NUR 282 Week 4 Study Guide - Advanced Clinical Nursing 2026 |Galen
College
1. A patient has a pH of 7.31, PaCO2 of 52 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), indicating
respiratory acidosis.
2. Which of the following is a classic sign of Cardiac Tamponade known as Beck’s
Triad?
A. Hypertension, Bradycardia, Irregular breathing
B. Bounding pulses, Polyuria, Weight gain
C. Tachycardia, Tachypnea, Hyperthermia
D. JVD, Hypotension, Muffled heart sounds
Answer: D
Rationale: Beck’s Triad consists of jugular venous distention, hypotension, and muffled
heart sounds.
,3. What is the first priority nursing action for a patient suspected of Autonomic
Dysreflexia?
A. Administer an antihypertensive medication
B. Call the healthcare provider
C. Raise the head of the bed to a high-Fowler’s position
D. Assess for bladder distention
Answer: C
Rationale: Raising the head of the bed helps decrease intracranial pressure and is the
immediate first action.
4. Cushing’s Triad is a late sign of increased intracranial pressure (ICP). What
does it consist of?
A. Tachycardia, Hypotension, Widening pulse pressure
B. Bradypnea, Hypotension, Narrowing pulse pressure
C. Bradycardia, Hypertension, Widening pulse pressure
D. Tachycardia, Hypertension, Narrowing pulse pressure
Answer: C
Rationale: Cushing’s Triad includes bradycardia, systolic hypertension with widening
pulse pressure, and irregular respirations.
5. A patient with Diabetic Ketoacidosis (DKA) is receiving insulin IV. What
electrolyte must the nurse monitor most closely?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium
Answer: B
Rationale: Insulin shifts potassium into the cells, which can cause life-threatening
hypokalemia.
, 6. What distinguishes Hyperosmolar Hyperglycemic State (HHS) from Diabetic
Ketoacidosis (DKA)?
A. HHS is characterized by profound dehydration and lack of ketosis
B. DKA occurs primarily in Type 2 Diabetes
C. HHS involves high levels of ketones
D. HHS presents with metabolic acidosis
Answer: A
Rationale: HHS occurs in Type 2 DM with extreme hyperglycemia and dehydration but no
significant ketosis.
7. A patient in Myxedema Coma would most likely display which clinical
manifestation?
A. Tachycardia
B. Hyperthermia
C. Exophthalmos
D. Severe hypotension and hypothermia
Answer: D
Rationale: Myxedema coma is severe hypothyroidism leading to slowed metabolism,
causing hypothermia and cardiovascular collapse.
8. Which medication is commonly used during a Thyroid Storm to inhibit the
peripheral conversion of T4 to T3?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Furosemide
D. Insulin
Answer: B
Rationale: PTU blocks the synthesis of thyroid hormones and the peripheral conversion of
T4 to T3.
College
1. A patient has a pH of 7.31, PaCO2 of 52 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory), indicating
respiratory acidosis.
2. Which of the following is a classic sign of Cardiac Tamponade known as Beck’s
Triad?
A. Hypertension, Bradycardia, Irregular breathing
B. Bounding pulses, Polyuria, Weight gain
C. Tachycardia, Tachypnea, Hyperthermia
D. JVD, Hypotension, Muffled heart sounds
Answer: D
Rationale: Beck’s Triad consists of jugular venous distention, hypotension, and muffled
heart sounds.
,3. What is the first priority nursing action for a patient suspected of Autonomic
Dysreflexia?
A. Administer an antihypertensive medication
B. Call the healthcare provider
C. Raise the head of the bed to a high-Fowler’s position
D. Assess for bladder distention
Answer: C
Rationale: Raising the head of the bed helps decrease intracranial pressure and is the
immediate first action.
4. Cushing’s Triad is a late sign of increased intracranial pressure (ICP). What
does it consist of?
A. Tachycardia, Hypotension, Widening pulse pressure
B. Bradypnea, Hypotension, Narrowing pulse pressure
C. Bradycardia, Hypertension, Widening pulse pressure
D. Tachycardia, Hypertension, Narrowing pulse pressure
Answer: C
Rationale: Cushing’s Triad includes bradycardia, systolic hypertension with widening
pulse pressure, and irregular respirations.
5. A patient with Diabetic Ketoacidosis (DKA) is receiving insulin IV. What
electrolyte must the nurse monitor most closely?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium
Answer: B
Rationale: Insulin shifts potassium into the cells, which can cause life-threatening
hypokalemia.
, 6. What distinguishes Hyperosmolar Hyperglycemic State (HHS) from Diabetic
Ketoacidosis (DKA)?
A. HHS is characterized by profound dehydration and lack of ketosis
B. DKA occurs primarily in Type 2 Diabetes
C. HHS involves high levels of ketones
D. HHS presents with metabolic acidosis
Answer: A
Rationale: HHS occurs in Type 2 DM with extreme hyperglycemia and dehydration but no
significant ketosis.
7. A patient in Myxedema Coma would most likely display which clinical
manifestation?
A. Tachycardia
B. Hyperthermia
C. Exophthalmos
D. Severe hypotension and hypothermia
Answer: D
Rationale: Myxedema coma is severe hypothyroidism leading to slowed metabolism,
causing hypothermia and cardiovascular collapse.
8. Which medication is commonly used during a Thyroid Storm to inhibit the
peripheral conversion of T4 to T3?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Furosemide
D. Insulin
Answer: B
Rationale: PTU blocks the synthesis of thyroid hormones and the peripheral conversion of
T4 to T3.
