NR 341 / NR341 Complex Adult Health 2026/2027 | Chamberlain University
NR341 Exam Study Guide, Complex Adult Health Exam Prep, Critical Care
Nursing, Respiratory Failure, Shock, Sepsis, Trauma, Burns, Neurological
Disorders, Renal & Cardiac Conditions, Practice Questions, Answers &
Rationales
Question 1: A nurse is assessing a patient who was admitted with acute
decompensated heart failure. Which assessment finding requires immediate
intervention?
A. Bibasilar crackles
B. Weight gain of 2 pounds in 24 hours
C. Pink frothy sputum
D. Jugular venous distention at 30 degrees
CORRECT ANSWER: C. Pink frothy sputum
Rationale: Pink frothy sputum indicates pulmonary edema with fluid filling the
alveoli and is a sign of acute respiratory failure requiring immediate intervention.
The other findings are consistent with heart failure but do not indicate the same
level of immediate airway compromise.
Question 2: A nurse is caring for a patient receiving mechanical ventilation. The
high-pressure alarm sounds. Which action should the nurse take first?
A. Silence the alarm
B. Assess the patient's breath sounds
C. Increase the FiO2
D. Administer a sedative
CORRECT ANSWER: B. Assess the patient's breath sounds
Rationale: The nurse should first assess the patient to determine the cause of the
high-pressure alarm, which could indicate mucus plugging, bronchospasm, or a
kink in the tubing. Assessment precedes any intervention.
Question 3: A patient with sepsis has a lactate level of 4.2 mmol/L. The nurse
understands that this finding indicates which pathophysiologic process?
A. Adequate tissue perfusion
B. Anaerobic metabolism due to inadequate perfusion
,C. Improved cardiac output
D. Resolution of infection
CORRECT ANSWER: B. Anaerobic metabolism due to inadequate perfusion
Rationale: An elevated lactate level indicates that cells are undergoing anaerobic
metabolism due to inadequate oxygen delivery, which is a hallmark of tissue
hypoperfusion in sepsis.
Question 4: A nurse is preparing to administer IV adenosine to a patient with
supraventricular tachycardia. Which action is essential?
A. Administer as a rapid IV push followed by a saline flush
B. Administer over 10 minutes via infusion pump
C. Monitor for hypertension
D. Ensure the patient has a full stomach
CORRECT ANSWER: A. Administer as a rapid IV push followed by a saline flush
Rationale: Adenosine has a very short half-life and must be administered rapidly
as a bolus followed immediately by a saline flush to reach the heart and terminate
the dysrhythmia.
Question 5: A patient is admitted with suspected acute respiratory distress
syndrome (ARDS). Which assessment finding is most consistent with this
diagnosis?
A. Elevated pulmonary artery occlusion pressure
B. Bilateral infiltrates on chest x-ray with normal cardiac function
C. Unilateral chest pain with decreased breath sounds
D. Bradycardia with hypertension
CORRECT ANSWER: B. Bilateral infiltrates on chest x-ray with normal cardiac
function
Rationale: ARDS is characterized by noncardiogenic pulmonary edema with
bilateral infiltrates and a normal pulmonary artery occlusion pressure,
distinguishing it from cardiogenic pulmonary edema.
,Question 6: A nurse is monitoring a patient with a pulmonary artery catheter.
The pulmonary artery occlusion pressure (PAOP) is 22 mm Hg. The nurse
interprets this as indicating which condition?
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Pulmonary hypertension
CORRECT ANSWER: B. Left ventricular failure
Rationale: An elevated PAOP indicates increased left ventricular end-diastolic
pressure, which is consistent with left ventricular failure and fluid overload.
Question 7: A patient in the emergency department has a suspected cervical
spine injury. Which action should the nurse take to maintain airway patency?
A. Perform a head-tilt chin-lift maneuver
B. Use a jaw-thrust maneuver without head extension
C. Place the patient in a supine position with a pillow under the head
D. Hyperextend the neck to open the airway
CORRECT ANSWER: B. Use a jaw-thrust maneuver without head extension
Rationale: The jaw-thrust maneuver is the safest method to open the airway in a
patient with a suspected cervical spine injury because it does not require head
extension, which could exacerbate spinal cord damage.
