NUR 2755 MDC4 FINAL EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
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Core Domains
• Critical Care & Hemodynamics
• Complex Respiratory & Cardiac Conditions
• Neurological & Renal Emergencies
• Endocrine & Metabolic Crises
• Burns, Shock & Trauma
• Emergency & Disaster Nursing
• Leadership, Delegation & Management
• End-of-Life & Palliative Care
• Ethics, Legal & Quality Improvement
• Prioritization & Clinical Judgment
Introduction
This certification examination assesses the knowledge and skills required to
deliver evidence-based nursing care for adult patients experiencing complex,
multi-system health alterations. The assessment evaluates understanding of
critical care and hemodynamics, complex respiratory and cardiac conditions,
neurological and renal emergencies, endocrine and metabolic crises, burns,
shock, and trauma, emergency and disaster nursing, leadership and delegation,
end-of-life and palliative care, and ethical and legal principles in nursing
,practice. The exam employs multiple-choice questions and scenario-based
items designed to test real-world application and clinical decision-making.
Candidates must demonstrate the ability to prioritize care, apply the nursing
process, and integrate knowledge across a wide range of clinical scenarios. A
passing score demonstrates readiness to practice safe, effective, and ethical
nursing care in complex healthcare environments.
SECTION ONE: QUESTIONS 1–100
1. A patient in the intensive care unit has a pulmonary artery catheter
(Swan-Ganz). Which hemodynamic value indicates left ventricular
preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Cardiac output (CO)
D. Systemic vascular resistance (SVR)
RATIONALE: PAWP reflects left ventricular end-diastolic pressure
(LVEDP), which is an indicator of left ventricular preload. CVP reflects right
ventricular preload. CO measures the heart's output, and SVR measures
afterload.
2. A patient in septic shock has a mean arterial pressure (MAP) of 55
mmHg. Which intervention should the nurse anticipate first?
A. Administering a bolus of intravenous fluids
B. Initiating norepinephrine infusion
C. Obtaining a blood culture
D. Administering broad-spectrum antibiotics
RATIONALE: In septic shock, the initial priority is fluid resuscitation with
intravenous fluids to restore intravascular volume and improve MAP.
,Vasopressors are initiated if fluid resuscitation fails to restore adequate
perfusion pressure. Blood cultures should be obtained before antibiotics, but
fluid resuscitation is the immediate priority for hemodynamic stabilization.
3. A nurse is caring for a patient with acute respiratory distress
syndrome (ARDS). Which ventilator setting is most appropriate to
prevent barotrauma?
A. High tidal volume (12 mL/kg)
B. Low tidal volume (6 mL/kg of predicted body weight)
C. High positive end-expiratory pressure (PEEP) of 20 cm H2O
D. High respiratory rate (30 breaths/min)
B. Low tidal volume (6 mL/kg of predicted body weight)
RATIONALE: Low tidal volume ventilation (6 mL/kg of predicted body
weight) is the standard of care for ARDS to prevent ventilator-induced lung
injury and barotrauma. High tidal volumes can cause alveolar overdistension
and worsen lung injury.
4. A patient with increased intracranial pressure (ICP) has a blood
pressure of 190/100 mm Hg, heart rate of 48 beats per minute, and
irregular respirations. This finding is known as:
A. Cushing's triad
B. Cheyne-Stokes respirations
C. Beck's triad
D. Virchow's triad
RATIONALE: Cushing's triad consists of hypertension, bradycardia, and
irregular respirations, and is a late sign of increased intracranial pressure. It
indicates impending herniation and requires immediate intervention.
, 5. A nurse is teaching a patient about phenytoin (Dilantin) for seizure
prevention. Which statement by the patient indicates understanding?
A. "I should brush my teeth gently because my gums may bleed."
B. "I can stop taking this medication once my seizures are controlled."
C. "I should take this medication with a large meal."
D. "I need to have my blood levels checked regularly."
RATIONALE: Patients taking phenytoin require regular serum drug level
monitoring because the therapeutic range is narrow. Gingival hyperplasia is a
common side effect, and patients should maintain good oral hygiene, not
avoid brushing. Medication should not be stopped abruptly.
6. A patient with a traumatic brain injury (TBI) has clear fluid draining
from the nose. Which action should the nurse take?
A. Insert a nasal packing to stop the drainage
B. Test the fluid for glucose using a dextrose stick
C. Have the patient blow their nose gently
D. Place the patient in a supine position
B. Test the fluid for glucose using a dextrose stick
RATIONALE: Clear fluid draining from the nose after TBI may indicate a
CSF leak. Testing for glucose (CSF contains glucose, mucus does not) helps
confirm the presence of CSF. Nasal packing and nose blowing are
contraindicated as they can introduce infection or increase ICP.
