electrolyte imbalance is most commonly expected during this phase?
A. Hypokalemia
B. Hypernatremia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Explanation: In the emergent phase of burns, cell destruction releases potassium into the
extracellular fluid, leading to hyperkalemia.
,3. Using the Parkland Formula, calculate the total fluid volume needed in the
first 24 hours for a 70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 14,000 mL
C. 2,800 mL
D. 11,200 mL
Answer: D
Explanation: Parkland Formula: 4 mL x kg x % TBSA. 4 x 70 x 40 = 11,200 mL.
4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, HCO3 24 mEq/L. How
should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: A
Explanation: The pH is low (<7.35) and the PaCO2 is high (>45), indicating respiratory
acidosis.
5. Which assessment finding is considered the most sensitive indicator of
increasing Intracranial Pressure (ICP)?
A. Change in Level of Consciousness (LOC)
B. Widening pulse pressure
C. Fixed and dilated pupils
D. Projectile vomiting
Answer: A
Explanation: A change in LOC is the earliest and most sensitive sign of neurological
deterioration and increased ICP.
, 6. A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation.
Which class of medication should the nurse anticipate administering next?
A. Diuretics
B. Calcium channel blockers
C. Beta-blockers
D. Vasopressors
Answer: D
Explanation: Vasopressors, such as norepinephrine, are indicated in septic shock when
fluid resuscitation fails to maintain an adequate MAP (usually >65 mmHg).
7. What is the primary goal of the intra-aortic balloon pump (IABP) in a patient
with cardiogenic shock?
A. To decrease afterload and increase coronary artery perfusion
B. To increase heart rate and systemic vascular resistance
C. To provide permanent circulatory support
D. To oxygenate the blood outside the body
Answer: A
Explanation: The IABP inflates during diastole to improve coronary perfusion and deflates
during systole to reduce afterload (workload) on the heart.
8. A patient with a T4 spinal cord injury reports a severe headache and nasal
congestion. The blood pressure is 190/110 mmHg. What is the priority nursing
action?
A. Administer PRN pain medication
B. Notify the provider and prepare for a CT scan
C. Sit the patient upright and check for bladder distention
D. Lower the head of the bed to improve cerebral blood flow
Answer: C
Updated and Verified Questions and
Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving
mechanical ventilation. Which setting is specifically used to keep the alveoli
open at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
C. Tidal Volume (VT)
D. Inspiratory Rate
Answer: A
Explanation: PEEP provides positive pressure at the end of expiration to prevent alveolar
collapse and improve oxygenation in patients with ARDS.
2. The nurse is caring for a patient in the emergent phase of a major burn injury.
Which electrolyte imbalance is most commonly expected during this phase?
A. Hypokalemia
B. Hypernatremia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Explanation: In the emergent phase of burns, cell destruction releases potassium into the
extracellular fluid, leading to hyperkalemia.
,3. Using the Parkland Formula, calculate the total fluid volume needed in the
first 24 hours for a 70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 14,000 mL
C. 2,800 mL
D. 11,200 mL
Answer: D
Explanation: Parkland Formula: 4 mL x kg x % TBSA. 4 x 70 x 40 = 11,200 mL.
4. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, HCO3 24 mEq/L. How
should the nurse interpret these results?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: A
Explanation: The pH is low (<7.35) and the PaCO2 is high (>45), indicating respiratory
acidosis.
5. Which assessment finding is considered the most sensitive indicator of
increasing Intracranial Pressure (ICP)?
A. Change in Level of Consciousness (LOC)
B. Widening pulse pressure
C. Fixed and dilated pupils
D. Projectile vomiting
Answer: A
Explanation: A change in LOC is the earliest and most sensitive sign of neurological
deterioration and increased ICP.
, 6. A patient in septic shock has a MAP of 55 mmHg despite fluid resuscitation.
Which class of medication should the nurse anticipate administering next?
A. Diuretics
B. Calcium channel blockers
C. Beta-blockers
D. Vasopressors
Answer: D
Explanation: Vasopressors, such as norepinephrine, are indicated in septic shock when
fluid resuscitation fails to maintain an adequate MAP (usually >65 mmHg).
7. What is the primary goal of the intra-aortic balloon pump (IABP) in a patient
with cardiogenic shock?
A. To decrease afterload and increase coronary artery perfusion
B. To increase heart rate and systemic vascular resistance
C. To provide permanent circulatory support
D. To oxygenate the blood outside the body
Answer: A
Explanation: The IABP inflates during diastole to improve coronary perfusion and deflates
during systole to reduce afterload (workload) on the heart.
8. A patient with a T4 spinal cord injury reports a severe headache and nasal
congestion. The blood pressure is 190/110 mmHg. What is the priority nursing
action?
A. Administer PRN pain medication
B. Notify the provider and prepare for a CT scan
C. Sit the patient upright and check for bladder distention
D. Lower the head of the bed to improve cerebral blood flow
Answer: C