Question 8: A nurse is calculating the Parkland formula for a patient with burns
to 40% of total body surface area weighing 70 kg. What volume should be
administered in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 8,400 mL
CORRECT ANSWER: C. 11,200 mL
Rationale: The Parkland formula is 4 mL × body weight (kg) × % TBSA burned. 4 ×
70 × 40 = 11,200 mL total. Half is given in the first 8 hours, so 5,600 mL is
, administered in the first 8 hours. However, the question asks for the volume in
the first 8 hours, which is half of the total, equaling 5,600 mL. Wait, let me
recalculate: 4 × 70 × 40 = 11,200 mL total for 24 hours. Half of that is 5,600 mL in
the first 8 hours. The correct answer should be B. 5,600 mL.
CORRECT ANSWER: B. 5,600 mL
Rationale: The Parkland formula calculates total fluid replacement as 4 mL ×
weight (kg) × % TBSA burned. For this patient: 4 × 70 × 40 = 11,200 mL over 24
hours. Half of this volume (5,600 mL) is administered in the first 8 hours, and the
remaining half over the next 16 hours.
Question 9: A nurse is caring for a patient with a new tracheostomy. Which
finding indicates a need for immediate suctioning?
A. Respiratory rate of 18 breaths per minute
B. Audible secretions and oxygen saturation of 88%
C. Pink, moist stoma
D. Request for pain medication
CORRECT ANSWER: B. Audible secretions and oxygen saturation of 88%
Rationale: Audible secretions with falling oxygen saturation indicate the need for
suctioning to clear the airway and improve oxygenation. Suctioning should be
performed when clinically indicated, not routinely.
Question 10: A patient with acute kidney injury has a potassium level of 6.8
mEq/L. Which intervention should the nurse anticipate first?
A. Administration of sodium bicarbonate
B. Administration of calcium gluconate
C. Initiation of hemodialysis
D. Administration of furosemide
CORRECT ANSWER: B. Administration of calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize the myocardial cell
membrane and prevent lethal dysrhythmias from hyperkalemia. It does not lower
potassium but protects the heart while other measures are implemented.
NR341 Exam Study Guide, Complex Adult Health Exam Prep, Critical Care
Nursing, Respiratory Failure, Shock, Sepsis, Trauma, Burns, Neurological
Disorders, Renal & Cardiac Conditions, Practice Questions, Answers &
Rationales
Question 1: A nurse is assessing a patient who was admitted with acute
decompensated heart failure. Which assessment finding requires immediate
intervention?
A. Bibasilar crackles
B. Weight gain of 2 pounds in 24 hours
C. Pink frothy sputum
D. Jugular venous distention at 30 degrees
CORRECT ANSWER: C. Pink frothy sputum
Rationale: Pink frothy sputum indicates pulmonary edema with fluid filling the
alveoli and is a sign of acute respiratory failure requiring immediate intervention.
The other findings are consistent with heart failure but do not indicate the same
level of immediate airway compromise.
Question 2: A nurse is caring for a patient receiving mechanical ventilation. The
high-pressure alarm sounds. Which action should the nurse take first?
A. Silence the alarm
B. Assess the patient's breath sounds
C. Increase the FiO2
D. Administer a sedative
CORRECT ANSWER: B. Assess the patient's breath sounds
Rationale: The nurse should first assess the patient to determine the cause of the
high-pressure alarm, which could indicate mucus plugging, bronchospasm, or a
kink in the tubing. Assessment precedes any intervention.
Question 3: A patient with sepsis has a lactate level of 4.2 mmol/L. The nurse
understands that this finding indicates which pathophysiologic process?
A. Adequate tissue perfusion
B. Anaerobic metabolism due to inadequate perfusion
,C. Improved cardiac output
D. Resolution of infection
CORRECT ANSWER: B. Anaerobic metabolism due to inadequate perfusion
Rationale: An elevated lactate level indicates that cells are undergoing anaerobic
metabolism due to inadequate oxygen delivery, which is a hallmark of tissue
hypoperfusion in sepsis.
Question 4: A nurse is preparing to administer IV adenosine to a patient with
supraventricular tachycardia. Which action is essential?
