NUR445 EXAM 4 STUDY GUIDE 2026/2027 | NURSING
PRACTICE QUESTIONS AND ANSWERS
A nurse is assisting with triaging clients following an explosion. Which of the following clients should the
nurse identify as the highest priority? - Correct answer✅✅ A conscious adult client who has second-
degree burns on both lower legs; respiratory rate is > 30/min
A charge nurse is discussing the phases of community response to disaster with nursing staff. Which of
the following statements indicates an understanding of the heroic phase of disaster response? - Correct
answer✅✅ "Personnel are willing to work in dangerous conditions to provide assistance."
A nurse is assessing an adolescent who experienced blunt trauma to the abdomen. Which of the
following findings is the nurse's priority? - Correct answer✅✅ Blood pressure 92/50 mm Hg
A nurse is caring for a client who experienced an open, right femur fracture following a motor-vehicle
crash. - Correct answer✅✅ The nurse should identify that the client is most likely experiencing
compartment syndrome. Compartment syndrome occurs following a fracture due to increased edema of
the extremity or restriction by a cast or splint. It is identified by the five Ps: pain, pallor, pulselessness,
paresthesia, and paralysis. Compartment syndrome is a medical emergency. The nurse's priorities are to
loosen the dressing to the splint and assess the client's peripheral pulses. A pulse volume recorder may
be necessary to detect the peripheral pulses. The nurse should frequently monitor the client's
neurovascular function to detect any changes that may indicate further progression of compartment
syndrome. The nurse should also monitor and treat the client's pain using prescribed opioids.
A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the
following agents should the nurse plan to administer a vaccine following exposure? - Correct
answer✅✅ Smallpox
Which of the following are potential signs or symptoms of internal bleeding caused by a brown recluse
spider bite? - Correct answer✅✅ Internal bleeding caused by a brown recluse spider bite can manifest
as abdominal pain, black or tarry stools, bloody or dark urine, and chest pain with shortness of breath.
Skin rash and itching, headache and dizziness, joint pain and swelling, numbness and tingling, and fever
and chills are not typically associated with internal bleeding from a spider bite.
,A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare
the protocol based on which of the following information? (Select all that apply.) - Correct answer✅✅
Botulism can produce paralysis within 12 to 72 hr following exposure is correct. Botulism is a neurotoxin
that can cause flaccid paralysis within hours of exposure. Notify the Centers for Disease Control and
Prevention (CDC) when more than three cases are confirmed is incorrect. Due to the threat of a botulism
outbreak, the CDC should be notified if even a single case is suspected. Botulism is acquired through
direct contact with an infected person is incorrect. Botulism is primarily acquired through ingestion of a
contaminated food source. Vomiting and diarrhea are expected findings following exposure is correct.
Vomiting and diarrhea are expected findings following ingestion of botulism. Botulism is a toxin found in
castor beans is incorrect. Ricin, rather than botulism, is a toxin found in castor beans.
A nurse is caring for a client who has burns to his face, ears, and eyelids. The nurse should identify which
of the following is the priority finding to report to the provider? - Correct answer✅✅ Difficulty
swallowing
A nurse in an emergency department is caring for a client who has a sucking chest wound resulting from
a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a
respiratory rate of 40/min. Which of the following actions should the nurse take? - Correct answer✅✅
Administer oxygen via nasal cannula.
A community health nurse is teaching a group of community members about natural disasters. Which of
the following information about natural disasters should the nurse include in the teaching? - Correct
answer✅✅ They are geological or meteorological occurrences.
A nurse is among the first responders to a mass-casualty incident and does not know what type of
personal protective equipment (PPE) is needed. Which of the following actions should the nurse take? -
Correct answer✅✅ Choose the highest level of protection equipment available.
A public health nurse is teaching a group of nurses about smallpox. Which of the following statements
by one of the nurses indicates understanding of the teaching? - Correct answer✅✅ "Unlike
chickenpox, the vesicles of smallpox are more abundant on the face."
