NUR 160 QUIZ AND ANSWERS A+ GRADED WITH
EXPERT SOLUTIONS - 120 Questions with Answers
Page 1
,Q1. A patient with septic shock has a pulmonary artery catheter. Which
hemodynamic pattern is most consistent with this condition?
A. High cardiac output, low systemic vascular resistance, low pulmonary capillary
wedge pressure
B. Low cardiac output, high systemic vascular resistance, high pulmonary capillary
wedge pressure
C. Low cardiac output, low systemic vascular resistance, low pulmonary capillary
wedge pressure
D. High cardiac output, low systemic vascular resistance, high pulmonary capillary
wedge pressure
Correct Answer: A. High cardiac output, low systemic vascular resistance, low
pulmonary capillary wedge pressure
Rationale: Septic shock typically presents with a hyperdynamic state: increased cardiac
output, decreased systemic vascular resistance (due to vasodilation), and low filling
pressures (PCWP) due to relative hypovolemia. Low SVR and low PCWP with high CO
are classic.
Why Wrong:
B - This pattern suggests cardiogenic shock with high SVR and elevated PCWP.
C - Low CO with low SVR is not typical; septic shock usually has high CO.
D - High PCWP is not expected in early septic shock; it indicates volume overload or
left heart failure.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2022). Critical Care Nursing, 9th
Ed., Ch. 9.
Q2. A nurse is caring for a patient with syndrome of inappropriate antidiuretic
hormone (SIADH) who has a serum sodium of 120 mEq/L. Which intravenous fluid
should the nurse question?
A. 0.9% sodium chloride at 50 mL/hr
B. 3% sodium chloride at 25 mL/hr
C. 0.45% sodium chloride at 100 mL/hr
D. Lactated Ringer's at 75 mL/hr
Correct Answer: C. 0.45% sodium chloride at 100 mL/hr
Rationale: In SIADH, patients are euvolemic with dilutional hyponatremia. Hypotonic
fluids like 0.45% saline worsen hyponatremia and should be avoided. Hypertonic saline is
used for severe symptoms, and isotonic saline is appropriate for slow correction.
Why Wrong:
A - 0.9% saline is isotonic and may be used for slow correction, though not ideal in all
cases.
B - 3% saline is indicated for severe hyponatremia with neurologic symptoms, not
Page 2
, contraindicated.
D - Lactated Ringer's is isotonic and not as harmful as hypotonic fluids, though it
contains potassium.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 51.
Q3. A patient on mechanical ventilation has a sudden increase in peak airway
pressure with no change in plateau pressure. Which condition is the most likely
cause?
A. Pneumothorax
B. Bronchospasm
C. Pulmonary edema
D. Mainstem intubation
Correct Answer: B. Bronchospasm
Rationale: An increase in peak pressure with unchanged plateau pressure indicates
increased airway resistance, such as bronchospasm, secretions, or kinked tubing.
Conditions like pneumothorax or pulmonary edema increase both peak and plateau
pressures (decreased compliance).
Why Wrong:
A - Pneumothorax decreases compliance, raising both peak and plateau pressures.
C - Pulmonary edema decreases compliance, raising both pressures.
D - Mainstem intubation would also decrease compliance, raising plateau pressure.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2022). Critical Care Nursing, 9th
Ed., Ch. 27.
Q4. Which medication requires the nurse to assess for QT interval prolongation
before administration?
A. Ondansetron
B. Metoprolol
C. Lorazepam
D. Acetaminophen
Correct Answer: A. Ondansetron
Rationale: Ondansetron (a 5-HT3 antagonist) is known to prolong the QT interval,
increasing the risk of torsades de pointes. Metoprolol, lorazepam, and acetaminophen do
not have significant QT-prolonging effects.
Why Wrong:
B - Metoprolol is a beta-blocker that can cause bradycardia but not QT prolongation.
C - Lorazepam is a benzodiazepine with no known QT effects.
D - Acetaminophen does not affect cardiac conduction.
Page 3
, Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 45.
Q5. A patient with acute pancreatitis has a serum calcium of 7.2 mg/dL and a positive
Chvostek sign. Which additional finding is most consistent with this condition?
