NUR 282 | Advanced Clinical / Transition Nursing | Week 6 Study
Guide 2026/2027 |Galen College
1. A nurse is caring for a patient in the ICU who has a Central Venous Pressure
(CVP) of 2 mmHg. Which intervention should the nurse anticipate?
A. Administration of a rapid IV fluid bolus
B. Administration of a loop diuretic
C. Application of continuous positive airway pressure
D. Placement of the patient in High-Fowler’s position
Answer: A
Rationale: A normal CVP is 2-8 mmHg. A CVP of 2 mmHg is at the lowest limit, often
indicating hypovolemia. IV fluids are typically ordered to increase preload.
2. A patient’s ECG monitor shows a rapid, irregular rhythm with no discernible P
waves. The patient is stable. Which rhythm is most likely?
A. Ventricular Fibrillation
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. Sinus Bradycardia
Answer: C
Rationale: Atrial Fibrillation is characterized by an irregular rhythm and the absence of P
waves, as the atria are quivering rather than contracting.
,3. During the emergent phase of a burn injury, which electrolyte imbalance is
most commonly expected?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Rationale: Hyperkalemia occurs during the emergent phase because of cell destruction,
which releases potassium into the extracellular fluid.
4. A patient with septic shock has a Mean Arterial Pressure (MAP) of 55 mmHg.
What is the priority nursing action?
A. Notify the provider and prepare for vasopressors
B. Increase the rate of the maintenance IV fluids
C. Document the finding as normal
D. Place the patient in a prone position
Answer: A
Rationale: A MAP of at least 65 mmHg is required to maintain adequate organ perfusion. A
MAP of 55 mmHg indicates inadequate tissue perfusion, requiring immediate intervention
such as vasopressors.
5. Which type of shock is characterized by bradycardia rather than tachycardia?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock is unique because the loss of sympathetic tone leads to
bradycardia and massive vasodilation, unlike other forms of shock.
, 6. When assessing a patient on a mechanical ventilator, the high-pressure alarm
sounds. Which of the following is a possible cause?
A. A leak in the ventilator circuit
B. Spontaneous breathing by the patient
C. The endotracheal tube has become disconnected
D. The patient is biting the endotracheal tube
Answer: D
Rationale: High-pressure alarms are triggered by increased resistance, such as the patient
biting the tube, secretions, or kinking in the tubing.
7. A nurse is calculating the Parkland Formula for a 70 kg patient with 40% Total
Body Surface Area (TBSA) burns. How much fluid should be given in the first 8
hours?
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 1,400 mL
Answer: B
Rationale: Parkland Formula: 4 mL x kg x % TBSA. (4 x 70 x 40 = 11,200 mL). Half is given
in the first 8 hours: 11, = 5,600 mL.
8. Which clinical manifestation is the hallmark of Acute Respiratory Distress
Syndrome (ARDS)?
A. Refractory hypoxemia
B. Respiratory alkalosis
C. Bradypnea
D. Increased lung compliance
Answer: A
Guide 2026/2027 |Galen College
1. A nurse is caring for a patient in the ICU who has a Central Venous Pressure
(CVP) of 2 mmHg. Which intervention should the nurse anticipate?
A. Administration of a rapid IV fluid bolus
B. Administration of a loop diuretic
C. Application of continuous positive airway pressure
D. Placement of the patient in High-Fowler’s position
Answer: A
Rationale: A normal CVP is 2-8 mmHg. A CVP of 2 mmHg is at the lowest limit, often
indicating hypovolemia. IV fluids are typically ordered to increase preload.
2. A patient’s ECG monitor shows a rapid, irregular rhythm with no discernible P
waves. The patient is stable. Which rhythm is most likely?
A. Ventricular Fibrillation
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. Sinus Bradycardia
Answer: C
Rationale: Atrial Fibrillation is characterized by an irregular rhythm and the absence of P
waves, as the atria are quivering rather than contracting.
,3. During the emergent phase of a burn injury, which electrolyte imbalance is
most commonly expected?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Rationale: Hyperkalemia occurs during the emergent phase because of cell destruction,
which releases potassium into the extracellular fluid.
4. A patient with septic shock has a Mean Arterial Pressure (MAP) of 55 mmHg.
What is the priority nursing action?
A. Notify the provider and prepare for vasopressors
B. Increase the rate of the maintenance IV fluids
C. Document the finding as normal
D. Place the patient in a prone position
Answer: A
Rationale: A MAP of at least 65 mmHg is required to maintain adequate organ perfusion. A
MAP of 55 mmHg indicates inadequate tissue perfusion, requiring immediate intervention
such as vasopressors.
5. Which type of shock is characterized by bradycardia rather than tachycardia?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock is unique because the loss of sympathetic tone leads to
bradycardia and massive vasodilation, unlike other forms of shock.
, 6. When assessing a patient on a mechanical ventilator, the high-pressure alarm
sounds. Which of the following is a possible cause?
A. A leak in the ventilator circuit
B. Spontaneous breathing by the patient
C. The endotracheal tube has become disconnected
D. The patient is biting the endotracheal tube
Answer: D
Rationale: High-pressure alarms are triggered by increased resistance, such as the patient
biting the tube, secretions, or kinking in the tubing.
7. A nurse is calculating the Parkland Formula for a 70 kg patient with 40% Total
Body Surface Area (TBSA) burns. How much fluid should be given in the first 8
hours?
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 1,400 mL
Answer: B
Rationale: Parkland Formula: 4 mL x kg x % TBSA. (4 x 70 x 40 = 11,200 mL). Half is given
in the first 8 hours: 11, = 5,600 mL.
8. Which clinical manifestation is the hallmark of Acute Respiratory Distress
Syndrome (ARDS)?
A. Refractory hypoxemia
B. Respiratory alkalosis
C. Bradypnea
D. Increased lung compliance
Answer: A