A nurse is admitting a client who sustained severe burn injuries. The nurse refers to the rule of nines to
determine the total body surface area of the burn injury. What percentage of body surface area should
the nurse estimate the client has burned? - Correct answer✅✅ 54%
, Which of the following are potential indications for spinal immobilization in clients? - Correct
answer✅✅ Spinal immobilization is indicated in clients with suspected spinal cord injury and loss of
consciousness as these conditions may be associated with spinal injury. Simple fractures of extremities,
acute myocardial infarction, asthma exacerbation, severe allergic reactions, and acute appendicitis do
not require spinal immobilization unless there is suspicion of associated spinal injury.
A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the
following clients should the nurse plan to care for first? - Correct answer✅✅ A client experiencing a
tension pneumothorax
When should a client with rib fractures use the incentive spirometer? - Correct answer✅✅ Every 1
hour while awake
A burn patient with 20% total body surface area (TBSA) burn is receiving fluid resuscitation. The Parkland
formula is being used to calculate the fluid replacement. The formula recommends administering 4 mL
of lactated Ringer's solution per kilogram of body weight for the first 24 hours, with half of the total
volume given in the first 8 hours. The patient weighs 70 kg. How much lactated Ringer's solution should
the patient receive in the first 8 hours? - Correct answer✅✅ 1400 mL
CORRECT
Correct! According to the Parkland formula, the patient should receive half of the total volume in the
first 8 hours. Therefore, the patient should receive 1400 mL of lactated Ringer's solution in the first 8
hours (70 kg x 20 mL/kg = 1400 mL).
A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should
administer which of the following fluids in the first 24 hr following a burn injury? - Correct answer✅✅
Lactated Ringer's
A nurse is triaging victims of a multiple motor-vehicle crash. The nurse assesses a client trapped under a
car who is apneic and has a weak pulse at 120/min. After repositioning his upper airway, the client
remains apneic. Which of the following actions should the nurse take? - Correct answer✅✅ Place a
black tag on the client's upper body and attempt to help the next client in need.
A nurse in the emergency department is caring for a client who has extensive partial and full-thickness
burns of the head, neck, and chest. While planning the client's care, the nurse should identify which of
the following risks as the priority for assessment and intervention? - Correct answer✅✅ Airway
obstruction
PRACTICE QUESTIONS AND ANSWERS
A nurse is assisting with triaging clients following an explosion. Which of the following clients should the
nurse identify as the highest priority? - Correct answer✅✅ A conscious adult client who has second-
degree burns on both lower legs; respiratory rate is > 30/min
A charge nurse is discussing the phases of community response to disaster with nursing staff. Which of
the following statements indicates an understanding of the heroic phase of disaster response? - Correct
answer✅✅ "Personnel are willing to work in dangerous conditions to provide assistance."
A nurse is assessing an adolescent who experienced blunt trauma to the abdomen. Which of the
following findings is the nurse's priority? - Correct answer✅✅ Blood pressure 92/50 mm Hg
A nurse is caring for a client who experienced an open, right femur fracture following a motor-vehicle
crash. - Correct answer✅✅ The nurse should identify that the client is most likely experiencing
compartment syndrome. Compartment syndrome occurs following a fracture due to increased edema of
the extremity or restriction by a cast or splint. It is identified by the five Ps: pain, pallor, pulselessness,
paresthesia, and paralysis. Compartment syndrome is a medical emergency. The nurse's priorities are to
loosen the dressing to the splint and assess the client's peripheral pulses. A pulse volume recorder may
be necessary to detect the peripheral pulses. The nurse should frequently monitor the client's
neurovascular function to detect any changes that may indicate further progression of compartment
syndrome. The nurse should also monitor and treat the client's pain using prescribed opioids.
A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the
following agents should the nurse plan to administer a vaccine following exposure? - Correct
answer✅✅ Smallpox
Which of the following are potential signs or symptoms of internal bleeding caused by a brown recluse
spider bite? - Correct answer✅✅ Internal bleeding caused by a brown recluse spider bite can manifest
as abdominal pain, black or tarry stools, bloody or dark urine, and chest pain with shortness of breath.
Skin rash and itching, headache and dizziness, joint pain and swelling, numbness and tingling, and fever
and chills are not typically associated with internal bleeding from a spider bite.
