NUR 253 EXAM 2 REVIEW QUESTIONS
& VERIFIED ANSWERS (A+
GUARANTEE) | GALEN COLLEGE OF
NURSING (2026/2027)
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on a ventilator with a high
PEEP setting. Which assessment finding is most concerning to the nurse?
A. Decrease in cardiac output
B. Oxygen saturation of 92%
C. Respiratory rate of 18 bpm
D. Tidal volume of 500 mL
Answer: A
Conceptual Explanation: High PEEP (Positive End-Expiratory Pressure) increases
intrathoracic pressure, which can decrease venous return to the heart, leading to decreased
cardiac output and hypotension.
,2. An arterial blood gas (ABG) shows: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L. Which
condition does this indicate?
A. Metabolic Acidosis
B. Partially Compensated Respiratory Alkalosis
C. Compensated Metabolic Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating no compensation has occurred yet.
3. Which medication is considered the first-line treatment for a patient experiencing an
anaphylactic shock?
A. Diphenhydramine IV
B. Epinephrine 1:1,000 IM
C. Methylprednisolone IV
D. Albuterol nebulizer
Answer: B
Conceptual Explanation: Epinephrine is the drug of choice for anaphylaxis as it causes
vasoconstriction and bronchodilation to counter the shock’s effects.
, 4. A nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect?
A. Metabolic alkalosis
B. Cold, clammy skin
C. Narrowed pulse pressure
D. Decreased heart rate
Answer: C
Conceptual Explanation: In the compensatory stage, the body attempts to maintain
perfusion. Narrowed pulse pressure is an early sign as diastolic pressure rises due to
vasoconstriction.
5. A patient has an 80% total body surface area (TBSA) burn. Using the Parkland formula, the
nurse calculates the total 24-hour fluid requirement. When should the first half of this fluid
be administered?
A. Within the first 8 hours after arrival at the hospital
B. Equally over the 24-hour period
C. Over the first 12 hours of the first day
D. Within the first 8 hours after the time of injury
Answer: D
& VERIFIED ANSWERS (A+
GUARANTEE) | GALEN COLLEGE OF
NURSING (2026/2027)
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on a ventilator with a high
PEEP setting. Which assessment finding is most concerning to the nurse?
A. Decrease in cardiac output
B. Oxygen saturation of 92%
C. Respiratory rate of 18 bpm
D. Tidal volume of 500 mL
Answer: A
Conceptual Explanation: High PEEP (Positive End-Expiratory Pressure) increases
intrathoracic pressure, which can decrease venous return to the heart, leading to decreased
cardiac output and hypotension.
,2. An arterial blood gas (ABG) shows: pH 7.28, PaCO2 55 mmHg, and HCO3 26 mEq/L. Which
condition does this indicate?
A. Metabolic Acidosis
B. Partially Compensated Respiratory Alkalosis
C. Compensated Metabolic Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating no compensation has occurred yet.
3. Which medication is considered the first-line treatment for a patient experiencing an
anaphylactic shock?
A. Diphenhydramine IV
B. Epinephrine 1:1,000 IM
C. Methylprednisolone IV
D. Albuterol nebulizer
Answer: B
Conceptual Explanation: Epinephrine is the drug of choice for anaphylaxis as it causes
vasoconstriction and bronchodilation to counter the shock’s effects.
, 4. A nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect?
A. Metabolic alkalosis
B. Cold, clammy skin
C. Narrowed pulse pressure
D. Decreased heart rate
Answer: C
Conceptual Explanation: In the compensatory stage, the body attempts to maintain
perfusion. Narrowed pulse pressure is an early sign as diastolic pressure rises due to
vasoconstriction.
5. A patient has an 80% total body surface area (TBSA) burn. Using the Parkland formula, the
nurse calculates the total 24-hour fluid requirement. When should the first half of this fluid
be administered?
A. Within the first 8 hours after arrival at the hospital
B. Equally over the 24-hour period
C. Over the first 12 hours of the first day
D. Within the first 8 hours after the time of injury
Answer: D
