NR341/NR 341 Exam 1 V1 | Complex Adult Health
Q&A with Rationale | Chamberlain University
1. A patient in the ICU develops a heart rate of 38 beats/minute with a blood pressure of
82/50 mmHg. The nurse notes the patient is confused and diaphoretic. Which medication
should be prepared for administration?
A. Adenosine
B. Atropine
C. Amiodarone
D. Epinephrine
Correct Answer: B
Explanation: Atropine is the primary pharmacological intervention for symptomatic
bradycardia as it increases the heart rate by blocking vagal stimulation. The patient’s low
blood pressure and altered mental status indicate poor perfusion requiring immediate
intervention. If atropine is ineffective, the nurse should then consider transcutaneous
pacing or a dopamine infusion.
2. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notices the high-pressure alarm is sounding. What is the most
appropriate initial action?
A. Empty condensation from the ventilator tubing
,B. Call the respiratory therapist to reset the alarm
C. Increase the oxygen concentration (FiO2)
D. Check the patient for the need for suctioning
Correct Answer: D
Explanation: A high-pressure alarm indicates that the ventilator is meeting resistance
when attempting to deliver the set tidal volume. Common causes include secretions in the
airway, the patient biting the tube, or tubing kinks, so suctioning is a priority assessment.
The nurse must quickly identify and resolve the obstruction to ensure adequate ventilation
and prevent barotrauma.
3. A client is admitted with cardiogenic shock following an acute myocardial infarction. The
nurse monitors the pulmonary artery wedge pressure (PAWP) and expects which finding?
A. Decreased PAWP (4 mmHg)
B. Increased PAWP (18 mmHg)
C. Normal PAWP (10 mmHg)
D. Absent PAWP
Correct Answer: B
Explanation: In cardiogenic shock, the left ventricle fails to pump effectively, leading to a
backup of blood into the pulmonary system. This results in an elevated PAWP, which
reflects high left-atrial and left-ventricular end-diastolic pressure. Effective management
, often involves diuretics and inotropic support to reduce this preload and improve
contractility.
4. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.28, PaCO2 48, HCO3 22
B. pH 7.45, PaCO2 35, HCO3 24
C. pH 7.32, PaCO2 50, HCO3 30
D. pH 7.50, PaCO2 30, HCO3 20
Correct Answer: C
Explanation: Partial compensation occurs when the pH is still outside the normal range,
but the opposite system (metabolic or respiratory) is attempting to correct the imbalance.
In this case, the pH is acidic (7.32), the CO2 is elevated (50), and the HCO3 is elevated (30)
to buffer the acid. Fully compensated would mean the pH has returned to the normal range
of 7.35 to 7.45.
5. The nurse is caring for a patient on a ventilator with positive end-expiratory pressure
(PEEP). What is a common side effect of PEEP that the nurse must monitor for?
A. Increased cardiac output
B. Hypotension
C. Decreased intracranial pressure
D. Respiratory alkalosis
Q&A with Rationale | Chamberlain University
1. A patient in the ICU develops a heart rate of 38 beats/minute with a blood pressure of
82/50 mmHg. The nurse notes the patient is confused and diaphoretic. Which medication
should be prepared for administration?
A. Adenosine
B. Atropine
C. Amiodarone
D. Epinephrine
Correct Answer: B
Explanation: Atropine is the primary pharmacological intervention for symptomatic
bradycardia as it increases the heart rate by blocking vagal stimulation. The patient’s low
blood pressure and altered mental status indicate poor perfusion requiring immediate
intervention. If atropine is ineffective, the nurse should then consider transcutaneous
pacing or a dopamine infusion.
2. A patient with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notices the high-pressure alarm is sounding. What is the most
appropriate initial action?
A. Empty condensation from the ventilator tubing
,B. Call the respiratory therapist to reset the alarm
C. Increase the oxygen concentration (FiO2)
D. Check the patient for the need for suctioning
Correct Answer: D
Explanation: A high-pressure alarm indicates that the ventilator is meeting resistance
when attempting to deliver the set tidal volume. Common causes include secretions in the
airway, the patient biting the tube, or tubing kinks, so suctioning is a priority assessment.
The nurse must quickly identify and resolve the obstruction to ensure adequate ventilation
and prevent barotrauma.
3. A client is admitted with cardiogenic shock following an acute myocardial infarction. The
nurse monitors the pulmonary artery wedge pressure (PAWP) and expects which finding?
A. Decreased PAWP (4 mmHg)
B. Increased PAWP (18 mmHg)
C. Normal PAWP (10 mmHg)
D. Absent PAWP
Correct Answer: B
Explanation: In cardiogenic shock, the left ventricle fails to pump effectively, leading to a
backup of blood into the pulmonary system. This results in an elevated PAWP, which
reflects high left-atrial and left-ventricular end-diastolic pressure. Effective management
, often involves diuretics and inotropic support to reduce this preload and improve
contractility.
4. Which arterial blood gas (ABG) result indicates partially compensated respiratory acidosis?
A. pH 7.28, PaCO2 48, HCO3 22
B. pH 7.45, PaCO2 35, HCO3 24
C. pH 7.32, PaCO2 50, HCO3 30
D. pH 7.50, PaCO2 30, HCO3 20
Correct Answer: C
Explanation: Partial compensation occurs when the pH is still outside the normal range,
but the opposite system (metabolic or respiratory) is attempting to correct the imbalance.
In this case, the pH is acidic (7.32), the CO2 is elevated (50), and the HCO3 is elevated (30)
to buffer the acid. Fully compensated would mean the pH has returned to the normal range
of 7.35 to 7.45.
5. The nurse is caring for a patient on a ventilator with positive end-expiratory pressure
(PEEP). What is a common side effect of PEEP that the nurse must monitor for?
A. Increased cardiac output
B. Hypotension
C. Decreased intracranial pressure
D. Respiratory alkalosis
