MSNC 505 ADVANCED CLINICAL
NURSING FINAL EXAM QUESTIONS
AND DETAILED SOLUTIONS JUST
RELEASED
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 25 mmHg. Which clinical condition is most likely?
A. Hypovolemic shock
B. Pulmonary embolism
C. Septic shock
D. Left ventricular heart failure
Answer: D
Conceptual Explanation: An elevated PAWP above 18 mmHg typically indicates increased
left ventricular end-diastolic pressure, a hallmark of left-sided heart failure or fluid
overload.
2. When interpreting Arterial Blood Gas (ABG) results, a pH of 7.28, PaCO2 of 55 mmHg, and
HCO3 of 28 mEq/L indicates which state?
A. Compensated metabolic acidosis
B. Uncompensated respiratory alkalosis
,C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The low pH indicates acidosis, high PaCO2 indicates respiratory
origin, and elevated HCO3 suggests the kidneys are attempting to compensate, though the
pH has not returned to normal.
3. Which pharmacological agent is the first-line treatment for a patient experiencing Torsades
de Pointes?
A. Magnesium Sulfate
B. Amiodarone
C. Lidocaine
D. Epinephrine
Answer: A
Conceptual Explanation: Intravenous Magnesium Sulfate is the treatment of choice for
Torsades de Pointes, regardless of the patient’s baseline magnesium level.
4. In the management of Acute Respiratory Distress Syndrome (ARDS), what is the primary
rationale for using high Positive End-Expiratory Pressure (PEEP)?
A. To decrease the risk of barotrauma
B. To increase functional residual capacity and recruit alveoli
, C. To reduce the patient’s respiratory rate
D. To increase venous return to the heart
Answer: B
Conceptual Explanation: High PEEP prevents alveolar collapse at the end of expiration,
increases functional residual capacity, and improves oxygenation by recruiting previously
closed alveoli.
5. A patient with a traumatic brain injury exhibits a widening pulse pressure, bradycardia, and
irregular respirations. What does this triad suggest?
A. Increased intracranial pressure (Cushing’s Triad)
B. Hypovolemic shock
C. Neurogenic shock
D. Brainstem herniation due to hypotension
Answer: A
Conceptual Explanation: Cushing’s Triad (systolic hypertension with widening pulse
pressure, bradycardia, and irregular respirations) is a late sign of significantly increased
intracranial pressure.
6. Which electrolyte abnormality is most commonly associated with the administration of
large volumes of stored packed red blood cells?
A. Hypermagnesemia
NURSING FINAL EXAM QUESTIONS
AND DETAILED SOLUTIONS JUST
RELEASED
1. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure
(PAWP) of 25 mmHg. Which clinical condition is most likely?
A. Hypovolemic shock
B. Pulmonary embolism
C. Septic shock
D. Left ventricular heart failure
Answer: D
Conceptual Explanation: An elevated PAWP above 18 mmHg typically indicates increased
left ventricular end-diastolic pressure, a hallmark of left-sided heart failure or fluid
overload.
2. When interpreting Arterial Blood Gas (ABG) results, a pH of 7.28, PaCO2 of 55 mmHg, and
HCO3 of 28 mEq/L indicates which state?
A. Compensated metabolic acidosis
B. Uncompensated respiratory alkalosis
,C. Partially compensated respiratory acidosis
D. Uncompensated respiratory acidosis
Answer: C
Conceptual Explanation: The low pH indicates acidosis, high PaCO2 indicates respiratory
origin, and elevated HCO3 suggests the kidneys are attempting to compensate, though the
pH has not returned to normal.
3. Which pharmacological agent is the first-line treatment for a patient experiencing Torsades
de Pointes?
A. Magnesium Sulfate
B. Amiodarone
C. Lidocaine
D. Epinephrine
Answer: A
Conceptual Explanation: Intravenous Magnesium Sulfate is the treatment of choice for
Torsades de Pointes, regardless of the patient’s baseline magnesium level.
4. In the management of Acute Respiratory Distress Syndrome (ARDS), what is the primary
rationale for using high Positive End-Expiratory Pressure (PEEP)?
A. To decrease the risk of barotrauma
B. To increase functional residual capacity and recruit alveoli
, C. To reduce the patient’s respiratory rate
D. To increase venous return to the heart
Answer: B
Conceptual Explanation: High PEEP prevents alveolar collapse at the end of expiration,
increases functional residual capacity, and improves oxygenation by recruiting previously
closed alveoli.
5. A patient with a traumatic brain injury exhibits a widening pulse pressure, bradycardia, and
irregular respirations. What does this triad suggest?
A. Increased intracranial pressure (Cushing’s Triad)
B. Hypovolemic shock
C. Neurogenic shock
D. Brainstem herniation due to hypotension
Answer: A
Conceptual Explanation: Cushing’s Triad (systolic hypertension with widening pulse
pressure, bradycardia, and irregular respirations) is a late sign of significantly increased
intracranial pressure.
6. Which electrolyte abnormality is most commonly associated with the administration of
large volumes of stored packed red blood cells?
A. Hypermagnesemia
