NUR2790/NUR 2790 Final Exam V2 |
Professional Nursing III / PN3 Q&A with
Rationale | Rasmussen University
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is being treated with
mechanical ventilation. Which ventilator setting is most critical for preventing alveolar
collapse at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Tidal Volume
C. Inspiratory Flow Rate
D. Fraction of Inspired Oxygen (FiO2)
Answer: A
Rationale: PEEP provides pressure at the end of expiration to keep the alveoli open and
improve gas exchange. It is a standard treatment for ARDS to prevent atelectasis and
improve oxygenation without increasing oxygen toxicity risks. Without adequate PEEP, the
stiff lungs of an ARDS patient would collapse between breaths.
2. A nurse is performing a primary survey on a trauma patient. Which action should the nurse
take first?
A. Assess the patient’s level of consciousness.
B. Check the patient’s blood pressure.
,C. Expose the patient to check for hidden injuries.
D. Assess the airway for patency while maintaining cervical spine immobilization.
Answer: D
Rationale: The primary survey follows the ABCDE sequence, where ‘A’ stands for Airway.
Ensuring a patent airway is the highest priority because lack of oxygen leads to rapid brain
death. Cervical spine protection must occur simultaneously to prevent permanent spinal
cord injury during airway maneuvers.
3. A patient arrives in the emergency department with burns to the chest, abdomen, and the
entire front of both legs. Using the Rule of Nines, what is the estimated percentage of Total
Body Surface Area (TBSA) burned?
A. 36%
B. 27%
C. 18%
D. 45%
Answer: A
Rationale: According to the Rule of Nines, the anterior trunk (chest and abdomen)
accounts for 18%. Each anterior leg accounts for 9%, totaling 18% for the front of both legs.
Adding 18% and 18% results in a total of 36% TBSA burned.
, 4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin and metabolic acidosis
B. Narrowing pulse pressure and increased heart rate
C. Anuria and profound hypotension
D. Mottling of the skin and lethargy
Answer: B
Rationale: During the compensatory stage, the body attempts to maintain homeostasis
through the activation of the sympathetic nervous system. An increased heart rate and
narrowing pulse pressure occur as cardiac output begins to fluctuate. Identifying these
early signs is crucial for preventing progression to the progressive stage of shock.
5. A patient with a T4 spinal cord injury suddenly reports a severe, throbbing headache and
has a blood pressure of 210/110 mmHg. What is the nurse’s priority action?
A. Administer an ordered antihypertensive medication.
B. Elevate the head of the bed to a high-Fowler’s position.
C. Notify the healthcare provider immediately.
D. Lower the head of the bed to a flat position.
Answer: B
Rationale: These symptoms indicate autonomic dysreflexia, a medical emergency for
patients with spinal cord injuries above T6. Elevating the head of the bed immediately
Professional Nursing III / PN3 Q&A with
Rationale | Rasmussen University
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is being treated with
mechanical ventilation. Which ventilator setting is most critical for preventing alveolar
collapse at the end of expiration?
A. Positive End-Expiratory Pressure (PEEP)
B. Tidal Volume
C. Inspiratory Flow Rate
D. Fraction of Inspired Oxygen (FiO2)
Answer: A
Rationale: PEEP provides pressure at the end of expiration to keep the alveoli open and
improve gas exchange. It is a standard treatment for ARDS to prevent atelectasis and
improve oxygenation without increasing oxygen toxicity risks. Without adequate PEEP, the
stiff lungs of an ARDS patient would collapse between breaths.
2. A nurse is performing a primary survey on a trauma patient. Which action should the nurse
take first?
A. Assess the patient’s level of consciousness.
B. Check the patient’s blood pressure.
,C. Expose the patient to check for hidden injuries.
D. Assess the airway for patency while maintaining cervical spine immobilization.
Answer: D
Rationale: The primary survey follows the ABCDE sequence, where ‘A’ stands for Airway.
Ensuring a patent airway is the highest priority because lack of oxygen leads to rapid brain
death. Cervical spine protection must occur simultaneously to prevent permanent spinal
cord injury during airway maneuvers.
3. A patient arrives in the emergency department with burns to the chest, abdomen, and the
entire front of both legs. Using the Rule of Nines, what is the estimated percentage of Total
Body Surface Area (TBSA) burned?
A. 36%
B. 27%
C. 18%
D. 45%
Answer: A
Rationale: According to the Rule of Nines, the anterior trunk (chest and abdomen)
accounts for 18%. Each anterior leg accounts for 9%, totaling 18% for the front of both legs.
Adding 18% and 18% results in a total of 36% TBSA burned.
, 4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin and metabolic acidosis
B. Narrowing pulse pressure and increased heart rate
C. Anuria and profound hypotension
D. Mottling of the skin and lethargy
Answer: B
Rationale: During the compensatory stage, the body attempts to maintain homeostasis
through the activation of the sympathetic nervous system. An increased heart rate and
narrowing pulse pressure occur as cardiac output begins to fluctuate. Identifying these
early signs is crucial for preventing progression to the progressive stage of shock.
5. A patient with a T4 spinal cord injury suddenly reports a severe, throbbing headache and
has a blood pressure of 210/110 mmHg. What is the nurse’s priority action?
A. Administer an ordered antihypertensive medication.
B. Elevate the head of the bed to a high-Fowler’s position.
C. Notify the healthcare provider immediately.
D. Lower the head of the bed to a flat position.
Answer: B
Rationale: These symptoms indicate autonomic dysreflexia, a medical emergency for
patients with spinal cord injuries above T6. Elevating the head of the bed immediately
