NUR 445/NUR 445 EXAM 1 EXAM NEWEST ACTUAL
EXAM 2026- 2027 COMPLETE EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES (100% RELIABLE SOLUTIONS)
RECENTLY UPDATED VERSION EDITION 2026 NUR
445 EXAM|GUARANTEED PASS A+ |BRAND NEW!!!
|INSTANT DOWNLOAD PDF
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg
despite fluid resuscitation. What is the priority intervention?
A) Administer vasopressors as ordered
B) Increase the rate of IV fluids
C) Reposition the patient supine
D) Obtain a blood culture
ANSWER: A
Rationale: A MAP < 65 mmHg indicates inadequate organ perfusion. After fluid
resuscitation, vasopressors (e.g., norepinephrine) are indicated to restore MAP to ≥
65 mmHg and maintain tissue perfusion.
2. Which hemodynamic parameter is most indicative 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
Rationale: PAWP reflects left atrial pressure and is the best measure of left
ventricular preload. CVP reflects right ventricular preload.
3. A patient in cardiogenic shock has a cardiac index of 1.8 L/min/m² (normal: 2.5–
4.0). Which finding would the nurse expect?
A) Bounding pulses and warm extremities
B) Cool, clammy skin and decreased urine output
C) Increased urine output and clear lung sounds
D) Flushed skin and bounding pulses
ANSWER: B
Rationale: Low cardiac index indicates poor tissue perfusion, resulting in
compensatory vasoconstriction (cool, clammy skin) and decreased renal perfusion
(low urine output).
4. Which type of shock is characterized by a low CVP, low PAWP, and low SVR?
A) Cardiogenic shock
B) Obstructive shock
C) Distributive shock (septic)
D) Hypovolemic shock
ANSWER: C
Rationale: Septic (distributive) shock typically shows low CVP/PAWP (relative
hypovolemia) and low SVR (vasodilation). Cardiogenic shock shows high filling
,pressures. Hypovolemic shock shows low filling pressures but normal or high
SVR.
5. A patient in hypovolemic shock receives 2 L of lactated Ringer's solution. MAP
increases from 48 to 62 mmHg. What does this indicate?
A) The patient is fluid responsive
B) The patient needs blood transfusion
C) Vasopressors are now contraindicated
D) The patient has developed fluid overload
ANSWER: A
Rationale: A positive response to fluid challenge (increase in MAP, improvement
in heart rate, urine output > 0.5 mL/kg/hr) indicates the patient is fluid responsive
and hypovolemia is a contributing factor.
6. Which medication is the first-line vasopressor for septic shock?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Vasopressin
ANSWER: C
Rationale: Norepinephrine is the first-line vasopressor for septic shock per
Surviving Sepsis Campaign guidelines due to its potent vasoconstrictive effects
with less tachycardia than dopamine.
, 7. A patient with an intra-aortic balloon pump (IABP) has a waveform with early
deflation. What is the most likely consequence?
A) Increased afterload
B) Decreased coronary perfusion
C) Increased cardiac output
D) Decreased left ventricular workload
ANSWER: B
Rationale: Early deflation of the IABP balloon causes the balloon to deflate before
the aortic valve opens, leading to decreased diastolic augmentation and reduced
coronary perfusion.
8. A pulmonary artery catheter shows PAWP = 25 mm Hg and CO = 2.1 L/min.
The nurse suspects:
A) Hypovolemic shock
B) Distributive shock
C) Cardiogenic shock
D) Obstructive shock
ANSWER: C
Rationale: High PAWP (>18) + low CO = left ventricular failure (cardiogenic
shock).
9. Mixed venous oxygen saturation (SvO₂) is 50% (normal 60–80%). This
indicates:
A) Increased oxygen extraction
EXAM 2026- 2027 COMPLETE EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH DETAILED
RATIONALES (100% RELIABLE SOLUTIONS)
RECENTLY UPDATED VERSION EDITION 2026 NUR
445 EXAM|GUARANTEED PASS A+ |BRAND NEW!!!
|INSTANT DOWNLOAD PDF
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg
despite fluid resuscitation. What is the priority intervention?
A) Administer vasopressors as ordered
B) Increase the rate of IV fluids
C) Reposition the patient supine
D) Obtain a blood culture
ANSWER: A
Rationale: A MAP < 65 mmHg indicates inadequate organ perfusion. After fluid
resuscitation, vasopressors (e.g., norepinephrine) are indicated to restore MAP to ≥
65 mmHg and maintain tissue perfusion.
2. Which hemodynamic parameter is most indicative 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
Rationale: PAWP reflects left atrial pressure and is the best measure of left
ventricular preload. CVP reflects right ventricular preload.
3. A patient in cardiogenic shock has a cardiac index of 1.8 L/min/m² (normal: 2.5–
4.0). Which finding would the nurse expect?
A) Bounding pulses and warm extremities
B) Cool, clammy skin and decreased urine output
C) Increased urine output and clear lung sounds
D) Flushed skin and bounding pulses
ANSWER: B
Rationale: Low cardiac index indicates poor tissue perfusion, resulting in
compensatory vasoconstriction (cool, clammy skin) and decreased renal perfusion
(low urine output).
4. Which type of shock is characterized by a low CVP, low PAWP, and low SVR?
A) Cardiogenic shock
B) Obstructive shock
C) Distributive shock (septic)
D) Hypovolemic shock
ANSWER: C
Rationale: Septic (distributive) shock typically shows low CVP/PAWP (relative
hypovolemia) and low SVR (vasodilation). Cardiogenic shock shows high filling
,pressures. Hypovolemic shock shows low filling pressures but normal or high
SVR.
5. A patient in hypovolemic shock receives 2 L of lactated Ringer's solution. MAP
increases from 48 to 62 mmHg. What does this indicate?
A) The patient is fluid responsive
B) The patient needs blood transfusion
C) Vasopressors are now contraindicated
D) The patient has developed fluid overload
ANSWER: A
Rationale: A positive response to fluid challenge (increase in MAP, improvement
in heart rate, urine output > 0.5 mL/kg/hr) indicates the patient is fluid responsive
and hypovolemia is a contributing factor.
6. Which medication is the first-line vasopressor for septic shock?
A) Dopamine
B) Epinephrine
C) Norepinephrine
D) Vasopressin
ANSWER: C
Rationale: Norepinephrine is the first-line vasopressor for septic shock per
Surviving Sepsis Campaign guidelines due to its potent vasoconstrictive effects
with less tachycardia than dopamine.
, 7. A patient with an intra-aortic balloon pump (IABP) has a waveform with early
deflation. What is the most likely consequence?
A) Increased afterload
B) Decreased coronary perfusion
C) Increased cardiac output
D) Decreased left ventricular workload
ANSWER: B
Rationale: Early deflation of the IABP balloon causes the balloon to deflate before
the aortic valve opens, leading to decreased diastolic augmentation and reduced
coronary perfusion.
8. A pulmonary artery catheter shows PAWP = 25 mm Hg and CO = 2.1 L/min.
The nurse suspects:
A) Hypovolemic shock
B) Distributive shock
C) Cardiogenic shock
D) Obstructive shock
ANSWER: C
Rationale: High PAWP (>18) + low CO = left ventricular failure (cardiogenic
shock).
9. Mixed venous oxygen saturation (SvO₂) is 50% (normal 60–80%). This
indicates:
A) Increased oxygen extraction
