Adult Theory III Exam 1 EXAM LATEST
QUESTIONS
-exam elaborations with 100% verified answer/solutions-
Excel & Succeed - academic year (2026-2027)
86 Q&A
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.
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
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.
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.
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.
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
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.
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
, 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
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.
A patient with septic shock has a BP of 70/46 mm Hg, pulse 136,
respirations 32, temperature 104° F, and blood glucose 246 mg/dL.
Which intervention ordered by the health care provider should the nurse
implement first?
a. Give normal saline IV at 500 mL/hr.
b. Give acetaminophen (Tylenol) 650 mg rectally.
c. Start insulin drip to maintain blood glucose at 110 to 150 mg/dL.
d. Start norepinephrine (Levophed) to keep systolic blood pressure >90
mm Hg.
ANS: A
Because of the low systemic vascular resistance (SVR) associated with septic
shock, fluid resuscitation is the initial therapy. The other actions also are
appropriate, and should be initiated quickly as well.
A patient is admitted to the emergency department (ED) for shock of
unknown etiology. The first action by the nurse should be to
a. administer oxygen.
b. obtain a 12-lead electrocardiogram (ECG).
c. obtain the blood pressure.
d. check the level of consciousness.
QUESTIONS
-exam elaborations with 100% verified answer/solutions-
Excel & Succeed - academic year (2026-2027)
86 Q&A
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.
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
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.
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.
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.
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
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.
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
, 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
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.
A patient with septic shock has a BP of 70/46 mm Hg, pulse 136,
respirations 32, temperature 104° F, and blood glucose 246 mg/dL.
Which intervention ordered by the health care provider should the nurse
implement first?
a. Give normal saline IV at 500 mL/hr.
b. Give acetaminophen (Tylenol) 650 mg rectally.
c. Start insulin drip to maintain blood glucose at 110 to 150 mg/dL.
d. Start norepinephrine (Levophed) to keep systolic blood pressure >90
mm Hg.
ANS: A
Because of the low systemic vascular resistance (SVR) associated with septic
shock, fluid resuscitation is the initial therapy. The other actions also are
appropriate, and should be initiated quickly as well.
A patient is admitted to the emergency department (ED) for shock of
unknown etiology. The first action by the nurse should be to
a. administer oxygen.
b. obtain a 12-lead electrocardiogram (ECG).
c. obtain the blood pressure.
d. check the level of consciousness.
