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NUR 265 Advanced Medical-Surgical Nursing Exam 2 | Versions V1, V2, V3 |
Original Practice Questions with Answers & Rationales
Exam 2 Content Focus: Respiratory, Cardiac, Neurologic,
Endocrine & Multi-System Emergencies
VERSION 1 (V1)
Questions
1. A client with acute respiratory distress syndrome (ARDS) is
being mechanically ventilated. The nurse notes the client's
oxygen saturation is 82% despite FiO2 of 80% and PEEP of 10
cm H2O. What is the priority intervention?
A. Decrease PEEP
B. Increase PEEP as prescribed and notify the provider
C. Administer a sedative
D. Extubate the client
Answer: B
Rationale: Persistent hypoxemia despite high FiO2 and PEEP
may require increased PEEP or alternative strategies (prone
positioning). The provider should be notified.
2. What is the hallmark sign of a tension pneumothorax?
A. Hypertension
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B. Hypotension, absent breath sounds on one side, tracheal
deviation, and jugular venous distention
C. Bradycardia only
D. Fever
Answer: B
Rationale: Tension pneumothorax causes hypotension, absent
breath sounds, tracheal deviation away from the affected side,
and JVD due to increased intrathoracic pressure.
3. What is the immediate treatment for tension
pneumothorax?
A. Observation
B. Needle decompression at the 2nd intercostal space,
midclavicular line
C. Antibiotics
D. Bronchodilators
Answer: B
Rationale: Immediate needle decompression at the 2nd
intercostal space, midclavicular line relieves pressure, followed
by chest tube insertion.
4. A client with a chest tube has continuous bubbling in the
water seal chamber. What does this indicate?
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A. Normal function
B. An air leak
C. A blocked tube
D. Drainage
Answer: B
Rationale: Continuous bubbling in the water seal chamber
indicates an air leak in the system or the client's pleural space.
5. What should the nurse do if a chest tube is accidentally
disconnected from the drainage system?
A. Clamp the tube
B. Place the end of the tube in sterile water or saline, then
reconnect
C. Remove the tube
D. Do nothing
Answer: B
Rationale: Placing the tube in sterile water creates a water seal,
preventing air from entering the pleural space until
reconnection.
6. What is the normal range for PaO2 in arterial blood gas?
A. 40–60 mmHg
B. 80–100 mmHg
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C. 100–150 mmHg
D. 150–200 mmHg
Answer: B
Rationale: Normal PaO2 is 80–100 mmHg on room air. Values
below 80 mmHg indicate hypoxemia.
7. A client has an ABG with pH 7.32, PaCO2 48 mmHg, HCO3
26 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: Low pH with elevated PaCO2 indicates respiratory
acidosis. Normal HCO3 indicates uncompensated.
8. A client has an ABG with pH 7.50, PaCO2 30 mmHg, HCO3
24 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
NUR 265 Advanced Medical-Surgical Nursing Exam 2 | Versions V1, V2, V3 |
Original Practice Questions with Answers & Rationales
Exam 2 Content Focus: Respiratory, Cardiac, Neurologic,
Endocrine & Multi-System Emergencies
VERSION 1 (V1)
Questions
1. A client with acute respiratory distress syndrome (ARDS) is
being mechanically ventilated. The nurse notes the client's
oxygen saturation is 82% despite FiO2 of 80% and PEEP of 10
cm H2O. What is the priority intervention?
A. Decrease PEEP
B. Increase PEEP as prescribed and notify the provider
C. Administer a sedative
D. Extubate the client
Answer: B
Rationale: Persistent hypoxemia despite high FiO2 and PEEP
may require increased PEEP or alternative strategies (prone
positioning). The provider should be notified.
2. What is the hallmark sign of a tension pneumothorax?
A. Hypertension
,https://www.stuvia.com/user/performance
B. Hypotension, absent breath sounds on one side, tracheal
deviation, and jugular venous distention
C. Bradycardia only
D. Fever
Answer: B
Rationale: Tension pneumothorax causes hypotension, absent
breath sounds, tracheal deviation away from the affected side,
and JVD due to increased intrathoracic pressure.
3. What is the immediate treatment for tension
pneumothorax?
A. Observation
B. Needle decompression at the 2nd intercostal space,
midclavicular line
C. Antibiotics
D. Bronchodilators
Answer: B
Rationale: Immediate needle decompression at the 2nd
intercostal space, midclavicular line relieves pressure, followed
by chest tube insertion.
4. A client with a chest tube has continuous bubbling in the
water seal chamber. What does this indicate?
,https://www.stuvia.com/user/performance
A. Normal function
B. An air leak
C. A blocked tube
D. Drainage
Answer: B
Rationale: Continuous bubbling in the water seal chamber
indicates an air leak in the system or the client's pleural space.
5. What should the nurse do if a chest tube is accidentally
disconnected from the drainage system?
A. Clamp the tube
B. Place the end of the tube in sterile water or saline, then
reconnect
C. Remove the tube
D. Do nothing
Answer: B
Rationale: Placing the tube in sterile water creates a water seal,
preventing air from entering the pleural space until
reconnection.
6. What is the normal range for PaO2 in arterial blood gas?
A. 40–60 mmHg
B. 80–100 mmHg
, https://www.stuvia.com/user/performance
C. 100–150 mmHg
D. 150–200 mmHg
Answer: B
Rationale: Normal PaO2 is 80–100 mmHg on room air. Values
below 80 mmHg indicate hypoxemia.
7. A client has an ABG with pH 7.32, PaCO2 48 mmHg, HCO3
26 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: Low pH with elevated PaCO2 indicates respiratory
acidosis. Normal HCO3 indicates uncompensated.
8. A client has an ABG with pH 7.50, PaCO2 30 mmHg, HCO3
24 mEq/L. What is the acid-base disturbance?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
