NUR 445 FINAL EXAM QUESTIONS AND ANSWERS | NUR 445
FINAL EXAM STUDY GUIDE & PRACTICE TEST 2026/2027
Hyperglycemia (2) - correct answer ✔✔-happens in both diabetic & non-diabetic pts
-BG >200 mg/dL
What contributes to hyperglycemia in critically ill pt? (8) - correct answer ✔✔-stress response
(hormones)
-meds (glucocorticoid therapy)
-overfeeding (too many calories)
-IV dextrose & TPN
-immobility
-increased insulin resistance
-deficient insulin secretion
-surgery
Why is hyperglycemia an issue in pts? (4) - correct answer ✔✔-impairs wound healing
-poor immune response
-inflammation
-endothelial dysfunction (inner lining of blood vessels)
Hyperglycemia Guidelines (5) - correct answer ✔✔-tx w/IV insulin until controlled
-target BG: < 180 mg/dL
-must receive glucose calorie source
-BG monitoring q1-2h until stable, then q4h
-confirm hypoglycemia from finger stick
Diabetes Insipidus (DI) - Clinical Manifestations (3) - correct answer ✔✔-polydipsia & polyuria
(inadequate ADH secretion OR decreased renal response)
-enormous quantities of extremely dilute/water-like urine (>3L/24hr)
-drinks 2-20L per day (craves cold H2O)
DI - Labs (8) - correct answer ✔✔-UO = increased (normal: 1-1.5 L/day)
-urine specific gravity = decreased, 1.001-1.005 (normal: 1.005-1.030)
-urine osmolality = decreased (normal: 300-1400)
-urine Na = decreased (normal: 40-220)
-serum ADH = decreased (normal: 1-5)
-serum osmolality = increased (normal: 280-300)
-serum Na = increased (normal: 135-145)
-fluid volume status = hypovolemia
Neurogenic Shock (3) - correct answer ✔✔-injury above T6
-prohibits SNS impulse from passing
-loss of vasoconstriction = dilated vessels
,Why does neurogenic shock look like hypovolemia? (2) - correct answer ✔✔-b/c the vessels are dilated
causing blood to pool in periphery
-decreased = venous return, CO, & perfusion
Neurogenic Shock - Triad s/sx (3) - correct answer ✔✔-hypotension
-bradycardia
-hypothermia
What does no SNS innervation in neurogenic shock cause? (3) - correct answer ✔✔-decreased BP
-decreased HR (very bradycardic)
-decreased temp (skin is still warm)
SIADH - Classic Profile (2) - correct answer ✔✔-small amount of concentrated urine (< 400 ml/day)
-decrease in serum Na
What causes the s/sx of SIADH? - correct answer ✔✔H2O retention (over secretion of ADH)
What is the severity of the s/sx of SIADH r/t? - correct answer ✔✔onset & severity of hyponatremia
What s/sx of SIADH are r/t onset & severity of hyponatremia? (6) - correct answer ✔✔-weakness
-confusion
-HA
-seizures
-coma
-fluid overload
Normal ABG Values - Acid-Base (4) - correct answer ✔✔-pH = 7.35-7.45
-PaCO2 = 35-45 mmHg
-HCO3 = 22-26 mEq/L
-BE = (-2)-(+2) mEq/L
Normal ABG Values - Oxygenation Status (3) - correct answer ✔✔-PaO2 = 80-100 mmHg
-SaO2/SpO2 = ≥95%
-Hgb = 12-18 g/dL
Respiratory Acidosis (3) - correct answer ✔✔pH: < 7.35
PaCO2: >45 mmHg
HCO3: normal
Respiratory Alkalosis (3) - correct answer ✔✔pH: >7.45
PaCO2: < 35 mmHg
HCO3: Normal
Metabolic Acidosis (4) - correct answer ✔✔pH: < 7.35
PaCO2: normal
HCO3: < 22 mEq/L
BE: < -2 mEq/L
, Metabolic Alkalosis (4) - correct answer ✔✔pH: >7.45
PaCO2: normal
HCO3: > 26 mEq/L
BE: >+2 mEq/L
ABG Compensation - correct answer ✔✔-uncompensated = either the CO2 or the HCO3 is normal (only
one abnormal)
-partially compensated = nothing is normal
-fully compensated = pH is normal
Stroke - Modifiable Risk Factors (4) - correct answer ✔✔-BP > 140/95 mmHg
-cardiac disease 2x more likely than those w/o
-DM & dyslipidemia (associated w/conditions that are risk factors)
-smoking
Stroke - Non-Modifiable Risk Factors (4) - correct answer ✔✔-age
-gender
-race/ethnicity (african-americans higher risk)
-genetics
Age & Strokes (2) - correct answer ✔✔-for each successive decade after 55 y/o stroke rate doubles
-prevalence in >75 is even higher
Gender & Strokes (3) - correct answer ✔✔-men at > risk before women until 75 y/o when it equals
-women >84 y/o are at higher risk
-marriage = protective factor
Ischemic-Thrombotic Stroke - Risk Factors (5) - correct answer ✔✔-HTN
-smoking
-high cholesterol
-DM
-atherosclerosis
Ischemic-Embolic Stroke - Risk Factors (5) - correct answer ✔✔-cardiac abnormalities
-*a.fib*
-valvular heart disease
-carotid plaque
-thrombosis
Hemorrhagic-Subarachnoid Stroke - Risk Factors (3) - correct answer ✔✔-ruptured aneurysm
-A/V malformation
-brain tumors
Hemorrhagic-Intracerebral Stroke - Risk Factors (2) - correct answer ✔✔-chronic HTN
-anticoagulant therapy
Cardiogenic Shock - correct answer ✔✔Heart fails to function as a pump
