NR341/NR 341 Final Exam V2 | Complex
Adult Health Q&A with Rationale |
Chamberlain University
1. A nurse is caring for a client with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L.
Which acid-base imbalance is the client experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH is below the normal range of 7.35 to 7.45, indicating acidosis.
The PaCO2 is elevated above the normal range of 35 to 45 mmHg, which points toward a
respiratory cause. Since the bicarbonate level is within the normal range, the condition is
uncompensated respiratory acidosis.
2. Which hemodynamic parameter is the best indicator of left-sided heart preload?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Mean Arterial Pressure (MAP)
C. Central Venous Pressure (CVP)
D. Systemic Vascular Resistance (SVR)
,Correct Answer: A
Expert Explanation: Pulmonary Artery Wedge Pressure (PAWP) reflects the pressure in
the left atrium and the left ventricular end-diastolic pressure. It is used clinically to assess
the volume status of the left heart. CVP measures right-sided preload, while SVR measures
afterload.
3. A mechanical ventilator alarm sounds ‘High Pressure’ for a client in the ICU. What is the
nurse’s first action?
A. Assess the client’s airway and breath sounds
B. Turn off the alarm
C. Increase the oxygen concentration
D. Disconnect the client and use a manual resuscitator bag
Correct Answer: A
Expert Explanation: The nurse must always assess the patient before troubleshooting the
equipment. A high-pressure alarm can be triggered by secretions, biting the tube, or kinks
in the circuit. If the patient is in immediate distress and the cause is not found, manual
bagging may then be required.
4. A client is in Ventricular Tachycardia (VT) and is pulseless. Which intervention is the highest
priority?
A. Administering Amiodarone
B. Defibrillation
, C. Performing synchronized cardioversion
D. Administering Epinephrine
Correct Answer: B
Expert Explanation: Pulseless ventricular tachycardia is a shockable rhythm that requires
immediate defibrillation. Synchronized cardioversion is used only if the patient has a pulse.
CPR should be initiated while waiting for the defibrillator to be charged and ready.
5. In the oliguric phase of Acute Kidney Injury (AKI), which electrolyte abnormality should the
nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Expert Explanation: Hyperkalemia is one of the most serious complications of the oliguric
phase because the kidneys are unable to excrete potassium. High potassium levels can lead
to life-threatening cardiac dysrhythmias. Monitoring the EKG for peaked T waves is a
priority assessment in this patient population.
Adult Health Q&A with Rationale |
Chamberlain University
1. A nurse is caring for a client with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L.
Which acid-base imbalance is the client experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Expert Explanation: The pH is below the normal range of 7.35 to 7.45, indicating acidosis.
The PaCO2 is elevated above the normal range of 35 to 45 mmHg, which points toward a
respiratory cause. Since the bicarbonate level is within the normal range, the condition is
uncompensated respiratory acidosis.
2. Which hemodynamic parameter is the best indicator of left-sided heart preload?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Mean Arterial Pressure (MAP)
C. Central Venous Pressure (CVP)
D. Systemic Vascular Resistance (SVR)
,Correct Answer: A
Expert Explanation: Pulmonary Artery Wedge Pressure (PAWP) reflects the pressure in
the left atrium and the left ventricular end-diastolic pressure. It is used clinically to assess
the volume status of the left heart. CVP measures right-sided preload, while SVR measures
afterload.
3. A mechanical ventilator alarm sounds ‘High Pressure’ for a client in the ICU. What is the
nurse’s first action?
A. Assess the client’s airway and breath sounds
B. Turn off the alarm
C. Increase the oxygen concentration
D. Disconnect the client and use a manual resuscitator bag
Correct Answer: A
Expert Explanation: The nurse must always assess the patient before troubleshooting the
equipment. A high-pressure alarm can be triggered by secretions, biting the tube, or kinks
in the circuit. If the patient is in immediate distress and the cause is not found, manual
bagging may then be required.
4. A client is in Ventricular Tachycardia (VT) and is pulseless. Which intervention is the highest
priority?
A. Administering Amiodarone
B. Defibrillation
, C. Performing synchronized cardioversion
D. Administering Epinephrine
Correct Answer: B
Expert Explanation: Pulseless ventricular tachycardia is a shockable rhythm that requires
immediate defibrillation. Synchronized cardioversion is used only if the patient has a pulse.
CPR should be initiated while waiting for the defibrillator to be charged and ready.
5. In the oliguric phase of Acute Kidney Injury (AKI), which electrolyte abnormality should the
nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Expert Explanation: Hyperkalemia is one of the most serious complications of the oliguric
phase because the kidneys are unable to excrete potassium. High potassium levels can lead
to life-threatening cardiac dysrhythmias. Monitoring the EKG for peaked T waves is a
priority assessment in this patient population.
