NUR 3300 Exam 3 V1 | NUR 3300 Nursing
Practice II | Q&A with Rationale (NUR3300
Exam 3) | William Paterson University
1. A patient presents with a pH of 7.28, PaCO2 of 55 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated above 45
mmHg, which matches the direction of the pH change, signifying a respiratory origin. The
bicarbonate level is within the normal range, indicating no compensation has occurred yet.
2. When caring for a patient with Diabetic Ketoacidosis (DKA), which intervention should the
nurse prioritize first?
A. Intravenous insulin infusion
B. Potassium replacement therapy
C. Frequent blood glucose monitoring
,D. Normal saline fluid resuscitation
Answer: D
Rationale: Fluid resuscitation is the immediate priority in DKA to restore circulatory
volume and stabilize blood pressure. Dehydration in DKA is often severe due to osmotic
diuresis caused by hyperglycemia. Once fluid replacement is initiated, insulin and
electrolyte management can follow safely.
3. A patient with hyperthyroidism is admitted with a temperature of 104°F, heart rate of 150
bpm, and extreme agitation. What is the nurse’s priority action?
A. Notifying the provider and preparing for beta-blocker administration
B. Preparing for emergency intubation
C. Assessing for signs of heart failure
D. Administering a cooling blanket and acetaminophen
Answer: A
Rationale: These symptoms indicate a thyroid storm, a life-threatening medical
emergency. Rapid administration of beta-blockers is essential to control the dangerous
cardiovascular effects of excessive thyroid hormones. The nurse must act quickly to
prevent cardiac collapse while coordinating further supportive care.
4. Which clinical manifestation should the nurse expect in a patient experiencing the oliguric
phase of Acute Kidney Injury (AKI)?
A. Hypokalemia and dehydration
, B. Hyperkalemia and fluid volume excess
C. Metabolic alkalosis and hypotension
D. Polyuria and hypocalcemia
Answer: B
Rationale: During the oliguric phase, the kidneys fail to excrete metabolic waste and
excess fluids. This leads to a build-up of potassium, causing hyperkalemia, and a retention
of water, causing fluid volume overload. Nurses must monitor for cardiac arrhythmias and
pulmonary edema during this critical phase.
5. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy
via nasal cannula. Which oxygen flow rate should the nurse maintain?
A. 5 to 6 L/min to maximize oxygenation
B. 1 to 2 L/min to prevent respiratory drive suppression
C. 10 L/min via non-rebreather mask
D. 0.5 L/min only during sleep
Answer: B
Rationale: Patients with chronic hypercapnia rely on a hypoxic drive to breathe rather
than high CO2 levels. Providing excessive oxygen can suppress this drive, leading to CO2
retention and respiratory arrest. A low flow rate of 1 to 2 L/min is usually sufficient to
maintain SaO2 without inhibiting the respiratory stimulus.
Practice II | Q&A with Rationale (NUR3300
Exam 3) | William Paterson University
1. A patient presents with a pH of 7.28, PaCO2 of 55 mmHg, and HCO3 of 25 mEq/L. Which
acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35, indicating acidosis. The PaCO2 is elevated above 45
mmHg, which matches the direction of the pH change, signifying a respiratory origin. The
bicarbonate level is within the normal range, indicating no compensation has occurred yet.
2. When caring for a patient with Diabetic Ketoacidosis (DKA), which intervention should the
nurse prioritize first?
A. Intravenous insulin infusion
B. Potassium replacement therapy
C. Frequent blood glucose monitoring
,D. Normal saline fluid resuscitation
Answer: D
Rationale: Fluid resuscitation is the immediate priority in DKA to restore circulatory
volume and stabilize blood pressure. Dehydration in DKA is often severe due to osmotic
diuresis caused by hyperglycemia. Once fluid replacement is initiated, insulin and
electrolyte management can follow safely.
3. A patient with hyperthyroidism is admitted with a temperature of 104°F, heart rate of 150
bpm, and extreme agitation. What is the nurse’s priority action?
A. Notifying the provider and preparing for beta-blocker administration
B. Preparing for emergency intubation
C. Assessing for signs of heart failure
D. Administering a cooling blanket and acetaminophen
Answer: A
Rationale: These symptoms indicate a thyroid storm, a life-threatening medical
emergency. Rapid administration of beta-blockers is essential to control the dangerous
cardiovascular effects of excessive thyroid hormones. The nurse must act quickly to
prevent cardiac collapse while coordinating further supportive care.
4. Which clinical manifestation should the nurse expect in a patient experiencing the oliguric
phase of Acute Kidney Injury (AKI)?
A. Hypokalemia and dehydration
, B. Hyperkalemia and fluid volume excess
C. Metabolic alkalosis and hypotension
D. Polyuria and hypocalcemia
Answer: B
Rationale: During the oliguric phase, the kidneys fail to excrete metabolic waste and
excess fluids. This leads to a build-up of potassium, causing hyperkalemia, and a retention
of water, causing fluid volume overload. Nurses must monitor for cardiac arrhythmias and
pulmonary edema during this critical phase.
5. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy
via nasal cannula. Which oxygen flow rate should the nurse maintain?
A. 5 to 6 L/min to maximize oxygenation
B. 1 to 2 L/min to prevent respiratory drive suppression
C. 10 L/min via non-rebreather mask
D. 0.5 L/min only during sleep
Answer: B
Rationale: Patients with chronic hypercapnia rely on a hypoxic drive to breathe rather
than high CO2 levels. Providing excessive oxygen can suppress this drive, leading to CO2
retention and respiratory arrest. A low flow rate of 1 to 2 L/min is usually sufficient to
maintain SaO2 without inhibiting the respiratory stimulus.