,A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare
the protocol based on which of the following information? (Select all that apply.) - Correct answer✅✅
Botulism can produce paralysis within 12 to 72 hr following exposure is correct. Botulism is a neurotoxin
that can cause flaccid paralysis within hours of exposure. Notify the Centers for Disease Control and
Prevention (CDC) when more than three cases are confirmed is incorrect. Due to the threat of a botulism
outbreak, the CDC should be notified if even a single case is suspected. Botulism is acquired through
direct contact with an infected person is incorrect. Botulism is primarily acquired through ingestion of a
contaminated food source. Vomiting and diarrhea are expected findings following exposure is correct.
Vomiting and diarrhea are expected findings following ingestion of botulism. Botulism is a toxin found in
castor beans is incorrect. Ricin, rather than botulism, is a toxin found in castor beans.
A nurse is caring for a client who has burns to his face, ears, and eyelids. The nurse should identify which
of the following is the priority finding to report to the provider? - Correct answer✅✅ Difficulty
swallowing
A nurse in an emergency department is caring for a client who has a sucking chest wound resulting from
a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a
respiratory rate of 40/min. Which of the following actions should the nurse take? - Correct answer✅✅
Administer oxygen via nasal cannula.
A community health nurse is teaching a group of community members about natural disasters. Which of
the following information about natural disasters should the nurse include in the teaching? - Correct
answer✅✅ They are geological or meteorological occurrences.
A nurse is among the first responders to a mass-casualty incident and does not know what type of
personal protective equipment (PPE) is needed. Which of the following actions should the nurse take? -
Correct answer✅✅ Choose the highest level of protection equipment available.
A public health nurse is teaching a group of nurses about smallpox. Which of the following statements
by one of the nurses indicates understanding of the teaching? - Correct answer✅✅ "Unlike
chickenpox, the vesicles of smallpox are more abundant on the face."
A nurse is admitting a client who sustained severe burn injuries. The nurse refers to the rule of nines to
determine the total body surface area of the burn injury. What percentage of body surface area should
the nurse estimate the client has burned? - Correct answer✅✅ 54%
, Which of the following are potential indications for spinal immobilization in clients? - Correct
answer✅✅ Spinal immobilization is indicated in clients with suspected spinal cord injury and loss of
consciousness as these conditions may be associated with spinal injury. Simple fractures of extremities,
acute myocardial infarction, asthma exacerbation, severe allergic reactions, and acute appendicitis do
not require spinal immobilization unless there is suspicion of associated spinal injury.
A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the
following clients should the nurse plan to care for first? - Correct answer✅✅ A client experiencing a
tension pneumothorax
When should a client with rib fractures use the incentive spirometer? - Correct answer✅✅ Every 1
hour while awake
A burn patient with 20% total body surface area (TBSA) burn is receiving fluid resuscitation. The Parkland
formula is being used to calculate the fluid replacement. The formula recommends administering 4 mL
of lactated Ringer's solution per kilogram of body weight for the first 24 hours, with half of the total
volume given in the first 8 hours. The patient weighs 70 kg. How much lactated Ringer's solution should
the patient receive in the first 8 hours? - Correct answer✅✅ 1400 mL
CORRECT
Correct! According to the Parkland formula, the patient should receive half of the total volume in the
first 8 hours. Therefore, the patient should receive 1400 mL of lactated Ringer's solution in the first 8
hours (70 kg x 20 mL/kg = 1400 mL).
A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should
administer which of the following fluids in the first 24 hr following a burn injury? - Correct answer✅✅
Lactated Ringer's
A nurse is triaging victims of a multiple motor-vehicle crash. The nurse assesses a client trapped under a
car who is apneic and has a weak pulse at 120/min. After repositioning his upper airway, the client
remains apneic. Which of the following actions should the nurse take? - Correct answer✅✅ Place a
black tag on the client's upper body and attempt to help the next client in need.
A nurse in the emergency department is caring for a client who has extensive partial and full-thickness
burns of the head, neck, and chest. While planning the client's care, the nurse should identify which of
the following risks as the priority for assessment and intervention? - Correct answer✅✅ Airway
obstruction
