NR 341 / NR341 Exam 2 Chamberlain 2026/2027 |
Complex Adult Health Review | Questions & Answers
with Rationales | Grade A | Verified Solutions
EXAM OVERVIEW
Component Details
Course NR 341 Complex Adult Health – Chamberlain University
Exam Exam 2
Shock States, Hemodynamics, Cardiac, Respiratory, Neurological, Burns,
Topics
Hepatic/Renal, Endocrine, Critical Care Interventions
Format Multiple Choice, Select-All-That-Apply, Priority Questions
Key Focus Clinical judgment, prioritization, complex multi-system conditions
Question 1
A patient in hypovolemic shock has a central venous pressure (CVP) of 2 mmHg. What is
the priority nursing intervention?
A) Administer a vasopressor
B) Administer isotonic crystalloids
C) Administer a beta-blocker
D) Place the patient in Trendelenburg position
Correct Answer: B
,Rationale: A low CVP (<2-6 mmHg) indicates hypovolemia. The priority is to restore
intravascular volume with isotonic crystalloids such as 0.9% normal saline or Lactated
Ringer's. Vasopressors should be used only after fluid resuscitation if hypotension
persists. Normal CVP is 2-6 mmHg. The Trendelenburg position is no longer
recommended.
Question 2
A patient with septic shock has a lactate level of 6 mmol/L. The nurse understands this
indicates:
A) Adequate tissue perfusion
B) Tissue hypoxia and anaerobic metabolism
C) Good prognosis
D) Normal finding
Correct Answer: B
Rationale: Elevated lactate indicates tissue hypoxia and anaerobic metabolism, a sign of
inadequate perfusion in shock. Normal lactate is <2 mmol/L. Elevated lactate is
associated with increased mortality and guides fluid resuscitation goals. The Surviving
Sepsis Campaign recommends lactate-guided resuscitation with a target of <2 mmol/L.
Question 3
A patient in septic shock has a central venous oxygen saturation (ScvO₂) of 55%. What
does this indicate?
A) Adequate tissue oxygenation
B) Inadequate tissue oxygenation
C) Fluid overload
D) Cardiac tamponade
Correct Answer: B
Rationale: A low ScvO₂ (<70%) indicates inadequate tissue oxygenation and decreased
oxygen delivery. This is a sign of shock that should be addressed with fluids,
,vasopressors, or blood products. Normal ScvO₂ is 70-80%. Early goal-directed therapy
targets ScvO₂ ≥70% in septic shock.
Question 4
What is the normal value for pulmonary vascular resistance (PVR)?
A) 20-50 dynes/sec/cm⁻⁵
B) 50-250 dynes/sec/cm⁻⁵
C) 250-500 dynes/sec/cm⁻⁵
D) 500-1000 dynes/sec/cm⁻⁵
Correct Answer: B
Rationale: Normal pulmonary vascular resistance (PVR) is 50-250 dynes/sec/cm⁻⁵.
Elevated PVR may indicate pulmonary hypertension, pulmonary embolism, or hypoxic
vasoconstriction. Systemic vascular resistance (SVR) is 800-1200 dynes/sec/cm⁻⁵.
Question 5
Which finding is consistent with cardiogenic shock?
A) CVP 2 mmHg
B) Warm, dry skin
C) Pulmonary artery wedge pressure (PAWP) 22 mmHg
D) Increased urine output
Correct Answer: C
Rationale: Cardiogenic shock is characterized by elevated PAWP (>15 mmHg) due to
left ventricular failure and fluid backup into the pulmonary circulation. Other findings
include hypotension, tachycardia, cool clammy skin, crackles, and decreased urine
output. Normal PAWP is 6-12 mmHg.
Question 6
A patient is in anaphylactic shock. What is the priority nursing intervention?
, A) Administer antihistamines
B) Administer epinephrine
C) Administer corticosteroids
D) Administer IV fluids
Correct Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylactic shock. It reverses
vasodilation, bronchospasm, and hypotension. Antihistamines and corticosteroids are
adjunctive therapies. IV fluids are also important but epinephrine is the priority.
Question 7
A patient is in neurogenic shock. Which finding is the nurse most likely to observe?
A) Hypotension and tachycardia
B) Hypotension and bradycardia
C) Hypertension and bradycardia
D) Hypertension and tachycardia
Correct Answer: B
Rationale: Neurogenic shock is characterized by hypotension and bradycardia due to
loss of sympathetic tone. The skin is warm and dry. This is unlike other types of shock,
which typically cause tachycardia. Causes include spinal cord injury above T6 and spinal
anesthesia.
Question 8
A patient in cardiogenic shock is receiving dobutamine. Which finding indicates the
medication is effective?
