NUR 282 | Advanced Clinical / Transition Nursing | Exam 6 2026 Galen
College
1. A patient in the ICU is on mechanical ventilation. The nurse notes a ‘high
pressure’ alarm. Which action should the nurse take first?
A. Call the respiratory therapist immediately.
B. Increase the oxygen concentration to 100%.
C. Check for kinks in the tubing or if the patient is biting the tube.
D. Disconnect the patient and use a manual resuscitation bag.
Answer: C
Rationale: High-pressure alarms are often caused by obstructions such as secretions, kinks
in the circuit, or the patient biting the ET tube.
2. A patient is admitted with suspected Acute Respiratory Distress Syndrome
(ARDS). Which clinical finding is a hallmark sign of ARDS?
A. Improvement of PaO2 with low-flow oxygen.
B. Respiratory alkalosis in the late stages.
C. Increased pulmonary capillary wedge pressure (PCWP) above 18 mmHg.
D. Refractory hypoxemia despite high levels of oxygen.
Answer: D
Rationale: Refractory hypoxemia, where the arterial oxygen remains low despite
increasing inspired oxygen concentrations, is a classic sign of ARDS.
,3. Which hemodynamic parameter is the best indicator of a patient’s fluid
volume status (preload) in the right side of the heart?
A. Mean Arterial Pressure (MAP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Central Venous Pressure (CVP)
D. Systemic Vascular Resistance (SVR)
Answer: C
Rationale: CVP measures the pressure in the right atrium and is used to assess right
ventricular preload and fluid volume status.
4. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which electrolyte imbalance is most likely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B
Rationale: During the oliguric phase of AKI, the kidneys cannot excrete potassium, leading
to life-threatening hyperkalemia.
5. A patient with cirrhosis has a high ammonia level and is showing signs of
confusion. Which medication should the nurse anticipate administering?
A. Propranolol
B. Spironolactone
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to reduce ammonia levels by trapping it in the gut and
expelling it through bowel movements.
, 6. In disaster triage, a patient with a sucking chest wound would be assigned
which color tag?
A. Green
B. Yellow
C. Black
D. Red
Answer: D
Rationale: Red tags (Immediate) are for life-threatening injuries that are treatable, such as
airway or breathing issues like a sucking chest wound.
7. A patient is exhibiting signs of Autonomic Dysreflexia after a spinal cord
injury at T4. What is the nurse’s first priority?
A. Administer an antihypertensive medication.
B. Place the patient in a high-Fowler’s position.
C. Assess the patient for a distended bladder.
D. Call the physician immediately.
Answer: B
Rationale: The first action is to sit the patient up to help lower blood pressure via
orthostatic changes, followed immediately by assessing for triggers (bladder/bowel).
8. What is the primary purpose of Positive End-Expiratory Pressure (PEEP) in a
mechanically ventilated patient?
A. To prevent the collapse of alveoli at the end of expiration.
B. To increase the tidal volume of every breath.
C. To reduce the risk of barotrauma.
D. To lower the respiratory rate.
Answer: A
Rationale: PEEP maintains pressure in the airway at the end of expiration to keep alveoli
open, improving gas exchange and oxygenation.
College
1. A patient in the ICU is on mechanical ventilation. The nurse notes a ‘high
pressure’ alarm. Which action should the nurse take first?
A. Call the respiratory therapist immediately.
B. Increase the oxygen concentration to 100%.
C. Check for kinks in the tubing or if the patient is biting the tube.
D. Disconnect the patient and use a manual resuscitation bag.
Answer: C
Rationale: High-pressure alarms are often caused by obstructions such as secretions, kinks
in the circuit, or the patient biting the ET tube.
2. A patient is admitted with suspected Acute Respiratory Distress Syndrome
(ARDS). Which clinical finding is a hallmark sign of ARDS?
A. Improvement of PaO2 with low-flow oxygen.
B. Respiratory alkalosis in the late stages.
C. Increased pulmonary capillary wedge pressure (PCWP) above 18 mmHg.
D. Refractory hypoxemia despite high levels of oxygen.
Answer: D
Rationale: Refractory hypoxemia, where the arterial oxygen remains low despite
increasing inspired oxygen concentrations, is a classic sign of ARDS.
,3. Which hemodynamic parameter is the best indicator of a patient’s fluid
volume status (preload) in the right side of the heart?
A. Mean Arterial Pressure (MAP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Central Venous Pressure (CVP)
D. Systemic Vascular Resistance (SVR)
Answer: C
Rationale: CVP measures the pressure in the right atrium and is used to assess right
ventricular preload and fluid volume status.
4. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury
(AKI). Which electrolyte imbalance is most likely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B
Rationale: During the oliguric phase of AKI, the kidneys cannot excrete potassium, leading
to life-threatening hyperkalemia.
5. A patient with cirrhosis has a high ammonia level and is showing signs of
confusion. Which medication should the nurse anticipate administering?
A. Propranolol
B. Spironolactone
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to reduce ammonia levels by trapping it in the gut and
expelling it through bowel movements.
, 6. In disaster triage, a patient with a sucking chest wound would be assigned
which color tag?
A. Green
B. Yellow
C. Black
D. Red
Answer: D
Rationale: Red tags (Immediate) are for life-threatening injuries that are treatable, such as
airway or breathing issues like a sucking chest wound.
7. A patient is exhibiting signs of Autonomic Dysreflexia after a spinal cord
injury at T4. What is the nurse’s first priority?
A. Administer an antihypertensive medication.
B. Place the patient in a high-Fowler’s position.
C. Assess the patient for a distended bladder.
D. Call the physician immediately.
Answer: B
Rationale: The first action is to sit the patient up to help lower blood pressure via
orthostatic changes, followed immediately by assessing for triggers (bladder/bowel).
8. What is the primary purpose of Positive End-Expiratory Pressure (PEEP) in a
mechanically ventilated patient?
A. To prevent the collapse of alveoli at the end of expiration.
B. To increase the tidal volume of every breath.
C. To reduce the risk of barotrauma.
D. To lower the respiratory rate.
Answer: A
Rationale: PEEP maintains pressure in the airway at the end of expiration to keep alveoli
open, improving gas exchange and oxygenation.