A. Prolonged QT interval on ECG
B. Negative Trousseau sign
C. Hyperactive deep tendon reflexes
D. Increased serum magnesium level
Correct Answer: A. Prolonged QT interval on ECG
Rationale: Hypocalcemia causes neuromuscular irritability, including a positive Chvostek
sign and prolonged QT interval. Trousseau sign is also positive in hypocalcemia, and
magnesium levels are often low, not high. Deep tendon reflexes are typically hyperactive,
not hypoactive.
Why Wrong:
B - Trousseau sign is typically positive in hypocalcemia, not negative.
C - Hyperactive reflexes are common, but this is not the best additional finding.
D - Magnesium is often low, not high, in pancreatitis-related hypocalcemia.
Reference: Ignatavicius, D.D., Workman, M.L., Rebar, C.R., & Heimgartner, N.M. (2021).
Medical-Surgical Nursing, 10th Ed., Ch. 40.
Q6. A nurse receives a handoff report on four patients. Which patient should the
nurse assess first?
A. Patient with a hemoglobin of 7.0 g/dL and no active bleeding
B. Patient with chest pain and ST-segment elevation on ECG
C. Patient with a fever of 101.2°F and a white blood cell count of 14,000/mm³
D. Patient with a blood glucose of 55 mg/dL who is diaphoretic
Correct Answer: B. Patient with chest pain and ST-segment elevation on ECG
Rationale: ST-segment elevation myocardial infarction (STEMI) is a life-threatening
emergency requiring immediate intervention to restore perfusion. While hypoglycemia is
urgent, it is rapidly correctable; the STEMI has the highest risk of death if not treated
promptly.
Why Wrong:
A - Asymptomatic anemia is not immediately life-threatening.
C - Fever with leukocytosis may indicate infection but is not as time-critical as
STEMI.
D - Hypoglycemia is urgent but can be quickly corrected with oral or IV glucose.
Reference: Ignatavicius, D.D., et al. (2021). Medical-Surgical Nursing, 10th Ed., Ch. 35.
Page 4
EXPERT SOLUTIONS - 120 Questions with Answers
Page 1
,Q1. A patient with septic shock has a pulmonary artery catheter. Which
hemodynamic pattern is most consistent with this condition?
A. High cardiac output, low systemic vascular resistance, low pulmonary capillary
wedge pressure
B. Low cardiac output, high systemic vascular resistance, high pulmonary capillary
wedge pressure
C. Low cardiac output, low systemic vascular resistance, low pulmonary capillary
wedge pressure
D. High cardiac output, low systemic vascular resistance, high pulmonary capillary
wedge pressure
Correct Answer: A. High cardiac output, low systemic vascular resistance, low
pulmonary capillary wedge pressure
Rationale: Septic shock typically presents with a hyperdynamic state: increased cardiac
output, decreased systemic vascular resistance (due to vasodilation), and low filling
pressures (PCWP) due to relative hypovolemia. Low SVR and low PCWP with high CO
are classic.
Why Wrong:
B - This pattern suggests cardiogenic shock with high SVR and elevated PCWP.
C - Low CO with low SVR is not typical; septic shock usually has high CO.
D - High PCWP is not expected in early septic shock; it indicates volume overload or
left heart failure.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2022). Critical Care Nursing, 9th
Ed., Ch. 9.
Q2. A nurse is caring for a patient with syndrome of inappropriate antidiuretic
hormone (SIADH) who has a serum sodium of 120 mEq/L. Which intravenous fluid
should the nurse question?
A. 0.9% sodium chloride at 50 mL/hr
B. 3% sodium chloride at 25 mL/hr
C. 0.45% sodium chloride at 100 mL/hr
D. Lactated Ringer's at 75 mL/hr
Correct Answer: C. 0.45% sodium chloride at 100 mL/hr
Rationale: In SIADH, patients are euvolemic with dilutional hyponatremia. Hypotonic
fluids like 0.45% saline worsen hyponatremia and should be avoided. Hypertonic saline is
used for severe symptoms, and isotonic saline is appropriate for slow correction.
