NUR 282 Advanced Clinical / Transition Nursing Exam 8 Study Guide
2026 |Galen College
1. A nurse is caring for a client in the early stages of septic shock. Which clinical
manifestation should the nurse expect to find?
A. Increased cardiac output
B. Decreased respiratory rate
C. Cool, clammy skin
D. Bradycardia
Answer: A
Rationale: In the early (hyperdynamic) stage of septic shock, cardiac output is often
increased as a compensatory mechanism, accompanied by warm, flushed skin and
tachycardia.
2. A client has sustained full-thickness burns to the entire left arm and the
anterior trunk. Using the Rule of Nines, what is the estimated total body surface
area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: The entire left arm is 9% and the anterior trunk is 18%. Total: 9% + 18% =
27%.
,3. Which of the following is the most appropriate task for a nurse to delegate to
an unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Assisting a stable client with range-of-motion exercises
C. Performing a sterile dressing change on a central line
D. Teaching a client how to use an incentive spirometer
Answer: B
Rationale: UAPs can assist with routine tasks for stable clients, such as hygiene and
exercises. Assessment, sterile procedures, and teaching require the skill of a licensed nurse.
4. The nurse is caring for a patient with Acute Respiratory Distress Syndrome
(ARDS). What is the primary rationale for using positive end-expiratory pressure
(PEEP)?
A. To decrease the risk of barotrauma
B. To decrease the patient’s work of breathing
C. To reduce the need for supplemental oxygen
D. To prevent alveolar collapse and improve oxygenation
Answer: D
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, which
improves gas exchange and prevents atelectasis in ARDS patients.
5. A client with a head injury develops a heart rate of 50 bpm, a blood pressure
of 180/60 mmHg, and irregular respirations. The nurse recognizes this as:
A. Beck’s Triad
B. Cushing’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: B
, Rationale: Cushing’s Triad consists of bradycardia, hypertension with a widening pulse
pressure, and irregular respirations, indicating increased intracranial pressure.
6. During a mass casualty incident, a nurse triages a victim who is unresponsive
and not breathing. After opening the airway, the victim remains breathless.
What color tag should be assigned?
A. Red
B. Yellow
C. Black
D. Green
Answer: C
Rationale: In disaster triage, victims who are not breathing even after airway
repositioning are classified as deceased or expectant and given a black tag.
7. A nurse is managing a patient with hypovolemic shock. Which intravenous
fluid is most appropriate for initial rapid volume expansion?
A. Dextrose 5% in water (D5W)
B. 0.45% Sodium Chloride
C. 0.9% Sodium Chloride
D. Dextrose 5% in 0.45% Sodium Chloride
Answer: C
Rationale: Isotonic crystalloids like 0.9% Sodium Chloride (Normal Saline) or Lactated
Ringer’s are used for initial volume replacement in shock.
2026 |Galen College
1. A nurse is caring for a client in the early stages of septic shock. Which clinical
manifestation should the nurse expect to find?
A. Increased cardiac output
B. Decreased respiratory rate
C. Cool, clammy skin
D. Bradycardia
Answer: A
Rationale: In the early (hyperdynamic) stage of septic shock, cardiac output is often
increased as a compensatory mechanism, accompanied by warm, flushed skin and
tachycardia.
2. A client has sustained full-thickness burns to the entire left arm and the
anterior trunk. Using the Rule of Nines, what is the estimated total body surface
area (TBSA) affected?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: The entire left arm is 9% and the anterior trunk is 18%. Total: 9% + 18% =
27%.
,3. Which of the following is the most appropriate task for a nurse to delegate to
an unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Assisting a stable client with range-of-motion exercises
C. Performing a sterile dressing change on a central line
D. Teaching a client how to use an incentive spirometer
Answer: B
Rationale: UAPs can assist with routine tasks for stable clients, such as hygiene and
exercises. Assessment, sterile procedures, and teaching require the skill of a licensed nurse.
4. The nurse is caring for a patient with Acute Respiratory Distress Syndrome
(ARDS). What is the primary rationale for using positive end-expiratory pressure
(PEEP)?
A. To decrease the risk of barotrauma
B. To decrease the patient’s work of breathing
C. To reduce the need for supplemental oxygen
D. To prevent alveolar collapse and improve oxygenation
Answer: D
Rationale: PEEP provides pressure at the end of expiration to keep alveoli open, which
improves gas exchange and prevents atelectasis in ARDS patients.
5. A client with a head injury develops a heart rate of 50 bpm, a blood pressure
of 180/60 mmHg, and irregular respirations. The nurse recognizes this as:
A. Beck’s Triad
B. Cushing’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: B
, Rationale: Cushing’s Triad consists of bradycardia, hypertension with a widening pulse
pressure, and irregular respirations, indicating increased intracranial pressure.
6. During a mass casualty incident, a nurse triages a victim who is unresponsive
and not breathing. After opening the airway, the victim remains breathless.
What color tag should be assigned?
A. Red
B. Yellow
C. Black
D. Green
Answer: C
Rationale: In disaster triage, victims who are not breathing even after airway
repositioning are classified as deceased or expectant and given a black tag.
7. A nurse is managing a patient with hypovolemic shock. Which intravenous
fluid is most appropriate for initial rapid volume expansion?
A. Dextrose 5% in water (D5W)
B. 0.45% Sodium Chloride
C. 0.9% Sodium Chloride
D. Dextrose 5% in 0.45% Sodium Chloride
Answer: C
Rationale: Isotonic crystalloids like 0.9% Sodium Chloride (Normal Saline) or Lactated
Ringer’s are used for initial volume replacement in shock.
