NUR 283 ADVANCED MEDICAL-
SURGICAL COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A patient in the ICU is being monitored for cardiogenic shock. Which hemodynamic
measurement most accurately reflects the increased left ventricular end-diastolic pressure
characteristic of this condition?
A. Central Venous Pressure (CVP)
B. Cardiac Index (CI)
C. Mean Arterial Pressure (MAP)
D. Pulmonary Artery Wedge Pressure (PAWP)
Answer: D
Conceptual Explanation: PAWP is a reliable indicator of left ventricular function and end-
diastolic pressure. In cardiogenic shock, PAWP increases as the heart fails to pump
effectively, leading to backup into the pulmonary system.
,2. A 70kg patient presents with partial-thickness burns to the entire anterior trunk and the
entire right arm. Using the Parkland Formula, calculate the total fluid volume required for the
first 8 hours of resuscitation.
A. 3,780 mL
B. 7,560 mL
C. 5,400 mL
D. 3,150 mL
Answer: A
Conceptual Explanation: Anterior trunk (18%) + Right arm (9%) = 27% TBSA. Parkland
formula: 4mL x 70kg x 27 = 7,560 mL total for 24 hours. The first half (3,780 mL) is given
over the first 8 hours.
3. Which assessment finding is pathognomonic for the early stage of neurogenic shock
compared to other types of distributive shock?
A. Tachycardia
B. Hypotension
C. Bradycardia
D. Cool, clammy skin
Answer: C
, Conceptual Explanation: Neurogenic shock results from the loss of sympathetic tone,
leading to parasympathetic dominance, which causes bradycardia. Most other shocks
present with compensatory tachycardia.
4. A patient with a traumatic brain injury (TBI) exhibits a widening pulse pressure,
bradycardia, and irregular respirations. The nurse recognizes this as which of the following?
A. Cushing’s Triad
B. Beck’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: A
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
(ICP) and indicates imminent brain herniation.
5. During a mass casualty incident (MCI), a triage nurse assesses a victim with a traumatic
amputation of the lower leg who is unconscious and has a respiratory rate of 8. Which color
tag should be assigned?
A. Red
B. Yellow
C. Green
D. Black
SURGICAL COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
1. A patient in the ICU is being monitored for cardiogenic shock. Which hemodynamic
measurement most accurately reflects the increased left ventricular end-diastolic pressure
characteristic of this condition?
A. Central Venous Pressure (CVP)
B. Cardiac Index (CI)
C. Mean Arterial Pressure (MAP)
D. Pulmonary Artery Wedge Pressure (PAWP)
Answer: D
Conceptual Explanation: PAWP is a reliable indicator of left ventricular function and end-
diastolic pressure. In cardiogenic shock, PAWP increases as the heart fails to pump
effectively, leading to backup into the pulmonary system.
,2. A 70kg patient presents with partial-thickness burns to the entire anterior trunk and the
entire right arm. Using the Parkland Formula, calculate the total fluid volume required for the
first 8 hours of resuscitation.
A. 3,780 mL
B. 7,560 mL
C. 5,400 mL
D. 3,150 mL
Answer: A
Conceptual Explanation: Anterior trunk (18%) + Right arm (9%) = 27% TBSA. Parkland
formula: 4mL x 70kg x 27 = 7,560 mL total for 24 hours. The first half (3,780 mL) is given
over the first 8 hours.
3. Which assessment finding is pathognomonic for the early stage of neurogenic shock
compared to other types of distributive shock?
A. Tachycardia
B. Hypotension
C. Bradycardia
D. Cool, clammy skin
Answer: C
, Conceptual Explanation: Neurogenic shock results from the loss of sympathetic tone,
leading to parasympathetic dominance, which causes bradycardia. Most other shocks
present with compensatory tachycardia.
4. A patient with a traumatic brain injury (TBI) exhibits a widening pulse pressure,
bradycardia, and irregular respirations. The nurse recognizes this as which of the following?
A. Cushing’s Triad
B. Beck’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: A
Conceptual Explanation: Cushing’s Triad is a late sign of increased intracranial pressure
(ICP) and indicates imminent brain herniation.
5. During a mass casualty incident (MCI), a triage nurse assesses a victim with a traumatic
amputation of the lower leg who is unconscious and has a respiratory rate of 8. Which color
tag should be assigned?
A. Red
B. Yellow
C. Green
D. Black
