BSN 346 Exam 1: Concepts of Nursing III
Updated and Verified Questions and Answers
1. A patient’s ECG monitor shows a rapid, regular rhythm with a rate of 180 bpm
and narrow QRS complexes. The patient is stable but reports palpitations.
Which intervention should the nurse anticipate first?
A. Defibrillation
B. Administration of Atropine
C. Vagal maneuvers
D. Synchronized cardioversion
Answer: C
Explanation: For stable Supraventricular Tachycardia (SVT), non-pharmacological
interventions like vagal maneuvers (e.g., Valsalva) are the first-line treatment before
medication or electrical therapy.
2. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation is most likely to be observed?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion and crackles. Options A, B, and D are signs of
right-sided heart failure.
,3. A patient is admitted with Acute Coronary Syndrome (ACS). The nurse notes
an elevated Troponin T level. What does this lab value indicate?
A. Early signs of atherosclerosis
B. Congestive heart failure exacerbation
C. Skeletal muscle trauma
D. Myocardial injury or necrosis
Answer: D
Explanation: Troponin is a protein released specifically by damaged cardiac muscle cells.
Elevated levels are highly sensitive and specific for myocardial infarction.
4. While monitoring a patient on a ventilator, the high-pressure alarm sounds.
Which of the following is a possible cause?
A. Patient biting the endotracheal tube
B. A leak in the cuff of the endotracheal tube
C. Disconnection from the ventilator
D. Spontaneous breathing by the patient
Answer: A
Explanation: High-pressure alarms are triggered by increased resistance, such as patient
biting, secretions, or kinking of the tube. Low-pressure alarms are triggered by
disconnections or leaks.
5. A nurse is reviewing ABG results for a patient with COPD: pH 7.32, PaCO2 55,
HCO3 28. How should the nurse interpret these results?
A. Respiratory Acidosis, partially compensated
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis, fully compensated
Answer: A
, Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3
is high (indicating the kidneys are trying to compensate), but the pH is not yet normal.
6. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which
condition should the nurse suspect?
A. Hypervolemia
B. Hypovolemia
C. Right-sided heart failure
D. Pulmonary hypertension
Answer: B
Explanation: Normal CVP is 2-8 mmHg. A low CVP (less than 2) indicates fluid volume
deficit or hypovolemia.
7. Which medication is the priority for a patient experiencing Ventricular
Fibrillation after unsuccessful defibrillation?
A. Dopamine
B. Epinephrine
C. Warfarin
D. Digoxin
Answer: B
Explanation: During ACLS for V-fib or pulseless V-tach, Epinephrine is the primary
vasopressor administered to increase coronary perfusion pressure.
8. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. What is the primary rationale for this?
A. To improve oxygenation by recruiting dorsal alveoli
B. To prevent skin breakdown on the back
C. To facilitate easier suctioning of secretions
D. To reduce the patient’s work of breathing
Answer: A
Updated and Verified Questions and Answers
1. A patient’s ECG monitor shows a rapid, regular rhythm with a rate of 180 bpm
and narrow QRS complexes. The patient is stable but reports palpitations.
Which intervention should the nurse anticipate first?
A. Defibrillation
B. Administration of Atropine
C. Vagal maneuvers
D. Synchronized cardioversion
Answer: C
Explanation: For stable Supraventricular Tachycardia (SVT), non-pharmacological
interventions like vagal maneuvers (e.g., Valsalva) are the first-line treatment before
medication or electrical therapy.
2. A nurse is caring for a patient with left-sided heart failure. Which clinical
manifestation is most likely to be observed?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion and crackles. Options A, B, and D are signs of
right-sided heart failure.
,3. A patient is admitted with Acute Coronary Syndrome (ACS). The nurse notes
an elevated Troponin T level. What does this lab value indicate?
A. Early signs of atherosclerosis
B. Congestive heart failure exacerbation
C. Skeletal muscle trauma
D. Myocardial injury or necrosis
Answer: D
Explanation: Troponin is a protein released specifically by damaged cardiac muscle cells.
Elevated levels are highly sensitive and specific for myocardial infarction.
4. While monitoring a patient on a ventilator, the high-pressure alarm sounds.
Which of the following is a possible cause?
A. Patient biting the endotracheal tube
B. A leak in the cuff of the endotracheal tube
C. Disconnection from the ventilator
D. Spontaneous breathing by the patient
Answer: A
Explanation: High-pressure alarms are triggered by increased resistance, such as patient
biting, secretions, or kinking of the tube. Low-pressure alarms are triggered by
disconnections or leaks.
5. A nurse is reviewing ABG results for a patient with COPD: pH 7.32, PaCO2 55,
HCO3 28. How should the nurse interpret these results?
A. Respiratory Acidosis, partially compensated
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis, fully compensated
Answer: A
, Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3
is high (indicating the kidneys are trying to compensate), but the pH is not yet normal.
6. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which
condition should the nurse suspect?
A. Hypervolemia
B. Hypovolemia
C. Right-sided heart failure
D. Pulmonary hypertension
Answer: B
Explanation: Normal CVP is 2-8 mmHg. A low CVP (less than 2) indicates fluid volume
deficit or hypovolemia.
7. Which medication is the priority for a patient experiencing Ventricular
Fibrillation after unsuccessful defibrillation?
A. Dopamine
B. Epinephrine
C. Warfarin
D. Digoxin
Answer: B
Explanation: During ACLS for V-fib or pulseless V-tach, Epinephrine is the primary
vasopressor administered to increase coronary perfusion pressure.
8. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the
prone position. What is the primary rationale for this?
A. To improve oxygenation by recruiting dorsal alveoli
B. To prevent skin breakdown on the back
C. To facilitate easier suctioning of secretions
D. To reduce the patient’s work of breathing
Answer: A
