NR341/NR 341 Exam 1 V3 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient in the ICU with a Central Venous Pressure (CVP) of 1 mmHg.
Which intervention should the nurse anticipate first?
A. Administering a prescribed loop diuretic
B. Administering a rapid intravenous fluid bolus
C. Preparing the patient for emergent dialysis
D. Titrating a norepinephrine infusion upwards
Correct Answer: B
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia. The priority intervention is to increase the patient’s circulating
volume through fluid resuscitation. The nurse must monitor the patient’s response to the
bolus to ensure the CVP returns to a therapeutic level.
2. A ventilator alarm sounds indicating ‘High Pressure’ for a patient who is intubated. After
assessing the patient, which action is most appropriate?
A. Disconnect the patient and provide manual bagging
B. Increase the fraction of inspired oxygen (FiO2)
C. Check the tubing for any kinks or obstructions
,D. Extubate the patient and apply a non-rebreather mask
Correct Answer: C
Expert Explanation: High-pressure alarms are commonly triggered by increased
resistance such as secretions, coughing, or kinks in the ventilator circuit. The nurse should
immediately assess the tubing and the patient’s airway to identify the source of resistance.
If the obstruction cannot be resolved quickly, the nurse should then consider manual
ventilation with a bag-valve-mask.
3. When managing a patient in the early stage of septic shock, which assessment finding is
the nurse most likely to observe?
A. Bradycardia and hypertension
B. Increased cardiac output and warm, flushed skin
C. Skin that is cool, clammy, and pale
D. Profound oliguria and a decrease in body temperature
Correct Answer: B
Expert Explanation: In the early ‘hyperdynamic’ phase of septic shock, the body
compensates by increasing cardiac output and causing vasodilation. This often manifests as
warm, flushed skin and a bounding pulse despite systemic infection. Recognizing these
signs early is crucial for initiating appropriate antibiotic and fluid therapy to prevent
progression to the cold phase.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological rationale for this intervention?
A. To reduce the risk of ventilator-associated pneumonia
B. To facilitate easier suctioning of thickened secretions
C. To decrease the patient’s work of breathing significantly
D. To improve oxygenation by recruiting dorsal lung alveoli
Correct Answer: D
Expert Explanation: Prone positioning helps redistribute pulmonary blood flow and
improves ventilation-perfusion matching. By turning the patient face down, the pressure of
the heart and abdominal contents on the lungs is reduced, allowing dorsal alveoli to
expand. This intervention is specifically utilized in ARDS to manage refractory hypoxemia
when other measures fail.
5. A nurse observes a patient’s ECG monitor and notes Supraventricular Tachycardia (SVT)
with a heart rate of 190 bpm. The patient is stable but symptomatic. Which medication is the
drug of choice for this rhythm?
A. Atropine 0.5 mg IV push
B. Amiodarone 150 mg IV over 10 minutes
C. Epinephrine 1 mg IV push every 3 minutes
D. Adenosine 6 mg rapid IV push
Health Q&A with Rationale | Chamberlain
University
1. A nurse is caring for a patient in the ICU with a Central Venous Pressure (CVP) of 1 mmHg.
Which intervention should the nurse anticipate first?
A. Administering a prescribed loop diuretic
B. Administering a rapid intravenous fluid bolus
C. Preparing the patient for emergent dialysis
D. Titrating a norepinephrine infusion upwards
Correct Answer: B
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2 to 8 mmHg,
indicating hypovolemia. The priority intervention is to increase the patient’s circulating
volume through fluid resuscitation. The nurse must monitor the patient’s response to the
bolus to ensure the CVP returns to a therapeutic level.
2. A ventilator alarm sounds indicating ‘High Pressure’ for a patient who is intubated. After
assessing the patient, which action is most appropriate?
A. Disconnect the patient and provide manual bagging
B. Increase the fraction of inspired oxygen (FiO2)
C. Check the tubing for any kinks or obstructions
,D. Extubate the patient and apply a non-rebreather mask
Correct Answer: C
Expert Explanation: High-pressure alarms are commonly triggered by increased
resistance such as secretions, coughing, or kinks in the ventilator circuit. The nurse should
immediately assess the tubing and the patient’s airway to identify the source of resistance.
If the obstruction cannot be resolved quickly, the nurse should then consider manual
ventilation with a bag-valve-mask.
3. When managing a patient in the early stage of septic shock, which assessment finding is
the nurse most likely to observe?
A. Bradycardia and hypertension
B. Increased cardiac output and warm, flushed skin
C. Skin that is cool, clammy, and pale
D. Profound oliguria and a decrease in body temperature
Correct Answer: B
Expert Explanation: In the early ‘hyperdynamic’ phase of septic shock, the body
compensates by increasing cardiac output and causing vasodilation. This often manifests as
warm, flushed skin and a bounding pulse despite systemic infection. Recognizing these
signs early is crucial for initiating appropriate antibiotic and fluid therapy to prevent
progression to the cold phase.
, 4. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed in the prone position.
What is the primary physiological rationale for this intervention?
A. To reduce the risk of ventilator-associated pneumonia
B. To facilitate easier suctioning of thickened secretions
C. To decrease the patient’s work of breathing significantly
D. To improve oxygenation by recruiting dorsal lung alveoli
Correct Answer: D
Expert Explanation: Prone positioning helps redistribute pulmonary blood flow and
improves ventilation-perfusion matching. By turning the patient face down, the pressure of
the heart and abdominal contents on the lungs is reduced, allowing dorsal alveoli to
expand. This intervention is specifically utilized in ARDS to manage refractory hypoxemia
when other measures fail.
5. A nurse observes a patient’s ECG monitor and notes Supraventricular Tachycardia (SVT)
with a heart rate of 190 bpm. The patient is stable but symptomatic. Which medication is the
drug of choice for this rhythm?
A. Atropine 0.5 mg IV push
B. Amiodarone 150 mg IV over 10 minutes
C. Epinephrine 1 mg IV push every 3 minutes
D. Adenosine 6 mg rapid IV push
