NURS 5220 EXAM 4 REVIEW
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. Which clinical manifestation most clearly differentiates Hyperosmolar Hyperglycemic State
(HHS) from Diabetic Ketoacidosis (DKA)?
A. Absence of significant ketosis and metabolic acidosis
B. Blood glucose levels exceeding 600 mg/dL
C. Severe dehydration and high serum osmolality
D. Altered mental status and neurological deficits
Answer: A
Conceptual Explanation: While both involve high glucose and dehydration, the hallmark
of HHS is the lack of significant ketosis and acidosis because there is enough insulin to
prevent lipolysis.
2. A patient with a traumatic brain injury (TBI) exhibits Cushing’s Triad. Which set of vital
signs is consistent with this finding?
A. BP 180/60, HR 50, RR 10 and irregular
B. BP 90/60, HR 120, RR 24
C. BP 130/80, HR 80, RR 16
,D. BP 150/100, HR 110, RR 30
Answer: A
Conceptual Explanation: Cushing’s Triad consists of widened pulse pressure (increased
systolic BP), bradycardia, and irregular respirations, indicating late-stage increased
intracranial pressure.
3. What is the primary pathophysiological mechanism behind Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Destruction of the posterior pituitary gland
B. Inability of the kidneys to respond to circulating ADH
C. Excessive water reabsorption in the distal tubule and collecting duct
D. Excessive glucose filtration leading to osmotic diuresis
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, which leads to water retention,
dilutional hyponatremia, and concentrated urine despite fluid volume expansion.
4. In the management of Autonomic Dysreflexia in a patient with a T6 spinal cord injury,
which action should the nurse take first?
A. Administer an antihypertensive medication
B. Elevate the head of the bed to 90 degrees
C. Notify the healthcare provider
, D. Perform a digital rectal exam to check for impaction
Answer: B
Conceptual Explanation: The priority is to lower blood pressure immediately through
gravity (sitting the patient upright) while simultaneously identifying and removing the
noxious stimulus.
5. Using the Parkland formula (4mL x kg x %TBSA), calculate the total fluid volume needed in
the first 24 hours for a 70kg patient with 40% total body surface area burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Conceptual Explanation: 4 mL x 70 kg x 40% = 11,200 mL. Half is given in the first 8
hours, and the rest over the next 16 hours.
6. Which hemodynamic profile is most indicative of early Septic Shock?
A. Increased Cardiac Output, Decreased SVR
B. Decreased Cardiac Output, Increased SVR
C. Decreased Cardiac Output, Decreased SVR
D. Increased Cardiac Output, Increased SVR
QUESTIONS & VERIFIED ANSWERS (A+
GUARANTEE)
1. Which clinical manifestation most clearly differentiates Hyperosmolar Hyperglycemic State
(HHS) from Diabetic Ketoacidosis (DKA)?
A. Absence of significant ketosis and metabolic acidosis
B. Blood glucose levels exceeding 600 mg/dL
C. Severe dehydration and high serum osmolality
D. Altered mental status and neurological deficits
Answer: A
Conceptual Explanation: While both involve high glucose and dehydration, the hallmark
of HHS is the lack of significant ketosis and acidosis because there is enough insulin to
prevent lipolysis.
2. A patient with a traumatic brain injury (TBI) exhibits Cushing’s Triad. Which set of vital
signs is consistent with this finding?
A. BP 180/60, HR 50, RR 10 and irregular
B. BP 90/60, HR 120, RR 24
C. BP 130/80, HR 80, RR 16
,D. BP 150/100, HR 110, RR 30
Answer: A
Conceptual Explanation: Cushing’s Triad consists of widened pulse pressure (increased
systolic BP), bradycardia, and irregular respirations, indicating late-stage increased
intracranial pressure.
3. What is the primary pathophysiological mechanism behind Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. Destruction of the posterior pituitary gland
B. Inability of the kidneys to respond to circulating ADH
C. Excessive water reabsorption in the distal tubule and collecting duct
D. Excessive glucose filtration leading to osmotic diuresis
Answer: C
Conceptual Explanation: SIADH involves excessive ADH, which leads to water retention,
dilutional hyponatremia, and concentrated urine despite fluid volume expansion.
4. In the management of Autonomic Dysreflexia in a patient with a T6 spinal cord injury,
which action should the nurse take first?
A. Administer an antihypertensive medication
B. Elevate the head of the bed to 90 degrees
C. Notify the healthcare provider
, D. Perform a digital rectal exam to check for impaction
Answer: B
Conceptual Explanation: The priority is to lower blood pressure immediately through
gravity (sitting the patient upright) while simultaneously identifying and removing the
noxious stimulus.
5. Using the Parkland formula (4mL x kg x %TBSA), calculate the total fluid volume needed in
the first 24 hours for a 70kg patient with 40% total body surface area burns.
A. 5,600 mL
B. 11,200 mL
C. 2,800 mL
D. 14,000 mL
Answer: B
Conceptual Explanation: 4 mL x 70 kg x 40% = 11,200 mL. Half is given in the first 8
hours, and the rest over the next 16 hours.
6. Which hemodynamic profile is most indicative of early Septic Shock?
A. Increased Cardiac Output, Decreased SVR
B. Decreased Cardiac Output, Increased SVR
C. Decreased Cardiac Output, Decreased SVR
D. Increased Cardiac Output, Increased SVR
