NR-341/NR341 Exam 1 V2 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted to the ICU with a diagnosis of sepsis. Which of the following
laboratory results most accurately indicates the severity of tissue hypoxia and the risk for
septic shock?
A. White blood cell count of 15,000/mm3
B. Blood urea nitrogen (BUN) of 25 mg/dL
C. Serum lactate level of 5.0 mmol/L
D. Serum glucose level of 160 mg/dL
Correct Answer: C
Expert Explanation: Serum lactate is a primary marker for tissue hypoperfusion and
cellular hypoxia in sepsis. An elevated lactate level above 2 mmol/L indicates that cells are
switching to anaerobic metabolism due to inadequate oxygen delivery. In the context of the
Sepsis-3 guidelines, a lactate level greater than 2 mmol/L despite fluid resuscitation is a
defining feature of septic shock.
2. The nurse is monitoring a patient’s hemodynamic parameters and notes a Central Venous
Pressure (CVP) of 1 mmHg. What is the most appropriate initial nursing action?
A. Increase the dose of the norepinephrine infusion
,B. Administer a prescribed 500 mL bolus of normal saline
C. Administer a dose of IV Furosemide (Lasix)
D. Assess the patient for signs of pulmonary edema
Correct Answer: B
Expert Explanation: A normal CVP typically ranges from 2 to 8 mmHg, so a value of 1
mmHg indicates low preload or hypovolemia. The priority intervention is to provide
volume resuscitation to improve cardiac output. Increasing vasopressors without adequate
volume can lead to further tissue ischemia, and diuretics would worsen the hypovolemic
state.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. It increases the patient’s comfort and reduces the need for sedation
B. It facilitates the drainage of secretions from the lower lobes
C. It decreases the risk of developing a tension pneumothorax
D. It improves oxygenation by recruiting collapsed alveoli in the dorsal lung regions
Correct Answer: D
Expert Explanation: Prone positioning is utilized in ARDS to improve gas exchange by
redistributing pulmonary blood flow and ventilation. In the supine position, the heart and
abdominal contents compress the dorsal lung segments, causing atelectasis. Placing the
, patient prone relieves this pressure and allows for the recruitment of previously collapsed
alveoli, thereby improving the PaO2/FiO2 ratio.
4. Which arterial blood gas (ABG) result is most consistent with a patient experiencing early
stage hypovolemic shock?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
C. pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 45 mmHg, HCO3 32 mEq/L
Correct Answer: B
Expert Explanation: In the early stages of shock, the patient often hyperventilates as a
compensatory mechanism for anxiety and early hypoxia. This leads to a decrease in PaCO2
and an increase in pH, resulting in respiratory alkalosis. As shock progresses and lactic acid
builds up, the patient will transition into metabolic acidosis.
5. A patient’s ventilator alarm sounds, indicating ‘High Pressure.’ Upon assessment, the nurse
finds the patient is biting the endotracheal tube. What is the most appropriate nursing
intervention?
A. Immediately suction the patient’s airway
B. Check the ventilator tubing for any kinks
C. Manually ventilate the patient with a bag-valve mask
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted to the ICU with a diagnosis of sepsis. Which of the following
laboratory results most accurately indicates the severity of tissue hypoxia and the risk for
septic shock?
A. White blood cell count of 15,000/mm3
B. Blood urea nitrogen (BUN) of 25 mg/dL
C. Serum lactate level of 5.0 mmol/L
D. Serum glucose level of 160 mg/dL
Correct Answer: C
Expert Explanation: Serum lactate is a primary marker for tissue hypoperfusion and
cellular hypoxia in sepsis. An elevated lactate level above 2 mmol/L indicates that cells are
switching to anaerobic metabolism due to inadequate oxygen delivery. In the context of the
Sepsis-3 guidelines, a lactate level greater than 2 mmol/L despite fluid resuscitation is a
defining feature of septic shock.
2. The nurse is monitoring a patient’s hemodynamic parameters and notes a Central Venous
Pressure (CVP) of 1 mmHg. What is the most appropriate initial nursing action?
A. Increase the dose of the norepinephrine infusion
,B. Administer a prescribed 500 mL bolus of normal saline
C. Administer a dose of IV Furosemide (Lasix)
D. Assess the patient for signs of pulmonary edema
Correct Answer: B
Expert Explanation: A normal CVP typically ranges from 2 to 8 mmHg, so a value of 1
mmHg indicates low preload or hypovolemia. The priority intervention is to provide
volume resuscitation to improve cardiac output. Increasing vasopressors without adequate
volume can lead to further tissue ischemia, and diuretics would worsen the hypovolemic
state.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological benefit of this intervention?
A. It increases the patient’s comfort and reduces the need for sedation
B. It facilitates the drainage of secretions from the lower lobes
C. It decreases the risk of developing a tension pneumothorax
D. It improves oxygenation by recruiting collapsed alveoli in the dorsal lung regions
Correct Answer: D
Expert Explanation: Prone positioning is utilized in ARDS to improve gas exchange by
redistributing pulmonary blood flow and ventilation. In the supine position, the heart and
abdominal contents compress the dorsal lung segments, causing atelectasis. Placing the
, patient prone relieves this pressure and allows for the recruitment of previously collapsed
alveoli, thereby improving the PaO2/FiO2 ratio.
4. Which arterial blood gas (ABG) result is most consistent with a patient experiencing early
stage hypovolemic shock?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
C. pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 45 mmHg, HCO3 32 mEq/L
Correct Answer: B
Expert Explanation: In the early stages of shock, the patient often hyperventilates as a
compensatory mechanism for anxiety and early hypoxia. This leads to a decrease in PaCO2
and an increase in pH, resulting in respiratory alkalosis. As shock progresses and lactic acid
builds up, the patient will transition into metabolic acidosis.
5. A patient’s ventilator alarm sounds, indicating ‘High Pressure.’ Upon assessment, the nurse
finds the patient is biting the endotracheal tube. What is the most appropriate nursing
intervention?
A. Immediately suction the patient’s airway
B. Check the ventilator tubing for any kinks
C. Manually ventilate the patient with a bag-valve mask
