ADN Exam Questions With Answers and detailed Rationales
Question 1.
A patient on a mechanical ventilator triggers the high-pressure alarm. Which action should
the nurse take first?
A. Auscultate the patient’s breath sounds and check for secretions.
B. Check for a leak in the ventilator circuit.
C. Increase the oxygen concentration to 100%.
D. Call the physician immediately.
Correct Answer: A. Auscultate the patient’s breath sounds and check for
secretions.
Explanation: High-pressure alarms are triggered by obstructions such as secretions,
coughing, or biting the tube. Auscultating and suctioning is the first priority.
Question 2.
Which ventilator setting is designed to keep the alveoli open at the end of expiration to
improve gas exchange?
A. Tidal Volume (Vt)
B. Fraction of Inspired Oxygen (FiO2)
C. Inspiratory Flow Rate
D. Positive End-Expiratory Pressure (PEEP)
Correct Answer: D. Positive End-Expiratory Pressure (PEEP)
Explanation: PEEP maintains pressure in the lungs at the end of expiration to prevent
alveolar collapse and improve oxygenation.
Question 3.
What is the primary difference between Assist-Control (AC) and Synchronized Intermittent
Mandatory Ventilation (SIMV)?
A. SIMV does not allow the patient to take spontaneous breaths.
B. AC provides a full preset volume for every breath, including spontaneous ones.
C. AC is used only for weaning patients from the ventilator.
D. SIMV requires the patient to be paralyzed with neuromuscular blockers.
Correct Answer: B. AC provides a full preset volume for every breath, including
spontaneous ones.
Explanation: In AC mode, every breath (ventilator-initiated or patient-initiated) receives
the preset tidal volume. In SIMV, spontaneous breaths are at the patient’s own volume.
,Question 4.
A patient is receiving propofol for sedation while on a ventilator. What is a critical nursing
assessment for this medication?
A. Monitor for hypertension.
B. Monitor serum triglyceride levels and blood pressure.
C. Check for urinary retention.
D. Assess for extrapyramidal symptoms.
Correct Answer: B. Monitor serum triglyceride levels and blood pressure.
Explanation: Propofol is a lipid-based emulsion that can cause hypotension and
hypertriglyceridemia, potentially leading to pancreatitis.
Question 5.
The nurse notes a low-pressure alarm on the ventilator. What is the most likely cause?
A. The patient is biting the endotracheal tube.
B. Kinked ventilator tubing.
C. Disconnection from the ventilator circuit.
D. Pneumothorax development.
Correct Answer: C. Disconnection from the ventilator circuit.
Explanation: Low-pressure alarms usually signify a leak or a disconnection in the circuit
where the pressure cannot be maintained.
Question 6.
Which drug is the reversal agent for benzodiazepines like Midazolam?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Acetylcysteine
Correct Answer: B. Flumazenil
Explanation: Flumazenil is the specific antagonist for benzodiazepine overdose or
reversal.
Question 7.
Before administering a neuromuscular blocking agent (NMBA) like Vecuronium, which
medication must be administered first?
A. A corticosteroid.
B. A sedative and an analgesic.
C. An antibiotic.
D. Atropine.
Correct Answer: B. A sedative and an analgesic.
Explanation: NMBAs paralyze muscles but do not provide sedation or pain relief. Patients
, must be sedated and have pain controlled before being paralyzed to prevent psychological
trauma.
Question 8.
The ‘Train of Four’ (TOF) monitoring is used to assess the effectiveness of which type of
medication?
A. Inotropic agents
B. Vasopressors
C. Sedatives
D. Neuromuscular blocking agents
Correct Answer: D. Neuromuscular blocking agents
Explanation: TOF uses peripheral nerve stimulation to determine the level of paralysis in
patients receiving neuromuscular blockers.
Question 9.
A patient in septic shock is receiving Norepinephrine (Levophed). What is the primary
intended effect of this drug?
A. Bronchodilation
B. Vasoconstriction to increase blood pressure
C. Increasing the heart rate to over 150 bpm
D. Sedation
Correct Answer: B. Vasoconstriction to increase blood pressure
Explanation: Norepinephrine is a potent alpha-1 agonist used to cause peripheral
vasoconstriction and increase Mean Arterial Pressure (MAP) in shock.
Question 10.
Which nursing intervention is most important for preventing Ventilator- Associated
Pneumonia (VAP)?
A. Keeping the head of the bed flat.
B. Maintaining the patient in a prone position.
C. Changing the ventilator circuit every 24 hours.
D. Providing oral care with chlorhexidine at least twice daily.
Correct Answer: D. Providing oral care with chlorhexidine at least twice daily.
Explanation: Chlorhexidine oral care and elevating the head of the bed (30-45 degrees)
are core components of the VAP prevention bundle.
