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NR 341 COMPLEX ADULT HEALTH – EXAM 1 PRACTICE
EXAMINATION 2026/2027 COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
ADULT HEALTH
Prepare effectively for the NR 341 Complex Adult Health Exam 1 with this focused
practice resource. It supports review of complex adult health conditions, patient
assessment, pathophysiology, nursing interventions, pharmacology, and clinical
judgment. Use the material to reinforce your knowledge, practice key concepts, and
identify areas that may require additional study. This resource is suited for nursing
students enrolled in NR 341, adult health learners, and candidates preparing for Exam
1.
MULTIPLE CHOICE.
SECTION 1: HEMODYNAMICS & SHOCK STATES (Questions 1–25)
1. The nurse is caring for a patient with a pulmonary artery catheter.
Which hemodynamic parameter is the BEST indicator of left ventricular
preload?
(A) Central venous pressure (CVP)
(B) Pulmonary artery wedge pressure (PAWP)
(C) Cardiac output (CO)
(D) Systemic vascular resistance (SVR)
Answer: (B) Pulmonary artery wedge pressure (PAWP)
Rationale: PAWP reflects left ventricular end-diastolic pressure and is the
best indicator of left ventricular preload. CVP reflects right ventricular
preload. CO measures cardiac output, and SVR measures afterload.
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2. A patient in the ICU has a pulmonary artery catheter with the following
readings: PAWP 22 mmHg, CO 3.0 L/min, SVR 1,900 dynes/sec/cm⁻⁵.
Which condition is MOST consistent with these findings?
(A) Hypovolemic shock
(B) Cardiogenic shock
(C) Septic shock (early)
(D) Neurogenic shock
Answer: (B) Cardiogenic shock
Rationale: Elevated PAWP (>18 mmHg) indicates increased left ventricular
filling pressure, and low cardiac output with elevated SVR is characteristic of
cardiogenic shock. Hypovolemic shock would show low PAWP. Septic shock
(early) would show low SVR.
3. The nurse is caring for a patient in septic shock who is receiving
norepinephrine. Which assessment finding indicates the medication is
having the desired therapeutic effect?
(A) Heart rate decreases from 110 to 95 bpm
(B) Mean arterial pressure (MAP) increases from 55 to 70 mmHg
(C) Central venous pressure (CVP) decreases from 12 to 8 mmHg
(D) Cardiac output decreases from 6.0 to 4.5 L/min
Answer: (B) Mean arterial pressure (MAP) increases from 55 to 70 mmHg
Rationale: Norepinephrine is a vasopressor used to increase systemic
vascular resistance and blood pressure in septic shock. The desired effect is
an increase in MAP to ≥65 mmHg to ensure adequate perfusion to vital
organs.
4. A patient with cardiogenic shock is started on dobutamine. Which of
the following is the PRIMARY mechanism of action of dobutamine?
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(A) Alpha-1 agonism causing vasoconstriction
(B) Beta-1 agonism causing increased cardiac contractility
(C) Beta-2 agonism causing vasodilation
(D) Dopaminergic agonism causing renal vasodilation
Answer: (B) Beta-1 agonism causing increased cardiac contractility
Rationale: Dobutamine is a positive inotrope that primarily stimulates beta-1
adrenergic receptors, increasing cardiac contractility and stroke volume. It
has minimal alpha-1 effects, making it useful for cardiogenic shock where
increased contractility is needed without significant vasoconstriction.
5. A patient with neurogenic shock following a C5 spinal cord injury has
hypotension and bradycardia. Which of the following BEST explains this
presentation?
(A) Increased sympathetic tone
(B) Loss of sympathetic tone with unopposed vagal activity
(C) Increased parasympathetic tone
(D) Decreased vagal tone
Answer: (B) Loss of sympathetic tone with unopposed vagal activity
Rationale: Neurogenic shock results from loss of sympathetic tone below the
level of injury, leading to vasodilation (hypotension) and unopposed vagal
tone (bradycardia). This is a classic presentation of spinal shock above T6.
6. The nurse is calculating a patient's mean arterial pressure (MAP). The
blood pressure is 110/70 mmHg. What is the MAP?
(A) 73 mmHg
(B) 83 mmHg
(C) 90 mmHg
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(D) 95 mmHg
Answer: (B) 83 mmHg
Rationale: MAP = [(2 × diastolic) + systolic] / 3 = [(2 × 70) + 110] / 3 = (140 +
110) / 3 = = 83.3 mmHg. A MAP of ≥65 mmHg is needed for adequate
organ perfusion.
7. The nurse is caring for a patient with a systemic vascular resistance
(SVR) of 2,500 dynes/sec/cm⁻⁵. Which of the following conditions is MOST
consistent with this finding?
(A) Septic shock
(B) Anaphylactic shock
(C) Cardiogenic shock
(D) Neurogenic shock
Answer: (C) Cardiogenic shock
Rationale: SVR is elevated (>1,200 dynes/sec/cm⁻⁵) in cardiogenic and
hypovolemic shock due to compensatory vasoconstriction. Septic,
anaphylactic, and neurogenic shock are distributive shocks characterized by
decreased SVR.
8. A patient in the ICU has a pulmonary artery catheter with the following
readings: PAWP 22 mmHg, CO 3.0 L/min, SVR 1,900 dynes/sec/cm⁻⁵.
Which intervention is MOST appropriate?
