Adult Theory III Exam 1 questions and
answers 2025/2026 latest update
When assessing a patient in shock, the nurse recognizes that the hemodynamics of shock include
A. a normal cardiac output in cardiogenic shock.
B. an increase in central venous pressure in hypovolemic shock.
C. an increase in systemic vascular resistance in all types of shock.
D. variations in cardiac output and decreased systemic vascular resistance in septic shock. - Answer ANS:
D
A nurse is caring for a patient with shock of unknown etiology whose hemodynamic monitoring
indicates BP 92/54, pulse 64, and an elevated pulmonary artery wedge pressure. Which collaborative
intervention ordered by the health care provider should the nurse question?
a. Infuse normal saline at 250 mL/hr.
b. Keep head of bed elevated to 30 degrees.
c. Hold nitroprusside (Nipride) if systolic BP <90 mm Hg.
d. Titrate dobutamine (Dobutrex) to keep systolic BP >90 mm Hg - Answer ANS: A
The patient's elevated pulmonary artery wedge pressure indicates volume excess. A saline infusion at
250 mL/hr will exacerbate the volume excess. The other actions are appropriate for the patient.
An older patient with cardiogenic shock is cool and clammy and hemodynamic monitoring indicates a
high systemic vascular resistance (SVR). Which intervention should the nurse anticipate doing next?
a. Increase the rate for the dopamine (Intropin) infusion.
b. Decrease the rate for the nitroglycerin (Tridil) infusion.
c. Increase the rate for the sodium nitroprusside (Nipride) infusion.
d. Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion. - Answer ANS: C
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which will improve
cardiac output. Changes in the D5/.9 NS and nitroglycerin infusions will not directly decrease SVR.
Increasing the dopamine will tend to increase SVR.
To evaluate the effectiveness of the pantoprazole (Protonix) ordered for a patient with systemic
inflammatory response syndrome (SIRS), which assessment will the nurse perform?
,a. Auscultate bowel sounds.
b. Palpate for abdominal pain.
c. Ask the patient about nausea.
d. Check stools for occult blood. - Answer ANS: D
Proton pump inhibitors are given to decrease the risk for stress ulcers in critically ill patients. The other
assessments also will be done, but these will not help in determining the effectiveness of the
pantoprazole administration.
The emergency department (ED) nurse receives report that a patient involved in a motor vehicle crash is
being transported to the facility with an estimated arrival in 1 minute. In preparation for the patient's
arrival, the nurse will obtain
a. hypothermia blanket.
b. lactated Ringer's solution.
c. two 14-gauge IV catheters.
d. dopamine (Intropin) infusion. - Answer ANS: C
A patient with multiple trauma may require fluid resuscitation to prevent or treat hypovolemic shock, so
the nurse will anticipate the need for 2 large bore IV lines to administer normal saline. Lactated Ringer's
solution should be used cautiously and will not be ordered until the patient has been assessed for
possible liver abnormalities. Vasopressor infusion is not used as the initial therapy for hypovolemic
shock. Patients in shock need to be kept warm not cool.
Which finding is the best indicator that the fluid resuscitation for a patient with hypovolemic shock has
been effective?
a. Hemoglobin is within normal limits.
b. Urine output is 60 mL over the last hour.
c. Central venous pressure (CVP) is normal.
d. Mean arterial pressure (MAP) is 72 mm Hg - Answer ANS: B
Assessment of end organ perfusion, such as an adequate urine output, is the best indicator that fluid
resuscitation has been successful. The hemoglobin level, CVP, and MAP are useful in determining the
effects of fluid administration, but they are not as useful as data indicating good organ perfusion.
, Norepinephrine (Levophed) has been prescribed for a patient who was admitted with dehydration and
hypotension. Which patient data indicate that the nurse should consult with the health care provider
before starting the norepinephrine?
a. The patient's central venous pressure is 3 mm Hg.
b. The patient is in sinus tachycardia at 120 beats/min.
c. The patient is receiving low dose dopamine (Intropin).
d. The patient has had no urine output since being admitted. - Answer ANS: A
Adequate fluid administration is essential before administration of vasopressors to patients with
hypovolemic shock. The patient's low central venous pressure indicates a need for more volume
replacement. The other patient data are not contraindications to norepinephrine administration.
A nurse is assessing a patient who is receiving a nitroprusside (Nipride) infusion to treat cardiogenic
shock. Which finding indicates that the medication is effective?
a. No new heart murmurs
b. Decreased troponin level
c. Warm, pink, and dry skin
d. Blood pressure 92/40 mm Hg - Answer C
Warm, pink, and dry skin indicates that perfusion to tissues is improved. Since nitroprusside is a
vasodilator, the blood pressure may be low even if the medication is effective. Absence of a heart
murmur and a decrease in troponin level are not indicators of improvement in shock.
