NUR283 COMPREHENSIVE 4 EXAM
QUESTIONS AND ANSWERS
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. Which setting change should the nurse anticipate if the patient’s PaO2 remains
low despite high FiO2 levels?
A. Decrease the respiratory rate
B. Decrease the Inspiratory to Expiratory (I:E) ratio
C. Increase the Tidal Volume to 12 mL/kg
D. Increase Positive End-Expiratory Pressure (PEEP)
Answer: D
Conceptual Explanation: Increasing PEEP helps open collapsed alveoli and improves
oxygenation in ARDS patients without increasing the risk of oxygen toxicity from
excessively high FiO2. High tidal volumes are avoided in ARDS to prevent ventilator-
induced lung injury.
2. A client is admitted with suspected Pheochromocytoma. Which clinical manifestation
should the nurse prioritize for immediate intervention?
A. Profuse diaphoresis
,B. Blood pressure of 210/110 mmHg
C. Heart rate of 95 beats per minute
D. Severe headache
Answer: B
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to severe hypertension. A blood pressure of 210/110 mmHg puts the patient at
immediate risk for stroke or organ damage.
3. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte abnormality is most likely to be observed?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Conceptual Explanation: In the oliguric phase of AKI, the kidneys cannot excrete
potassium, leading to hyperkalemia, which is potentially life-threatening due to cardiac
arrhythmias.
, 4. A patient with a history of Cirrhosis presents with altered mental status and asterixis.
Which medication does the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
Conceptual Explanation: Asterixis and altered mental status are signs of hepatic
encephalopathy caused by high ammonia levels. Lactulose promotes ammonia excretion
via the bowel.
5. When assessing a patient with a suspected Tension Pneumothorax, which finding requires
the most urgent notification of the physician?
A. Absence of breath sounds on the affected side
B. Tracheal deviation to the unaffected side
C. Hyperresonance on percussion
D. Subcutaneous emphysema
Answer: B
QUESTIONS AND ANSWERS
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation. Which setting change should the nurse anticipate if the patient’s PaO2 remains
low despite high FiO2 levels?
A. Decrease the respiratory rate
B. Decrease the Inspiratory to Expiratory (I:E) ratio
C. Increase the Tidal Volume to 12 mL/kg
D. Increase Positive End-Expiratory Pressure (PEEP)
Answer: D
Conceptual Explanation: Increasing PEEP helps open collapsed alveoli and improves
oxygenation in ARDS patients without increasing the risk of oxygen toxicity from
excessively high FiO2. High tidal volumes are avoided in ARDS to prevent ventilator-
induced lung injury.
2. A client is admitted with suspected Pheochromocytoma. Which clinical manifestation
should the nurse prioritize for immediate intervention?
A. Profuse diaphoresis
,B. Blood pressure of 210/110 mmHg
C. Heart rate of 95 beats per minute
D. Severe headache
Answer: B
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to severe hypertension. A blood pressure of 210/110 mmHg puts the patient at
immediate risk for stroke or organ damage.
3. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte abnormality is most likely to be observed?
A. Hypokalemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Conceptual Explanation: In the oliguric phase of AKI, the kidneys cannot excrete
potassium, leading to hyperkalemia, which is potentially life-threatening due to cardiac
arrhythmias.
, 4. A patient with a history of Cirrhosis presents with altered mental status and asterixis.
Which medication does the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
Conceptual Explanation: Asterixis and altered mental status are signs of hepatic
encephalopathy caused by high ammonia levels. Lactulose promotes ammonia excretion
via the bowel.
5. When assessing a patient with a suspected Tension Pneumothorax, which finding requires
the most urgent notification of the physician?
A. Absence of breath sounds on the affected side
B. Tracheal deviation to the unaffected side
C. Hyperresonance on percussion
D. Subcutaneous emphysema
Answer: B