(A) Administer a fluid bolus
(B) Administer a vasopressor
(C) Administer a diuretic
(D) Administer a vasodilator
Answer: (C) Administer a diuretic
NR 341 COMPLEX ADULT HEALTH – EXAM 1 PRACTICE
EXAMINATION 2026/2027 COMPLETE (150) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
ADULT HEALTH
Prepare effectively for the NR 341 Complex Adult Health Exam 1 with this focused
practice resource. It supports review of complex adult health conditions, patient
assessment, pathophysiology, nursing interventions, pharmacology, and clinical
judgment. Use the material to reinforce your knowledge, practice key concepts, and
identify areas that may require additional study. This resource is suited for nursing
students enrolled in NR 341, adult health learners, and candidates preparing for Exam
1.
MULTIPLE CHOICE.
SECTION 1: HEMODYNAMICS & SHOCK STATES (Questions 1–25)
1. The nurse is caring for a patient with a pulmonary artery catheter.
Which hemodynamic parameter is the BEST indicator of left ventricular
preload?
(A) Central venous pressure (CVP)
(B) Pulmonary artery wedge pressure (PAWP)
(C) Cardiac output (CO)
(D) Systemic vascular resistance (SVR)
Answer: (B) Pulmonary artery wedge pressure (PAWP)
Rationale: PAWP reflects left ventricular end-diastolic pressure and is the
best indicator of left ventricular preload. CVP reflects right ventricular
preload. CO measures cardiac output, and SVR measures afterload.
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2. A patient in the ICU has a pulmonary artery catheter with the following
readings: PAWP 22 mmHg, CO 3.0 L/min, SVR 1,900 dynes/sec/cm⁻⁵.
Which condition is MOST consistent with these findings?
(A) Hypovolemic shock
(B) Cardiogenic shock
(C) Septic shock (early)
(D) Neurogenic shock
Answer: (B) Cardiogenic shock
Rationale: Elevated PAWP (>18 mmHg) indicates increased left ventricular
filling pressure, and low cardiac output with elevated SVR is characteristic of
cardiogenic shock. Hypovolemic shock would show low PAWP. Septic shock
(early) would show low SVR.
3. The nurse is caring for a patient in septic shock who is receiving
norepinephrine. Which assessment finding indicates the medication is
having the desired therapeutic effect?
(A) Heart rate decreases from 110 to 95 bpm
(B) Mean arterial pressure (MAP) increases from 55 to 70 mmHg
(C) Central venous pressure (CVP) decreases from 12 to 8 mmHg
(D) Cardiac output decreases from 6.0 to 4.5 L/min
Answer: (B) Mean arterial pressure (MAP) increases from 55 to 70 mmHg
Rationale: Norepinephrine is a vasopressor used to increase systemic
vascular resistance and blood pressure in septic shock. The desired effect is
an increase in MAP to ≥65 mmHg to ensure adequate perfusion to vital
organs.
4. A patient with cardiogenic shock is started on dobutamine. Which of
the following is the PRIMARY mechanism of action of dobutamine?
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(A) Alpha-1 agonism causing vasoconstriction
(B) Beta-1 agonism causing increased cardiac contractility
(C) Beta-2 agonism causing vasodilation
(D) Dopaminergic agonism causing renal vasodilation
Answer: (B) Beta-1 agonism causing increased cardiac contractility
Rationale: Dobutamine is a positive inotrope that primarily stimulates beta-1
adrenergic receptors, increasing cardiac contractility and stroke volume. It
has minimal alpha-1 effects, making it useful for cardiogenic shock where
increased contractility is needed without significant vasoconstriction.
5. A patient with neurogenic shock following a C5 spinal cord injury has
hypotension and bradycardia. Which of the following BEST explains this
presentation?
(A) Increased sympathetic tone
(B) Loss of sympathetic tone with unopposed vagal activity
(C) Increased parasympathetic tone
(D) Decreased vagal tone
Answer: (B) Loss of sympathetic tone with unopposed vagal activity
Rationale: Neurogenic shock results from loss of sympathetic tone below the
level of injury, leading to vasodilation (hypotension) and unopposed vagal
tone (bradycardia). This is a classic presentation of spinal shock above T6.
6. The nurse is calculating a patient's mean arterial pressure (MAP). The
blood pressure is 110/70 mmHg. What is the MAP?
(A) 73 mmHg
(B) 83 mmHg
(C) 90 mmHg
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(D) 95 mmHg
Answer: (B) 83 mmHg
Rationale: MAP = [(2 × diastolic) + systolic] / 3 = [(2 × 70) + 110] / 3 = (140 +
110) / 3 = = 83.3 mmHg. A MAP of ≥65 mmHg is needed for adequate
organ perfusion.
7. The nurse is caring for a patient with a systemic vascular resistance
(SVR) of 2,500 dynes/sec/cm⁻⁵. Which of the following conditions is MOST
consistent with this finding?
(A) Septic shock
(B) Anaphylactic shock
(C) Cardiogenic shock
(D) Neurogenic shock
Answer: (C) Cardiogenic shock
Rationale: SVR is elevated (>1,200 dynes/sec/cm⁻⁵) in cardiogenic and
hypovolemic shock due to compensatory vasoconstriction. Septic,
anaphylactic, and neurogenic shock are distributive shocks characterized by
decreased SVR.
8. A patient in the ICU has a pulmonary artery catheter with the following
readings: PAWP 22 mmHg, CO 3.0 L/min, SVR 1,900 dynes/sec/cm⁻⁵.
Which intervention is MOST appropriate?
(A) Administer a fluid bolus
(B) Administer a vasopressor
(C) Administer a diuretic
(D) Administer a vasodilator
Answer: (C) Administer a diuretic
