NUR 417 Exam 3 V1 | NUR 417 Nursing Care of the
Adult II | Actual Q&A with Rationale (NUR417
Exam 3) | Concordia
1. A patient in the progressive stage of septic shock has a blood pressure of 82/40 mmHg and
a heart rate of 126 bpm. Which intervention should the nurse prioritize first?
A. Obtaining blood cultures from two different sites.
B. Starting a norepinephrine infusion to maintain MAP > 65 mmHg.
C. Administering a bolus of 0.9% Normal Saline at 30 mL/kg.
D. Administering broad-spectrum antibiotics within the hour.
Correct Answer: C
Explanation: Fluid resuscitation is the first-line treatment for sepsis-induced hypotension
according to the Surviving Sepsis Campaign. The goal is to restore circulating volume and
improve tissue perfusion before initiating vasopressors. While antibiotics and cultures are
vital, stabilizing the hemodynamics with volume is the immediate priority.
2. A patient with a spinal cord injury at T3 is experiencing neurogenic shock. Which clinical
finding does the nurse expect to observe?
A. Tachycardia and hypertension.
B. Cool, clammy extremities and tachypnea.
C. Bradycardia and hypotension.
,D. Increased systemic vascular resistance (SVR).
Correct Answer: C
Explanation: Neurogenic shock is characterized by the loss of sympathetic tone, leading to
massive vasodilation and bradycardia. Unlike other forms of shock, the heart rate does not
increase as a compensatory mechanism because the sympathetic nervous system is
disrupted. Hypotension occurs due to the decreased peripheral vascular resistance.
3. Which lab result most clearly indicates that a patient is developing Disseminated
Intravascular Coagulation (DIC)?
A. Elevated D-dimer and decreased fibrinogen.
B. Increased platelet count and decreased PT.
C. Decreased BUN and Creatinine.
D. Elevated Hemoglobin and Hematocrit.
Correct Answer: A
Explanation: DIC involves simultaneous widespread clotting and bleeding, leading to the
consumption of clotting factors. An elevated D-dimer indicates the breakdown of clots,
while a decreased fibrinogen level reflects the consumption of these factors. This
laboratory profile is a hallmark of the condition’s progression.
, 4. A patient is admitted with 35% Total Body Surface Area (TBSA) burns. Using the Parkland
formula (4mL/kg/%TBSA), what is the total fluid volume for the first 24 hours for a patient
weighing 80kg?
A. 8,400 mL
B. 5,600 mL
C. 11,200 mL
D. 10,000 mL
Correct Answer: C
Explanation: The Parkland formula is calculated as 4mL x weight in kg x % TBSA burned.
For this patient, the calculation is 4mL * 80kg * 35 = 11,200 mL. Half of this total (5,600
mL) must be administered within the first 8 hours from the time of the burn injury.
5. A nurse is caring for a patient receiving chemotherapy who has a neutrophil count of
450/mm³. Which nursing action is essential? (Select All That Apply)
A. Place the patient in a private room.
B. Ensure all visitors wash their hands before entering.
C. Serve the patient fresh salads and fruit to boost immunity.
D. Monitor the patient’s temperature every 4 hours.
E. Avoid invasive procedures such as urinary catheterization if possible.
F. Allow the patient to keep fresh flowers in the room.
Adult II | Actual Q&A with Rationale (NUR417
Exam 3) | Concordia
1. A patient in the progressive stage of septic shock has a blood pressure of 82/40 mmHg and
a heart rate of 126 bpm. Which intervention should the nurse prioritize first?
A. Obtaining blood cultures from two different sites.
B. Starting a norepinephrine infusion to maintain MAP > 65 mmHg.
C. Administering a bolus of 0.9% Normal Saline at 30 mL/kg.
D. Administering broad-spectrum antibiotics within the hour.
Correct Answer: C
Explanation: Fluid resuscitation is the first-line treatment for sepsis-induced hypotension
according to the Surviving Sepsis Campaign. The goal is to restore circulating volume and
improve tissue perfusion before initiating vasopressors. While antibiotics and cultures are
vital, stabilizing the hemodynamics with volume is the immediate priority.
2. A patient with a spinal cord injury at T3 is experiencing neurogenic shock. Which clinical
finding does the nurse expect to observe?
A. Tachycardia and hypertension.
B. Cool, clammy extremities and tachypnea.
C. Bradycardia and hypotension.
,D. Increased systemic vascular resistance (SVR).
Correct Answer: C
Explanation: Neurogenic shock is characterized by the loss of sympathetic tone, leading to
massive vasodilation and bradycardia. Unlike other forms of shock, the heart rate does not
increase as a compensatory mechanism because the sympathetic nervous system is
disrupted. Hypotension occurs due to the decreased peripheral vascular resistance.
3. Which lab result most clearly indicates that a patient is developing Disseminated
Intravascular Coagulation (DIC)?
A. Elevated D-dimer and decreased fibrinogen.
B. Increased platelet count and decreased PT.
C. Decreased BUN and Creatinine.
D. Elevated Hemoglobin and Hematocrit.
Correct Answer: A
Explanation: DIC involves simultaneous widespread clotting and bleeding, leading to the
consumption of clotting factors. An elevated D-dimer indicates the breakdown of clots,
while a decreased fibrinogen level reflects the consumption of these factors. This
laboratory profile is a hallmark of the condition’s progression.
, 4. A patient is admitted with 35% Total Body Surface Area (TBSA) burns. Using the Parkland
formula (4mL/kg/%TBSA), what is the total fluid volume for the first 24 hours for a patient
weighing 80kg?
A. 8,400 mL
B. 5,600 mL
C. 11,200 mL
D. 10,000 mL
Correct Answer: C
Explanation: The Parkland formula is calculated as 4mL x weight in kg x % TBSA burned.
For this patient, the calculation is 4mL * 80kg * 35 = 11,200 mL. Half of this total (5,600
mL) must be administered within the first 8 hours from the time of the burn injury.
5. A nurse is caring for a patient receiving chemotherapy who has a neutrophil count of
450/mm³. Which nursing action is essential? (Select All That Apply)
A. Place the patient in a private room.
B. Ensure all visitors wash their hands before entering.
C. Serve the patient fresh salads and fruit to boost immunity.
D. Monitor the patient’s temperature every 4 hours.
E. Avoid invasive procedures such as urinary catheterization if possible.
F. Allow the patient to keep fresh flowers in the room.
