NR 341 EXAM 2 (FINAL) STUDY GUIDE
2026/2027 UPDATE |ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS
[100% CORRECT] ALREADY GRADED A+
1. After a patient with septic shock receives 2 L of normal saline, the central
venous pressure (CVP) is 10 mmHg and blood pressure is 82/40 mmHg.
Which medication should the nurse anticipate?
A) Dobutamine
B) Norepinephrine
C) Epinephrine
D) Vasopressin
Answer B: Norepinephrine
Rationale: Fluid resuscitation alone is insufficient; norepinephrine is the first-line
vasopressor for septic shock to restore MAP ≥65 mmHg.
2. The nurse is monitoring a patient with cardiogenic shock. Which
hemodynamic parameter is most indicative of left-sided heart failure?
A) Central venous pressure (CVP) 8 mmHg
B) Pulmonary artery wedge pressure (PAWP) 22 mmHg
C) Cardiac index (CI) 3.0 L/min/m²
,D) Systemic vascular resistance (SVR) 800 dynes/sec/cm⁻⁵
Answer B: Pulmonary artery wedge pressure (PAWP) 22 mmHg
Rationale: PAWP reflects left ventricular filling pressure; >18 mmHg indicates left-
sided heart failure.
3. A patient with neurogenic shock from a spinal cord injury at T6 presents
with bradycardia and hypotension. The nurse understands that the primary
cause of hypotension in this condition is:
A) Myocardial depression
B) Loss of sympathetic tone leading to vasodilation
C) Hypovolemia
D) Increased vagal tone
Answer B: Loss of sympathetic tone leading to vasodilation
Rationale: Neurogenic shock causes loss of sympathetic outflow, leading to
vasodilation and relative hypovolemia.
4. The nurse is caring for a patient in septic shock. Which finding indicates
that the patient's condition is improving?
A) Serum lactate 4.0 mmol/L
B) Central venous oxygen saturation (ScvO₂) 72%
C) Mean arterial pressure (MAP) 60 mmHg
D) Urine output 20 mL/hr
Answer B: Central venous oxygen saturation (ScvO₂) 72%
,Rationale: ScvO₂ ≥70% indicates adequate tissue oxygenation and perfusion.
5. The nurse is preparing to administer a vasopressor via a central line. Which
medication requires a central line due to risk of extravasation?
A) Dobutamine
B) Norepinephrine
C) Milrinone
D) Nitroglycerin
Answer B: Norepinephrine
Rationale: Norepinephrine is a potent vasoconstrictor; extravasation causes tissue
necrosis and requires a central line.
6. A patient with a pulmonary artery catheter has a pulmonary artery wedge
pressure (PAWP) of 6 mmHg. The nurse interprets this as:
A) Fluid overload
B) Hypovolemia
C) Left-sided heart failure
D) Pulmonary hypertension
Answer B: Hypovolemia
Rationale: Normal PAWP is 4-12 mmHg; low PAWP (<8 mmHg) indicates
hypovolemia.
, 7. The nurse is assessing a patient in hypovolemic shock. Which finding is
most consistent?
A) Jugular venous distention
B) Tachycardia and decreased urine output
C) Crackles in bilateral lung bases
D) Bounding pulses
Answer B: Tachycardia and decreased urine output
Rationale: Hypovolemia causes compensatory tachycardia and decreased
perfusion to kidneys.
8. Which vasoactive medication is indicated for a patient with cardiogenic
shock and low cardiac output?
A) Norepinephrine
B) Dobutamine
C) Phenylephrine
D) Vasopressin
Answer B: Dobutamine
Rationale: Dobutamine is a positive inotrope that increases cardiac contractility
and improves cardiac output.
9. A patient with septic shock is prescribed norepinephrine. The nurse
monitors for which adverse effect?
A) Bradycardia
2026/2027 UPDATE |ACTUAL EXAM
QUESTIONS AND VERIFIED ANSWERS
[100% CORRECT] ALREADY GRADED A+
1. After a patient with septic shock receives 2 L of normal saline, the central
venous pressure (CVP) is 10 mmHg and blood pressure is 82/40 mmHg.
Which medication should the nurse anticipate?
A) Dobutamine
B) Norepinephrine
C) Epinephrine
D) Vasopressin
Answer B: Norepinephrine
Rationale: Fluid resuscitation alone is insufficient; norepinephrine is the first-line
vasopressor for septic shock to restore MAP ≥65 mmHg.
2. The nurse is monitoring a patient with cardiogenic shock. Which
hemodynamic parameter is most indicative of left-sided heart failure?
A) Central venous pressure (CVP) 8 mmHg
B) Pulmonary artery wedge pressure (PAWP) 22 mmHg
C) Cardiac index (CI) 3.0 L/min/m²
,D) Systemic vascular resistance (SVR) 800 dynes/sec/cm⁻⁵
Answer B: Pulmonary artery wedge pressure (PAWP) 22 mmHg
Rationale: PAWP reflects left ventricular filling pressure; >18 mmHg indicates left-
sided heart failure.
3. A patient with neurogenic shock from a spinal cord injury at T6 presents
with bradycardia and hypotension. The nurse understands that the primary
cause of hypotension in this condition is:
A) Myocardial depression
B) Loss of sympathetic tone leading to vasodilation
C) Hypovolemia
D) Increased vagal tone
Answer B: Loss of sympathetic tone leading to vasodilation
Rationale: Neurogenic shock causes loss of sympathetic outflow, leading to
vasodilation and relative hypovolemia.
4. The nurse is caring for a patient in septic shock. Which finding indicates
that the patient's condition is improving?
A) Serum lactate 4.0 mmol/L
B) Central venous oxygen saturation (ScvO₂) 72%
C) Mean arterial pressure (MAP) 60 mmHg
D) Urine output 20 mL/hr
Answer B: Central venous oxygen saturation (ScvO₂) 72%
,Rationale: ScvO₂ ≥70% indicates adequate tissue oxygenation and perfusion.
5. The nurse is preparing to administer a vasopressor via a central line. Which
medication requires a central line due to risk of extravasation?
A) Dobutamine
B) Norepinephrine
C) Milrinone
D) Nitroglycerin
Answer B: Norepinephrine
Rationale: Norepinephrine is a potent vasoconstrictor; extravasation causes tissue
necrosis and requires a central line.
6. A patient with a pulmonary artery catheter has a pulmonary artery wedge
pressure (PAWP) of 6 mmHg. The nurse interprets this as:
A) Fluid overload
B) Hypovolemia
C) Left-sided heart failure
D) Pulmonary hypertension
Answer B: Hypovolemia
Rationale: Normal PAWP is 4-12 mmHg; low PAWP (<8 mmHg) indicates
hypovolemia.
, 7. The nurse is assessing a patient in hypovolemic shock. Which finding is
most consistent?
A) Jugular venous distention
B) Tachycardia and decreased urine output
C) Crackles in bilateral lung bases
D) Bounding pulses
Answer B: Tachycardia and decreased urine output
Rationale: Hypovolemia causes compensatory tachycardia and decreased
perfusion to kidneys.
8. Which vasoactive medication is indicated for a patient with cardiogenic
shock and low cardiac output?
A) Norepinephrine
B) Dobutamine
C) Phenylephrine
D) Vasopressin
Answer B: Dobutamine
Rationale: Dobutamine is a positive inotrope that increases cardiac contractility
and improves cardiac output.
9. A patient with septic shock is prescribed norepinephrine. The nurse
monitors for which adverse effect?
A) Bradycardia
