NUR 231 EXAM 3 - ADVANCED NURSING
CONCEPTS QUESTIONS AND ANSWERS
100% VERIFIED (2026/2027) | ILLINOIS
STATE UNIVERSITY
1. A patient in the ICU with a pulmonary artery catheter has a Pulmonary Artery Wedge
Pressure (PAWP) of 22 mmHg. Which clinical finding should the nurse expect to assess?
A. Dry mucous membranes and poor skin turgor
B. Bilateral crackles and dyspnea
C. Decreased jugular venous distention
D. Increased urinary output and flat neck veins
Answer: B
Conceptual Explanation: An elevated PAWP (normal 6-12 mmHg) indicates left
ventricular end-diastolic pressure elevation, commonly seen in left-sided heart failure,
which leads to pulmonary congestion and crackles.
2. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L. How should
the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
,C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (uncompensated).
3. A patient with a history of heart failure is admitted with a new onset of atrial fibrillation
with a ventricular response rate of 140 bpm. Which medication should the nurse anticipate
administering first?
A. Atropine
B. Diltiazem
C. Epinephrine
D. Lidocaine
Answer: B
Conceptual Explanation: Diltiazem is a calcium channel blocker used to control the
ventricular rate in atrial fibrillation.
4. The nurse is monitoring a patient on a mechanical ventilator. The ‘High Pressure’ alarm
begins to sound. Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Increase the oxygen concentration to 100%
, C. Call the respiratory therapist to recalibrate
D. Assess the patient for a need to suction
Answer: D
Conceptual Explanation: High pressure alarms are triggered by increased resistance,
often caused by secretions, biting the tube, or coughing; suctioning is the first assessment
step.
5. A patient in the oliguric phase of Acute Kidney Injury (AKI) has a potassium level of 6.8
mEq/L. Which EKG change is the nurse most likely to observe?
A. U waves and ST depression
B. Tall, peaked T waves
C. Shortened PR interval
D. Prominent P waves
Answer: B
Conceptual Explanation: Hyperkalemia classically causes tall, peaked T waves, followed
by PR prolongation and widened QRS as levels increase.
6. Which assessment finding in a patient with Acute Respiratory Distress Syndrome (ARDS)
indicates that the condition is worsening?
A. Hypercapnia with a pH of 7.45
B. Hypoxemia that does not respond to increased oxygen concentrations
CONCEPTS QUESTIONS AND ANSWERS
100% VERIFIED (2026/2027) | ILLINOIS
STATE UNIVERSITY
1. A patient in the ICU with a pulmonary artery catheter has a Pulmonary Artery Wedge
Pressure (PAWP) of 22 mmHg. Which clinical finding should the nurse expect to assess?
A. Dry mucous membranes and poor skin turgor
B. Bilateral crackles and dyspnea
C. Decreased jugular venous distention
D. Increased urinary output and flat neck veins
Answer: B
Conceptual Explanation: An elevated PAWP (normal 6-12 mmHg) indicates left
ventricular end-diastolic pressure elevation, commonly seen in left-sided heart failure,
which leads to pulmonary congestion and crackles.
2. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L. How should
the nurse interpret these findings?
A. Compensated metabolic acidosis
B. Partially compensated respiratory alkalosis
,C. Uncompensated respiratory acidosis
D. Uncompensated metabolic alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is within the normal range (uncompensated).
3. A patient with a history of heart failure is admitted with a new onset of atrial fibrillation
with a ventricular response rate of 140 bpm. Which medication should the nurse anticipate
administering first?
A. Atropine
B. Diltiazem
C. Epinephrine
D. Lidocaine
Answer: B
Conceptual Explanation: Diltiazem is a calcium channel blocker used to control the
ventricular rate in atrial fibrillation.
4. The nurse is monitoring a patient on a mechanical ventilator. The ‘High Pressure’ alarm
begins to sound. Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Increase the oxygen concentration to 100%
, C. Call the respiratory therapist to recalibrate
D. Assess the patient for a need to suction
Answer: D
Conceptual Explanation: High pressure alarms are triggered by increased resistance,
often caused by secretions, biting the tube, or coughing; suctioning is the first assessment
step.
5. A patient in the oliguric phase of Acute Kidney Injury (AKI) has a potassium level of 6.8
mEq/L. Which EKG change is the nurse most likely to observe?
A. U waves and ST depression
B. Tall, peaked T waves
C. Shortened PR interval
D. Prominent P waves
Answer: B
Conceptual Explanation: Hyperkalemia classically causes tall, peaked T waves, followed
by PR prolongation and widened QRS as levels increase.
6. Which assessment finding in a patient with Acute Respiratory Distress Syndrome (ARDS)
indicates that the condition is worsening?
A. Hypercapnia with a pH of 7.45
B. Hypoxemia that does not respond to increased oxygen concentrations
