NR341/NR 341 Exam 1 V1 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted with severe sepsis and a Central Venous Pressure (CVP) of 2 mmHg.
Which intervention should the nurse prioritize?
A. Starting a continuous infusion of Norepinephrine.
B. Administering a prescribed bolus of 0.9% Normal Saline.
C. Performing a 12-lead Electrocardiogram.
D. Obtaining a STAT chest X-ray for heart size assessment.
Correct Answer: B
Expert Explanation: A CVP of 2 mmHg indicates a low preload and significant
hypovolemia, which is common in early septic shock. According to the Surviving Sepsis
Campaign, the immediate priority is volume resuscitation to restore organ perfusion.
Administering fluids is necessary before considering vasopressors to ensure there is
adequate volume to circulate.
2. The nurse notes the ventilator high-pressure alarm is sounding for a patient with ARDS.
Which action is most appropriate?
A. Checking the circuit for any disconnections or leaks.
B. Suctioning the patient to clear excessive secretions.
,C. Decreasing the PEEP setting to reduce intrathoracic pressure.
D. Extubating the patient to provide bag-valve-mask ventilation.
Correct Answer: B
Expert Explanation: A high-pressure alarm indicates that the ventilator is meeting
resistance when trying to deliver a breath. Common causes include secretions in the
airway, the patient biting the tube, or kinks in the tubing. Suctioning the patient addresses
the physiological barrier of secretions and helps stabilize airway pressures.
3. A patient’s ABG results are: pH 7.28, PaCO2 52 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Alkalosis
C. Partially Compensated Respiratory Alkalosis
D. Uncompensated Respiratory Acidosis
Correct Answer: D
Expert Explanation: The pH of 7.28 is below the normal range, indicating acidosis. The
PaCO2 is elevated at 52, which causes the drop in pH, identifying the cause as respiratory.
Since the HCO3 is within the normal range of 22-26, no compensation has occurred yet
from the kidneys.
, 4. During hemodynamic monitoring, the nurse calculates a Mean Arterial Pressure (MAP) of
55 mmHg. What is the clinical significance of this finding?
A. This is a normal finding for a patient at rest.
B. The patient is at risk for inadequate organ perfusion.
C. The patient is experiencing hypertensive urgency.
D. The patient has adequate cerebral blood flow.
Correct Answer: B
Expert Explanation: A Mean Arterial Pressure of at least 60 to 65 mmHg is generally
required to maintain adequate perfusion to vital organs like the kidneys and brain. A MAP
of 55 mmHg indicates a high risk for ischemia and multi-organ dysfunction syndrome. The
nurse must notify the provider immediately to initiate fluid or vasopressor therapy.
5. A patient in the ICU is being treated for Neurogenic Shock. Which clinical manifestation is
characteristic of this condition?
A. Tachycardia and hypertension.
B. Cool, clammy skin with rapid respirations.
C. Bradycardia and hypotension.
D. Bounding pulses and a high fever.
Correct Answer: C
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted with severe sepsis and a Central Venous Pressure (CVP) of 2 mmHg.
Which intervention should the nurse prioritize?
A. Starting a continuous infusion of Norepinephrine.
B. Administering a prescribed bolus of 0.9% Normal Saline.
C. Performing a 12-lead Electrocardiogram.
D. Obtaining a STAT chest X-ray for heart size assessment.
Correct Answer: B
Expert Explanation: A CVP of 2 mmHg indicates a low preload and significant
hypovolemia, which is common in early septic shock. According to the Surviving Sepsis
Campaign, the immediate priority is volume resuscitation to restore organ perfusion.
Administering fluids is necessary before considering vasopressors to ensure there is
adequate volume to circulate.
2. The nurse notes the ventilator high-pressure alarm is sounding for a patient with ARDS.
Which action is most appropriate?
A. Checking the circuit for any disconnections or leaks.
B. Suctioning the patient to clear excessive secretions.
,C. Decreasing the PEEP setting to reduce intrathoracic pressure.
D. Extubating the patient to provide bag-valve-mask ventilation.
Correct Answer: B
Expert Explanation: A high-pressure alarm indicates that the ventilator is meeting
resistance when trying to deliver a breath. Common causes include secretions in the
airway, the patient biting the tube, or kinks in the tubing. Suctioning the patient addresses
the physiological barrier of secretions and helps stabilize airway pressures.
3. A patient’s ABG results are: pH 7.28, PaCO2 52 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these findings?
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Alkalosis
C. Partially Compensated Respiratory Alkalosis
D. Uncompensated Respiratory Acidosis
Correct Answer: D
Expert Explanation: The pH of 7.28 is below the normal range, indicating acidosis. The
PaCO2 is elevated at 52, which causes the drop in pH, identifying the cause as respiratory.
Since the HCO3 is within the normal range of 22-26, no compensation has occurred yet
from the kidneys.
, 4. During hemodynamic monitoring, the nurse calculates a Mean Arterial Pressure (MAP) of
55 mmHg. What is the clinical significance of this finding?
A. This is a normal finding for a patient at rest.
B. The patient is at risk for inadequate organ perfusion.
C. The patient is experiencing hypertensive urgency.
D. The patient has adequate cerebral blood flow.
Correct Answer: B
Expert Explanation: A Mean Arterial Pressure of at least 60 to 65 mmHg is generally
required to maintain adequate perfusion to vital organs like the kidneys and brain. A MAP
of 55 mmHg indicates a high risk for ischemia and multi-organ dysfunction syndrome. The
nurse must notify the provider immediately to initiate fluid or vasopressor therapy.
5. A patient in the ICU is being treated for Neurogenic Shock. Which clinical manifestation is
characteristic of this condition?
A. Tachycardia and hypertension.
B. Cool, clammy skin with rapid respirations.
C. Bradycardia and hypotension.
D. Bounding pulses and a high fever.
Correct Answer: C
