NR341/NR 341 Final Exam V2 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which clinical finding should the nurse expect to assess?
A. Bilateral crackles in the lungs
B. Flat neck veins
C. Decreased skin turgor
D. Hypotension and tachycardia
Correct Answer: A
Explanation: A normal PAWP range is 6 to 12 mmHg, and an elevation to 22 mmHg
indicates left-sided heart failure or fluid overload. This increased pressure causes fluid to
back up into the pulmonary system, leading to pulmonary edema and crackles. The nurse
must prioritize respiratory assessment and potential diuretic administration.
2. The nurse is caring for a patient in the compensatory stage of shock. Which finding
indicates the body’s attempt to maintain homeostasis?
A. Anuria
B. Metabolic acidosis
C. Increased heart rate
,D. Lethargy
Correct Answer: C
Explanation: In the compensatory stage of shock, the sympathetic nervous system is
activated to maintain cardiac output and blood pressure. Tachycardia is a primary
compensatory mechanism resulting from catecholamine release. If the underlying cause is
not treated, the patient will eventually progress to the progressive stage where these
mechanisms fail.
3. A patient with ARDS is placed on mechanical ventilation with High-Level PEEP. What is the
most important complication the nurse should monitor for?
A. Respiratory alkalosis
B. Increased cardiac output
C. Hypothermia
D. Pneumothorax
Correct Answer: D
Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase
intrathoracic pressure, which can lead to barotrauma and a pneumothorax. Additionally,
high PEEP can decrease venous return to the heart, leading to a drop in cardiac output and
hypotension. Frequent lung sound assessments and monitoring of hemodynamic stability
are essential nursing interventions.
, 4. Which laboratory result is most consistent with a diagnosis of Disseminated Intravascular
Coagulation (DIC)?
A. Decreased D-dimer
B. Increased Fibrin Degradation Products (FDPs)
C. Increased Fibrinogen
D. Increased Platelet count
Correct Answer: B
Explanation: DIC involves the simultaneous formation of microclots and the depletion of
clotting factors, leading to excessive bleeding. Elevated FDPs and D-dimers occur as the
body attempts to break down these many small clots. Treatment focuses on addressing the
underlying cause while managing hemorrhage and clotting complications.
5. A patient is admitted with Acute Pancreatitis. Which position is likely to provide the most
pain relief for this patient?
A. Supine with legs extended
B. High-Fowler’s position
C. Side-lying with knees flexed (fetal position)
D. Trendelenburg position
Correct Answer: C
Health Q&A with Rationale | Chamberlain
University
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 22 mmHg. Which clinical finding should the nurse expect to assess?
A. Bilateral crackles in the lungs
B. Flat neck veins
C. Decreased skin turgor
D. Hypotension and tachycardia
Correct Answer: A
Explanation: A normal PAWP range is 6 to 12 mmHg, and an elevation to 22 mmHg
indicates left-sided heart failure or fluid overload. This increased pressure causes fluid to
back up into the pulmonary system, leading to pulmonary edema and crackles. The nurse
must prioritize respiratory assessment and potential diuretic administration.
2. The nurse is caring for a patient in the compensatory stage of shock. Which finding
indicates the body’s attempt to maintain homeostasis?
A. Anuria
B. Metabolic acidosis
C. Increased heart rate
,D. Lethargy
Correct Answer: C
Explanation: In the compensatory stage of shock, the sympathetic nervous system is
activated to maintain cardiac output and blood pressure. Tachycardia is a primary
compensatory mechanism resulting from catecholamine release. If the underlying cause is
not treated, the patient will eventually progress to the progressive stage where these
mechanisms fail.
3. A patient with ARDS is placed on mechanical ventilation with High-Level PEEP. What is the
most important complication the nurse should monitor for?
A. Respiratory alkalosis
B. Increased cardiac output
C. Hypothermia
D. Pneumothorax
Correct Answer: D
Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase
intrathoracic pressure, which can lead to barotrauma and a pneumothorax. Additionally,
high PEEP can decrease venous return to the heart, leading to a drop in cardiac output and
hypotension. Frequent lung sound assessments and monitoring of hemodynamic stability
are essential nursing interventions.
, 4. Which laboratory result is most consistent with a diagnosis of Disseminated Intravascular
Coagulation (DIC)?
A. Decreased D-dimer
B. Increased Fibrin Degradation Products (FDPs)
C. Increased Fibrinogen
D. Increased Platelet count
Correct Answer: B
Explanation: DIC involves the simultaneous formation of microclots and the depletion of
clotting factors, leading to excessive bleeding. Elevated FDPs and D-dimers occur as the
body attempts to break down these many small clots. Treatment focuses on addressing the
underlying cause while managing hemorrhage and clotting complications.
5. A patient is admitted with Acute Pancreatitis. Which position is likely to provide the most
pain relief for this patient?
A. Supine with legs extended
B. High-Fowler’s position
C. Side-lying with knees flexed (fetal position)
D. Trendelenburg position
Correct Answer: C
