NUR2790/NUR 2790 Exam 1 V3 |
Professional Nursing III / PN3 Q&A with
Rationale | Rasmussen University
1. A patient with a pH of 7.28, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L is most likely
experiencing which condition?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated above 45
mmHg, indicating a respiratory cause. The bicarbonate level remains within the normal
range, showing no compensation has occurred yet. This pattern is classic for acute
respiratory failure or hypoventilation.
2. Which clinical manifestation is most indicative of the compensatory stage of shock?
A. Decreased urine output and cold skin
B. Hypotension and bradycardia
C. Lethargy and metabolic acidosis
D. Increased heart rate and narrowed pulse pressure
,Answer: D
Rationale: In the compensatory stage of shock, the body attempts to maintain homeostasis
through the activation of the sympathetic nervous system. An increased heart rate helps
maintain cardiac output while vasoconstriction narrows the pulse pressure. These signs
indicate that the body is still successfully using its reserve mechanisms to support blood
pressure.
3. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Assess for kinks in the tubing or biting of the tube
B. Assess the patient for a possible pneumothorax
C. Suction the patient to clear secretions
D. Check for a leak in the ventilator circuit
Answer: A
Rationale: High-pressure alarms are triggered by resistance to air flow, which can be
caused by the patient biting the tube or a kink in the tubing. The nurse should quickly
inspect the circuit for physical obstructions before moving to more invasive interventions.
If the patient is biting the tube, a bite block may be necessary to maintain airway patency.
4. The Parkland formula is used to calculate fluid resuscitation for a burn patient. What is the
standard formula for the first 24 hours?
A. 2 mL x kg x %TBSA
, B. 4 mL x kg x %TBSA
C. 6 mL x kg x %TBSA
D. 8 mL x kg x %TBSA
Answer: B
Rationale: The Parkland formula specifically uses 4 mL of Lactated Ringer’s multiplied by
the patient’s weight in kilograms and the total body surface area percentage of the burn.
Half of this calculated volume is administered within the first 8 hours post-injury. The
remaining half is given over the subsequent 16 hours to ensure adequate hydration and
organ perfusion.
5. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which intervention
should the nurse anticipate?
A. Administration of a diuretic
B. Decreasing the IV infusion rate
C. Administration of an IV fluid bolus
D. Initiating a vasodilator infusion
Answer: C
Rationale: A normal CVP ranges from 2 to 8 mmHg, so a value of 1 mmHg suggests
hypovolemia or low preload. The nurse should anticipate fluid resuscitation to increase the
Professional Nursing III / PN3 Q&A with
Rationale | Rasmussen University
1. A patient with a pH of 7.28, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L is most likely
experiencing which condition?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated above 45
mmHg, indicating a respiratory cause. The bicarbonate level remains within the normal
range, showing no compensation has occurred yet. This pattern is classic for acute
respiratory failure or hypoventilation.
2. Which clinical manifestation is most indicative of the compensatory stage of shock?
A. Decreased urine output and cold skin
B. Hypotension and bradycardia
C. Lethargy and metabolic acidosis
D. Increased heart rate and narrowed pulse pressure
,Answer: D
Rationale: In the compensatory stage of shock, the body attempts to maintain homeostasis
through the activation of the sympathetic nervous system. An increased heart rate helps
maintain cardiac output while vasoconstriction narrows the pulse pressure. These signs
indicate that the body is still successfully using its reserve mechanisms to support blood
pressure.
3. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Assess for kinks in the tubing or biting of the tube
B. Assess the patient for a possible pneumothorax
C. Suction the patient to clear secretions
D. Check for a leak in the ventilator circuit
Answer: A
Rationale: High-pressure alarms are triggered by resistance to air flow, which can be
caused by the patient biting the tube or a kink in the tubing. The nurse should quickly
inspect the circuit for physical obstructions before moving to more invasive interventions.
If the patient is biting the tube, a bite block may be necessary to maintain airway patency.
4. The Parkland formula is used to calculate fluid resuscitation for a burn patient. What is the
standard formula for the first 24 hours?
A. 2 mL x kg x %TBSA
, B. 4 mL x kg x %TBSA
C. 6 mL x kg x %TBSA
D. 8 mL x kg x %TBSA
Answer: B
Rationale: The Parkland formula specifically uses 4 mL of Lactated Ringer’s multiplied by
the patient’s weight in kilograms and the total body surface area percentage of the burn.
Half of this calculated volume is administered within the first 8 hours post-injury. The
remaining half is given over the subsequent 16 hours to ensure adequate hydration and
organ perfusion.
5. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which intervention
should the nurse anticipate?
A. Administration of a diuretic
B. Decreasing the IV infusion rate
C. Administration of an IV fluid bolus
D. Initiating a vasodilator infusion
Answer: C
Rationale: A normal CVP ranges from 2 to 8 mmHg, so a value of 1 mmHg suggests
hypovolemia or low preload. The nurse should anticipate fluid resuscitation to increase the