Question 1.
A patient on a mechanical ventilator triggers the high-pressure alarm. Which action should
the nurse take first?
A. Auscultate the patient’s breath sounds and check for secretions.
B. Check for a leak in the ventilator circuit.
C. Increase the oxygen concentration to 100%.
D. Call the physician immediately.
Correct Answer: A. Auscultate the patient’s breath sounds and check for
secretions.
Explanation: High-pressure alarms are triggered by obstructions such as secretions,
coughing, or biting the tube. Auscultating and suctioning is the first priority.
Question 2.
Which ventilator setting is designed to keep the alveoli open at the end of expiration to
improve gas exchange?
A. Tidal Volume (Vt)
B. Fraction of Inspired Oxygen (FiO2)
C. Inspiratory Flow Rate
D. Positive End-Expiratory Pressure (PEEP)
Correct Answer: D. Positive End-Expiratory Pressure (PEEP)
Explanation: PEEP maintains pressure in the lungs at the end of expiration to prevent
alveolar collapse and improve oxygenation.
Question 3.
What is the primary difference between Assist-Control (AC) and Synchronized Intermittent
Mandatory Ventilation (SIMV)?
A. SIMV does not allow the patient to take spontaneous breaths.
B. AC provides a full preset volume for every breath, including spontaneous ones.
C. AC is used only for weaning patients from the ventilator.
D. SIMV requires the patient to be paralyzed with neuromuscular blockers.
Correct Answer: B. AC provides a full preset volume for every breath, including
spontaneous ones.
Explanation: In AC mode, every breath (ventilator-initiated or patient-initiated) receives
the preset tidal volume. In SIMV, spontaneous breaths are at the patient’s own volume.
,Question 4.
A patient is receiving propofol for sedation while on a ventilator. What is a critical nursing
assessment for this medication?
A. Monitor for hypertension.
B. Monitor serum triglyceride levels and blood pressure.
C. Check for urinary retention.
D. Assess for extrapyramidal symptoms.
Correct Answer: B. Monitor serum triglyceride levels and blood pressure.
Explanation: Propofol is a lipid-based emulsion that can cause hypotension and
hypertriglyceridemia, potentially leading to pancreatitis.
Question 5.
The nurse notes a low-pressure alarm on the ventilator. What is the most likely cause?
A. The patient is biting the endotracheal tube.
B. Kinked ventilator tubing.
C. Disconnection from the ventilator circuit.
D. Pneumothorax development.
Correct Answer: C. Disconnection from the ventilator circuit.
Explanation: Low-pressure alarms usually signify a leak or a disconnection in the circuit
where the pressure cannot be maintained.
Question 6.
Which drug is the reversal agent for benzodiazepines like Midazolam?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Acetylcysteine
Correct Answer: B. Flumazenil
Explanation: Flumazenil is the specific antagonist for benzodiazepine overdose or
reversal.
Question 7.
Before administering a neuromuscular blocking agent (NMBA) like Vecuronium, which
medication must be administered first?
A. A corticosteroid.
B. A sedative and an analgesic.
C. An antibiotic.
D. Atropine.
Correct Answer: B. A sedative and an analgesic.
Explanation: NMBAs paralyze muscles but do not provide sedation or pain relief. Patients
, must be sedated and have pain controlled before being paralyzed to prevent psychological
trauma.
Question 8.
The ‘Train of Four’ (TOF) monitoring is used to assess the effectiveness of which type of
medication?
A. Inotropic agents
B. Vasopressors
C. Sedatives
D. Neuromuscular blocking agents
Correct Answer: D. Neuromuscular blocking agents
Explanation: TOF uses peripheral nerve stimulation to determine the level of paralysis in
patients receiving neuromuscular blockers.
Question 9.
A patient in septic shock is receiving Norepinephrine (Levophed). What is the primary
intended effect of this drug?
A. Bronchodilation
B. Vasoconstriction to increase blood pressure
C. Increasing the heart rate to over 150 bpm
D. Sedation
Correct Answer: B. Vasoconstriction to increase blood pressure
Explanation: Norepinephrine is a potent alpha-1 agonist used to cause peripheral
vasoconstriction and increase Mean Arterial Pressure (MAP) in shock.
Question 10.
Which nursing intervention is most important for preventing Ventilator- Associated
Pneumonia (VAP)?
A. Keeping the head of the bed flat.
B. Maintaining the patient in a prone position.
C. Changing the ventilator circuit every 24 hours.
D. Providing oral care with chlorhexidine at least twice daily.
Correct Answer: D. Providing oral care with chlorhexidine at least twice daily.
Explanation: Chlorhexidine oral care and elevating the head of the bed (30-45 degrees)
are core components of the VAP prevention bundle.
