NSG 430: ADULT HEALTH NURSING II -
COMPREHENSIVE EXAM PREP 2027
1. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes the patient’s PaO2 is 58 mmHg despite an FiO2 of 80%. Which
intervention should the nurse anticipate next?
A. Decreasing the PEEP setting
B. Administering a bolus of IV crystalloids
C. Increasing the respiratory rate
D. Initiating prone positioning
Answer: D
Conceptual Explanation: Prone positioning is used in ARDS to improve oxygenation by
recruiting collapsed alveoli and improving ventilation-perfusion matching when high FiO2
levels are insufficient.
2. A patient in the ICU is being monitored with a pulmonary artery catheter. The Central
Venous Pressure (CVP) is 15 mmHg. Which clinical finding should the nurse expect?
A. Flat neck veins
,B. Poor skin turgor
C. Dry mucous membranes
D. Jugular venous distention
Answer: D
Conceptual Explanation: A normal CVP is 2-8 mmHg. A value of 15 mmHg indicates fluid
volume overload or right-sided heart failure, commonly manifested as jugular venous
distention.
3. The nurse is caring for a patient with a traumatic brain injury. The patient’s blood pressure
is 180/60 mmHg, heart rate is 48 bpm, and respirations are irregular. This set of vital signs is
indicative of:
A. Horner’s Syndrome
B. Beck’s Triad
C. Virchow’s Triad
D. Cushing’s Triad
Answer: D
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending brain
herniation.
, 4. Which lab value is the most definitive indicator of Acute Kidney Injury (AKI) in a critically ill
patient?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
C. Urine Specific Gravity
D. Serum Creatinine
Answer: D
Conceptual Explanation: Serum creatinine is a more specific indicator of kidney function
than BUN, as it is not as easily influenced by diet or hydration status.
5. A patient with full-thickness burns over 40% of their body is in the emergent phase. What
is the primary nursing priority?
A. Fluid resuscitation
B. Preventing infection
C. Pain management
D. Range of motion exercises
Answer: A
Conceptual Explanation: During the emergent (resuscitative) phase of burn care, the
massive fluid shift from the intravascular to the interstitial space makes fluid resuscitation
the highest priority to prevent hypovolemic shock.
COMPREHENSIVE EXAM PREP 2027
1. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes the patient’s PaO2 is 58 mmHg despite an FiO2 of 80%. Which
intervention should the nurse anticipate next?
A. Decreasing the PEEP setting
B. Administering a bolus of IV crystalloids
C. Increasing the respiratory rate
D. Initiating prone positioning
Answer: D
Conceptual Explanation: Prone positioning is used in ARDS to improve oxygenation by
recruiting collapsed alveoli and improving ventilation-perfusion matching when high FiO2
levels are insufficient.
2. A patient in the ICU is being monitored with a pulmonary artery catheter. The Central
Venous Pressure (CVP) is 15 mmHg. Which clinical finding should the nurse expect?
A. Flat neck veins
,B. Poor skin turgor
C. Dry mucous membranes
D. Jugular venous distention
Answer: D
Conceptual Explanation: A normal CVP is 2-8 mmHg. A value of 15 mmHg indicates fluid
volume overload or right-sided heart failure, commonly manifested as jugular venous
distention.
3. The nurse is caring for a patient with a traumatic brain injury. The patient’s blood pressure
is 180/60 mmHg, heart rate is 48 bpm, and respirations are irregular. This set of vital signs is
indicative of:
A. Horner’s Syndrome
B. Beck’s Triad
C. Virchow’s Triad
D. Cushing’s Triad
Answer: D
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure and impending brain
herniation.
, 4. Which lab value is the most definitive indicator of Acute Kidney Injury (AKI) in a critically ill
patient?
A. Blood Urea Nitrogen (BUN)
B. Serum Potassium
C. Urine Specific Gravity
D. Serum Creatinine
Answer: D
Conceptual Explanation: Serum creatinine is a more specific indicator of kidney function
than BUN, as it is not as easily influenced by diet or hydration status.
5. A patient with full-thickness burns over 40% of their body is in the emergent phase. What
is the primary nursing priority?
A. Fluid resuscitation
B. Preventing infection
C. Pain management
D. Range of motion exercises
Answer: A
Conceptual Explanation: During the emergent (resuscitative) phase of burn care, the
massive fluid shift from the intravascular to the interstitial space makes fluid resuscitation
the highest priority to prevent hypovolemic shock.
