NUR 2755 EXAM 2
Multidimensional Care IV – Shock, Burns, ARDS,
and Critical Care – Questions with Answers and
Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
NUR 2755 Exam 2 at Rasmussen University. Topics include shock states, burn management, ARDS,
mechanical ventilation, and critical care prioritization.
1. A patient has a blood pressure of 84/46 mmHg. Calculate the mean
arterial pressure (MAP).
A. 54 mmHg
B. 59 mmHg
C. 65 mmHg
D. 72 mmHg
Correct Answer: B — 59 mmHg
Rationale: MAP = (SBP + 2×DBP) ÷ 3 = (84 + 2×46) ÷ 3 = (84 + 92) ÷ 3 = 176 ÷ 3 =
58.7, rounded to 59 mmHg. A MAP below 65 mmHg indicates inadequate organ
perfusion and risk for hypoperfusion .
,2. A patient in septic shock has a MAP of 58 mmHg despite fluid
resuscitation. Which vasopressor should be initiated as first-line
therapy according to the Surviving Sepsis Campaign guidelines?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Correct Answer: B — Norepinephrine
Rationale: Norepinephrine is the first-line vasopressor for septic shock due to its
potent alpha-adrenergic effects and lower arrhythmia risk. Dopamine is no longer
recommended as first-line. Epinephrine is reserved for refractory cases .
3. A patient with acute respiratory distress syndrome (ARDS) is on
volume-controlled ventilation with a tidal volume of 8 mL/kg ideal
body weight. Which change best reflects lung-protective ventilation
strategy?
A. Increase tidal volume to 10 mL/kg to improve oxygenation
B. Decrease tidal volume to 6 mL/kg and adjust rate to maintain minute
ventilation
,C. Switch to pressure-controlled ventilation with high inspiratory pressure
D. Increase positive end-expiratory pressure without changing tidal volume
Correct Answer: B — Decrease tidal volume to 6 mL/kg and adjust rate
to maintain minute ventilation
Rationale: Lung-protective ventilation in ARDS uses low tidal volumes (6 mL/kg
ideal body weight) to reduce ventilator-induced lung injury. Higher tidal volumes
increase barotrauma .
4. Which laboratory finding is most consistent with acute tubular
necrosis (ATN) in a patient with acute kidney injury?
A. Fractional excretion of sodium (FeNa) < 1%
B. Urine sodium < 20 mEq/L
C. Fractional excretion of sodium (FeNa) > 2%
D. Urine osmolality > 500 mOsm/kg
Correct Answer: C — Fractional excretion of sodium (FeNa) > 2%
Rationale: In ATN, tubular damage impairs sodium reabsorption, leading to FeNa
> 2% and urine sodium > 40 mEq/L. FeNa < 1% suggests prerenal azotemia .
, 5. A client arrives in the emergency department with an ischemic
stroke. Because the healthcare team is considering tissue plasminogen
activator (tPA), what should the nurse perform FIRST?
A. Ask what medications the client is taking
B. Complete the history and health assessment
C. Identify the time of onset of the stroke
D. Determine if the client is scheduled for any surgical procedures
Correct Answer: C — Identify the time of onset of the stroke
Rationale: The time of onset of the stroke is the priority because tPA must be
administered within 3–4.5 hours of symptom onset. This information determines
eligibility for thrombolytic therapy .
6. A patient with increased intracranial pressure (ICP) has an
assessment finding of hypertension, bradycardia, and irregular
respirations. This is known as:
A. Cushing's triad
B. Autonomic dysreflexia
C. Neurogenic shock
D. Spinal shock
Multidimensional Care IV – Shock, Burns, ARDS,
and Critical Care – Questions with Answers and
Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
NUR 2755 Exam 2 at Rasmussen University. Topics include shock states, burn management, ARDS,
mechanical ventilation, and critical care prioritization.
1. A patient has a blood pressure of 84/46 mmHg. Calculate the mean
arterial pressure (MAP).
A. 54 mmHg
B. 59 mmHg
C. 65 mmHg
D. 72 mmHg
Correct Answer: B — 59 mmHg
Rationale: MAP = (SBP + 2×DBP) ÷ 3 = (84 + 2×46) ÷ 3 = (84 + 92) ÷ 3 = 176 ÷ 3 =
58.7, rounded to 59 mmHg. A MAP below 65 mmHg indicates inadequate organ
perfusion and risk for hypoperfusion .
,2. A patient in septic shock has a MAP of 58 mmHg despite fluid
resuscitation. Which vasopressor should be initiated as first-line
therapy according to the Surviving Sepsis Campaign guidelines?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Correct Answer: B — Norepinephrine
Rationale: Norepinephrine is the first-line vasopressor for septic shock due to its
potent alpha-adrenergic effects and lower arrhythmia risk. Dopamine is no longer
recommended as first-line. Epinephrine is reserved for refractory cases .
3. A patient with acute respiratory distress syndrome (ARDS) is on
volume-controlled ventilation with a tidal volume of 8 mL/kg ideal
body weight. Which change best reflects lung-protective ventilation
strategy?
A. Increase tidal volume to 10 mL/kg to improve oxygenation
B. Decrease tidal volume to 6 mL/kg and adjust rate to maintain minute
ventilation
,C. Switch to pressure-controlled ventilation with high inspiratory pressure
D. Increase positive end-expiratory pressure without changing tidal volume
Correct Answer: B — Decrease tidal volume to 6 mL/kg and adjust rate
to maintain minute ventilation
Rationale: Lung-protective ventilation in ARDS uses low tidal volumes (6 mL/kg
ideal body weight) to reduce ventilator-induced lung injury. Higher tidal volumes
increase barotrauma .
4. Which laboratory finding is most consistent with acute tubular
necrosis (ATN) in a patient with acute kidney injury?
A. Fractional excretion of sodium (FeNa) < 1%
B. Urine sodium < 20 mEq/L
C. Fractional excretion of sodium (FeNa) > 2%
D. Urine osmolality > 500 mOsm/kg
Correct Answer: C — Fractional excretion of sodium (FeNa) > 2%
Rationale: In ATN, tubular damage impairs sodium reabsorption, leading to FeNa
> 2% and urine sodium > 40 mEq/L. FeNa < 1% suggests prerenal azotemia .
, 5. A client arrives in the emergency department with an ischemic
stroke. Because the healthcare team is considering tissue plasminogen
activator (tPA), what should the nurse perform FIRST?
A. Ask what medications the client is taking
B. Complete the history and health assessment
C. Identify the time of onset of the stroke
D. Determine if the client is scheduled for any surgical procedures
Correct Answer: C — Identify the time of onset of the stroke
Rationale: The time of onset of the stroke is the priority because tPA must be
administered within 3–4.5 hours of symptom onset. This information determines
eligibility for thrombolytic therapy .
6. A patient with increased intracranial pressure (ICP) has an
assessment finding of hypertension, bradycardia, and irregular
respirations. This is known as:
A. Cushing's triad
B. Autonomic dysreflexia
C. Neurogenic shock
D. Spinal shock
