NR341/NR 341 Exam 1 V2 | Complex Adult Health
Q&A with Rationale | Chamberlain University
1. A nurse is caring for a patient with a pulmonary artery catheter. The patient’s pulmonary
artery wedge pressure (PAWP) is 18 mmHg. Which of the following conditions should the
nurse suspect?
A. Hypovolemia
B. Left-sided heart failure
C. Septic shock
D. Pulmonary embolism
Correct Answer: B
Explanation: A normal PAWP ranges from 6 to 12 mmHg, and an elevation to 18 mmHg
suggests fluid backup from the left side of the heart. This finding is characteristic of left-
sided heart failure or fluid volume overload. The nurse should assess the patient for
crackles and dyspnea, as these are common clinical manifestations of increased pulmonary
pressures.
2. The nurse is assessing a patient on a mechanical ventilator and notes the high-pressure
alarm is sounding. Which action should the nurse take first?
A. Increase the oxygen concentration
B. Silence the alarm and monitor the patient
,C. Check for kinks in the ventilator tubing
D. Change the ventilator settings
Correct Answer: C
Explanation: A high-pressure alarm indicates that the ventilator is meeting resistance
when delivering a breath, which can be caused by kinks in the tubing or secretions in the
airway. The nurse’s first priority is to assess for mechanical obstructions like kinks or the
patient biting the ET tube. If no obstruction is found, the nurse should suction the patient to
clear any secretions.
3. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Explanation: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated above 45
mmHg, which points to a respiratory cause. Since the bicarbonate level is within the normal
range, this represents uncompensated respiratory acidosis. The nurse must address the
patient’s ventilation to help clear the excess carbon dioxide.
,4. Which of the following is a primary nursing intervention for a patient in the early stages of
septic shock?
A. Restricting fluid intake to prevent edema
B. Initiating a continuous nitroglycerin infusion
C. Administering large volumes of IV crystalloids
D. Administering beta-blockers to slow the heart rate
Correct Answer: C
Explanation: The initial management of septic shock focuses on restoring tissue perfusion
through aggressive fluid resuscitation with crystalloids. Patients typically require at least
30 mL/kg of IV fluids to stabilize their blood pressure and improve cardiac output. The
nurse must monitor for fluid responsiveness and prepare for vasopressor therapy if fluids
alone are insufficient.
5. When monitoring a patient with an arterial line, the nurse notes that the waveform is
‘dampened.’ What is the nurse’s first action?
A. Recalibrate the monitor
B. Notify the physician immediately
C. Check for air bubbles or kinks in the system
D. Increase the pressure in the flush bag
Correct Answer: C
, Explanation: A dampened waveform can lead to inaccurate blood pressure readings and is
often caused by physical obstructions in the tubing. The nurse should inspect the pressure
tubing for air bubbles, blood clots, or kinks that could interfere with the signal. Proper
maintenance of the arterial line ensures reliable hemodynamic monitoring and patient
safety.
6. A patient presents with a heart rate of 160 bpm and a narrow QRS complex on the EKG.
The patient is stable but reports palpitations. Which medication should the nurse expect to
administer?
A. Atropine
B. Epinephrine
C. Adenosine
D. Amiodarone
Correct Answer: C
Explanation: Adenosine is the first-line medication for stable supraventricular tachycardia
(SVT) because it temporarily slows conduction through the AV node. It should be
administered as a rapid IV bolus followed by a quick saline flush due to its very short half-
life. The nurse must have emergency equipment nearby, as a brief period of asystole is
expected after administration.
Q&A with Rationale | Chamberlain University
1. A nurse is caring for a patient with a pulmonary artery catheter. The patient’s pulmonary
artery wedge pressure (PAWP) is 18 mmHg. Which of the following conditions should the
nurse suspect?
A. Hypovolemia
B. Left-sided heart failure
C. Septic shock
D. Pulmonary embolism
Correct Answer: B
Explanation: A normal PAWP ranges from 6 to 12 mmHg, and an elevation to 18 mmHg
suggests fluid backup from the left side of the heart. This finding is characteristic of left-
sided heart failure or fluid volume overload. The nurse should assess the patient for
crackles and dyspnea, as these are common clinical manifestations of increased pulmonary
pressures.
2. The nurse is assessing a patient on a mechanical ventilator and notes the high-pressure
alarm is sounding. Which action should the nurse take first?
A. Increase the oxygen concentration
B. Silence the alarm and monitor the patient
,C. Check for kinks in the ventilator tubing
D. Change the ventilator settings
Correct Answer: C
Explanation: A high-pressure alarm indicates that the ventilator is meeting resistance
when delivering a breath, which can be caused by kinks in the tubing or secretions in the
airway. The nurse’s first priority is to assess for mechanical obstructions like kinks or the
patient biting the ET tube. If no obstruction is found, the nurse should suction the patient to
clear any secretions.
3. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Correct Answer: D
Explanation: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated above 45
mmHg, which points to a respiratory cause. Since the bicarbonate level is within the normal
range, this represents uncompensated respiratory acidosis. The nurse must address the
patient’s ventilation to help clear the excess carbon dioxide.
,4. Which of the following is a primary nursing intervention for a patient in the early stages of
septic shock?
A. Restricting fluid intake to prevent edema
B. Initiating a continuous nitroglycerin infusion
C. Administering large volumes of IV crystalloids
D. Administering beta-blockers to slow the heart rate
Correct Answer: C
Explanation: The initial management of septic shock focuses on restoring tissue perfusion
through aggressive fluid resuscitation with crystalloids. Patients typically require at least
30 mL/kg of IV fluids to stabilize their blood pressure and improve cardiac output. The
nurse must monitor for fluid responsiveness and prepare for vasopressor therapy if fluids
alone are insufficient.
5. When monitoring a patient with an arterial line, the nurse notes that the waveform is
‘dampened.’ What is the nurse’s first action?
A. Recalibrate the monitor
B. Notify the physician immediately
C. Check for air bubbles or kinks in the system
D. Increase the pressure in the flush bag
Correct Answer: C
, Explanation: A dampened waveform can lead to inaccurate blood pressure readings and is
often caused by physical obstructions in the tubing. The nurse should inspect the pressure
tubing for air bubbles, blood clots, or kinks that could interfere with the signal. Proper
maintenance of the arterial line ensures reliable hemodynamic monitoring and patient
safety.
6. A patient presents with a heart rate of 160 bpm and a narrow QRS complex on the EKG.
The patient is stable but reports palpitations. Which medication should the nurse expect to
administer?
A. Atropine
B. Epinephrine
C. Adenosine
D. Amiodarone
Correct Answer: C
Explanation: Adenosine is the first-line medication for stable supraventricular tachycardia
(SVT) because it temporarily slows conduction through the AV node. It should be
administered as a rapid IV bolus followed by a quick saline flush due to its very short half-
life. The nurse must have emergency equipment nearby, as a brief period of asystole is
expected after administration.
