NR 341 – Complex Adult Health Midterm
Exam (Exam 3) Questions and Answers
with Rationales 2025
1. A client with septic shock is receiving norepinephrine. Which parameter
indicates the medication is effective?
A. Heart rate of 120 bpm
B. MAP of 70 mm Hg
C. Respiratory rate of 28/min
D. Capillary refill of >4 seconds
Answer: B. MAP of 70 mm Hg
Rationale:
Norepinephrine increases systemic vascular resistance and improves blood
pressure. A MAP ≥65 mm Hg indicates adequate perfusion.
2. A burn client has deep partial-thickness burns over 25% of the body. Which
finding requires immediate intervention?
A. Pain level of 7/10
,B. Urine output of 10 mL/hr
C. Heart rate of 102 bpm
D. Blood pressure of 135/82 mm Hg
Answer: B. Urine output of 10 mL/hr
Rationale:
Low urine output indicates inadequate renal perfusion and possible
hypovolemia. Immediate fluid resuscitation is needed.
3. A patient on mechanical ventilation suddenly becomes agitated with high-
pressure alarms. What is the nurse’s first action?
A. Call the respiratory therapist
B. Administer a sedative
C. Check for kinks or obstruction in the tubing
D. Silence the alarm and reassess in 5 minutes
Answer: C. Check for kinks or obstruction in the tubing
Rationale:
High-pressure alarms indicate resistance to airflow. The nurse should first check
for any tubing issues before taking further action.
4. Which lab value is expected in early septic shock?
A. Elevated lactate
B. Decreased WBC count
C. Increased platelet count
D. Decreased hematocrit
, Answer: A. Elevated lactate
Rationale:
Elevated lactate levels indicate tissue hypoperfusion and anaerobic
metabolism—hallmark signs of early septic shock.
5. The nurse is assessing a client with cardiogenic shock. Which finding is
expected?
A. Bradycardia
B. Bounding pulses
C. Cool, clammy skin
D. Decreased CVP
Answer: C. Cool, clammy skin
Rationale:
Cardiogenic shock results in poor perfusion, leading to vasoconstriction and
cool, clammy extremities.
6. What is the priority nursing diagnosis for a patient in the progressive stage of
shock?
A. Risk for constipation
B. Ineffective tissue perfusion
C. Impaired gas exchange
D. Disturbed sleep pattern
Answer: B. Ineffective tissue perfusion
Rationale:
Exam (Exam 3) Questions and Answers
with Rationales 2025
1. A client with septic shock is receiving norepinephrine. Which parameter
indicates the medication is effective?
A. Heart rate of 120 bpm
B. MAP of 70 mm Hg
C. Respiratory rate of 28/min
D. Capillary refill of >4 seconds
Answer: B. MAP of 70 mm Hg
Rationale:
Norepinephrine increases systemic vascular resistance and improves blood
pressure. A MAP ≥65 mm Hg indicates adequate perfusion.
2. A burn client has deep partial-thickness burns over 25% of the body. Which
finding requires immediate intervention?
A. Pain level of 7/10
,B. Urine output of 10 mL/hr
C. Heart rate of 102 bpm
D. Blood pressure of 135/82 mm Hg
Answer: B. Urine output of 10 mL/hr
Rationale:
Low urine output indicates inadequate renal perfusion and possible
hypovolemia. Immediate fluid resuscitation is needed.
3. A patient on mechanical ventilation suddenly becomes agitated with high-
pressure alarms. What is the nurse’s first action?
A. Call the respiratory therapist
B. Administer a sedative
C. Check for kinks or obstruction in the tubing
D. Silence the alarm and reassess in 5 minutes
Answer: C. Check for kinks or obstruction in the tubing
Rationale:
High-pressure alarms indicate resistance to airflow. The nurse should first check
for any tubing issues before taking further action.
4. Which lab value is expected in early septic shock?
A. Elevated lactate
B. Decreased WBC count
C. Increased platelet count
D. Decreased hematocrit
, Answer: A. Elevated lactate
Rationale:
Elevated lactate levels indicate tissue hypoperfusion and anaerobic
metabolism—hallmark signs of early septic shock.
5. The nurse is assessing a client with cardiogenic shock. Which finding is
expected?
A. Bradycardia
B. Bounding pulses
C. Cool, clammy skin
D. Decreased CVP
Answer: C. Cool, clammy skin
Rationale:
Cardiogenic shock results in poor perfusion, leading to vasoconstriction and
cool, clammy extremities.
6. What is the priority nursing diagnosis for a patient in the progressive stage of
shock?
A. Risk for constipation
B. Ineffective tissue perfusion
C. Impaired gas exchange
D. Disturbed sleep pattern
Answer: B. Ineffective tissue perfusion
Rationale:
