NUR 282 | Advanced Clinical / Transition Nursing | Exam 6 Study
Guide 2026 |Galen College
1. A patient with a central venous catheter has a Central Venous Pressure (CVP)
of 1 mmHg. Which intervention should the nurse anticipate first?
A. Administering a prescribed diuretic
B. Checking the patient for signs of fluid overload
C. Decreasing the rate of IV fluid administration
D. Increasing the rate of IV fluid administration
Answer: D
Rationale: The normal range for CVP is 2 to 8 mmHg. A CVP of 1 mmHg indicates
hypovolemia, requiring fluid resuscitation.
2. Which clinical manifestation is a hallmark sign of the ‘compensatory’ stage of
shock?
A. Metabolic acidosis
B. Confusion and lethargy
C. Narrowed pulse pressure
D. Increased heart rate and cool, clammy skin
Answer: D
Rationale: In the compensatory stage, the body activates the sympathetic nervous system,
leading to tachycardia and peripheral vasoconstriction to maintain blood pressure.
,3. The nurse is caring for a patient on mechanical ventilation. Which setting
helps prevent alveolar collapse at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Tidal Volume (VT)
C. Positive End-Expiratory Pressure (PEEP)
D. Inspiratory Rate
Answer: C
Rationale: PEEP maintains pressure in the airways at the end of expiration to keep alveoli
open, improving oxygenation.
4. When calculating the fluid resuscitation needs for a burn patient using the
Parkland Formula, which fluid is most appropriate for the first 24 hours?
A. 0.45% Normal Saline
B. Albumin 5%
C. 5% Dextrose in Water
D. Lactated Ringer’s
Answer: D
Rationale: Lactated Ringer’s is the isotonic solution of choice for burn resuscitation
because it closely matches the body’s extracellular fluid composition.
5. A patient’s ABG results are: pH 7.28, PaCO2 55, HCO3 26. How should the
nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates the
cause is respiratory.
, 6. In the ‘Emergent Phase’ of a burn injury, what is the primary electrolyte
imbalance the nurse should monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: A
Rationale: Cellular destruction from burns releases potassium into the extracellular space,
leading to hyperkalemia.
7. Which type of shock is characterized by a low Systemic Vascular Resistance
(SVR) and high Cardiac Output initially?
A. Hypovolemic Shock
B. Cardiogenic Shock
C. Obstructive Shock
D. Septic Shock
Answer: D
Rationale: Septic shock is a distributive shock where massive vasodilation reduces SVR,
and the body initially compensates with increased cardiac output (Hyperdynamic phase).
8. A patient with a traumatic brain injury has an Intracranial Pressure (ICP) of 22
mmHg. Which nursing action is most appropriate?
A. Perform vigorous endotracheal suctioning
B. Keep the head of the bed flat
C. Encourage the patient to cough and deep breathe
D. Administer Mannitol as prescribed
Answer: D
Rationale: Mannitol is an osmotic diuretic used to reduce cerebral edema and lower ICP.
Suctioning and coughing can further increase ICP.
Guide 2026 |Galen College
1. A patient with a central venous catheter has a Central Venous Pressure (CVP)
of 1 mmHg. Which intervention should the nurse anticipate first?
A. Administering a prescribed diuretic
B. Checking the patient for signs of fluid overload
C. Decreasing the rate of IV fluid administration
D. Increasing the rate of IV fluid administration
Answer: D
Rationale: The normal range for CVP is 2 to 8 mmHg. A CVP of 1 mmHg indicates
hypovolemia, requiring fluid resuscitation.
2. Which clinical manifestation is a hallmark sign of the ‘compensatory’ stage of
shock?
A. Metabolic acidosis
B. Confusion and lethargy
C. Narrowed pulse pressure
D. Increased heart rate and cool, clammy skin
Answer: D
Rationale: In the compensatory stage, the body activates the sympathetic nervous system,
leading to tachycardia and peripheral vasoconstriction to maintain blood pressure.
,3. The nurse is caring for a patient on mechanical ventilation. Which setting
helps prevent alveolar collapse at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Tidal Volume (VT)
C. Positive End-Expiratory Pressure (PEEP)
D. Inspiratory Rate
Answer: C
Rationale: PEEP maintains pressure in the airways at the end of expiration to keep alveoli
open, improving oxygenation.
4. When calculating the fluid resuscitation needs for a burn patient using the
Parkland Formula, which fluid is most appropriate for the first 24 hours?
A. 0.45% Normal Saline
B. Albumin 5%
C. 5% Dextrose in Water
D. Lactated Ringer’s
Answer: D
Rationale: Lactated Ringer’s is the isotonic solution of choice for burn resuscitation
because it closely matches the body’s extracellular fluid composition.
5. A patient’s ABG results are: pH 7.28, PaCO2 55, HCO3 26. How should the
nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates the
cause is respiratory.
, 6. In the ‘Emergent Phase’ of a burn injury, what is the primary electrolyte
imbalance the nurse should monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: A
Rationale: Cellular destruction from burns releases potassium into the extracellular space,
leading to hyperkalemia.
7. Which type of shock is characterized by a low Systemic Vascular Resistance
(SVR) and high Cardiac Output initially?
A. Hypovolemic Shock
B. Cardiogenic Shock
C. Obstructive Shock
D. Septic Shock
Answer: D
Rationale: Septic shock is a distributive shock where massive vasodilation reduces SVR,
and the body initially compensates with increased cardiac output (Hyperdynamic phase).
8. A patient with a traumatic brain injury has an Intracranial Pressure (ICP) of 22
mmHg. Which nursing action is most appropriate?
A. Perform vigorous endotracheal suctioning
B. Keep the head of the bed flat
C. Encourage the patient to cough and deep breathe
D. Administer Mannitol as prescribed
Answer: D
Rationale: Mannitol is an osmotic diuretic used to reduce cerebral edema and lower ICP.
Suctioning and coughing can further increase ICP.
