NSG 233 Exam 1: (Latest 2026/2027 Update) Emergency Nursing & Shock
Management | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NSG 233 – Emergency Nursing / Critical Care
Source: NSG 233 Exam 1 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What are the priority interventions in caring for a patient in hypovolemic shock?
Correct Answer: Treat the underlying cause (stop bleeding), fluid and blood replacement (two large-
gauge IV lines), administer isotonic fluids (NS, LR), modified Trendelenburg position (passive leg
raising).
1. Stop the loss of fluid first (hemorrhage control, antiemetics).
2. Replace volume with 0.9% NS or LR; blood products for hemorrhagic shock.
3. Passive leg raising augments venous return temporarily.
2. What is the single most important priority in poison emergencies?
Correct Answer: Airway stabilization (ABCs).
1. Airway obstruction kills fastest; secure airway before decontamination.
2. Assess breathing, circulation; administer oxygen.
3. After stabilization, identify poison and administer antidote.
3. What are the signs and symptoms of carbon monoxide poisoning and the priority assessment?
Correct Answer: Headache, dizziness, confusion, palpitations, muscle weakness, intoxication, coma,
death. Priority: assess carboxyhemoglobin levels (SpO2 will appear normal).
1. Pulse oximetry falsely normal; CO-oximeter needed.
2. Cherry red lips (late sign).
3. Treatment: 100% high-flow oxygen via NRB; hyperbaric oxygen for severe poisoning.
4. What is the risk with hypothermia regarding spontaneous ventricular fibrillation (V-fib)?
Correct Answer: Risk for hypoxia, acidosis, and dysrhythmias. Must rewarm to >32.2°C (90°F) before
defibrillation (defibrillation is ineffective below that temperature).
1. At temperatures <90°F (32°C), defibrillation and medications are ineffective.
2. CPR initiated; active rewarming first (ECMO, warm fluids).
3. Monitor for rewarming afterdrop (acidosis, arrhythmias).
, 5. Who must be screened for intimate partner violence (IPV) in the emergency department?
Correct Answer: Every patient must be screened: "Do you feel safe at home?"
1. Universal screening recommended by JCAHO and CDC.
2. Screen privately (without partner present).
3. Provide resources (hotline, shelter).
6. What are the assessment findings in the compensatory stage of shock?
Correct Answer: Normal BP, >100 bpm, >20 breaths/min, PaCO2 <32, cold/clammy skin, decreased
urine output, confused/agitated, respiratory alkalosis.
1. Sympathetic activation maintains BP (compensation).
2. Tachycardia, tachypnea, cool/clammy skin from vasoconstriction.
3. Hypocapnia from hyperventilation leads to respiratory alkalosis.
7. What are the assessment findings in the progressive stage of shock?
Correct Answer: Systolic <90, MAP <65, >150 bpm, rapid shallow respirations, crackles, PaO2 <80,
PaCO2 >45, mottled/petechiae, urine output <0.5 mL/kg/hr, lethargy, metabolic acidosis.
1. Compensatory mechanisms fail → hypotension, anaerobic metabolism.
2. Lactic acidosis, worsening organ dysfunction.
3. Requires fluid resuscitation and vasopressors.
8. What are the findings in irreversible shock?
Correct Answer: Requires mechanical/pharmacologic support; erratic HR; intubation; jaundice; anuric
(needs dialysis); unconscious; profound acidosis.
1. End-organ failure (liver, kidneys, brain).
2. Multi-organ dysfunction syndrome (MODS) develops.
3. Recovery unlikely; goals shift to comfort care.
9. What is multiple organ dysfunction syndrome (MODS)?
Correct Answer: Altered organ function in acutely ill patients requiring medical intervention to support
continued organ function. Most commonly seen in sepsis from inadequate tissue perfusion. Assessment
tools: APACHE, SAPS, PIRO, SOFA.
1. Two or more organ systems fail (e.g., lungs, kidneys, liver).
2. High mortality (50-80%).
3. Prevention: early recognition and treatment of shock.
10. What is the pathophysiology of hypovolemic shock?
Correct Answer: Decreased intravascular volume → decreased venous return → decreased stroke
volume, cardiac output, and tissue perfusion.
