NUR 265 EXAM 3 - ADVANCED MED-
SURG AND CRITICAL CARE
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
of the following ventilator settings is most critical for improving oxygenation by preventing
alveolar collapse at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of inspired oxygen (FiO2) at 100%
C. Tidal volume of 10 mL/kg
D. Inspiratory to Expiratory (I:E) ratio of 1:2
Answer: A
Conceptual Explanation: PEEP maintains pressure in the lungs at the end of expiration to
keep alveoli open, improving gas exchange and preventing atelectasis in ARDS patients.
2. A patient with septic shock is receiving large volumes of crystalloid fluids. Which
hemodynamic parameter would best indicate that the patient is developing fluid volume
overload?
A. Mean Arterial Pressure (MAP) of 70 mmHg
,B. Central Venous Pressure (CVP) of 18 mmHg
C. Systemic Vascular Resistance (SVR) of 1200 dynes
D. Cardiac Output (CO) of 5 L/min
Answer: B
Conceptual Explanation: CVP reflects right atrial pressure and fluid volume status. A
normal CVP is 2-8 mmHg; 18 mmHg indicates significant fluid volume excess or right-sided
heart failure.
3. While monitoring a patient on a mechanical ventilator, the high-pressure alarm sounds.
Which action should the nurse take first?
A. Assess the patient’s breath sounds and check for airway obstruction
B. Silence the alarm and increase the FiO2
C. Call the respiratory therapist to change the ventilator tubing
D. Check for a leak in the cuff of the endotracheal tube
Answer: A
Conceptual Explanation: High-pressure alarms are triggered by increased resistance
(kinked tubing, secretions, biting the tube, or pneumothorax). The nurse must first assess
the patient’s physiological status and airway.
, 4. A patient presents with the following ABG results: pH 7.28, PaCO2 55 mmHg, HCO3 26
mEq/L, and PaO2 72 mmHg. How should the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause). The HCO3 is normal, meaning no compensation has occurred yet.
5. Which clinical finding is most characteristic of the ‘Hyperdynamic’ or early phase of septic
shock?
A. Cold, clammy skin and bradycardia
B. Warm, flushed skin and increased cardiac output
C. Decreased cardiac output and high SVR
D. Severe hypotension and oliguria
Answer: B
Conceptual Explanation: In early (warm) sepsis, vasodilation causes warm, flushed skin
and the heart compensates by increasing cardiac output (tachycardia).
SURG AND CRITICAL CARE
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
of the following ventilator settings is most critical for improving oxygenation by preventing
alveolar collapse at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Fraction of inspired oxygen (FiO2) at 100%
C. Tidal volume of 10 mL/kg
D. Inspiratory to Expiratory (I:E) ratio of 1:2
Answer: A
Conceptual Explanation: PEEP maintains pressure in the lungs at the end of expiration to
keep alveoli open, improving gas exchange and preventing atelectasis in ARDS patients.
2. A patient with septic shock is receiving large volumes of crystalloid fluids. Which
hemodynamic parameter would best indicate that the patient is developing fluid volume
overload?
A. Mean Arterial Pressure (MAP) of 70 mmHg
,B. Central Venous Pressure (CVP) of 18 mmHg
C. Systemic Vascular Resistance (SVR) of 1200 dynes
D. Cardiac Output (CO) of 5 L/min
Answer: B
Conceptual Explanation: CVP reflects right atrial pressure and fluid volume status. A
normal CVP is 2-8 mmHg; 18 mmHg indicates significant fluid volume excess or right-sided
heart failure.
3. While monitoring a patient on a mechanical ventilator, the high-pressure alarm sounds.
Which action should the nurse take first?
A. Assess the patient’s breath sounds and check for airway obstruction
B. Silence the alarm and increase the FiO2
C. Call the respiratory therapist to change the ventilator tubing
D. Check for a leak in the cuff of the endotracheal tube
Answer: A
Conceptual Explanation: High-pressure alarms are triggered by increased resistance
(kinked tubing, secretions, biting the tube, or pneumothorax). The nurse must first assess
the patient’s physiological status and airway.
, 4. A patient presents with the following ABG results: pH 7.28, PaCO2 55 mmHg, HCO3 26
mEq/L, and PaO2 72 mmHg. How should the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause). The HCO3 is normal, meaning no compensation has occurred yet.
5. Which clinical finding is most characteristic of the ‘Hyperdynamic’ or early phase of septic
shock?
A. Cold, clammy skin and bradycardia
B. Warm, flushed skin and increased cardiac output
C. Decreased cardiac output and high SVR
D. Severe hypotension and oliguria
Answer: B
Conceptual Explanation: In early (warm) sepsis, vasodilation causes warm, flushed skin
and the heart compensates by increasing cardiac output (tachycardia).
