NUR 334 HIGH ACUITY NURSING FINAL
EXAM QUESTIONS AND DETAILED
ANSWERS 2026/2027
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg despite
adequate fluid resuscitation. Which vasopressor is considered the first-line choice according
to the Surviving Sepsis Campaign?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Answer: B
Conceptual Explanation: Norepinephrine is the first-choice vasopressor for septic shock
because it effectively increases MAP with less tachycardia than dopamine.
2. Which of the following clinical manifestations is most indicative of the ‘Cold Phase’ (Late
stage) of septic shock?
A. Hypotension and cool, clammy skin
B. Decreased systemic vascular resistance (SVR)
C. Increased cardiac output and bounding pulses
,D. Flushed, warm extremities
Answer: A
Conceptual Explanation: The late phase of septic shock is characterized by hypovolemia,
decreased cardiac output, and peripheral vasoconstriction, leading to cool and clammy
skin.
3. A patient with ARDS is being mechanically ventilated. Which ventilator strategy is
prioritized to prevent ventilator-induced lung injury (VILI)?
A. High tidal volumes to maximize alveolar recruitment
B. Minimizing Positive End-Expiratory Pressure (PEEP)
C. Maintaining a high FiO2 (100%) at all times
D. Low tidal volume (6 mL/kg predicted body weight)
Answer: D
Conceptual Explanation: Low tidal volume ventilation is the gold standard for ARDS to
prevent barotrauma and volutrauma.
4. The nurse identifies a ‘Low Pressure’ alarm on the mechanical ventilator. What is the most
likely cause?
A. The patient is biting the endotracheal tube
B. A disconnection in the ventilator circuit
C. Secretions are blocking the airway
, D. The patient is experiencing a pneumothorax
Answer: B
Conceptual Explanation: Low pressure alarms are usually caused by a leak or
disconnection, whereas high pressure alarms are caused by obstructions or decreased
compliance.
5. A patient is admitted with Acute Pancreatitis. Which assessment finding represents
Cullen’s sign?
A. Bruising on the flanks (sides)
B. Bruising around the umbilicus
C. Pain in the left shoulder
D. Rigid, board-like abdomen
Answer: B
Conceptual Explanation: Cullen’s sign is periumbilical ecchymosis indicating
retroperitoneal hemorrhage. Grey Turner’s sign is flank bruising.
6. A patient’s hemodynamic monitor shows a Pulmonary Artery Wedge Pressure (PAWP) of
22 mmHg. This finding is most consistent with which condition?
A. Hypovolemic shock
B. Dehydration
C. Left-sided heart failure
EXAM QUESTIONS AND DETAILED
ANSWERS 2026/2027
1. A patient with septic shock has a mean arterial pressure (MAP) of 55 mmHg despite
adequate fluid resuscitation. Which vasopressor is considered the first-line choice according
to the Surviving Sepsis Campaign?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Answer: B
Conceptual Explanation: Norepinephrine is the first-choice vasopressor for septic shock
because it effectively increases MAP with less tachycardia than dopamine.
2. Which of the following clinical manifestations is most indicative of the ‘Cold Phase’ (Late
stage) of septic shock?
A. Hypotension and cool, clammy skin
B. Decreased systemic vascular resistance (SVR)
C. Increased cardiac output and bounding pulses
,D. Flushed, warm extremities
Answer: A
Conceptual Explanation: The late phase of septic shock is characterized by hypovolemia,
decreased cardiac output, and peripheral vasoconstriction, leading to cool and clammy
skin.
3. A patient with ARDS is being mechanically ventilated. Which ventilator strategy is
prioritized to prevent ventilator-induced lung injury (VILI)?
A. High tidal volumes to maximize alveolar recruitment
B. Minimizing Positive End-Expiratory Pressure (PEEP)
C. Maintaining a high FiO2 (100%) at all times
D. Low tidal volume (6 mL/kg predicted body weight)
Answer: D
Conceptual Explanation: Low tidal volume ventilation is the gold standard for ARDS to
prevent barotrauma and volutrauma.
4. The nurse identifies a ‘Low Pressure’ alarm on the mechanical ventilator. What is the most
likely cause?
A. The patient is biting the endotracheal tube
B. A disconnection in the ventilator circuit
C. Secretions are blocking the airway
, D. The patient is experiencing a pneumothorax
Answer: B
Conceptual Explanation: Low pressure alarms are usually caused by a leak or
disconnection, whereas high pressure alarms are caused by obstructions or decreased
compliance.
5. A patient is admitted with Acute Pancreatitis. Which assessment finding represents
Cullen’s sign?
A. Bruising on the flanks (sides)
B. Bruising around the umbilicus
C. Pain in the left shoulder
D. Rigid, board-like abdomen
Answer: B
Conceptual Explanation: Cullen’s sign is periumbilical ecchymosis indicating
retroperitoneal hemorrhage. Grey Turner’s sign is flank bruising.
6. A patient’s hemodynamic monitor shows a Pulmonary Artery Wedge Pressure (PAWP) of
22 mmHg. This finding is most consistent with which condition?
A. Hypovolemic shock
B. Dehydration
C. Left-sided heart failure
