QUESTIONS AND ANSWERS | 2026
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140 Questions with Answers and Detailed Rationales
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NURS 306 FINAL REVIEW | QUESTIONS AND ANSWERS | 2026 UPDATE | 100% CORRECT - WCU.. It
contains 140 carefully selected questions that reflect the most current exam content and testing strategies. Each
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pathophysiology, pharmacology, or clinical reasoning.
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Review Summary 140 Questions
Foundations - Application - NURS 306 Review AND 2026 Update 100 Correct - WCU Nursing NURS 306
Advanced Medical-surgical Nursing Undergraduate YEAR 4 Senior
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-24 Acute, Laboratory, Shock, Respiratory, Syndrome
Safety AND Infection Control 25-48 Acute, Intervention, Appropriate, Finding, Indicates
Health Promotion AND 49-72 Finding, Chronic, Acute, Indicates, Disease
Maintenance
Psychosocial Integrity 73-96 Finding, Indicates, Requires, Intervention, Consistent
Basic CARE AND Comfort 97-120 Receiving, Medication, Likely, Disease, Appropriate
Pharmacological Therapies 121-140 Finding, Prescribed, Infusion, Receiving, Medication
TOTAL 140 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
In a patient with septic shock and acute respiratory distress syndrome (ARDS), which
ventilator strategy best balances lung protection with hemodynamic support?
A. Volume-controlled ventilation with tidal B. Pressure-regulated volume control with
volume 10 mL/kg ideal body weight and tidal volume 6 mL/kg ideal body weight and
PEEP 5 cm H2O PEEP titrated to driving pressure
C. Pressure-controlled ventilation with peak D. Airway pressure release ventilation
pressure 40 cm H2O and FiO2 100% (APRV) with high continuous positive airway
pressure and spontaneous breathing
Correct: B - Pressure-regulated volume control with tidal volume 6 mL/kg ideal body
weight and PEEP titrated to driving pressure
Rationale:Low tidal volume ventilation (6 mL/kg IBW) and PEEP titration to driving pressure
are evidence-based for ARDS, reducing volutrauma while optimizing oxygenation. High peak
pressures (option C) increase barotrauma, and APRV (option D) may cause hemodynamic
compromise. Option A uses excessive tidal volume.
Q2.
A patient in cardiogenic shock has a pulmonary artery catheter showing cardiac index 1.8
L/min/m², pulmonary capillary wedge pressure 22 mm Hg, and systemic vascular
resistance 1400 dynes-s-cm. Which pharmacologic intervention is most appropriate?
A. Norepinephrine infusion titrated to mean B. Milrinone infusion at 0.5 mcg/kg/min
arterial pressure 65 mm Hg
C. Furosemide 40 mg IV bolus D. Nitroglycerin infusion at 10 mcg/min
Correct: B - Milrinone infusion at 0.5 mcg/kg/min
Rationale:Cardiogenic shock with high SVR and low cardiac output benefits from an inotrope
with vasodilation, such as milrinone, to improve contractility and reduce afterload.
Norepinephrine (A) increases SVR, worsening perfusion. Furosemide (C) reduces preload but
does not improve contractility. Nitroglycerin (D) primarily venodilates and may drop preload
excessively.
Q3.
Which laboratory finding is most consistent with syndrome of inappropriate antidiuretic
hormone secretion (SIADH) in a patient with small cell lung cancer?
Page 3
, Section A - Management OF CARE
A. Serum sodium 128 mEq/L, urine B. Serum sodium 132 mEq/L, urine
osmolality 600 mOsm/kg, urine sodium 80 osmolality 100 mOsm/kg, urine sodium 10
mEq/L, serum osmolality 250 mOsm/kg mEq/L, serum osmolality 290 mOsm/kg
C. Serum sodium 120 mEq/L, urine D. Serum sodium 135 mEq/L, urine
osmolality 800 mOsm/kg, urine sodium 5 osmolality 300 mOsm/kg, urine sodium 40
mEq/L, serum osmolality 260 mOsm/kg mEq/L, serum osmolality 285 mOsm/kg
Correct: A - Serum sodium 128 mEq/L, urine osmolality 600 mOsm/kg, urine sodium 80
mEq/L, serum osmolality 250 mOsm/kg
Rationale:SIADH is characterized by hypotonic hyponatremia (low serum osmolality),
inappropriately concentrated urine (high urine osmolality), and elevated urine sodium due to
continued ADH secretion. Option A matches these criteria. Option B suggests primary
polydipsia (dilute urine). Option C has low urine sodium, suggesting hypovolemia. Option D is
normal.
Q4.
A postoperative patient develops sudden dyspnea, chest pain, and hypoxemia. An ECG
shows sinus tachycardia and an S1Q3T3 pattern. Which diagnostic test has the highest
sensitivity for confirming the suspected diagnosis?
A. Chest X-ray B. D-dimer assay
C. Computed tomography pulmonary D. Ventilation-perfusion (V/Q) scan
angiography (CTPA)
Correct: C - Computed tomography pulmonary angiography (CTPA)
Rationale:CTPA is the gold standard for diagnosing pulmonary embolism, with high sensitivity
and specificity. D-dimer is sensitive but nonspecific. Chest X-ray is not diagnostic. V/Q scan is
used when CTPA is contraindicated or inconclusive, but is less sensitive in high-probability
scenarios.
Q5.
Which assessment finding most reliably indicates adequate tissue perfusion in a patient
receiving vasopressor support for distributive shock?
A. Mean arterial pressure (MAP) of 65 mm B. Lactate clearance of 10% within 6 hours
Hg
C. Urine output of 0.5 mL/kg/hr D. Central venous oxygen saturation (ScvO)
of 70%
Correct: B - Lactate clearance of 10% within 6 hours
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