NUR 282 | Advanced Clinical / Transition Nursing | Week 2 Study
Guide 2026 |Galen College
1. A patient presents to the Emergency Department with signs of septic shock.
After ensuring the airway is patent, which intervention should the nurse
prioritize first?
A. Administer broad-spectrum antibiotics
B. Initiate rapid fluid resuscitation with isotonic crystalloids
C. Obtain blood cultures from two different sites
D. Administer vasopressors to maintain MAP > 65 mmHg
Answer: B
Rationale: Fluid resuscitation is a priority in shock to restore circulating volume and
improve tissue perfusion before initiating other treatments like antibiotics or vasopressors.
2. In the ‘Primary Survey’ of a trauma patient, what does the ‘D’ stand for in the
ABCDE mnemonic?
A. Disability (Neurological status)
B. Decontamination
C. Deformity check
D. Drugs and Diagnostics
Answer: A
Rationale: D stands for Disability, which involves assessing the patient’s level of
consciousness using the Glasgow Coma Scale (GCS) and checking pupil reactivity.
,3. Which arterial blood gas (ABG) result is most indicative of a patient in
uncompensated metabolic acidosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.50, PaCO2 30, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.45, PaCO2 40, HCO3 24
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A low HCO3 (less than 22) indicates a
metabolic origin, and a normal PaCO2 indicates it is uncompensated.
4. A nurse is caring for a patient with a suspected tension pneumothorax. Which
clinical finding should the nurse report immediately?
A. Diminished breath sounds on the affected side
B. Oxygen saturation of 92% on room air
C. Tracheal deviation to the unaffected side
D. Chest pain upon inspiration
Answer: C
Rationale: Tracheal deviation is a late and critical sign of tension pneumothorax, indicating
significant mediastinal shift and potential cardiovascular collapse.
5. A patient with a head injury exhibits a blood pressure of 180/60 mmHg, a
pulse of 50 bpm, and irregular respirations. This cluster of symptoms is known
as:
A. Cushing’s Triad
B. Beck’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: A
, Rationale: Cushing’s Triad (widening pulse pressure, bradycardia, and irregular
respirations) indicates increased intracranial pressure (ICP).
6. When caring for a patient on mechanical ventilation, the high-pressure alarm
sounds. What is the nurse’s first action?
A. Check for a disconnected circuit
B. Manually bag the patient with 100% oxygen
C. Call the respiratory therapist to adjust the settings
D. Assess the patient’s need for suctioning
Answer: D
Rationale: High-pressure alarms are often caused by obstructions such as secretions,
biting the tube, or kinks. Suctioning is a common first intervention.
7. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR)?
A. Hypovolemic shock
B. Septic shock (Early stage)
C. Cardiogenic shock
D. Obstructive shock
Answer: B
Rationale: Early or ‘warm’ septic shock involves vasodilation and a compensatory increase
in cardiac output, resulting in low SVR and high CO.
8. A patient has a Glasgow Coma Scale (GCS) score of 7. What is the priority
nursing diagnosis?
A. Risk for impaired skin integrity
B. Ineffective airway clearance
C. Impaired physical mobility
D. Self-care deficit
Answer: B
Guide 2026 |Galen College
1. A patient presents to the Emergency Department with signs of septic shock.
After ensuring the airway is patent, which intervention should the nurse
prioritize first?
A. Administer broad-spectrum antibiotics
B. Initiate rapid fluid resuscitation with isotonic crystalloids
C. Obtain blood cultures from two different sites
D. Administer vasopressors to maintain MAP > 65 mmHg
Answer: B
Rationale: Fluid resuscitation is a priority in shock to restore circulating volume and
improve tissue perfusion before initiating other treatments like antibiotics or vasopressors.
2. In the ‘Primary Survey’ of a trauma patient, what does the ‘D’ stand for in the
ABCDE mnemonic?
A. Disability (Neurological status)
B. Decontamination
C. Deformity check
D. Drugs and Diagnostics
Answer: A
Rationale: D stands for Disability, which involves assessing the patient’s level of
consciousness using the Glasgow Coma Scale (GCS) and checking pupil reactivity.
,3. Which arterial blood gas (ABG) result is most indicative of a patient in
uncompensated metabolic acidosis?
A. pH 7.32, PaCO2 50, HCO3 28
B. pH 7.50, PaCO2 30, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.45, PaCO2 40, HCO3 24
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A low HCO3 (less than 22) indicates a
metabolic origin, and a normal PaCO2 indicates it is uncompensated.
4. A nurse is caring for a patient with a suspected tension pneumothorax. Which
clinical finding should the nurse report immediately?
A. Diminished breath sounds on the affected side
B. Oxygen saturation of 92% on room air
C. Tracheal deviation to the unaffected side
D. Chest pain upon inspiration
Answer: C
Rationale: Tracheal deviation is a late and critical sign of tension pneumothorax, indicating
significant mediastinal shift and potential cardiovascular collapse.
5. A patient with a head injury exhibits a blood pressure of 180/60 mmHg, a
pulse of 50 bpm, and irregular respirations. This cluster of symptoms is known
as:
A. Cushing’s Triad
B. Beck’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: A
, Rationale: Cushing’s Triad (widening pulse pressure, bradycardia, and irregular
respirations) indicates increased intracranial pressure (ICP).
6. When caring for a patient on mechanical ventilation, the high-pressure alarm
sounds. What is the nurse’s first action?
A. Check for a disconnected circuit
B. Manually bag the patient with 100% oxygen
C. Call the respiratory therapist to adjust the settings
D. Assess the patient’s need for suctioning
Answer: D
Rationale: High-pressure alarms are often caused by obstructions such as secretions,
biting the tube, or kinks. Suctioning is a common first intervention.
7. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance (SVR)?
A. Hypovolemic shock
B. Septic shock (Early stage)
C. Cardiogenic shock
D. Obstructive shock
Answer: B
Rationale: Early or ‘warm’ septic shock involves vasodilation and a compensatory increase
in cardiac output, resulting in low SVR and high CO.
8. A patient has a Glasgow Coma Scale (GCS) score of 7. What is the priority
nursing diagnosis?
A. Risk for impaired skin integrity
B. Ineffective airway clearance
C. Impaired physical mobility
D. Self-care deficit
Answer: B