A. Administer as a rapid IV push followed by a saline flush
B. Administer over 10 minutes via infusion pump
C. Monitor for hypertension
D. Ensure the patient has a full stomach
CORRECT ANSWER: A. Administer as a rapid IV push followed by a saline flush
Rationale: Adenosine has a very short half-life and must be administered rapidly
as a bolus followed immediately by a saline flush to reach the heart and terminate
the dysrhythmia.
Question 5: A patient is admitted with suspected acute respiratory distress
syndrome (ARDS). Which assessment finding is most consistent with this
diagnosis?
A. Elevated pulmonary artery occlusion pressure
B. Bilateral infiltrates on chest x-ray with normal cardiac function
C. Unilateral chest pain with decreased breath sounds
D. Bradycardia with hypertension
CORRECT ANSWER: B. Bilateral infiltrates on chest x-ray with normal cardiac
function
Rationale: ARDS is characterized by noncardiogenic pulmonary edema with
bilateral infiltrates and a normal pulmonary artery occlusion pressure,
distinguishing it from cardiogenic pulmonary edema.
,Question 6: A nurse is monitoring a patient with a pulmonary artery catheter.
The pulmonary artery occlusion pressure (PAOP) is 22 mm Hg. The nurse
interprets this as indicating which condition?
A. Hypovolemia
B. Left ventricular failure
C. Right ventricular failure
D. Pulmonary hypertension
CORRECT ANSWER: B. Left ventricular failure
Rationale: An elevated PAOP indicates increased left ventricular end-diastolic
pressure, which is consistent with left ventricular failure and fluid overload.
Question 7: A patient in the emergency department has a suspected cervical
spine injury. Which action should the nurse take to maintain airway patency?
A. Perform a head-tilt chin-lift maneuver
B. Use a jaw-thrust maneuver without head extension
C. Place the patient in a supine position with a pillow under the head
D. Hyperextend the neck to open the airway
CORRECT ANSWER: B. Use a jaw-thrust maneuver without head extension
Rationale: The jaw-thrust maneuver is the safest method to open the airway in a
patient with a suspected cervical spine injury because it does not require head
extension, which could exacerbate spinal cord damage.
Question 8: A nurse is calculating the Parkland formula for a patient with burns
to 40% of total body surface area weighing 70 kg. What volume should be
administered in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 8,400 mL
CORRECT ANSWER: C. 11,200 mL
Rationale: The Parkland formula is 4 mL × body weight (kg) × % TBSA burned. 4 ×
70 × 40 = 11,200 mL total. Half is given in the first 8 hours, so 5,600 mL is
, administered in the first 8 hours. However, the question asks for the volume in
the first 8 hours, which is half of the total, equaling 5,600 mL. Wait, let me
recalculate: 4 × 70 × 40 = 11,200 mL total for 24 hours. Half of that is 5,600 mL in
the first 8 hours. The correct answer should be B. 5,600 mL.
CORRECT ANSWER: B. 5,600 mL
Rationale: The Parkland formula calculates total fluid replacement as 4 mL ×
weight (kg) × % TBSA burned. For this patient: 4 × 70 × 40 = 11,200 mL over 24
hours. Half of this volume (5,600 mL) is administered in the first 8 hours, and the
remaining half over the next 16 hours.
Question 9: A nurse is caring for a patient with a new tracheostomy. Which
finding indicates a need for immediate suctioning?
A. Respiratory rate of 18 breaths per minute
B. Audible secretions and oxygen saturation of 88%
C. Pink, moist stoma
D. Request for pain medication
CORRECT ANSWER: B. Audible secretions and oxygen saturation of 88%
Rationale: Audible secretions with falling oxygen saturation indicate the need for
suctioning to clear the airway and improve oxygenation. Suctioning should be
performed when clinically indicated, not routinely.
Question 10: A patient with acute kidney injury has a potassium level of 6.8
mEq/L. Which intervention should the nurse anticipate first?
A. Administration of sodium bicarbonate
B. Administration of calcium gluconate
C. Initiation of hemodialysis
D. Administration of furosemide
CORRECT ANSWER: B. Administration of calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize the myocardial cell
membrane and prevent lethal dysrhythmias from hyperkalemia. It does not lower
potassium but protects the heart while other measures are implemented.
