NR 324 | Adult Health II | Exam 8 Practice Questions 2026
|Chamberlain College
1. Which clinical manifestation is a hallmark sign of the exudative phase of
Acute Respiratory Distress Syndrome (ARDS)?
A. Refractory hypoxemia
B. Bradycardia and hypertension
C. Increased lung compliance
D. Respiratory alkalosis with high PaO2
Answer: A
Rationale: Refractory hypoxemia, where the PaO2 does not improve despite increasing
oxygen concentrations, is a classic sign of early ARDS due to intrapulmonary shunting.
2. A patient is on mechanical ventilation with Positive End-Expiratory Pressure
(PEEP). What is the primary purpose of PEEP?
A. To increase the fraction of inspired oxygen (FiO2)
B. To prevent barotrauma by lowering peak pressures
C. To provide a backup respiratory rate
D. To keep alveoli open and improve functional residual capacity
Answer: D
Rationale: PEEP maintains pressure in the airway at the end of expiration to prevent
alveolar collapse, thereby improving gas exchange.
,3. A nurse is caring for a patient in the compensatory stage of shock. Which
finding should the nurse expect?
A. Hypotension and lethargy
B. Tachycardia and narrowed pulse pressure
C. Anuria and metabolic acidosis
D. Cold, cyanotic skin and mottled extremities
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis via the
sympathetic nervous system, resulting in increased heart rate and vasoconstriction.
4. Which lab value is most indicative of tissue hypoperfusion in a patient with
suspected septic shock?
A. Decreased White Blood Cell (WBC) count
B. Decreased Blood Urea Nitrogen (BUN)
C. Increased Serum Bicarbonate
D. Elevated Serum Lactate
Answer: D
Rationale: Serum lactate levels increase when cells switch to anaerobic metabolism due to
inadequate oxygen delivery to tissues.
5. Using the Parkland Formula, calculate the total fluid resuscitation needed in
the first 24 hours for a 70kg patient with 50% Total Body Surface Area (TBSA)
burns.
A. 14,000 mL
B. 7,000 mL
C. 28,000 mL
D. 10,500 mL
Answer: A
Rationale: Parkland Formula: 4mL x weight(kg) x TBSA(%). 4 x 70 x 50 = 14,000 mL.
, 6. An adult patient has burns on the entire left arm, the entire chest, and the
entire abdomen. Using the Rule of Nines, what is the TBSA?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: Left arm (9%) + Chest (9%) + Abdomen (9%) = 27%.
7. Which arterial blood gas (ABG) result is consistent with a patient experiencing
early-stage Acute Respiratory Failure?
A. pH 7.30, PaCO2 55, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.35, PaCO2 40, HCO3 22
D. pH 7.50, PaCO2 45, HCO3 35
Answer: B
Rationale: Early respiratory failure often manifests as respiratory alkalosis due to
hyperventilation in an attempt to maintain oxygenation.
8. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the priority
nursing action?
A. Check for bladder distention or fecal impaction
B. Administer PRN antihypertensive medication
C. Lower the head of the bed to the flat position
D. Perform a neurological assessment
Answer: A
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the noxious stimulus, commonly a full bladder or bowel.
|Chamberlain College
1. Which clinical manifestation is a hallmark sign of the exudative phase of
Acute Respiratory Distress Syndrome (ARDS)?
A. Refractory hypoxemia
B. Bradycardia and hypertension
C. Increased lung compliance
D. Respiratory alkalosis with high PaO2
Answer: A
Rationale: Refractory hypoxemia, where the PaO2 does not improve despite increasing
oxygen concentrations, is a classic sign of early ARDS due to intrapulmonary shunting.
2. A patient is on mechanical ventilation with Positive End-Expiratory Pressure
(PEEP). What is the primary purpose of PEEP?
A. To increase the fraction of inspired oxygen (FiO2)
B. To prevent barotrauma by lowering peak pressures
C. To provide a backup respiratory rate
D. To keep alveoli open and improve functional residual capacity
Answer: D
Rationale: PEEP maintains pressure in the airway at the end of expiration to prevent
alveolar collapse, thereby improving gas exchange.
,3. A nurse is caring for a patient in the compensatory stage of shock. Which
finding should the nurse expect?
A. Hypotension and lethargy
B. Tachycardia and narrowed pulse pressure
C. Anuria and metabolic acidosis
D. Cold, cyanotic skin and mottled extremities
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis via the
sympathetic nervous system, resulting in increased heart rate and vasoconstriction.
4. Which lab value is most indicative of tissue hypoperfusion in a patient with
suspected septic shock?
A. Decreased White Blood Cell (WBC) count
B. Decreased Blood Urea Nitrogen (BUN)
C. Increased Serum Bicarbonate
D. Elevated Serum Lactate
Answer: D
Rationale: Serum lactate levels increase when cells switch to anaerobic metabolism due to
inadequate oxygen delivery to tissues.
5. Using the Parkland Formula, calculate the total fluid resuscitation needed in
the first 24 hours for a 70kg patient with 50% Total Body Surface Area (TBSA)
burns.
A. 14,000 mL
B. 7,000 mL
C. 28,000 mL
D. 10,500 mL
Answer: A
Rationale: Parkland Formula: 4mL x weight(kg) x TBSA(%). 4 x 70 x 50 = 14,000 mL.
, 6. An adult patient has burns on the entire left arm, the entire chest, and the
entire abdomen. Using the Rule of Nines, what is the TBSA?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: Left arm (9%) + Chest (9%) + Abdomen (9%) = 27%.
7. Which arterial blood gas (ABG) result is consistent with a patient experiencing
early-stage Acute Respiratory Failure?
A. pH 7.30, PaCO2 55, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 24
C. pH 7.35, PaCO2 40, HCO3 22
D. pH 7.50, PaCO2 45, HCO3 35
Answer: B
Rationale: Early respiratory failure often manifests as respiratory alkalosis due to
hyperventilation in an attempt to maintain oxygenation.
8. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the priority
nursing action?
A. Check for bladder distention or fecal impaction
B. Administer PRN antihypertensive medication
C. Lower the head of the bed to the flat position
D. Perform a neurological assessment
Answer: A
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the noxious stimulus, commonly a full bladder or bowel.