FINAL EXAM STUDY GUIDE & PRACTICE TEST 2026/2027
Hyperglycemia (2) - correct answer ✔✔-happens in both diabetic & non-diabetic pts
-BG >200 mg/dL
What contributes to hyperglycemia in critically ill pt? (8) - correct answer ✔✔-stress response
(hormones)
-meds (glucocorticoid therapy)
-overfeeding (too many calories)
-IV dextrose & TPN
-immobility
-increased insulin resistance
-deficient insulin secretion
-surgery
Why is hyperglycemia an issue in pts? (4) - correct answer ✔✔-impairs wound healing
-poor immune response
-inflammation
-endothelial dysfunction (inner lining of blood vessels)
Hyperglycemia Guidelines (5) - correct answer ✔✔-tx w/IV insulin until controlled
-target BG: < 180 mg/dL
-must receive glucose calorie source
-BG monitoring q1-2h until stable, then q4h
-confirm hypoglycemia from finger stick
Diabetes Insipidus (DI) - Clinical Manifestations (3) - correct answer ✔✔-polydipsia & polyuria
(inadequate ADH secretion OR decreased renal response)
-enormous quantities of extremely dilute/water-like urine (>3L/24hr)
-drinks 2-20L per day (craves cold H2O)
DI - Labs (8) - correct answer ✔✔-UO = increased (normal: 1-1.5 L/day)
-urine specific gravity = decreased, 1.001-1.005 (normal: 1.005-1.030)
-urine osmolality = decreased (normal: 300-1400)
-urine Na = decreased (normal: 40-220)
-serum ADH = decreased (normal: 1-5)
-serum osmolality = increased (normal: 280-300)
-serum Na = increased (normal: 135-145)
-fluid volume status = hypovolemia
Neurogenic Shock (3) - correct answer ✔✔-injury above T6
-prohibits SNS impulse from passing
-loss of vasoconstriction = dilated vessels
,Why does neurogenic shock look like hypovolemia? (2) - correct answer ✔✔-b/c the vessels are dilated
causing blood to pool in periphery
-decreased = venous return, CO, & perfusion
Neurogenic Shock - Triad s/sx (3) - correct answer ✔✔-hypotension
-bradycardia
-hypothermia
What does no SNS innervation in neurogenic shock cause? (3) - correct answer ✔✔-decreased BP
-decreased HR (very bradycardic)
-decreased temp (skin is still warm)
SIADH - Classic Profile (2) - correct answer ✔✔-small amount of concentrated urine (< 400 ml/day)
-decrease in serum Na
What causes the s/sx of SIADH? - correct answer ✔✔H2O retention (over secretion of ADH)
What is the severity of the s/sx of SIADH r/t? - correct answer ✔✔onset & severity of hyponatremia
What s/sx of SIADH are r/t onset & severity of hyponatremia? (6) - correct answer ✔✔-weakness
-confusion
-HA
-seizures
-coma
-fluid overload
Normal ABG Values - Acid-Base (4) - correct answer ✔✔-pH = 7.35-7.45
-PaCO2 = 35-45 mmHg
-HCO3 = 22-26 mEq/L
-BE = (-2)-(+2) mEq/L
Normal ABG Values - Oxygenation Status (3) - correct answer ✔✔-PaO2 = 80-100 mmHg
-SaO2/SpO2 = ≥95%
-Hgb = 12-18 g/dL
Respiratory Acidosis (3) - correct answer ✔✔pH: < 7.35
PaCO2: >45 mmHg
HCO3: normal
Respiratory Alkalosis (3) - correct answer ✔✔pH: >7.45
PaCO2: < 35 mmHg
HCO3: Normal
Metabolic Acidosis (4) - correct answer ✔✔pH: < 7.35
PaCO2: normal
HCO3: < 22 mEq/L
BE: < -2 mEq/L
, Metabolic Alkalosis (4) - correct answer ✔✔pH: >7.45
PaCO2: normal
HCO3: > 26 mEq/L
BE: >+2 mEq/L
ABG Compensation - correct answer ✔✔-uncompensated = either the CO2 or the HCO3 is normal (only
one abnormal)
-partially compensated = nothing is normal
-fully compensated = pH is normal
Stroke - Modifiable Risk Factors (4) - correct answer ✔✔-BP > 140/95 mmHg
-cardiac disease 2x more likely than those w/o
-DM & dyslipidemia (associated w/conditions that are risk factors)
-smoking
Stroke - Non-Modifiable Risk Factors (4) - correct answer ✔✔-age
-gender
-race/ethnicity (african-americans higher risk)
-genetics
Age & Strokes (2) - correct answer ✔✔-for each successive decade after 55 y/o stroke rate doubles
-prevalence in >75 is even higher
Gender & Strokes (3) - correct answer ✔✔-men at > risk before women until 75 y/o when it equals
-women >84 y/o are at higher risk
-marriage = protective factor
Ischemic-Thrombotic Stroke - Risk Factors (5) - correct answer ✔✔-HTN
-smoking
-high cholesterol
-DM
-atherosclerosis
Ischemic-Embolic Stroke - Risk Factors (5) - correct answer ✔✔-cardiac abnormalities
-*a.fib*
-valvular heart disease
-carotid plaque
-thrombosis
Hemorrhagic-Subarachnoid Stroke - Risk Factors (3) - correct answer ✔✔-ruptured aneurysm
-A/V malformation
-brain tumors
Hemorrhagic-Intracerebral Stroke - Risk Factors (2) - correct answer ✔✔-chronic HTN
-anticoagulant therapy
Cardiogenic Shock - correct answer ✔✔Heart fails to function as a pump
