NURS 201 | Medical-Surgical Nursing – Promoting Wellness | Week 10
Advanced Quiz 2026 |WCU
1. A patient in the early stages of septic shock is exhibiting a high cardiac output
and low systemic vascular resistance. Which phase of shock is this patient most
likely experiencing?
A. Hyperdynamic (Warm) phase
B. Compensatory stage
C. Hypodynamic (Cold) phase
D. Refractory stage
Answer: A
Rationale: The hyperdynamic or ‘warm’ phase of septic shock is characterized by
vasodilation, which leads to low systemic vascular resistance and a compensatory increase
in cardiac output.
2. A client with 45% total body surface area (TBSA) burns is in the emergent
phase. Which electrolyte imbalance should the nurse prioritize for monitoring?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: During the emergent phase of a burn, massive cell destruction releases
potassium into the extracellular fluid, leading to life-threatening hyperkalemia.
,3. Which clinical finding is most characteristic of the ‘progressive stage’ of
shock?
A. Increased urinary output due to fluid resuscitation
B. Respiratory alkalosis due to tachypnea
C. Narrow pulse pressure with stable mentation
D. Mean arterial pressure (MAP) decrease of 20 mmHg from baseline
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, and the MAP
typically drops more than 20 mmHg from baseline, leading to organ ischemia.
4. A nurse is caring for a patient with Disseminated Intravascular Coagulation
(DIC). Which laboratory result would the nurse expect to find?
A. Decreased Prothrombin Time (PT)
B. Increased Fibrinogen levels
C. Increased Fibrin Degradation Products (FDPs)
D. Decreased D-dimer levels
Answer: C
Rationale: DIC involves widespread clotting followed by fibrinolysis. Increased FDPs and
D-dimer levels indicate the body is attempting to break down excessive clots.
5. When calculating fluid resuscitation for a 70kg patient with 50% TBSA burns
using the Parkland Formula (4mL/kg/%TBSA), how much fluid should be given in
the first 8 hours?
A. 14,000 mL
B. 10,500 mL
C. 3,500 mL
D. 7,000 mL
Answer: D
, Rationale: Total fluid = 4mL x 70kg x 50 = 14,000 mL. Half of the total (7,000 mL) is
administered in the first 8 hours.
6. A patient with ARDS is being mechanically ventilated. The provider orders an
increase in Positive End-Expiratory Pressure (PEEP). What is the primary risk of
high PEEP?
A. Increased cardiac output
B. Increased venous return to the heart
C. Respiratory acidosis
D. Barotrauma and pneumothorax
Answer: D
Rationale: High PEEP increases intrathoracic pressure, which can cause alveolar rupture
(barotrauma) and decrease venous return, potentially lowering cardiac output.
7. Which assessment finding indicates that a patient with a spinal cord injury at
T6 is experiencing autonomic dysreflexia?
A. Hypotension and tachycardia
B. Severe headache and profuse sweating above the injury level
C. Flaccid paralysis below the level of injury
D. Extreme cold and pale skin above the injury level
Answer: B
Rationale: Autonomic dysreflexia is characterized by extreme hypertension, bradycardia,
severe headache, and flushing/sweating above the level of the spinal cord lesion.
Advanced Quiz 2026 |WCU
1. A patient in the early stages of septic shock is exhibiting a high cardiac output
and low systemic vascular resistance. Which phase of shock is this patient most
likely experiencing?
A. Hyperdynamic (Warm) phase
B. Compensatory stage
C. Hypodynamic (Cold) phase
D. Refractory stage
Answer: A
Rationale: The hyperdynamic or ‘warm’ phase of septic shock is characterized by
vasodilation, which leads to low systemic vascular resistance and a compensatory increase
in cardiac output.
2. A client with 45% total body surface area (TBSA) burns is in the emergent
phase. Which electrolyte imbalance should the nurse prioritize for monitoring?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: During the emergent phase of a burn, massive cell destruction releases
potassium into the extracellular fluid, leading to life-threatening hyperkalemia.
,3. Which clinical finding is most characteristic of the ‘progressive stage’ of
shock?
A. Increased urinary output due to fluid resuscitation
B. Respiratory alkalosis due to tachypnea
C. Narrow pulse pressure with stable mentation
D. Mean arterial pressure (MAP) decrease of 20 mmHg from baseline
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, and the MAP
typically drops more than 20 mmHg from baseline, leading to organ ischemia.
4. A nurse is caring for a patient with Disseminated Intravascular Coagulation
(DIC). Which laboratory result would the nurse expect to find?
A. Decreased Prothrombin Time (PT)
B. Increased Fibrinogen levels
C. Increased Fibrin Degradation Products (FDPs)
D. Decreased D-dimer levels
Answer: C
Rationale: DIC involves widespread clotting followed by fibrinolysis. Increased FDPs and
D-dimer levels indicate the body is attempting to break down excessive clots.
5. When calculating fluid resuscitation for a 70kg patient with 50% TBSA burns
using the Parkland Formula (4mL/kg/%TBSA), how much fluid should be given in
the first 8 hours?
A. 14,000 mL
B. 10,500 mL
C. 3,500 mL
D. 7,000 mL
Answer: D
, Rationale: Total fluid = 4mL x 70kg x 50 = 14,000 mL. Half of the total (7,000 mL) is
administered in the first 8 hours.
6. A patient with ARDS is being mechanically ventilated. The provider orders an
increase in Positive End-Expiratory Pressure (PEEP). What is the primary risk of
high PEEP?
A. Increased cardiac output
B. Increased venous return to the heart
C. Respiratory acidosis
D. Barotrauma and pneumothorax
Answer: D
Rationale: High PEEP increases intrathoracic pressure, which can cause alveolar rupture
(barotrauma) and decrease venous return, potentially lowering cardiac output.
7. Which assessment finding indicates that a patient with a spinal cord injury at
T6 is experiencing autonomic dysreflexia?
A. Hypotension and tachycardia
B. Severe headache and profuse sweating above the injury level
C. Flaccid paralysis below the level of injury
D. Extreme cold and pale skin above the injury level
Answer: B
Rationale: Autonomic dysreflexia is characterized by extreme hypertension, bradycardia,
severe headache, and flushing/sweating above the level of the spinal cord lesion.
