NR 324 | Adult Health II | Exam 7 Practice Questions 2026
|Chamberlain College
1. A patient in the compensatory stage of shock exhibits which of the following
clinical manifestations?
A. Cold, clammy skin and metabolic acidosis
B. Lethargy and decreased urine output below 20 mL/hr
C. Increased heart rate and narrowed pulse pressure
D. Hypotension and bradycardia
Answer: C
Rationale: In the compensatory stage, the sympathetic nervous system is activated,
resulting in tachycardia and vasoconstriction to maintain blood pressure. The pulse
pressure narrows as the diastolic pressure rises due to vasoconstriction.
2. Which hemodynamic parameter is the best indicator of fluid volume status in
a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Cardiac Output (CO)
D. Central Venous Pressure (CVP)
Answer: D
Rationale: CVP reflects the filling pressure of the right atrium and is a primary indicator of
venous return and right-sided heart preload, making it useful for monitoring fluid status.
,3. The nurse notes that a patient’s Pulmonary Artery Wedge Pressure (PAWP) is
18 mmHg. What does this value indicate?
A. Left ventricular failure or fluid overload
B. Right-sided heart failure
C. Hypovolemia
D. Normal cardiac function
Answer: A
Rationale: Normal PAWP is 6-12 mmHg. A level of 18 mmHg indicates elevated left-sided
filling pressures, often seen in heart failure or fluid volume excess.
4. A patient with septic shock has a lactate level of 5 mmol/L. This finding
indicates:
A. Aerobic metabolism and efficient oxygen use
B. Respiratory alkalosis due to hyperventilation
C. Tissue hypoperfusion and anaerobic metabolism
D. Adequate hepatic clearance of metabolites
Answer: C
Rationale: Elevated lactate levels (above 2 mmol/L) are a hallmark of tissue hypoxia,
indicating that cells have switched to anaerobic metabolism due to inadequate oxygen
delivery.
5. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM or IV
D. Albuterol nebulizer
Answer: C
, Rationale: Epinephrine is the drug of choice because it causes vasoconstriction (to
increase BP) and bronchodilation (to open airways) rapidly.
6. A patient with a T4 spinal cord injury presents with a BP of 82/40 and a HR of
48. The nurse suspects:
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock is characterized by the ‘classic triad’ of hypotension,
bradycardia, and poikilothermia due to loss of sympathetic tone.
7. What is the primary pathophysiology behind Acute Respiratory Distress
Syndrome (ARDS)?
A. Excessive mucus production in the bronchioles
B. Alveolar-capillary membrane damage and increased permeability
C. Loss of elastic recoil in the lungs
D. Bacterial infection of the pleural space
Answer: B
Rationale: ARDS is caused by damage to the alveolar-capillary membrane, which leads to
fluid leaking into the alveoli, causing severe hypoxia and reduced lung compliance.
8. A patient on a ventilator has a high-pressure alarm sounding. What is the
most likely cause?
A. Disconnection from the ventilator
B. Biting the endotracheal tube
C. A leak in the ET tube cuff
D. Spontaneous breathing by the patient
Answer: B
|Chamberlain College
1. A patient in the compensatory stage of shock exhibits which of the following
clinical manifestations?
A. Cold, clammy skin and metabolic acidosis
B. Lethargy and decreased urine output below 20 mL/hr
C. Increased heart rate and narrowed pulse pressure
D. Hypotension and bradycardia
Answer: C
Rationale: In the compensatory stage, the sympathetic nervous system is activated,
resulting in tachycardia and vasoconstriction to maintain blood pressure. The pulse
pressure narrows as the diastolic pressure rises due to vasoconstriction.
2. Which hemodynamic parameter is the best indicator of fluid volume status in
a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Cardiac Output (CO)
D. Central Venous Pressure (CVP)
Answer: D
Rationale: CVP reflects the filling pressure of the right atrium and is a primary indicator of
venous return and right-sided heart preload, making it useful for monitoring fluid status.
,3. The nurse notes that a patient’s Pulmonary Artery Wedge Pressure (PAWP) is
18 mmHg. What does this value indicate?
A. Left ventricular failure or fluid overload
B. Right-sided heart failure
C. Hypovolemia
D. Normal cardiac function
Answer: A
Rationale: Normal PAWP is 6-12 mmHg. A level of 18 mmHg indicates elevated left-sided
filling pressures, often seen in heart failure or fluid volume excess.
4. A patient with septic shock has a lactate level of 5 mmol/L. This finding
indicates:
A. Aerobic metabolism and efficient oxygen use
B. Respiratory alkalosis due to hyperventilation
C. Tissue hypoperfusion and anaerobic metabolism
D. Adequate hepatic clearance of metabolites
Answer: C
Rationale: Elevated lactate levels (above 2 mmol/L) are a hallmark of tissue hypoxia,
indicating that cells have switched to anaerobic metabolism due to inadequate oxygen
delivery.
5. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM or IV
D. Albuterol nebulizer
Answer: C
, Rationale: Epinephrine is the drug of choice because it causes vasoconstriction (to
increase BP) and bronchodilation (to open airways) rapidly.
6. A patient with a T4 spinal cord injury presents with a BP of 82/40 and a HR of
48. The nurse suspects:
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock is characterized by the ‘classic triad’ of hypotension,
bradycardia, and poikilothermia due to loss of sympathetic tone.
7. What is the primary pathophysiology behind Acute Respiratory Distress
Syndrome (ARDS)?
A. Excessive mucus production in the bronchioles
B. Alveolar-capillary membrane damage and increased permeability
C. Loss of elastic recoil in the lungs
D. Bacterial infection of the pleural space
Answer: B
Rationale: ARDS is caused by damage to the alveolar-capillary membrane, which leads to
fluid leaking into the alveoli, causing severe hypoxia and reduced lung compliance.
8. A patient on a ventilator has a high-pressure alarm sounding. What is the
most likely cause?
A. Disconnection from the ventilator
B. Biting the endotracheal tube
C. A leak in the ET tube cuff
D. Spontaneous breathing by the patient
Answer: B
