NUR 417 Exam 1 V3 | NUR 417 Nursing Care of the
Adult II | Actual Q&A with Rationale (NUR417
Exam 1) | Concordia
1. A patient in the intensive care unit is showing a sinus bradycardia rhythm with a heart rate
of 38 beats per minute and a blood pressure of 82/48 mmHg. The patient is complaining of
dizziness and chest pain. Which intervention is the nurse’s immediate priority?
A. Prepare for immediate synchronized cardioversion.
B. Begin chest compressions immediately.
C. Start a Dopamine infusion at 10 mcg/kg/min.
D. Administer 0.5 mg of Atropine IV push.
Correct Answer: D
Explanation: According to ACLS guidelines for symptomatic bradycardia, Atropine is the
first-line medication to increase the heart rate. The patient is showing signs of poor
perfusion including hypotension and chest pain, making intervention urgent. If Atropine is
ineffective, the nurse would then consider transcutaneous pacing or vasopressor infusions.
2. A nurse is caring for a patient who was admitted with Acute Respiratory Distress Syndrome
(ARDS). The patient is currently on mechanical ventilation with a PEEP of 15 cm H2O. Which
complication should the nurse monitor for most closely associated with high PEEP?
A. Respiratory alkalosis due to hyperventilation.
B. Increased renal perfusion and urine output.
,C. Pneumothorax and decreased cardiac output.
D. Decreased intracranial pressure.
Correct Answer: C
Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase
intrathoracic pressure, which can lead to barotrauma such as a pneumothorax.
Additionally, the increased pressure decreases venous return to the heart, leading to
reduced cardiac output and hypotension. Nurses must frequently assess lung sounds and
hemodynamic stability in these patients.
3. The nurse is reviewing the Arterial Blood Gas (ABG) results for a patient with diabetic
ketoacidosis (DKA): pH 7.25, PaCO2 30 mmHg, HCO3 15 mEq/L. How should the nurse
interpret these findings?
A. Uncompensated respiratory acidosis.
B. Fully compensated metabolic alkalosis.
C. Partially compensated metabolic acidosis.
D. Partially compensated respiratory alkalosis.
Correct Answer: C
Explanation: The pH is low (acidosis), and the primary problem is a low HCO3 (metabolic).
The PaCO2 is also low, indicating that the lungs are attempting to compensate by blowing
off CO2. Because the pH has not yet returned to the normal range, it is considered partially
compensated metabolic acidosis.
,4. A patient is admitted with septic shock. The nurse notes the following: BP 80/40 mmHg, HR
120 bpm, and a lactate level of 5 mmol/L. What is the priority nursing action within the first
hour of the ‘Sepsis Six’ or surviving sepsis bundle?
A. Administer a 2-liter bolus of 5% Dextrose in Water.
B. Obtain blood cultures and start broad-spectrum antibiotics.
C. Place the patient in a Trendelenburg position to improve BP.
D. Wait for the central venous pressure (CVP) result before giving fluids.
Correct Answer: B
Explanation: Early identification and treatment of the infection source are critical in sepsis
management. Obtaining cultures before antibiotic administration is essential for targeted
therapy, although antibiotics should not be delayed if cultures are difficult to obtain. Fluid
resuscitation with isotonic crystalloids (not D5W) is also a priority but must be
accompanied by infection control.
5. The nurse is monitoring a patient’s Central Venous Pressure (CVP) and notes a reading of 1
mmHg. Which clinical assessment finding would the nurse expect to accompany this result?
A. Jugular venous distention and S3 heart sound.
B. Crackles in the lung bases and peripheral edema.
C. Increased urine output and hypertension.
D. Dry mucous membranes and poor skin turgor.
, Correct Answer: D
Explanation: A normal CVP ranges from 2 to 8 mmHg. A low CVP of 1 mmHg indicates
hypovolemia or fluid volume deficit. Clinical signs of dehydration, such as dry mucous
membranes and poor turgor, correlate with low venous filling pressures.
6. A patient with a history of heart failure is experiencing frequent Premature Ventricular
Contractions (PVCs). Which electrolyte imbalance should the nurse prioritize checking?
A. Hyponatremia and Hypercalcemia.
B. Hypochloremia and Hypermagnesemia.
C. Hyperkalemia and Hypocalcemia.
D. Hypokalemia and Hypomagnesemia.
Correct Answer: D
Explanation: Low levels of potassium and magnesium are common causes of ventricular
irritability and PVCs. Patients with heart failure are often on diuretics, which can further
deplete these electrolytes. Correcting these imbalances is a priority to prevent more lethal
dysrhythmias like Ventricular Tachycardia.
