NUR 265 ADVANCED MED-SURG &
CRITICAL CARE QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A patient in the progressive stage of shock exhibits which of the following physiological
changes?
A. Increased pH and decreased PaCO2 due to hyperventilation
B. Activation of the Renin-Angiotensin system to maintain blood pressure
C. Failure of the sodium-potassium pump leading to cellular edema
D. Peripheral vasodilation to increase organ perfusion
Answer: C
Conceptual Explanation: In the progressive stage of shock, compensatory mechanisms
fail. The lack of ATP causes the sodium-potassium pump to fail, leading to cellular swelling
and death.
,2. Which assessment finding is most indicative of the ‘Cushing’s Triad’ in a patient with
increased intracranial pressure?
A. Tachycardia, hypertension, and Cheyne-Stokes respirations
B. Tachycardia, hypotension, and tachypnea
C. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
D. Bradycardia, hypotension, and apnea
Answer: C
Conceptual Explanation: Cushing’s Triad is a late sign of increased ICP consisting of a
widening pulse pressure (systolic goes up), bradycardia, and irregular respiratory patterns.
3. Using the Parkland Formula, calculate the fluid resuscitation volume for the first 8 hours
for a 70kg patient with 40% TBSA burns.
A. 11,200 mL
B. 2,800 mL
C. 4,200 mL
D. 5,600 mL
Answer: D
Conceptual Explanation: Parkland Formula: 4mL x kg x %TBSA. Total = 4 x 70 x 40 =
11,200 mL. Half is given in the first 8 hours: 11, = 5,600 mL.
, 4. A nurse is caring for a patient with a spinal cord injury at T4. The patient reports a sudden
severe headache and has a BP of 190/100. What is the priority action?
A. Check for bladder distention or fecal impaction
B. Administer PRN antihypertensive medication
C. Lower the head of the bed to the Trendelenburg position
D. Increase the IV fluid rate to maintain perfusion
Answer: A
Conceptual Explanation: These are signs of Autonomic Dysreflexia, often triggered by a
full bladder or bowel. The first action is to identify and remove the noxious stimulus while
sitting the patient upright.
5. What is the hallmark physiological indicator of Acute Respiratory Distress Syndrome
(ARDS)?
A. Hypoxemia refractory to supplemental oxygen
B. Hypercapnia refractory to oxygen therapy
C. Increased pulmonary compliance
D. Decreased pulmonary artery wedge pressure (PAWP)
Answer: A
Conceptual Explanation: Refractory hypoxemia, where the PaO2 does not improve even
with high concentrations of oxygen, is the hallmark of ARDS due to significant shunting.
CRITICAL CARE QUESTIONS AND
ANSWERS WITH VERIFIED SOLUTIONS
2026/2027 UPDATE. JUST RELEASED
1. A patient in the progressive stage of shock exhibits which of the following physiological
changes?
A. Increased pH and decreased PaCO2 due to hyperventilation
B. Activation of the Renin-Angiotensin system to maintain blood pressure
C. Failure of the sodium-potassium pump leading to cellular edema
D. Peripheral vasodilation to increase organ perfusion
Answer: C
Conceptual Explanation: In the progressive stage of shock, compensatory mechanisms
fail. The lack of ATP causes the sodium-potassium pump to fail, leading to cellular swelling
and death.
,2. Which assessment finding is most indicative of the ‘Cushing’s Triad’ in a patient with
increased intracranial pressure?
A. Tachycardia, hypertension, and Cheyne-Stokes respirations
B. Tachycardia, hypotension, and tachypnea
C. Bradycardia, hypertension with a widening pulse pressure, and irregular respirations
D. Bradycardia, hypotension, and apnea
Answer: C
Conceptual Explanation: Cushing’s Triad is a late sign of increased ICP consisting of a
widening pulse pressure (systolic goes up), bradycardia, and irregular respiratory patterns.
3. Using the Parkland Formula, calculate the fluid resuscitation volume for the first 8 hours
for a 70kg patient with 40% TBSA burns.
A. 11,200 mL
B. 2,800 mL
C. 4,200 mL
D. 5,600 mL
Answer: D
Conceptual Explanation: Parkland Formula: 4mL x kg x %TBSA. Total = 4 x 70 x 40 =
11,200 mL. Half is given in the first 8 hours: 11, = 5,600 mL.
, 4. A nurse is caring for a patient with a spinal cord injury at T4. The patient reports a sudden
severe headache and has a BP of 190/100. What is the priority action?
A. Check for bladder distention or fecal impaction
B. Administer PRN antihypertensive medication
C. Lower the head of the bed to the Trendelenburg position
D. Increase the IV fluid rate to maintain perfusion
Answer: A
Conceptual Explanation: These are signs of Autonomic Dysreflexia, often triggered by a
full bladder or bowel. The first action is to identify and remove the noxious stimulus while
sitting the patient upright.
5. What is the hallmark physiological indicator of Acute Respiratory Distress Syndrome
(ARDS)?
A. Hypoxemia refractory to supplemental oxygen
B. Hypercapnia refractory to oxygen therapy
C. Increased pulmonary compliance
D. Decreased pulmonary artery wedge pressure (PAWP)
Answer: A
Conceptual Explanation: Refractory hypoxemia, where the PaO2 does not improve even
with high concentrations of oxygen, is the hallmark of ARDS due to significant shunting.
