NUR 282 Advanced Clinical / Transition Nursing Exam 4 Study Guide
2026 |Galen College
1. During a mass casualty incident (MCI), which color tag is assigned to a patient
with a tension pneumothorax who requires immediate life-saving intervention?
A. Green
B. Red
C. Yellow
D. Black
Answer: B
Rationale: Red tags are for ‘immediate’ life-threatening injuries that are survivable with
rapid intervention, such as airway obstruction or tension pneumothorax.
2. A patient is admitted with suspected Septic Shock. Which of the following
assessment findings is most indicative of the ‘Cold’ (late) phase of septic shock?
A. Warm, flushed skin
B. Bounding pulses
C. Increased cardiac output
D. Cool, clammy skin with mottled extremities
Answer: D
Rationale: In the late or ‘cold’ phase of septic shock, cardiac output falls, and peripheral
vasoconstriction occurs, leading to cool, clammy, and mottled skin.
,3. Which lab result is the most specific indicator for the diagnosis of
Disseminated Intravascular Coagulation (DIC)?
A. Decreased Prothrombin Time (PT)
B. Decreased BUN
C. Increased Platelet count
D. Elevated D-dimer
Answer: D
Rationale: D-dimer measures fibrin degradation products; an elevated level is a hallmark
of the clot breakdown occurring in DIC.
4. A patient has suffered 36% total body surface area (TBSA) burns. Using the
Parkland Formula (4mL x kg x %TBSA), how much fluid should be administered
in the first 8 hours if the patient weighs 70kg?
A. 5,040 mL
B. 10,080 mL
C. 2,520 mL
D. 7,560 mL
Answer: A
Rationale: Total fluid = 4 * 70 * 36 = 10,080 mL. Half of this total (5,040 mL) is given in the
first 8 hours.
5. In the primary survey of a trauma patient, what does the ‘C’ stand for?
A. Compression
B. Circulation
C. Consciousness
D. Cervical Spine
Answer: B
Rationale: The primary survey follows ABCDE: Airway, Breathing, Circulation, Disability,
and Exposure.
, 6. Which medication is considered the first-line treatment for a patient
experiencing Anaphylactic Shock?
A. Diphenhydramine
B. Epinephrine
C. Methylprednisolone
D. Albuterol
Answer: B
Rationale: Epinephrine is the gold standard for anaphylaxis to cause vasoconstriction and
bronchodilation.
7. Which finding is a classic sign of Neurogenic Shock that differentiates it from
other forms of shock?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hyperthermia
Answer: A
Rationale: Neurogenic shock involves a loss of sympathetic tone, leading to the unique
combination of hypotension and bradycardia.
8. A patient with Multi-Organ Dysfunction Syndrome (MODS) is developing
Acute Respiratory Distress Syndrome (ARDS). What vent setting is typically used
to keep alveoli open?
A. Fraction of Inspired Oxygen (FiO2) at 100%
B. Inspiratory Flow Rate
C. Low Tidal Volume
D. Positive End-Expiratory Pressure (PEEP)
Answer: D
2026 |Galen College
1. During a mass casualty incident (MCI), which color tag is assigned to a patient
with a tension pneumothorax who requires immediate life-saving intervention?
A. Green
B. Red
C. Yellow
D. Black
Answer: B
Rationale: Red tags are for ‘immediate’ life-threatening injuries that are survivable with
rapid intervention, such as airway obstruction or tension pneumothorax.
2. A patient is admitted with suspected Septic Shock. Which of the following
assessment findings is most indicative of the ‘Cold’ (late) phase of septic shock?
A. Warm, flushed skin
B. Bounding pulses
C. Increased cardiac output
D. Cool, clammy skin with mottled extremities
Answer: D
Rationale: In the late or ‘cold’ phase of septic shock, cardiac output falls, and peripheral
vasoconstriction occurs, leading to cool, clammy, and mottled skin.
,3. Which lab result is the most specific indicator for the diagnosis of
Disseminated Intravascular Coagulation (DIC)?
A. Decreased Prothrombin Time (PT)
B. Decreased BUN
C. Increased Platelet count
D. Elevated D-dimer
Answer: D
Rationale: D-dimer measures fibrin degradation products; an elevated level is a hallmark
of the clot breakdown occurring in DIC.
4. A patient has suffered 36% total body surface area (TBSA) burns. Using the
Parkland Formula (4mL x kg x %TBSA), how much fluid should be administered
in the first 8 hours if the patient weighs 70kg?
A. 5,040 mL
B. 10,080 mL
C. 2,520 mL
D. 7,560 mL
Answer: A
Rationale: Total fluid = 4 * 70 * 36 = 10,080 mL. Half of this total (5,040 mL) is given in the
first 8 hours.
5. In the primary survey of a trauma patient, what does the ‘C’ stand for?
A. Compression
B. Circulation
C. Consciousness
D. Cervical Spine
Answer: B
Rationale: The primary survey follows ABCDE: Airway, Breathing, Circulation, Disability,
and Exposure.
, 6. Which medication is considered the first-line treatment for a patient
experiencing Anaphylactic Shock?
A. Diphenhydramine
B. Epinephrine
C. Methylprednisolone
D. Albuterol
Answer: B
Rationale: Epinephrine is the gold standard for anaphylaxis to cause vasoconstriction and
bronchodilation.
7. Which finding is a classic sign of Neurogenic Shock that differentiates it from
other forms of shock?
A. Bradycardia
B. Hypertension
C. Tachycardia
D. Hyperthermia
Answer: A
Rationale: Neurogenic shock involves a loss of sympathetic tone, leading to the unique
combination of hypotension and bradycardia.
8. A patient with Multi-Organ Dysfunction Syndrome (MODS) is developing
Acute Respiratory Distress Syndrome (ARDS). What vent setting is typically used
to keep alveoli open?
A. Fraction of Inspired Oxygen (FiO2) at 100%
B. Inspiratory Flow Rate
C. Low Tidal Volume
D. Positive End-Expiratory Pressure (PEEP)
Answer: D