A) Decreased heart rate
B) Increased blood pressure
C) Increased urine output
D) Decreased PAWP
Correct Answer: C
Complex Adult Health Review | Questions & Answers
with Rationales | Grade A | Verified Solutions
EXAM OVERVIEW
Component Details
Course NR 341 Complex Adult Health – Chamberlain University
Exam Exam 2
Shock States, Hemodynamics, Cardiac, Respiratory, Neurological, Burns,
Topics
Hepatic/Renal, Endocrine, Critical Care Interventions
Format Multiple Choice, Select-All-That-Apply, Priority Questions
Key Focus Clinical judgment, prioritization, complex multi-system conditions
Question 1
A patient in hypovolemic shock has a central venous pressure (CVP) of 2 mmHg. What is
the priority nursing intervention?
A) Administer a vasopressor
B) Administer isotonic crystalloids
C) Administer a beta-blocker
D) Place the patient in Trendelenburg position
Correct Answer: B
,Rationale: A low CVP (<2-6 mmHg) indicates hypovolemia. The priority is to restore
intravascular volume with isotonic crystalloids such as 0.9% normal saline or Lactated
Ringer's. Vasopressors should be used only after fluid resuscitation if hypotension
persists. Normal CVP is 2-6 mmHg. The Trendelenburg position is no longer
recommended.
Question 2
A patient with septic shock has a lactate level of 6 mmol/L. The nurse understands this
indicates:
A) Adequate tissue perfusion
B) Tissue hypoxia and anaerobic metabolism
C) Good prognosis
D) Normal finding
Correct Answer: B
Rationale: Elevated lactate indicates tissue hypoxia and anaerobic metabolism, a sign of
inadequate perfusion in shock. Normal lactate is <2 mmol/L. Elevated lactate is
associated with increased mortality and guides fluid resuscitation goals. The Surviving
Sepsis Campaign recommends lactate-guided resuscitation with a target of <2 mmol/L.
Question 3
A patient in septic shock has a central venous oxygen saturation (ScvO₂) of 55%. What
does this indicate?
A) Adequate tissue oxygenation
B) Inadequate tissue oxygenation
C) Fluid overload
D) Cardiac tamponade
Correct Answer: B
Rationale: A low ScvO₂ (<70%) indicates inadequate tissue oxygenation and decreased
oxygen delivery. This is a sign of shock that should be addressed with fluids,
,vasopressors, or blood products. Normal ScvO₂ is 70-80%. Early goal-directed therapy
targets ScvO₂ ≥70% in septic shock.
Question 4
What is the normal value for pulmonary vascular resistance (PVR)?
A) 20-50 dynes/sec/cm⁻⁵
B) 50-250 dynes/sec/cm⁻⁵
C) 250-500 dynes/sec/cm⁻⁵
D) 500-1000 dynes/sec/cm⁻⁵
Correct Answer: B
Rationale: Normal pulmonary vascular resistance (PVR) is 50-250 dynes/sec/cm⁻⁵.
Elevated PVR may indicate pulmonary hypertension, pulmonary embolism, or hypoxic
vasoconstriction. Systemic vascular resistance (SVR) is 800-1200 dynes/sec/cm⁻⁵.
Question 5
Which finding is consistent with cardiogenic shock?
A) CVP 2 mmHg
B) Warm, dry skin
C) Pulmonary artery wedge pressure (PAWP) 22 mmHg
D) Increased urine output
Correct Answer: C
Rationale: Cardiogenic shock is characterized by elevated PAWP (>15 mmHg) due to
left ventricular failure and fluid backup into the pulmonary circulation. Other findings
include hypotension, tachycardia, cool clammy skin, crackles, and decreased urine
output. Normal PAWP is 6-12 mmHg.
Question 6
A patient is in anaphylactic shock. What is the priority nursing intervention?
, A) Administer antihistamines
B) Administer epinephrine
C) Administer corticosteroids
D) Administer IV fluids
Correct Answer: B
Rationale: Epinephrine is the first-line treatment for anaphylactic shock. It reverses
vasodilation, bronchospasm, and hypotension. Antihistamines and corticosteroids are
adjunctive therapies. IV fluids are also important but epinephrine is the priority.
Question 7
A patient is in neurogenic shock. Which finding is the nurse most likely to observe?
A) Hypotension and tachycardia
B) Hypotension and bradycardia
C) Hypertension and bradycardia
D) Hypertension and tachycardia
Correct Answer: B
Rationale: Neurogenic shock is characterized by hypotension and bradycardia due to
loss of sympathetic tone. The skin is warm and dry. This is unlike other types of shock,
which typically cause tachycardia. Causes include spinal cord injury above T6 and spinal
anesthesia.
Question 8
A patient in cardiogenic shock is receiving dobutamine. Which finding indicates the
medication is effective?
A) Decreased heart rate
B) Increased blood pressure
C) Increased urine output
D) Decreased PAWP
Correct Answer: C
