NUR 282 | Advanced Clinical / Transition Nursing | Exams 1–5
Comprehensive Quiz 2026 |Galen College
1. A patient with a high-level spinal cord injury (T6 or above) reports a sudden,
severe headache and is found to have a blood pressure of 190/100 mmHg and a
heart rate of 52 bpm. What is the priority nursing action?
A. Administer an antihypertensive medication immediately.
B. Assess for bladder distention or fecal impaction.
C. Place the patient in a supine position to stabilize blood pressure.
D. Increase the IV fluid rate to improve cardiac output.
Answer: B
Rationale: Autonomic Dysreflexia is a medical emergency often caused by noxious stimuli
below the level of injury (like a full bladder). The priority is to find and remove the cause
while sitting the patient upright.
2. An arterial blood gas (ABG) result shows: pH 7.30, PaCO2 55 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The low pH indicates acidosis, and the high PaCO2 indicates a respiratory cause.
The HCO3 is within normal range, suggesting no compensation yet.
,3. A client is admitted to the ICU with Acute Respiratory Distress Syndrome
(ARDS). Which ventilator setting is specifically used to prevent alveolar collapse
at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Tidal Volume (VT)
D. Inspiratory:Expiratory (I:E) Ratio
Answer: B
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, improving
gas exchange and oxygenation in ARDS.
4. The nurse is caring for a patient in the compensatory stage of shock. Which
clinical manifestation should the nurse expect to observe?
A. Decreased heart rate and lethargy
B. Increased heart rate and narrowed pulse pressure
C. Profound hypotension and anuria
D. Petechiae and mottled skin
Answer: B
Rationale: In the compensatory stage, the body activates the sympathetic nervous system
to maintain cardiac output, leading to tachycardia and peripheral vasoconstriction
(narrowed pulse pressure).
5. Using the Parkland formula, a patient weighing 70 kg with 40% total body
surface area (TBSA) burns should receive how much fluid in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 1,400 mL
Answer: B
, Rationale: Parkland formula: 4mL x kg x %TBSA. (4 x 70 x 40 = 11,200 mL total for 24
hours). Half is given in the first 8 hours: 11, = 5,600 mL.
6. A patient’s cardiac monitor shows a rapid rhythm with no discernible P waves
and irregular QRS complexes. The nurse identifies this as:
A. Ventricular Tachycardia
B. First-degree Heart Block
C. Sinus Bradycardia
D. Atrial Fibrillation
Answer: D
Rationale: Atrial fibrillation is characterized by the absence of P waves and an irregularly
irregular ventricular response.
7. Which assessment finding is part of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Hypotension, muffled heart sounds, and JVD
C. Bradycardia, widening pulse pressure, and irregular respirations
D. Pinpoint pupils, hypertension, and hyperthermia
Answer: C
Rationale: Cushing’s Triad (systolic hypertension with widening pulse pressure,
bradycardia, and irregular breathing) is a late sign of increased ICP.
8. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
appropriate for the LPN?
A. Developing the initial plan of care for a new admission
B. Administering a scheduled subcutaneous insulin injection
C. Providing discharge teaching to a patient after a CABG
D. Evaluating the effectiveness of a new IV analgesic
Answer: B
Comprehensive Quiz 2026 |Galen College
1. A patient with a high-level spinal cord injury (T6 or above) reports a sudden,
severe headache and is found to have a blood pressure of 190/100 mmHg and a
heart rate of 52 bpm. What is the priority nursing action?
A. Administer an antihypertensive medication immediately.
B. Assess for bladder distention or fecal impaction.
C. Place the patient in a supine position to stabilize blood pressure.
D. Increase the IV fluid rate to improve cardiac output.
Answer: B
Rationale: Autonomic Dysreflexia is a medical emergency often caused by noxious stimuli
below the level of injury (like a full bladder). The priority is to find and remove the cause
while sitting the patient upright.
2. An arterial blood gas (ABG) result shows: pH 7.30, PaCO2 55 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The low pH indicates acidosis, and the high PaCO2 indicates a respiratory cause.
The HCO3 is within normal range, suggesting no compensation yet.
,3. A client is admitted to the ICU with Acute Respiratory Distress Syndrome
(ARDS). Which ventilator setting is specifically used to prevent alveolar collapse
at the end of expiration?
A. Fraction of Inspired Oxygen (FiO2)
B. Positive End-Expiratory Pressure (PEEP)
C. Tidal Volume (VT)
D. Inspiratory:Expiratory (I:E) Ratio
Answer: B
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, improving
gas exchange and oxygenation in ARDS.
4. The nurse is caring for a patient in the compensatory stage of shock. Which
clinical manifestation should the nurse expect to observe?
A. Decreased heart rate and lethargy
B. Increased heart rate and narrowed pulse pressure
C. Profound hypotension and anuria
D. Petechiae and mottled skin
Answer: B
Rationale: In the compensatory stage, the body activates the sympathetic nervous system
to maintain cardiac output, leading to tachycardia and peripheral vasoconstriction
(narrowed pulse pressure).
5. Using the Parkland formula, a patient weighing 70 kg with 40% total body
surface area (TBSA) burns should receive how much fluid in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 1,400 mL
Answer: B
, Rationale: Parkland formula: 4mL x kg x %TBSA. (4 x 70 x 40 = 11,200 mL total for 24
hours). Half is given in the first 8 hours: 11, = 5,600 mL.
6. A patient’s cardiac monitor shows a rapid rhythm with no discernible P waves
and irregular QRS complexes. The nurse identifies this as:
A. Ventricular Tachycardia
B. First-degree Heart Block
C. Sinus Bradycardia
D. Atrial Fibrillation
Answer: D
Rationale: Atrial fibrillation is characterized by the absence of P waves and an irregularly
irregular ventricular response.
7. Which assessment finding is part of Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Hypotension, muffled heart sounds, and JVD
C. Bradycardia, widening pulse pressure, and irregular respirations
D. Pinpoint pupils, hypertension, and hyperthermia
Answer: C
Rationale: Cushing’s Triad (systolic hypertension with widening pulse pressure,
bradycardia, and irregular breathing) is a late sign of increased ICP.
8. A nurse is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
appropriate for the LPN?
A. Developing the initial plan of care for a new admission
B. Administering a scheduled subcutaneous insulin injection
C. Providing discharge teaching to a patient after a CABG
D. Evaluating the effectiveness of a new IV analgesic
Answer: B
