NR341/NR 341 Exam 3 V2 | Complex Adult Health
Q&A with Rationale | Chamberlain University
1. A patient is admitted with suspected Septic Shock. Which of the following hemodynamic
parameters would the nurse expect to find during the early (hyperdynamic) phase?
A. Decreased cardiac output and increased systemic vascular resistance (SVR).
B. Increased cardiac output and decreased systemic vascular resistance (SVR).
C. Increased pulmonary capillary wedge pressure (PCWP) and bradycardia.
D. Decreased central venous pressure (CVP) and hypertension.
Correct Answer: B
Explanation: In the early or ‘warm’ phase of septic shock, the body attempts to
compensate for massive vasodilation by increasing cardiac output. The systemic vascular
resistance (SVR) decreases significantly due to the inflammatory mediators causing
peripheral vasodilation. This phase is characterized by warm, flushed skin and a high-flow,
low-resistance state.
2. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS) on a
ventilator. Which setting is specifically used to prevent alveolar collapse at the end of
expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
,C. Tidal Volume (Vt)
D. Inspiratory Flow Rate
Correct Answer: A
Explanation: Positive End-Expiratory Pressure (PEEP) provides a set amount of pressure
in the lungs at the end of the respiratory cycle. This pressure keeps the alveoli open, which
improves gas exchange and prevents atelectasis in patients with ARDS. High levels of PEEP
are often required in ARDS, though the nurse must monitor for complications like
barotrauma.
3. A patient has suffered full-thickness burns to 40% of their Total Body Surface Area (TBSA).
Using the Parkland formula (4mL/kg/%TBSA), if the patient weighs 70kg, how much fluid
should be administered in the first 8 hours?
A. 11,200 mL
B. 2,800 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Explanation: The total fluid requirement for 24 hours is calculated as 4 mL 70 kg 40 =
11,200 mL. According to the Parkland formula, half of this total volume must be
administered within the first 8 hours from the time of the burn injury. Therefore, 11,200
divided by 2 equals 5,600 mL to be infused in the initial 8-hour window.
, 4. The nurse identifies that a patient with a T4 spinal cord injury is experiencing a sudden
onset of a severe headache, blurred vision, and a blood pressure of 190/100 mmHg. What is
the priority nursing action?
A. Administer PRN antihypertensive medication immediately.
B. Place the patient in a sitting position and check the bladder for distention.
C. Assess the patient’s temperature for signs of infection.
D. Perform a neurological assessment including Glasgow Coma Scale.
Correct Answer: B
Explanation: The patient is exhibiting classic signs of autonomic dysreflexia, which occurs
in patients with spinal cord injuries at T6 or above. The first priority is to sit the patient up
to lower blood pressure and identify the trigger, which is frequently a distended bladder or
impacted bowel. Relieving the stimulus is the definitive treatment to prevent complications
like cerebral hemorrhage.
5. A patient with a head injury has a documented intracranial pressure (ICP) of 22 mmHg and
a Mean Arterial Pressure (MAP) of 70 mmHg. What is the calculated Cerebral Perfusion
Pressure (CPP)?
A. 92 mmHg
B. 48 mmHg
C. 1.47 mmHg
D. 60 mmHg
Q&A with Rationale | Chamberlain University
1. A patient is admitted with suspected Septic Shock. Which of the following hemodynamic
parameters would the nurse expect to find during the early (hyperdynamic) phase?
A. Decreased cardiac output and increased systemic vascular resistance (SVR).
B. Increased cardiac output and decreased systemic vascular resistance (SVR).
C. Increased pulmonary capillary wedge pressure (PCWP) and bradycardia.
D. Decreased central venous pressure (CVP) and hypertension.
Correct Answer: B
Explanation: In the early or ‘warm’ phase of septic shock, the body attempts to
compensate for massive vasodilation by increasing cardiac output. The systemic vascular
resistance (SVR) decreases significantly due to the inflammatory mediators causing
peripheral vasodilation. This phase is characterized by warm, flushed skin and a high-flow,
low-resistance state.
2. A nurse is caring for a patient with Acute Respiratory Distress Syndrome (ARDS) on a
ventilator. Which setting is specifically used to prevent alveolar collapse at the end of
expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of Inspired Oxygen (FiO2)
,C. Tidal Volume (Vt)
D. Inspiratory Flow Rate
Correct Answer: A
Explanation: Positive End-Expiratory Pressure (PEEP) provides a set amount of pressure
in the lungs at the end of the respiratory cycle. This pressure keeps the alveoli open, which
improves gas exchange and prevents atelectasis in patients with ARDS. High levels of PEEP
are often required in ARDS, though the nurse must monitor for complications like
barotrauma.
3. A patient has suffered full-thickness burns to 40% of their Total Body Surface Area (TBSA).
Using the Parkland formula (4mL/kg/%TBSA), if the patient weighs 70kg, how much fluid
should be administered in the first 8 hours?
A. 11,200 mL
B. 2,800 mL
C. 5,600 mL
D. 8,400 mL
Correct Answer: C
Explanation: The total fluid requirement for 24 hours is calculated as 4 mL 70 kg 40 =
11,200 mL. According to the Parkland formula, half of this total volume must be
administered within the first 8 hours from the time of the burn injury. Therefore, 11,200
divided by 2 equals 5,600 mL to be infused in the initial 8-hour window.
, 4. The nurse identifies that a patient with a T4 spinal cord injury is experiencing a sudden
onset of a severe headache, blurred vision, and a blood pressure of 190/100 mmHg. What is
the priority nursing action?
A. Administer PRN antihypertensive medication immediately.
B. Place the patient in a sitting position and check the bladder for distention.
C. Assess the patient’s temperature for signs of infection.
D. Perform a neurological assessment including Glasgow Coma Scale.
Correct Answer: B
Explanation: The patient is exhibiting classic signs of autonomic dysreflexia, which occurs
in patients with spinal cord injuries at T6 or above. The first priority is to sit the patient up
to lower blood pressure and identify the trigger, which is frequently a distended bladder or
impacted bowel. Relieving the stimulus is the definitive treatment to prevent complications
like cerebral hemorrhage.
5. A patient with a head injury has a documented intracranial pressure (ICP) of 22 mmHg and
a Mean Arterial Pressure (MAP) of 70 mmHg. What is the calculated Cerebral Perfusion
Pressure (CPP)?
A. 92 mmHg
B. 48 mmHg
C. 1.47 mmHg
D. 60 mmHg
