NURS 354 QUIZ 1 QUESTIONS AND
ANSWERS 2026 VERIFIED
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with High Positive End-Expiratory Pressure (PEEP). The nurse should monitor for
which significant complication?
A. Increased cardiac output
B. Respiratory alkalosis
C. Pneumothorax due to barotrauma
D. Decreased intracranial pressure
Answer: C
Conceptual Explanation: High PEEP levels increase the risk of barotrauma, which can lead
to a pneumothorax by overdistending the alveoli. It also typically decreases cardiac output
by increasing intrathoracic pressure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of a
massive pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 28
,D. pH 7.25, PaCO2 35, HCO3 18
Answer: B
Conceptual Explanation: Early pulmonary embolism causes tachypnea and
hyperventilation as the body tries to compensate for hypoxia, leading to respiratory
alkalosis (high pH, low PaCO2).
3. A patient with a history of Chronic Heart Failure presents with an S3 gallop, peripheral
edema, and jugular venous distention. Which medication class is the priority for immediate
preload reduction?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Loop diuretics
Answer: D
Conceptual Explanation: Loop diuretics like Furosemide are the first-line treatment for
acute fluid overload in heart failure to reduce preload quickly.
4. In a patient with Increased Intracranial Pressure (ICP), which of the following nursing
interventions is contraindicated?
A. Maintaining the head of the bed at 30 degrees
B. Clustering nursing activities to provide rest
, C. Hyperflexion of the hips
D. Maintaining neutral neck alignment
Answer: C
Conceptual Explanation: Hyperflexion of the hips increases intra-abdominal and
intrathoracic pressure, which can impede venous return from the brain and further
increase ICP.
5. A patient in the ICU develops Torsades de Pointes. The nurse should anticipate the
administration of which medication?
A. Amiodarone
B. Magnesium Sulfate
C. Atropine
D. Epinephrine
Answer: B
Conceptual Explanation: Magnesium Sulfate is the treatment of choice for Torsades de
Pointes, a specific type of polymorphic ventricular tachycardia.
6. Which laboratory value is the most sensitive indicator of Acute Kidney Injury (AKI) in a
critically ill patient?
A. Glomerular Filtration Rate (GFR)
B. Blood Urea Nitrogen (BUN)
ANSWERS 2026 VERIFIED
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with High Positive End-Expiratory Pressure (PEEP). The nurse should monitor for
which significant complication?
A. Increased cardiac output
B. Respiratory alkalosis
C. Pneumothorax due to barotrauma
D. Decreased intracranial pressure
Answer: C
Conceptual Explanation: High PEEP levels increase the risk of barotrauma, which can lead
to a pneumothorax by overdistending the alveoli. It also typically decreases cardiac output
by increasing intrathoracic pressure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of a
massive pulmonary embolism?
A. pH 7.30, PaCO2 50, HCO3 24
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.35, PaCO2 45, HCO3 28
,D. pH 7.25, PaCO2 35, HCO3 18
Answer: B
Conceptual Explanation: Early pulmonary embolism causes tachypnea and
hyperventilation as the body tries to compensate for hypoxia, leading to respiratory
alkalosis (high pH, low PaCO2).
3. A patient with a history of Chronic Heart Failure presents with an S3 gallop, peripheral
edema, and jugular venous distention. Which medication class is the priority for immediate
preload reduction?
A. Beta-blockers
B. Calcium channel blockers
C. ACE inhibitors
D. Loop diuretics
Answer: D
Conceptual Explanation: Loop diuretics like Furosemide are the first-line treatment for
acute fluid overload in heart failure to reduce preload quickly.
4. In a patient with Increased Intracranial Pressure (ICP), which of the following nursing
interventions is contraindicated?
A. Maintaining the head of the bed at 30 degrees
B. Clustering nursing activities to provide rest
, C. Hyperflexion of the hips
D. Maintaining neutral neck alignment
Answer: C
Conceptual Explanation: Hyperflexion of the hips increases intra-abdominal and
intrathoracic pressure, which can impede venous return from the brain and further
increase ICP.
5. A patient in the ICU develops Torsades de Pointes. The nurse should anticipate the
administration of which medication?
A. Amiodarone
B. Magnesium Sulfate
C. Atropine
D. Epinephrine
Answer: B
Conceptual Explanation: Magnesium Sulfate is the treatment of choice for Torsades de
Pointes, a specific type of polymorphic ventricular tachycardia.
6. Which laboratory value is the most sensitive indicator of Acute Kidney Injury (AKI) in a
critically ill patient?
A. Glomerular Filtration Rate (GFR)
B. Blood Urea Nitrogen (BUN)