7. Which clinical manifestations are characteristic of the ‘cold’ or late phase of septic shock?
(Select All That Apply)
A. Mottled, cool skin
B. Increased cardiac output
Adult II | Actual Q&A with Rationale (NUR417
Exam 1) | Concordia
1. A patient in the intensive care unit is showing a sinus bradycardia rhythm with a heart rate
of 38 beats per minute and a blood pressure of 82/48 mmHg. The patient is complaining of
dizziness and chest pain. Which intervention is the nurse’s immediate priority?
A. Prepare for immediate synchronized cardioversion.
B. Begin chest compressions immediately.
C. Start a Dopamine infusion at 10 mcg/kg/min.
D. Administer 0.5 mg of Atropine IV push.
Correct Answer: D
Explanation: According to ACLS guidelines for symptomatic bradycardia, Atropine is the
first-line medication to increase the heart rate. The patient is showing signs of poor
perfusion including hypotension and chest pain, making intervention urgent. If Atropine is
ineffective, the nurse would then consider transcutaneous pacing or vasopressor infusions.
2. A nurse is caring for a patient who was admitted with Acute Respiratory Distress Syndrome
(ARDS). The patient is currently on mechanical ventilation with a PEEP of 15 cm H2O. Which
complication should the nurse monitor for most closely associated with high PEEP?
A. Respiratory alkalosis due to hyperventilation.
B. Increased renal perfusion and urine output.
,C. Pneumothorax and decreased cardiac output.
D. Decreased intracranial pressure.
Correct Answer: C
Explanation: High levels of Positive End-Expiratory Pressure (PEEP) increase
intrathoracic pressure, which can lead to barotrauma such as a pneumothorax.
Additionally, the increased pressure decreases venous return to the heart, leading to
reduced cardiac output and hypotension. Nurses must frequently assess lung sounds and
hemodynamic stability in these patients.
3. The nurse is reviewing the Arterial Blood Gas (ABG) results for a patient with diabetic
ketoacidosis (DKA): pH 7.25, PaCO2 30 mmHg, HCO3 15 mEq/L. How should the nurse
interpret these findings?
A. Uncompensated respiratory acidosis.
B. Fully compensated metabolic alkalosis.
C. Partially compensated metabolic acidosis.
D. Partially compensated respiratory alkalosis.
Correct Answer: C
Explanation: The pH is low (acidosis), and the primary problem is a low HCO3 (metabolic).
The PaCO2 is also low, indicating that the lungs are attempting to compensate by blowing
off CO2. Because the pH has not yet returned to the normal range, it is considered partially
compensated metabolic acidosis.
,4. A patient is admitted with septic shock. The nurse notes the following: BP 80/40 mmHg, HR
120 bpm, and a lactate level of 5 mmol/L. What is the priority nursing action within the first
hour of the ‘Sepsis Six’ or surviving sepsis bundle?
A. Administer a 2-liter bolus of 5% Dextrose in Water.
B. Obtain blood cultures and start broad-spectrum antibiotics.
C. Place the patient in a Trendelenburg position to improve BP.
D. Wait for the central venous pressure (CVP) result before giving fluids.
Correct Answer: B
Explanation: Early identification and treatment of the infection source are critical in sepsis
management. Obtaining cultures before antibiotic administration is essential for targeted
therapy, although antibiotics should not be delayed if cultures are difficult to obtain. Fluid
resuscitation with isotonic crystalloids (not D5W) is also a priority but must be
accompanied by infection control.
5. The nurse is monitoring a patient’s Central Venous Pressure (CVP) and notes a reading of 1
mmHg. Which clinical assessment finding would the nurse expect to accompany this result?
A. Jugular venous distention and S3 heart sound.
B. Crackles in the lung bases and peripheral edema.
C. Increased urine output and hypertension.
D. Dry mucous membranes and poor skin turgor.
, Correct Answer: D
Explanation: A normal CVP ranges from 2 to 8 mmHg. A low CVP of 1 mmHg indicates
hypovolemia or fluid volume deficit. Clinical signs of dehydration, such as dry mucous
membranes and poor turgor, correlate with low venous filling pressures.
6. A patient with a history of heart failure is experiencing frequent Premature Ventricular
Contractions (PVCs). Which electrolyte imbalance should the nurse prioritize checking?
A. Hyponatremia and Hypercalcemia.
B. Hypochloremia and Hypermagnesemia.
C. Hyperkalemia and Hypocalcemia.
D. Hypokalemia and Hypomagnesemia.
Correct Answer: D
Explanation: Low levels of potassium and magnesium are common causes of ventricular
irritability and PVCs. Patients with heart failure are often on diuretics, which can further
deplete these electrolytes. Correcting these imbalances is a priority to prevent more lethal
dysrhythmias like Ventricular Tachycardia.
7. Which clinical manifestations are characteristic of the ‘cold’ or late phase of septic shock?
(Select All That Apply)
A. Mottled, cool skin
B. Increased cardiac output
