NUR 265 EXAM 4 - ADVANCED
CRITICAL CARE NURSING QUESTIONS
AND ANSWERS | 2026 UPDATE | 100%
CORRECT - GALEN COLLEGE OF
NURSING.
1. A patient who weighs 80 kg suffered 40% total body surface area (TBSA) burns. Using the
Parkland formula, how much fluid should the nurse administer in the first 8 hours?
A. 25,600 mL
B. 3,200 mL
C. 12,800 mL
D. 6,400 mL
Answer: D
Conceptual Explanation: The Parkland formula is 4 mL x kg x % TBSA. Total fluid = 4 x 80
x 40 = 12,800 mL. Half is given in the first 8 hours: 12, = 6,400 mL.
2. Which assessment finding in a patient with a circumferential chest burn most requires an
immediate escharotomy?
A. Complaint of 10/10 pain with movement
B. Heart rate of 110 beats per minute
,C. Rapid, shallow respirations and decreased chest expansion
D. Serosanguinous drainage from the wound
Answer: C
Conceptual Explanation: Circumferential burns can cause restriction of chest wall
expansion, leading to respiratory distress. An escharotomy is needed to relieve the
pressure and allow for adequate ventilation.
3. A client in the oliguric phase of Acute Kidney Injury (AKI) has a potassium level of 6.8
mEq/L. Which medication should the nurse expect to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular Insulin and D50W
D. Calcium Gluconate
Answer: D
Conceptual Explanation: While insulin and Kayexalate lower potassium, Calcium
Gluconate is given first in severe hyperkalemia to stabilize the myocardial cell membrane
and prevent lethal arrhythmias.
4. Which ABG result indicates fully compensated respiratory acidosis?
A. pH 7.35, PaCO2 50, HCO3 30
B. pH 7.30, PaCO2 50, HCO3 24
, C. pH 7.45, PaCO2 30, HCO3 20
D. pH 7.40, PaCO2 40, HCO3 24
Answer: A
Conceptual Explanation: In fully compensated respiratory acidosis, the pH is within the
normal range but on the acidic side (7.35), PaCO2 is high (acidosis), and HCO3 is high
(compensation).
5. A nurse is caring for a patient in septic shock. The patient’s CVP is 2 mmHg and BP is 80/40.
What is the priority intervention?
A. Start a norepinephrine drip
B. Administer a dose of IV broad-spectrum antibiotics
C. Administer a 500 mL IV bolus of Normal Saline
D. Obtain blood cultures from two different sites
Answer: C
Conceptual Explanation: The low CVP (Normal 2-8 mmHg) indicates hypovolemia.
According to Sepsis Bundles, fluid resuscitation is the first step before starting
vasopressors.
6. In the emergent phase of burn care, which electrolyte imbalance is the nurse most likely to
observe?
A. Hyperkalemia and Hypernatremia
CRITICAL CARE NURSING QUESTIONS
AND ANSWERS | 2026 UPDATE | 100%
CORRECT - GALEN COLLEGE OF
NURSING.
1. A patient who weighs 80 kg suffered 40% total body surface area (TBSA) burns. Using the
Parkland formula, how much fluid should the nurse administer in the first 8 hours?
A. 25,600 mL
B. 3,200 mL
C. 12,800 mL
D. 6,400 mL
Answer: D
Conceptual Explanation: The Parkland formula is 4 mL x kg x % TBSA. Total fluid = 4 x 80
x 40 = 12,800 mL. Half is given in the first 8 hours: 12, = 6,400 mL.
2. Which assessment finding in a patient with a circumferential chest burn most requires an
immediate escharotomy?
A. Complaint of 10/10 pain with movement
B. Heart rate of 110 beats per minute
,C. Rapid, shallow respirations and decreased chest expansion
D. Serosanguinous drainage from the wound
Answer: C
Conceptual Explanation: Circumferential burns can cause restriction of chest wall
expansion, leading to respiratory distress. An escharotomy is needed to relieve the
pressure and allow for adequate ventilation.
3. A client in the oliguric phase of Acute Kidney Injury (AKI) has a potassium level of 6.8
mEq/L. Which medication should the nurse expect to administer first to protect the heart?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Furosemide (Lasix)
C. Regular Insulin and D50W
D. Calcium Gluconate
Answer: D
Conceptual Explanation: While insulin and Kayexalate lower potassium, Calcium
Gluconate is given first in severe hyperkalemia to stabilize the myocardial cell membrane
and prevent lethal arrhythmias.
4. Which ABG result indicates fully compensated respiratory acidosis?
A. pH 7.35, PaCO2 50, HCO3 30
B. pH 7.30, PaCO2 50, HCO3 24
, C. pH 7.45, PaCO2 30, HCO3 20
D. pH 7.40, PaCO2 40, HCO3 24
Answer: A
Conceptual Explanation: In fully compensated respiratory acidosis, the pH is within the
normal range but on the acidic side (7.35), PaCO2 is high (acidosis), and HCO3 is high
(compensation).
5. A nurse is caring for a patient in septic shock. The patient’s CVP is 2 mmHg and BP is 80/40.
What is the priority intervention?
A. Start a norepinephrine drip
B. Administer a dose of IV broad-spectrum antibiotics
C. Administer a 500 mL IV bolus of Normal Saline
D. Obtain blood cultures from two different sites
Answer: C
Conceptual Explanation: The low CVP (Normal 2-8 mmHg) indicates hypovolemia.
According to Sepsis Bundles, fluid resuscitation is the first step before starting
vasopressors.
6. In the emergent phase of burn care, which electrolyte imbalance is the nurse most likely to
observe?
A. Hyperkalemia and Hypernatremia
