GALEN NUR 283 COMP 1–3 EXAMS
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A client in the ICU is on a ventilator and the high-pressure alarm sounds. Which action
should the nurse take first?
A. Check for a leak in the ventilator circuit.
B. Increase the oxygen concentration to 100%.
C. Auscultate the client’s breath sounds for a potential pneumothorax.
D. Assess the client and suction the airway for secretions.
Answer: D
Conceptual Explanation: High-pressure alarms are commonly triggered by secretions,
biting the tube, or kinks. The nurse should first assess the client and suction if needed to
clear the airway.
2. A client with Acute Respiratory Distress Syndrome (ARDS) is positioned in the prone
position. What is the primary rationale for this intervention?
A. To reduce the workload of the diaphragm during inspiration.
B. To decrease the risk of aspiration pneumonia.
,C. To facilitate easier suctioning of bronchial secretions.
D. To improve oxygenation by recruiting dormant alveoli in the posterior lung fields.
Answer: D
Conceptual Explanation: Prone positioning in ARDS helps shift perfusion to
underventilated lung areas and recruits posterior alveoli, thereby improving V/Q matching
and oxygenation.
3. The nurse is interpreting ABG results for a patient: pH 7.31, PaCO2 52 mmHg, HCO3 28
mEq/L. Which acid-base imbalance is present?
A. Partially Compensated Respiratory Acidosis
B. Uncompensated Metabolic Acidosis
C. Fully Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high (attempting to compensate), but the pH has not returned to normal,
indicating partial compensation.
4. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this finding indicate?
A. The suction is set to the correct level.
, B. There is an air leak in the system or the client’s pleural space.
C. The lung has fully re-expanded.
D. This is a normal finding during the expiratory phase.
Answer: B
Conceptual Explanation: Intermittent bubbling is normal in a pneumothorax, but
continuous bubbling in the water-seal chamber indicates a persistent air leak that requires
troubleshooting.
5. Which assessment finding is the most sensitive early indicator of increased intracranial
pressure (ICP)?
A. Change in the level of consciousness
B. Fixed and dilated pupils
C. Cushing’s Triad (bradycardia, hypertension, irregular respirations)
D. Decerebrate posturing
Answer: A
Conceptual Explanation: A change in the level of consciousness (restlessness, irritability,
or lethargy) is the earliest and most sensitive sign of neurological deterioration due to
increased ICP.
COMPREHENSIVE REVIEW QUESTIONS
AND ANSWERS
1. A client in the ICU is on a ventilator and the high-pressure alarm sounds. Which action
should the nurse take first?
A. Check for a leak in the ventilator circuit.
B. Increase the oxygen concentration to 100%.
C. Auscultate the client’s breath sounds for a potential pneumothorax.
D. Assess the client and suction the airway for secretions.
Answer: D
Conceptual Explanation: High-pressure alarms are commonly triggered by secretions,
biting the tube, or kinks. The nurse should first assess the client and suction if needed to
clear the airway.
2. A client with Acute Respiratory Distress Syndrome (ARDS) is positioned in the prone
position. What is the primary rationale for this intervention?
A. To reduce the workload of the diaphragm during inspiration.
B. To decrease the risk of aspiration pneumonia.
,C. To facilitate easier suctioning of bronchial secretions.
D. To improve oxygenation by recruiting dormant alveoli in the posterior lung fields.
Answer: D
Conceptual Explanation: Prone positioning in ARDS helps shift perfusion to
underventilated lung areas and recruits posterior alveoli, thereby improving V/Q matching
and oxygenation.
3. The nurse is interpreting ABG results for a patient: pH 7.31, PaCO2 52 mmHg, HCO3 28
mEq/L. Which acid-base imbalance is present?
A. Partially Compensated Respiratory Acidosis
B. Uncompensated Metabolic Acidosis
C. Fully Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high (attempting to compensate), but the pH has not returned to normal,
indicating partial compensation.
4. A client with a chest tube has continuous bubbling in the water-seal chamber. What does
this finding indicate?
A. The suction is set to the correct level.
, B. There is an air leak in the system or the client’s pleural space.
C. The lung has fully re-expanded.
D. This is a normal finding during the expiratory phase.
Answer: B
Conceptual Explanation: Intermittent bubbling is normal in a pneumothorax, but
continuous bubbling in the water-seal chamber indicates a persistent air leak that requires
troubleshooting.
5. Which assessment finding is the most sensitive early indicator of increased intracranial
pressure (ICP)?
A. Change in the level of consciousness
B. Fixed and dilated pupils
C. Cushing’s Triad (bradycardia, hypertension, irregular respirations)
D. Decerebrate posturing
Answer: A
Conceptual Explanation: A change in the level of consciousness (restlessness, irritability,
or lethargy) is the earliest and most sensitive sign of neurological deterioration due to
increased ICP.