7. A patient is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is expected?
A. Blood glucose of 180 mg/dL
B. Serum bicarbonate of 28 mEq/L
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS
RATIONALES 2026/2027 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
• Critical Care & Hemodynamics
• Complex Respiratory & Cardiac Conditions
• Neurological & Renal Emergencies
• Endocrine & Metabolic Crises
• Burns, Shock & Trauma
• Emergency & Disaster Nursing
• Leadership, Delegation & Management
• End-of-Life & Palliative Care
• Ethics, Legal & Quality Improvement
• Prioritization & Clinical Judgment
Introduction
This certification examination assesses the knowledge and skills required to
deliver evidence-based nursing care for adult patients experiencing complex,
multi-system health alterations. The assessment evaluates understanding of
critical care and hemodynamics, complex respiratory and cardiac conditions,
neurological and renal emergencies, endocrine and metabolic crises, burns,
shock, and trauma, emergency and disaster nursing, leadership and delegation,
end-of-life and palliative care, and ethical and legal principles in nursing
,practice. The exam employs multiple-choice questions and scenario-based
items designed to test real-world application and clinical decision-making.
Candidates must demonstrate the ability to prioritize care, apply the nursing
process, and integrate knowledge across a wide range of clinical scenarios. A
passing score demonstrates readiness to practice safe, effective, and ethical
nursing care in complex healthcare environments.
SECTION ONE: QUESTIONS 1–100
1. A patient in the intensive care unit has a pulmonary artery catheter
(Swan-Ganz). Which hemodynamic value indicates left ventricular
preload?
A. Central venous pressure (CVP)
B. Pulmonary artery wedge pressure (PAWP)
C. Cardiac output (CO)
D. Systemic vascular resistance (SVR)
RATIONALE: PAWP reflects left ventricular end-diastolic pressure
(LVEDP), which is an indicator of left ventricular preload. CVP reflects right
ventricular preload. CO measures the heart's output, and SVR measures
afterload.
2. A patient in septic shock has a mean arterial pressure (MAP) of 55
mmHg. Which intervention should the nurse anticipate first?
A. Administering a bolus of intravenous fluids
B. Initiating norepinephrine infusion
C. Obtaining a blood culture
D. Administering broad-spectrum antibiotics
RATIONALE: In septic shock, the initial priority is fluid resuscitation with
intravenous fluids to restore intravascular volume and improve MAP.
,Vasopressors are initiated if fluid resuscitation fails to restore adequate
perfusion pressure. Blood cultures should be obtained before antibiotics, but
fluid resuscitation is the immediate priority for hemodynamic stabilization.
3. A nurse is caring for a patient with acute respiratory distress
syndrome (ARDS). Which ventilator setting is most appropriate to
prevent barotrauma?
A. High tidal volume (12 mL/kg)
B. Low tidal volume (6 mL/kg of predicted body weight)
C. High positive end-expiratory pressure (PEEP) of 20 cm H2O
D. High respiratory rate (30 breaths/min)
B. Low tidal volume (6 mL/kg of predicted body weight)
RATIONALE: Low tidal volume ventilation (6 mL/kg of predicted body
weight) is the standard of care for ARDS to prevent ventilator-induced lung
injury and barotrauma. High tidal volumes can cause alveolar overdistension
and worsen lung injury.
4. A patient with increased intracranial pressure (ICP) has a blood
pressure of 190/100 mm Hg, heart rate of 48 beats per minute, and
irregular respirations. This finding is known as:
A. Cushing's triad
B. Cheyne-Stokes respirations
C. Beck's triad
D. Virchow's triad
RATIONALE: Cushing's triad consists of hypertension, bradycardia, and
irregular respirations, and is a late sign of increased intracranial pressure. It
indicates impending herniation and requires immediate intervention.
, 5. A nurse is teaching a patient about phenytoin (Dilantin) for seizure
prevention. Which statement by the patient indicates understanding?
A. "I should brush my teeth gently because my gums may bleed."
B. "I can stop taking this medication once my seizures are controlled."
C. "I should take this medication with a large meal."
D. "I need to have my blood levels checked regularly."
RATIONALE: Patients taking phenytoin require regular serum drug level
monitoring because the therapeutic range is narrow. Gingival hyperplasia is a
common side effect, and patients should maintain good oral hygiene, not
avoid brushing. Medication should not be stopped abruptly.
6. A patient with a traumatic brain injury (TBI) has clear fluid draining
from the nose. Which action should the nurse take?
A. Insert a nasal packing to stop the drainage
B. Test the fluid for glucose using a dextrose stick
C. Have the patient blow their nose gently
D. Place the patient in a supine position
B. Test the fluid for glucose using a dextrose stick
RATIONALE: Clear fluid draining from the nose after TBI may indicate a
CSF leak. Testing for glucose (CSF contains glucose, mucus does not) helps
confirm the presence of CSF. Nasal packing and nose blowing are
contraindicated as they can introduce infection or increase ICP.
7. A patient is admitted with diabetic ketoacidosis (DKA). Which
laboratory finding is expected?
A. Blood glucose of 180 mg/dL
B. Serum bicarbonate of 28 mEq/L