Why Wrong:
A - 0.9% saline is isotonic and may be used for slow correction, though not ideal in all
cases.
B - 3% saline is indicated for severe hyponatremia with neurologic symptoms, not
Page 2
, contraindicated.
D - Lactated Ringer's is isotonic and not as harmful as hypotonic fluids, though it
contains potassium.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 51.
Q3. A patient on mechanical ventilation has a sudden increase in peak airway
pressure with no change in plateau pressure. Which condition is the most likely
cause?
A. Pneumothorax
B. Bronchospasm
C. Pulmonary edema
D. Mainstem intubation
Correct Answer: B. Bronchospasm
Rationale: An increase in peak pressure with unchanged plateau pressure indicates
increased airway resistance, such as bronchospasm, secretions, or kinked tubing.
Conditions like pneumothorax or pulmonary edema increase both peak and plateau
pressures (decreased compliance).
Why Wrong:
A - Pneumothorax decreases compliance, raising both peak and plateau pressures.
C - Pulmonary edema decreases compliance, raising both pressures.
D - Mainstem intubation would also decrease compliance, raising plateau pressure.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2022). Critical Care Nursing, 9th
Ed., Ch. 27.
Q4. Which medication requires the nurse to assess for QT interval prolongation
before administration?
A. Ondansetron
B. Metoprolol
C. Lorazepam
D. Acetaminophen
Correct Answer: A. Ondansetron
Rationale: Ondansetron (a 5-HT3 antagonist) is known to prolong the QT interval,
increasing the risk of torsades de pointes. Metoprolol, lorazepam, and acetaminophen do
not have significant QT-prolonging effects.
Why Wrong:
B - Metoprolol is a beta-blocker that can cause bradycardia but not QT prolongation.
C - Lorazepam is a benzodiazepine with no known QT effects.
D - Acetaminophen does not affect cardiac conduction.
Page 3
, Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 45.
Q5. A patient with acute pancreatitis has a serum calcium of 7.2 mg/dL and a positive
Chvostek sign. Which additional finding is most consistent with this condition?
A. Prolonged QT interval on ECG
B. Negative Trousseau sign
C. Hyperactive deep tendon reflexes
D. Increased serum magnesium level
Correct Answer: A. Prolonged QT interval on ECG
Rationale: Hypocalcemia causes neuromuscular irritability, including a positive Chvostek
sign and prolonged QT interval. Trousseau sign is also positive in hypocalcemia, and
magnesium levels are often low, not high. Deep tendon reflexes are typically hyperactive,
not hypoactive.
Why Wrong:
B - Trousseau sign is typically positive in hypocalcemia, not negative.
C - Hyperactive reflexes are common, but this is not the best additional finding.
D - Magnesium is often low, not high, in pancreatitis-related hypocalcemia.
Reference: Ignatavicius, D.D., Workman, M.L., Rebar, C.R., & Heimgartner, N.M. (2021).
Medical-Surgical Nursing, 10th Ed., Ch. 40.
Q6. A nurse receives a handoff report on four patients. Which patient should the
nurse assess first?
A. Patient with a hemoglobin of 7.0 g/dL and no active bleeding
B. Patient with chest pain and ST-segment elevation on ECG
C. Patient with a fever of 101.2°F and a white blood cell count of 14,000/mm³
D. Patient with a blood glucose of 55 mg/dL who is diaphoretic
Correct Answer: B. Patient with chest pain and ST-segment elevation on ECG
Rationale: ST-segment elevation myocardial infarction (STEMI) is a life-threatening
emergency requiring immediate intervention to restore perfusion. While hypoglycemia is
urgent, it is rapidly correctable; the STEMI has the highest risk of death if not treated
promptly.
Why Wrong:
A - Asymptomatic anemia is not immediately life-threatening.
C - Fever with leukocytosis may indicate infection but is not as time-critical as
STEMI.
D - Hypoglycemia is urgent but can be quickly corrected with oral or IV glucose.
Reference: Ignatavicius, D.D., et al. (2021). Medical-Surgical Nursing, 10th Ed., Ch. 35.
Page 4
