NURS 307 EXAM 3 COMPREHENSIVE
ASSESSMENT QUESTIONS AND
VERIFIED ANSWERS | 100% CORRECT |
GRADE A+
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. Which setting adjustment is most critical to prevent Ventilator-Induced Lung
Injury (VILI)?
A. Maintaining a Plateau Pressure (Pplat) below 30 cm H2O
B. Increasing the Tidal Volume (Vt) to 12 mL/kg
C. Decreasing Positive End-Expiratory Pressure (PEEP) to 2 cm H2O
D. Increasing the Fraction of Inspired Oxygen (FiO2) to 100% for long durations
Answer: A
Conceptual Explanation: Limiting plateau pressure is essential to prevent barotrauma
and volutrauma in ARDS patients, as their lungs are non-compliant; high volumes or
pressures can cause further injury.
2. A patient presents with a serum sodium of 118 mEq/L. Which complication is the nurse
most concerned about if sodium is replaced too rapidly?
A. Cerebral Edema
,B. Central Pontine Myelinolysis
C. Acute Tubular Necrosis
D. Pulmonary Edema
Answer: B
Conceptual Explanation: Rapid correction of hyponatremia can lead to osmotic
demyelination syndrome, specifically central pontine myelinolysis, causing permanent
neurological damage.
3. Which clinical finding is most indicative of the ‘Compensatory Stage’ of shock?
A. Narrowing pulse pressure and cold, clammy skin
B. Anuria and metabolic acidosis
C. Lethargy and decreased responsiveness
D. Refractory hypotension and organ failure
Answer: A
Conceptual Explanation: In the compensatory stage, the body uses the SNS to maintain
cardiac output, leading to vasoconstriction (cold skin) and increased diastolic pressure,
which narrows the pulse pressure.
4. In a patient with SIADH, which laboratory result is most expected?
A. Serum osmolality 320 mOsm/kg
B. Urine specific gravity 1.002
, C. Serum sodium 125 mEq/L
D. Urine output of 400 mL/hr
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, leading to water retention and
dilutional hyponatremia (low serum sodium). Urine becomes concentrated, not dilute.
5. Which EKG change is most characteristic of Hyperkalemia?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Tall, peaked T waves are the classic early sign of hyperkalemia.
As levels rise, the QRS widens and P waves may disappear.
6. A patient with a traumatic brain injury has an ICP of 22 mmHg. Which intervention should
be prioritized?
A. Place the patient in Trendelenburg position
B. Administer Mannitol (Osmitrol) IV as ordered
C. Encourage frequent coughing and deep breathing
ASSESSMENT QUESTIONS AND
VERIFIED ANSWERS | 100% CORRECT |
GRADE A+
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. Which setting adjustment is most critical to prevent Ventilator-Induced Lung
Injury (VILI)?
A. Maintaining a Plateau Pressure (Pplat) below 30 cm H2O
B. Increasing the Tidal Volume (Vt) to 12 mL/kg
C. Decreasing Positive End-Expiratory Pressure (PEEP) to 2 cm H2O
D. Increasing the Fraction of Inspired Oxygen (FiO2) to 100% for long durations
Answer: A
Conceptual Explanation: Limiting plateau pressure is essential to prevent barotrauma
and volutrauma in ARDS patients, as their lungs are non-compliant; high volumes or
pressures can cause further injury.
2. A patient presents with a serum sodium of 118 mEq/L. Which complication is the nurse
most concerned about if sodium is replaced too rapidly?
A. Cerebral Edema
,B. Central Pontine Myelinolysis
C. Acute Tubular Necrosis
D. Pulmonary Edema
Answer: B
Conceptual Explanation: Rapid correction of hyponatremia can lead to osmotic
demyelination syndrome, specifically central pontine myelinolysis, causing permanent
neurological damage.
3. Which clinical finding is most indicative of the ‘Compensatory Stage’ of shock?
A. Narrowing pulse pressure and cold, clammy skin
B. Anuria and metabolic acidosis
C. Lethargy and decreased responsiveness
D. Refractory hypotension and organ failure
Answer: A
Conceptual Explanation: In the compensatory stage, the body uses the SNS to maintain
cardiac output, leading to vasoconstriction (cold skin) and increased diastolic pressure,
which narrows the pulse pressure.
4. In a patient with SIADH, which laboratory result is most expected?
A. Serum osmolality 320 mOsm/kg
B. Urine specific gravity 1.002
, C. Serum sodium 125 mEq/L
D. Urine output of 400 mL/hr
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, leading to water retention and
dilutional hyponatremia (low serum sodium). Urine becomes concentrated, not dilute.
5. Which EKG change is most characteristic of Hyperkalemia?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Tall, peaked T waves are the classic early sign of hyperkalemia.
As levels rise, the QRS widens and P waves may disappear.
6. A patient with a traumatic brain injury has an ICP of 22 mmHg. Which intervention should
be prioritized?
A. Place the patient in Trendelenburg position
B. Administer Mannitol (Osmitrol) IV as ordered
C. Encourage frequent coughing and deep breathing
