NR341/NR 341 Exam 1 V2 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient in the ICU who is being monitored for hemodynamic
instability. The nurse notes a Central Venous Pressure (CVP) of 1 mmHg. Which action should
the nurse prioritize?
A. Position the patient in a High-Fowler’s position.
B. Initiate a continuous infusion of furosemide.
C. Prepare the patient for immediate intubation.
D. Administer a prescribed bolus of normal saline.
Correct Answer: D
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia or decreased preload. The nurse should expect to administer
intravenous fluids to restore circulating volume and increase cardiac output. Monitoring
for clinical signs of fluid resuscitation success, such as increased urine output and
stabilized blood pressure, is essential.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Hypotension with a systolic BP below 90 mmHg.
B. Anuria and peripheral edema.
,C. Metabolic acidosis and lethargy.
D. Cool, clammy skin and narrowed pulse pressure.
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain perfusion to vital organs. This results in
vasoconstriction of the skin and GI tract, leading to cool, clammy skin and a narrowing
pulse pressure as the diastolic pressure rises. The nurse must recognize these early signs to
prevent progression to the progressive or irreversible stages of shock.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high levels of PEEP. What is the primary purpose of PEEP in this patient?
A. To reduce the risk of barotrauma during inspiration.
B. To decrease the patient’s work of breathing.
C. To increase the fraction of inspired oxygen (FiO2) concentration.
D. To prevent the collapse of alveoli at the end of expiration.
Correct Answer: D
Expert Explanation: Positive End-Expiratory Pressure (PEEP) is used in ARDS to prevent
alveolar collapse and promote recruitment of closed alveoli. By maintaining pressure at the
end of expiration, PEEP improves gas exchange and helps treat refractory hypoxemia. The
nurse must monitor for side effects of high PEEP, such as decreased cardiac output or
pneumothorax.
, 4. The nurse is interpreting ABG results for a patient with severe COPD: pH 7.32, PaCO2 55
mmHg, HCO3 28 mEq/L. Which interpretation is correct?
A. Uncompensated metabolic acidosis.
B. Partially compensated respiratory acidosis.
C. Fully compensated respiratory alkalosis.
D. Uncompensated respiratory acidosis.
Correct Answer: B
Expert Explanation: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated,
indicating a respiratory cause. The HCO3 is also elevated above the normal range of 22-26
mEq/L, suggesting that the kidneys are attempting to compensate. Because the pH has not
yet returned to the normal range, it is classified as partially compensated respiratory
acidosis.
5. When caring for a patient with Septic Shock, which order should the nurse implement first?
A. Start a norepinephrine drip to maintain MAP > 65.
B. Obtain blood cultures from two different sites.
C. Administer a broad-spectrum antibiotic.
D. Infuse 30 mL/kg of isotonic crystalloid fluids.
Correct Answer: B
Health Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient in the ICU who is being monitored for hemodynamic
instability. The nurse notes a Central Venous Pressure (CVP) of 1 mmHg. Which action should
the nurse prioritize?
A. Position the patient in a High-Fowler’s position.
B. Initiate a continuous infusion of furosemide.
C. Prepare the patient for immediate intubation.
D. Administer a prescribed bolus of normal saline.
Correct Answer: D
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia or decreased preload. The nurse should expect to administer
intravenous fluids to restore circulating volume and increase cardiac output. Monitoring
for clinical signs of fluid resuscitation success, such as increased urine output and
stabilized blood pressure, is essential.
2. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Hypotension with a systolic BP below 90 mmHg.
B. Anuria and peripheral edema.
,C. Metabolic acidosis and lethargy.
D. Cool, clammy skin and narrowed pulse pressure.
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain perfusion to vital organs. This results in
vasoconstriction of the skin and GI tract, leading to cool, clammy skin and a narrowing
pulse pressure as the diastolic pressure rises. The nurse must recognize these early signs to
prevent progression to the progressive or irreversible stages of shock.
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high levels of PEEP. What is the primary purpose of PEEP in this patient?
A. To reduce the risk of barotrauma during inspiration.
B. To decrease the patient’s work of breathing.
C. To increase the fraction of inspired oxygen (FiO2) concentration.
D. To prevent the collapse of alveoli at the end of expiration.
Correct Answer: D
Expert Explanation: Positive End-Expiratory Pressure (PEEP) is used in ARDS to prevent
alveolar collapse and promote recruitment of closed alveoli. By maintaining pressure at the
end of expiration, PEEP improves gas exchange and helps treat refractory hypoxemia. The
nurse must monitor for side effects of high PEEP, such as decreased cardiac output or
pneumothorax.
, 4. The nurse is interpreting ABG results for a patient with severe COPD: pH 7.32, PaCO2 55
mmHg, HCO3 28 mEq/L. Which interpretation is correct?
A. Uncompensated metabolic acidosis.
B. Partially compensated respiratory acidosis.
C. Fully compensated respiratory alkalosis.
D. Uncompensated respiratory acidosis.
Correct Answer: B
Expert Explanation: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated,
indicating a respiratory cause. The HCO3 is also elevated above the normal range of 22-26
mEq/L, suggesting that the kidneys are attempting to compensate. Because the pH has not
yet returned to the normal range, it is classified as partially compensated respiratory
acidosis.
5. When caring for a patient with Septic Shock, which order should the nurse implement first?
A. Start a norepinephrine drip to maintain MAP > 65.
B. Obtain blood cultures from two different sites.
C. Administer a broad-spectrum antibiotic.
D. Infuse 30 mL/kg of isotonic crystalloid fluids.
Correct Answer: B
