NR341/NR 341 Exam 3 V3 | Complex Adult Health
Q&A with Rationale | Chamberlain University
1. A patient in the Intensive Care Unit (ICU) has a Central Venous Pressure (CVP) of 2 mmHg.
Which intervention should the nurse anticipate first?
A. Administration of a loop diuretic
B. Positioning the patient in high-Fowler’s position
C. Initiation of a norepinephrine infusion
D. Administration of a 500 mL bolus of Normal Saline
Correct Answer: D
Explanation: The CVP measures right atrial pressure and is an indicator of fluid volume
status, with a normal range typically being 2 to 8 mmHg. A value of 2 mmHg suggests
hypovolemia or a need for volume expansion. Administering a fluid bolus is the standard
initial treatment to increase preload and improve cardiac output.
2. Which assessment finding is a hallmark sign of the compensatory stage of shock?
A. Mean Arterial Pressure (MAP) less than 60 mmHg
B. Metabolic acidosis and hyperkalemia
C. Increased heart rate and narrowed pulse pressure
D. Unresponsiveness to verbal stimuli
Correct Answer: C
,Explanation: In the compensatory stage of shock, the body activates the sympathetic
nervous system to maintain perfusion to vital organs. This results in an increased heart
rate and vasoconstriction, which narrows the pulse pressure. Monitoring these early vital
sign changes is crucial for preventing progression to the progressive stage.
3. A patient with a diagnosis of septic shock remains hypotensive after receiving a 30 mL/kg
fluid bolus. What is the next priority medication?
A. Norepinephrine
B. Dobutamine
C. Dopamine
D. Epinephrine
Correct Answer: A
Explanation: Norepinephrine is the first-line vasopressor of choice for septic shock when
fluid resuscitation fails to restore adequate blood pressure. It acts primarily on alpha-
adrenergic receptors to cause vasoconstriction and increase systemic vascular resistance.
This intervention is part of the Surviving Sepsis Campaign’s 1-hour bundle to maintain a
MAP of at least 65 mmHg.
4. The nurse is caring for a patient who has suffered a full-thickness burn to 40% of their Total
Body Surface Area (TBSA). Which electrolyte abnormality is expected during the emergent
phase?
A. Hypokalemia
, B. Hypocalcemia
C. Hypernatremia
D. Hyperkalemia
Correct Answer: D
Explanation: During the emergent phase of a burn injury, massive cell destruction occurs,
which releases intracellular potassium into the extracellular space. This results in
hyperkalemia, which can lead to life-threatening cardiac dysrhythmias. The nurse must
monitor the ECG and potassium levels closely during the first 24 to 48 hours.
5. Using the Parkland Formula, calculate the total fluid volume needed in the first 24 hours
for a 75 kg patient with a 50% TBSA burn.
A. 7,500 mL
B. 15,000 mL
C. 10,000 mL
D. 18,750 mL
Correct Answer: B
Explanation: The Parkland Formula is calculated as 4 mL x weight in kg x % TBSA burned.
For this patient, the calculation is 4 mL x 75 kg x 50, which equals 15,000 mL. Half of this
volume (7,500 mL) must be infused within the first 8 hours from the time of the burn
injury.
Q&A with Rationale | Chamberlain University
1. A patient in the Intensive Care Unit (ICU) has a Central Venous Pressure (CVP) of 2 mmHg.
Which intervention should the nurse anticipate first?
A. Administration of a loop diuretic
B. Positioning the patient in high-Fowler’s position
C. Initiation of a norepinephrine infusion
D. Administration of a 500 mL bolus of Normal Saline
Correct Answer: D
Explanation: The CVP measures right atrial pressure and is an indicator of fluid volume
status, with a normal range typically being 2 to 8 mmHg. A value of 2 mmHg suggests
hypovolemia or a need for volume expansion. Administering a fluid bolus is the standard
initial treatment to increase preload and improve cardiac output.
2. Which assessment finding is a hallmark sign of the compensatory stage of shock?
A. Mean Arterial Pressure (MAP) less than 60 mmHg
B. Metabolic acidosis and hyperkalemia
C. Increased heart rate and narrowed pulse pressure
D. Unresponsiveness to verbal stimuli
Correct Answer: C
,Explanation: In the compensatory stage of shock, the body activates the sympathetic
nervous system to maintain perfusion to vital organs. This results in an increased heart
rate and vasoconstriction, which narrows the pulse pressure. Monitoring these early vital
sign changes is crucial for preventing progression to the progressive stage.
3. A patient with a diagnosis of septic shock remains hypotensive after receiving a 30 mL/kg
fluid bolus. What is the next priority medication?
A. Norepinephrine
B. Dobutamine
C. Dopamine
D. Epinephrine
Correct Answer: A
Explanation: Norepinephrine is the first-line vasopressor of choice for septic shock when
fluid resuscitation fails to restore adequate blood pressure. It acts primarily on alpha-
adrenergic receptors to cause vasoconstriction and increase systemic vascular resistance.
This intervention is part of the Surviving Sepsis Campaign’s 1-hour bundle to maintain a
MAP of at least 65 mmHg.
4. The nurse is caring for a patient who has suffered a full-thickness burn to 40% of their Total
Body Surface Area (TBSA). Which electrolyte abnormality is expected during the emergent
phase?
A. Hypokalemia
, B. Hypocalcemia
C. Hypernatremia
D. Hyperkalemia
Correct Answer: D
Explanation: During the emergent phase of a burn injury, massive cell destruction occurs,
which releases intracellular potassium into the extracellular space. This results in
hyperkalemia, which can lead to life-threatening cardiac dysrhythmias. The nurse must
monitor the ECG and potassium levels closely during the first 24 to 48 hours.
5. Using the Parkland Formula, calculate the total fluid volume needed in the first 24 hours
for a 75 kg patient with a 50% TBSA burn.
A. 7,500 mL
B. 15,000 mL
C. 10,000 mL
D. 18,750 mL
Correct Answer: B
Explanation: The Parkland Formula is calculated as 4 mL x weight in kg x % TBSA burned.
For this patient, the calculation is 4 mL x 75 kg x 50, which equals 15,000 mL. Half of this
volume (7,500 mL) must be infused within the first 8 hours from the time of the burn
injury.
