NUR 2356: MULTIDIMENSIONAL CARE
III COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with a high level of Positive End-Expiratory Pressure (PEEP). The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
nurse’s priority action?
A. Increase the FIO2 to 100% immediately.
B. Suction the patient to clear potential mucus plugs.
C. Prepare for immediate needle thoracostomy or chest tube insertion.
D. Document the findings as a normal response to high PEEP.
Answer: C
Conceptual Explanation: High levels of PEEP increase the risk of barotrauma, such as
tension pneumothorax. A sudden drop in BP and unilateral decreased breath sounds
suggest this complication, requiring urgent decompression.
,2. A client is admitted to the burn unit with second and third-degree burns over the entire left
arm, left leg, and anterior trunk. Using the Rule of Nines, what is the total percentage of Body
Surface Area (BSA) affected?
A. 36%
B. 54%
C. 45%
D. 27%
Answer: C
Conceptual Explanation: Left arm (9%) + Left leg (18%) + Anterior trunk (18%) = 45%.
3. An ICU nurse is monitoring a patient in the ‘warm phase’ of septic shock. Which
hemodynamic finding is most consistent with this stage?
A. Decreased cardiac output and high systemic vascular resistance.
B. Severe peripheral vasoconstriction and hypertension.
C. Increased pulmonary artery wedge pressure and bradycardia.
D. Increased cardiac output and low systemic vascular resistance.
Answer: D
Conceptual Explanation: Early or ‘warm’ septic shock is characterized by hyperdynamic
state: high CO and low SVR due to vasodilation.
, 4. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 55 mmHg, HCO3 28 mEq/L.
How should the nurse interpret these results?
A. Fully compensated metabolic acidosis.
B. Partially compensated metabolic alkalosis.
C. Uncompensated respiratory alkalosis.
D. Partially compensated respiratory acidosis.
Answer: D
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory cause), and
HCO3 is high (compensatory effort by kidneys), but the pH is not yet normal, indicating
partial compensation.
5. The nurse is caring for a patient with a traumatic brain injury. The patient’s vital signs show
a widening pulse pressure, bradycardia, and irregular respirations. What does this ‘Cushing’s
Triad’ indicate?
A. Imminent brain herniation due to increased intracranial pressure.
B. Severe hypovolemic shock requiring fluid resuscitation.
C. Recovery phase of a concussion.
D. Development of diabetes insipidus.
Answer: A
III COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with a high level of Positive End-Expiratory Pressure (PEEP). The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
nurse’s priority action?
A. Increase the FIO2 to 100% immediately.
B. Suction the patient to clear potential mucus plugs.
C. Prepare for immediate needle thoracostomy or chest tube insertion.
D. Document the findings as a normal response to high PEEP.
Answer: C
Conceptual Explanation: High levels of PEEP increase the risk of barotrauma, such as
tension pneumothorax. A sudden drop in BP and unilateral decreased breath sounds
suggest this complication, requiring urgent decompression.
,2. A client is admitted to the burn unit with second and third-degree burns over the entire left
arm, left leg, and anterior trunk. Using the Rule of Nines, what is the total percentage of Body
Surface Area (BSA) affected?
A. 36%
B. 54%
C. 45%
D. 27%
Answer: C
Conceptual Explanation: Left arm (9%) + Left leg (18%) + Anterior trunk (18%) = 45%.
3. An ICU nurse is monitoring a patient in the ‘warm phase’ of septic shock. Which
hemodynamic finding is most consistent with this stage?
A. Decreased cardiac output and high systemic vascular resistance.
B. Severe peripheral vasoconstriction and hypertension.
C. Increased pulmonary artery wedge pressure and bradycardia.
D. Increased cardiac output and low systemic vascular resistance.
Answer: D
Conceptual Explanation: Early or ‘warm’ septic shock is characterized by hyperdynamic
state: high CO and low SVR due to vasodilation.
, 4. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 55 mmHg, HCO3 28 mEq/L.
How should the nurse interpret these results?
A. Fully compensated metabolic acidosis.
B. Partially compensated metabolic alkalosis.
C. Uncompensated respiratory alkalosis.
D. Partially compensated respiratory acidosis.
Answer: D
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory cause), and
HCO3 is high (compensatory effort by kidneys), but the pH is not yet normal, indicating
partial compensation.
5. The nurse is caring for a patient with a traumatic brain injury. The patient’s vital signs show
a widening pulse pressure, bradycardia, and irregular respirations. What does this ‘Cushing’s
Triad’ indicate?
A. Imminent brain herniation due to increased intracranial pressure.
B. Severe hypovolemic shock requiring fluid resuscitation.
C. Recovery phase of a concussion.
D. Development of diabetes insipidus.
Answer: A
