BSN Week 6 Quiz: Complex Med-Surg Integration 2026|Galen
1. A patient in septic shock has a blood pressure of 82/46 mmHg after a 2-liter
fluid bolus. Which medication should the nurse anticipate administering next?
A. Furosemide
B. Norepinephrine
C. Nitroprusside
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluid
resuscitation fails to maintain adequate mean arterial pressure.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of
shock?
A. Narrowing pulse pressure
B. Cold, clammy skin
C. Metabolic acidosis
D. Anuria
Answer: A
Rationale: In the compensatory stage, the body attempts to maintain homeostasis, often
resulting in a narrowing pulse pressure due to increased diastolic pressure from
vasoconstriction.
,3. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation with High PEEP. What is the primary risk of high PEEP?
A. Hypoventilation
B. Fluid volume deficit
C. Respiratory alkalosis
D. Barotrauma
Answer: D
Rationale: High Positive End-Expiratory Pressure (PEEP) increases the risk of alveolar
rupture and barotrauma, potentially leading to a pneumothorax.
4. Which laboratory value is most indicative of Disseminated Intravascular
Coagulation (DIC)?
A. Decreased Fibrin Split Products (FSPs)
B. Increased Platelet count
C. Elevated D-dimer
D. Shortened Prothrombin Time (PT)
Answer: C
Rationale: DIC is characterized by the depletion of clotting factors and simultaneous clot
breakdown, leading to elevated D-dimer levels and Fibrin Split Products.
5. The nurse is caring for a patient with a T4 spinal cord injury. The patient
reports a sudden pounding headache and has a BP of 190/100 mmHg. What is
the priority action?
A. Administer PRN antihypertensives
B. Check the patient’s bladder for distention
C. Lower the head of the bed
D. Notify the physician immediately
Answer: B
, Rationale: These are signs of Autonomic Dysreflexia. The priority is to remove the
triggering stimulus, most commonly a full bladder or impacted bowel.
6. A patient with cirrhosis and hepatic encephalopathy is receiving Lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce serum potassium
B. To increase protein absorption
C. To prevent esophageal varices
D. To decrease serum ammonia levels
Answer: D
Rationale: Lactulose traps ammonia in the gut and promotes its excretion through stools
to improve neurological status in hepatic encephalopathy.
7. In the emergent phase of burn care, which electrolyte abnormality is most
commonly expected?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction from burns releases potassium into the extracellular fluid,
leading to hyperkalemia during the first 24-48 hours.
8. A patient has a CVP (Central Venous Pressure) of 1 mmHg and a BP of 88/50
mmHg. Which intervention is most appropriate?
A. Administering a diuretic
B. Starting a dopamine drip
C. Administering a rapid IV fluid bolus
D. Restricting oral fluids
Answer: C
1. A patient in septic shock has a blood pressure of 82/46 mmHg after a 2-liter
fluid bolus. Which medication should the nurse anticipate administering next?
A. Furosemide
B. Norepinephrine
C. Nitroprusside
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluid
resuscitation fails to maintain adequate mean arterial pressure.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of
shock?
A. Narrowing pulse pressure
B. Cold, clammy skin
C. Metabolic acidosis
D. Anuria
Answer: A
Rationale: In the compensatory stage, the body attempts to maintain homeostasis, often
resulting in a narrowing pulse pressure due to increased diastolic pressure from
vasoconstriction.
,3. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation with High PEEP. What is the primary risk of high PEEP?
A. Hypoventilation
B. Fluid volume deficit
C. Respiratory alkalosis
D. Barotrauma
Answer: D
Rationale: High Positive End-Expiratory Pressure (PEEP) increases the risk of alveolar
rupture and barotrauma, potentially leading to a pneumothorax.
4. Which laboratory value is most indicative of Disseminated Intravascular
Coagulation (DIC)?
A. Decreased Fibrin Split Products (FSPs)
B. Increased Platelet count
C. Elevated D-dimer
D. Shortened Prothrombin Time (PT)
Answer: C
Rationale: DIC is characterized by the depletion of clotting factors and simultaneous clot
breakdown, leading to elevated D-dimer levels and Fibrin Split Products.
5. The nurse is caring for a patient with a T4 spinal cord injury. The patient
reports a sudden pounding headache and has a BP of 190/100 mmHg. What is
the priority action?
A. Administer PRN antihypertensives
B. Check the patient’s bladder for distention
C. Lower the head of the bed
D. Notify the physician immediately
Answer: B
, Rationale: These are signs of Autonomic Dysreflexia. The priority is to remove the
triggering stimulus, most commonly a full bladder or impacted bowel.
6. A patient with cirrhosis and hepatic encephalopathy is receiving Lactulose.
What is the primary therapeutic goal of this medication?
A. To reduce serum potassium
B. To increase protein absorption
C. To prevent esophageal varices
D. To decrease serum ammonia levels
Answer: D
Rationale: Lactulose traps ammonia in the gut and promotes its excretion through stools
to improve neurological status in hepatic encephalopathy.
7. In the emergent phase of burn care, which electrolyte abnormality is most
commonly expected?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction from burns releases potassium into the extracellular fluid,
leading to hyperkalemia during the first 24-48 hours.
8. A patient has a CVP (Central Venous Pressure) of 1 mmHg and a BP of 88/50
mmHg. Which intervention is most appropriate?
A. Administering a diuretic
B. Starting a dopamine drip
C. Administering a rapid IV fluid bolus
D. Restricting oral fluids
Answer: C
