NUR 2502 MULTIDIMENSIONAL CARE
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient in the intensive care unit is being treated for Acute Respiratory Distress
Syndrome (ARDS). The nurse notes the patient’s PaO2 remains low despite increasing the
FiO2 to 80%. Which pathophysiological mechanism explains this finding?
A. Alveolar-capillary membrane thickening
B. Right-to-left intrapulmonary shunting
C. Increased compliance of the lung tissue
D. Decreased carbon dioxide diffusion
Answer: B
Conceptual Explanation: In ARDS, fluid fills the alveoli, causing a right-to-left shunt where
blood passes through the lungs without being oxygenated. This leads to refractory
hypoxemia, where oxygen levels do not improve with supplemental oxygen.
,2. A client with a C6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The nurse finds the blood pressure is 190/110 mmHg and the heart rate is 52
bpm. What is the priority nursing action?
A. Administer an ordered antihypertensive medication
B. Check the client for bladder distention or fecal impaction
C. Lower the head of the bed to the Trendelenburg position
D. Perform a neurological assessment using the Glasgow Coma Scale
Answer: B
Conceptual Explanation: These symptoms indicate Autonomic Dysreflexia, a medical
emergency in SCI patients. The priority is to identify and remove the noxious stimulus,
most commonly a distended bladder or impacted bowel.
3. The nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect to observe?
A. Metabolic acidosis and cold, clammy skin
B. Decreased urinary output and narrowing pulse pressure
C. Lethargy and moist crackles in the lungs
D. Anuria and absent peripheral pulses
Answer: B
, Conceptual Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis. Symptoms include tachycardia, narrowing pulse pressure, and
decreased urinary output as blood is shunted to vital organs.
4. A client is admitted with Diabetic Ketoacidosis (DKA). The arterial blood gas results are: pH
7.25, PaCO2 30 mmHg, HCO3 15 mEq/L. How should the nurse interpret these results?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis with no compensation
C. Metabolic alkalosis with full compensation
D. Metabolic acidosis with partial compensation
Answer: D
Conceptual Explanation: The low pH indicates acidosis. The low HCO3 indicates a
metabolic cause. The low PaCO2 indicates the lungs are attempting to compensate by
blowing off CO2, but since the pH is not normal, it is partial compensation.
5. A patient with acute pancreatitis develops Trousseau’s sign. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient in the intensive care unit is being treated for Acute Respiratory Distress
Syndrome (ARDS). The nurse notes the patient’s PaO2 remains low despite increasing the
FiO2 to 80%. Which pathophysiological mechanism explains this finding?
A. Alveolar-capillary membrane thickening
B. Right-to-left intrapulmonary shunting
C. Increased compliance of the lung tissue
D. Decreased carbon dioxide diffusion
Answer: B
Conceptual Explanation: In ARDS, fluid fills the alveoli, causing a right-to-left shunt where
blood passes through the lungs without being oxygenated. This leads to refractory
hypoxemia, where oxygen levels do not improve with supplemental oxygen.
,2. A client with a C6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The nurse finds the blood pressure is 190/110 mmHg and the heart rate is 52
bpm. What is the priority nursing action?
A. Administer an ordered antihypertensive medication
B. Check the client for bladder distention or fecal impaction
C. Lower the head of the bed to the Trendelenburg position
D. Perform a neurological assessment using the Glasgow Coma Scale
Answer: B
Conceptual Explanation: These symptoms indicate Autonomic Dysreflexia, a medical
emergency in SCI patients. The priority is to identify and remove the noxious stimulus,
most commonly a distended bladder or impacted bowel.
3. The nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect to observe?
A. Metabolic acidosis and cold, clammy skin
B. Decreased urinary output and narrowing pulse pressure
C. Lethargy and moist crackles in the lungs
D. Anuria and absent peripheral pulses
Answer: B
, Conceptual Explanation: In the compensatory stage of shock, the body attempts to
maintain homeostasis. Symptoms include tachycardia, narrowing pulse pressure, and
decreased urinary output as blood is shunted to vital organs.
4. A client is admitted with Diabetic Ketoacidosis (DKA). The arterial blood gas results are: pH
7.25, PaCO2 30 mmHg, HCO3 15 mEq/L. How should the nurse interpret these results?
A. Respiratory alkalosis with partial compensation
B. Respiratory acidosis with no compensation
C. Metabolic alkalosis with full compensation
D. Metabolic acidosis with partial compensation
Answer: D
Conceptual Explanation: The low pH indicates acidosis. The low HCO3 indicates a
metabolic cause. The low PaCO2 indicates the lungs are attempting to compensate by
blowing off CO2, but since the pH is not normal, it is partial compensation.
5. A patient with acute pancreatitis develops Trousseau’s sign. Which electrolyte imbalance
should the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hypernatremia
