NUR 282 | Advanced Clinical / Transition Nursing | Exam 1 Practice
Quiz 2026 |Galen College
1. A patient’s ABG results are pH 7.25, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, it is uncompensated
respiratory acidosis.
2. A client presents with deep partial-thickness burns to the entire left arm and
the entire left leg. Using the Rule of Nines, what is the estimated total body
surface area (TBSA) burned?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: According to the Rule of Nines, an entire arm is 9% and an entire leg is 18%. 9%
+ 18% = 27%.
,3. Which clinical manifestation is considered an early sign of hypovolemic
shock?
A. Cold, clammy skin
B. Bradypnea
C. Tachycardia
D. Profound hypotension
Answer: C
Rationale: Tachycardia is one of the earliest signs of shock as the body attempts to
maintain cardiac output in response to decreased stroke volume.
4. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
most appropriate for the LPN to perform?
A. Administering oral medications to a stable patient
B. Performing the initial admission assessment on a new patient
C. Developing the nursing care plan for a patient with complex needs
D. Providing discharge teaching to a patient after surgery
Answer: A
Rationale: LPNs can provide routine care and administer medications to stable patients.
Assessment, planning, and teaching are primarily RN responsibilities.
5. Using the Parkland Formula, calculate the total fluid volume needed in the
first 24 hours for a 70 kg patient with 40% TBSA burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
, 6. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. What
is the priority nursing action?
A. Assessing the patient’s pupils
B. Preparing for intubation and mechanical ventilation
C. Monitoring urine output
D. Assessing deep tendon reflexes
Answer: B
Rationale: A GCS score of 8 or less generally indicates the need for airway protection
through intubation (‘Less than 8, intubate’).
7. During the emergent phase of burn care, which electrolyte imbalance is the
nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction during a burn releases potassium into the extracellular
space, leading to hyperkalemia.
8. A patient in the ICU is suspected of having Septic Shock. Which lab value is
most indicative of tissue hypoperfusion in this patient?
A. Elevated Serum Lactate
B. Elevated white blood cell count
C. Decreased BUN
D. Elevated Hemoglobin
Answer: A
Rationale: Serum lactate levels increase when tissues shift from aerobic to anaerobic
metabolism due to hypoperfusion.
Quiz 2026 |Galen College
1. A patient’s ABG results are pH 7.25, PaCO2 50 mmHg, and HCO3 24 mEq/L.
Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is within the normal range, it is uncompensated
respiratory acidosis.
2. A client presents with deep partial-thickness burns to the entire left arm and
the entire left leg. Using the Rule of Nines, what is the estimated total body
surface area (TBSA) burned?
A. 27%
B. 18%
C. 36%
D. 45%
Answer: A
Rationale: According to the Rule of Nines, an entire arm is 9% and an entire leg is 18%. 9%
+ 18% = 27%.
,3. Which clinical manifestation is considered an early sign of hypovolemic
shock?
A. Cold, clammy skin
B. Bradypnea
C. Tachycardia
D. Profound hypotension
Answer: C
Rationale: Tachycardia is one of the earliest signs of shock as the body attempts to
maintain cardiac output in response to decreased stroke volume.
4. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is
most appropriate for the LPN to perform?
A. Administering oral medications to a stable patient
B. Performing the initial admission assessment on a new patient
C. Developing the nursing care plan for a patient with complex needs
D. Providing discharge teaching to a patient after surgery
Answer: A
Rationale: LPNs can provide routine care and administer medications to stable patients.
Assessment, planning, and teaching are primarily RN responsibilities.
5. Using the Parkland Formula, calculate the total fluid volume needed in the
first 24 hours for a 70 kg patient with 40% TBSA burns.
A. 11,200 mL
B. 5,600 mL
C. 2,800 mL
D. 8,400 mL
Answer: A
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
, 6. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. What
is the priority nursing action?
A. Assessing the patient’s pupils
B. Preparing for intubation and mechanical ventilation
C. Monitoring urine output
D. Assessing deep tendon reflexes
Answer: B
Rationale: A GCS score of 8 or less generally indicates the need for airway protection
through intubation (‘Less than 8, intubate’).
7. During the emergent phase of burn care, which electrolyte imbalance is the
nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction during a burn releases potassium into the extracellular
space, leading to hyperkalemia.
8. A patient in the ICU is suspected of having Septic Shock. Which lab value is
most indicative of tissue hypoperfusion in this patient?
A. Elevated Serum Lactate
B. Elevated white blood cell count
C. Decreased BUN
D. Elevated Hemoglobin
Answer: A
Rationale: Serum lactate levels increase when tissues shift from aerobic to anaerobic
metabolism due to hypoperfusion.