1. Causes: external fluid losses (hemorrhage) or internal shifts (dehydration, ascites).
2. Oxygen delivery impaired → cellular hypoxia.
3. Treatment: stop loss, replace volume.
Management | Q&A | Grade A | 100% Correct (Verified Answers) – Nursing
Program
Subject: NSG 233 – Emergency Nursing / Critical Care
Source: NSG 233 Exam 1 Blueprint 2026/2027
Format: Q&A Guide with Rationale | Verified Grade A
1. What are the priority interventions in caring for a patient in hypovolemic shock?
Correct Answer: Treat the underlying cause (stop bleeding), fluid and blood replacement (two large-
gauge IV lines), administer isotonic fluids (NS, LR), modified Trendelenburg position (passive leg
raising).
1. Stop the loss of fluid first (hemorrhage control, antiemetics).
2. Replace volume with 0.9% NS or LR; blood products for hemorrhagic shock.
3. Passive leg raising augments venous return temporarily.
2. What is the single most important priority in poison emergencies?
Correct Answer: Airway stabilization (ABCs).
1. Airway obstruction kills fastest; secure airway before decontamination.
2. Assess breathing, circulation; administer oxygen.
3. After stabilization, identify poison and administer antidote.
3. What are the signs and symptoms of carbon monoxide poisoning and the priority assessment?
Correct Answer: Headache, dizziness, confusion, palpitations, muscle weakness, intoxication, coma,
death. Priority: assess carboxyhemoglobin levels (SpO2 will appear normal).
1. Pulse oximetry falsely normal; CO-oximeter needed.
2. Cherry red lips (late sign).
3. Treatment: 100% high-flow oxygen via NRB; hyperbaric oxygen for severe poisoning.
4. What is the risk with hypothermia regarding spontaneous ventricular fibrillation (V-fib)?
Correct Answer: Risk for hypoxia, acidosis, and dysrhythmias. Must rewarm to >32.2°C (90°F) before
defibrillation (defibrillation is ineffective below that temperature).
1. At temperatures <90°F (32°C), defibrillation and medications are ineffective.
2. CPR initiated; active rewarming first (ECMO, warm fluids).
3. Monitor for rewarming afterdrop (acidosis, arrhythmias).
, 5. Who must be screened for intimate partner violence (IPV) in the emergency department?
Correct Answer: Every patient must be screened: "Do you feel safe at home?"
1. Universal screening recommended by JCAHO and CDC.
2. Screen privately (without partner present).
3. Provide resources (hotline, shelter).
6. What are the assessment findings in the compensatory stage of shock?
Correct Answer: Normal BP, >100 bpm, >20 breaths/min, PaCO2 <32, cold/clammy skin, decreased
urine output, confused/agitated, respiratory alkalosis.
1. Sympathetic activation maintains BP (compensation).
2. Tachycardia, tachypnea, cool/clammy skin from vasoconstriction.
3. Hypocapnia from hyperventilation leads to respiratory alkalosis.
7. What are the assessment findings in the progressive stage of shock?
Correct Answer: Systolic <90, MAP <65, >150 bpm, rapid shallow respirations, crackles, PaO2 <80,
PaCO2 >45, mottled/petechiae, urine output <0.5 mL/kg/hr, lethargy, metabolic acidosis.
1. Compensatory mechanisms fail → hypotension, anaerobic metabolism.
2. Lactic acidosis, worsening organ dysfunction.
3. Requires fluid resuscitation and vasopressors.
8. What are the findings in irreversible shock?
Correct Answer: Requires mechanical/pharmacologic support; erratic HR; intubation; jaundice; anuric
(needs dialysis); unconscious; profound acidosis.
1. End-organ failure (liver, kidneys, brain).
2. Multi-organ dysfunction syndrome (MODS) develops.
3. Recovery unlikely; goals shift to comfort care.
9. What is multiple organ dysfunction syndrome (MODS)?
Correct Answer: Altered organ function in acutely ill patients requiring medical intervention to support
continued organ function. Most commonly seen in sepsis from inadequate tissue perfusion. Assessment
tools: APACHE, SAPS, PIRO, SOFA.
1. Two or more organ systems fail (e.g., lungs, kidneys, liver).
2. High mortality (50-80%).
3. Prevention: early recognition and treatment of shock.
10. What is the pathophysiology of hypovolemic shock?
Correct Answer: Decreased intravascular volume → decreased venous return → decreased stroke
volume, cardiac output, and tissue perfusion.
1. Causes: external fluid losses (hemorrhage) or internal shifts (dehydration, ascites).
2. Oxygen delivery impaired → cellular hypoxia.
3. Treatment: stop loss, replace volume.