Which assessment information is most important for the nurse to obtain to evaluate whether treatment
of a patient with anaphylactic shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation - Answer ANS: D
Because the airway edema that is associated with anaphylaxis can affect airway and breathing, the
oxygen saturation is the most critical assessment. Improvements in the other assessments will also be
expected with effective treatment of anaphylactic shock.
answers 2025/2026 latest update
When assessing a patient in shock, the nurse recognizes that the hemodynamics of shock include
A. a normal cardiac output in cardiogenic shock.
B. an increase in central venous pressure in hypovolemic shock.
C. an increase in systemic vascular resistance in all types of shock.
D. variations in cardiac output and decreased systemic vascular resistance in septic shock. - Answer ANS:
D
A nurse is caring for a patient with shock of unknown etiology whose hemodynamic monitoring
indicates BP 92/54, pulse 64, and an elevated pulmonary artery wedge pressure. Which collaborative
intervention ordered by the health care provider should the nurse question?
a. Infuse normal saline at 250 mL/hr.
b. Keep head of bed elevated to 30 degrees.
c. Hold nitroprusside (Nipride) if systolic BP <90 mm Hg.
d. Titrate dobutamine (Dobutrex) to keep systolic BP >90 mm Hg - Answer ANS: A
The patient's elevated pulmonary artery wedge pressure indicates volume excess. A saline infusion at
250 mL/hr will exacerbate the volume excess. The other actions are appropriate for the patient.
An older patient with cardiogenic shock is cool and clammy and hemodynamic monitoring indicates a
high systemic vascular resistance (SVR). Which intervention should the nurse anticipate doing next?
a. Increase the rate for the dopamine (Intropin) infusion.
b. Decrease the rate for the nitroglycerin (Tridil) infusion.
c. Increase the rate for the sodium nitroprusside (Nipride) infusion.
d. Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion. - Answer ANS: C
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which will improve
cardiac output. Changes in the D5/.9 NS and nitroglycerin infusions will not directly decrease SVR.
Increasing the dopamine will tend to increase SVR.
To evaluate the effectiveness of the pantoprazole (Protonix) ordered for a patient with systemic
inflammatory response syndrome (SIRS), which assessment will the nurse perform?
,a. Auscultate bowel sounds.
b. Palpate for abdominal pain.
c. Ask the patient about nausea.
d. Check stools for occult blood. - Answer ANS: D
Proton pump inhibitors are given to decrease the risk for stress ulcers in critically ill patients. The other
assessments also will be done, but these will not help in determining the effectiveness of the
pantoprazole administration.
The emergency department (ED) nurse receives report that a patient involved in a motor vehicle crash is
being transported to the facility with an estimated arrival in 1 minute. In preparation for the patient's
arrival, the nurse will obtain
a. hypothermia blanket.
b. lactated Ringer's solution.
c. two 14-gauge IV catheters.
d. dopamine (Intropin) infusion. - Answer ANS: C
A patient with multiple trauma may require fluid resuscitation to prevent or treat hypovolemic shock, so
the nurse will anticipate the need for 2 large bore IV lines to administer normal saline. Lactated Ringer's
solution should be used cautiously and will not be ordered until the patient has been assessed for
possible liver abnormalities. Vasopressor infusion is not used as the initial therapy for hypovolemic
shock. Patients in shock need to be kept warm not cool.
Which finding is the best indicator that the fluid resuscitation for a patient with hypovolemic shock has
been effective?
a. Hemoglobin is within normal limits.
b. Urine output is 60 mL over the last hour.
c. Central venous pressure (CVP) is normal.
d. Mean arterial pressure (MAP) is 72 mm Hg - Answer ANS: B
Assessment of end organ perfusion, such as an adequate urine output, is the best indicator that fluid
resuscitation has been successful. The hemoglobin level, CVP, and MAP are useful in determining the
effects of fluid administration, but they are not as useful as data indicating good organ perfusion.
, Norepinephrine (Levophed) has been prescribed for a patient who was admitted with dehydration and
hypotension. Which patient data indicate that the nurse should consult with the health care provider
before starting the norepinephrine?
a. The patient's central venous pressure is 3 mm Hg.
b. The patient is in sinus tachycardia at 120 beats/min.
c. The patient is receiving low dose dopamine (Intropin).
d. The patient has had no urine output since being admitted. - Answer ANS: A
Adequate fluid administration is essential before administration of vasopressors to patients with
hypovolemic shock. The patient's low central venous pressure indicates a need for more volume
replacement. The other patient data are not contraindications to norepinephrine administration.
A nurse is assessing a patient who is receiving a nitroprusside (Nipride) infusion to treat cardiogenic
shock. Which finding indicates that the medication is effective?
a. No new heart murmurs
b. Decreased troponin level
c. Warm, pink, and dry skin
d. Blood pressure 92/40 mm Hg - Answer C
Warm, pink, and dry skin indicates that perfusion to tissues is improved. Since nitroprusside is a
vasodilator, the blood pressure may be low even if the medication is effective. Absence of a heart
murmur and a decrease in troponin level are not indicators of improvement in shock.
Which assessment information is most important for the nurse to obtain to evaluate whether treatment
of a patient with anaphylactic shock has been effective?
a. Heart rate
b. Orientation
c. Blood pressure
d. Oxygen saturation - Answer ANS: D
Because the airway edema that is associated with anaphylaxis can affect airway and breathing, the
oxygen saturation is the most critical assessment. Improvements in the other assessments will also be
expected with effective treatment of anaphylactic shock.
