NUR 282 | Advanced Clinical / Transition Nursing | Week 5 Study
Guide 2026 |Galen College
1. A patient is admitted with suspected septic shock. Which of the following
clinical findings most accurately reflects the early (hyperdynamic) phase of
septic shock?
A. Cold, clammy skin
B. Hypotension with tachycardia
C. Bradycardia and narrowed pulse pressure
D. Warm, flushed skin and high cardiac output
Answer: D
Rationale: In early or ‘warm’ septic shock, peripheral vasodilation leads to warm, flushed
skin and a compensatory increase in cardiac output.
2. When assessing a patient’s hemodynamic status, the nurse calculates the
Mean Arterial Pressure (MAP). If the blood pressure is 90/60 mmHg, what is the
MAP?
A. 75 mmHg
B. 70 mmHg
C. 80 mmHg
D. 65 mmHg
Answer: B
Rationale: MAP is calculated as [Systolic + (2 x Diastolic)] / 3. Here: [90 + (2 x 60)] / 3 =
= 70 mmHg.
,3. A nurse is caring for a patient on mechanical ventilation. The high-pressure
alarm sounds. Which of the following is a potential cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. Disconnection of the ventilator tubing
D. Deflation of the cuff on the endotracheal tube
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
coughing, or biting the tube. Leaks and disconnections cause low-pressure alarms.
4. Which hemodynamic parameter specifically measures the right-sided heart
preload?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Systemic Vascular Resistance (SVR)
C. Central Venous Pressure (CVP)
D. Cardiac Index (CI)
Answer: C
Rationale: Central Venous Pressure (CVP) reflects the pressure in the right atrium and is
an indicator of right ventricular end-diastolic volume (preload).
5. A patient in neurogenic shock is expected to exhibit which of the following
combinations of vital signs?
A. Hypertension and tachycardia
B. Hypotension and bradycardia
C. Hypotension and tachycardia
D. Hypertension and bradycardia
Answer: B
Rationale: Neurogenic shock results in the loss of sympathetic tone, leading to vasodilation
(hypotension) and a lack of compensatory tachycardia (bradycardia).
, 6. The nurse is monitoring a patient for Systemic Inflammatory Response
Syndrome (SIRS). Which criteria would support this diagnosis?
A. WBC count of 8,000/mm3
B. Temperature of 37.5 C (99.5 F)
C. PaCO2 greater than 45 mmHg
D. Heart rate greater than 90 beats/min
Answer: D
Rationale: SIRS criteria include HR > 90, Temp > 38C or < 36C, RR > 20 or PaCO2 < 32, and
WBC > 12,000 or < 4,000.
7. A patient has a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg.
Which clinical manifestation should the nurse anticipate?
A. Flat neck veins and dry mucous membranes
B. Hyperactive bowel sounds and hunger
C. Crackles in the lungs and dyspnea
D. Hypotension and bradycardia
Answer: C
Rationale: Normal PAWP is 6-12 mmHg. A level of 22 indicates left-sided heart failure or
fluid overload, leading to pulmonary congestion (crackles).
8. During the ‘Golden Hour’ of trauma management, what is the priority
assessment for a patient arriving in the Emergency Department?
A. Obtaining a full medical history
B. Assessing for distal pulses in all extremities
C. Inserting a large-bore IV and foley catheter
D. Airway maintenance with cervical spine protection
Answer: D
Rationale: The primary survey always begins with Airway (A) and Cervical spine
stabilization to prevent further injury.
Guide 2026 |Galen College
1. A patient is admitted with suspected septic shock. Which of the following
clinical findings most accurately reflects the early (hyperdynamic) phase of
septic shock?
A. Cold, clammy skin
B. Hypotension with tachycardia
C. Bradycardia and narrowed pulse pressure
D. Warm, flushed skin and high cardiac output
Answer: D
Rationale: In early or ‘warm’ septic shock, peripheral vasodilation leads to warm, flushed
skin and a compensatory increase in cardiac output.
2. When assessing a patient’s hemodynamic status, the nurse calculates the
Mean Arterial Pressure (MAP). If the blood pressure is 90/60 mmHg, what is the
MAP?
A. 75 mmHg
B. 70 mmHg
C. 80 mmHg
D. 65 mmHg
Answer: B
Rationale: MAP is calculated as [Systolic + (2 x Diastolic)] / 3. Here: [90 + (2 x 60)] / 3 =
= 70 mmHg.
,3. A nurse is caring for a patient on mechanical ventilation. The high-pressure
alarm sounds. Which of the following is a potential cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. Disconnection of the ventilator tubing
D. Deflation of the cuff on the endotracheal tube
Answer: B
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
coughing, or biting the tube. Leaks and disconnections cause low-pressure alarms.
4. Which hemodynamic parameter specifically measures the right-sided heart
preload?
A. Pulmonary Artery Wedge Pressure (PAWP)
B. Systemic Vascular Resistance (SVR)
C. Central Venous Pressure (CVP)
D. Cardiac Index (CI)
Answer: C
Rationale: Central Venous Pressure (CVP) reflects the pressure in the right atrium and is
an indicator of right ventricular end-diastolic volume (preload).
5. A patient in neurogenic shock is expected to exhibit which of the following
combinations of vital signs?
A. Hypertension and tachycardia
B. Hypotension and bradycardia
C. Hypotension and tachycardia
D. Hypertension and bradycardia
Answer: B
Rationale: Neurogenic shock results in the loss of sympathetic tone, leading to vasodilation
(hypotension) and a lack of compensatory tachycardia (bradycardia).
, 6. The nurse is monitoring a patient for Systemic Inflammatory Response
Syndrome (SIRS). Which criteria would support this diagnosis?
A. WBC count of 8,000/mm3
B. Temperature of 37.5 C (99.5 F)
C. PaCO2 greater than 45 mmHg
D. Heart rate greater than 90 beats/min
Answer: D
Rationale: SIRS criteria include HR > 90, Temp > 38C or < 36C, RR > 20 or PaCO2 < 32, and
WBC > 12,000 or < 4,000.
7. A patient has a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg.
Which clinical manifestation should the nurse anticipate?
A. Flat neck veins and dry mucous membranes
B. Hyperactive bowel sounds and hunger
C. Crackles in the lungs and dyspnea
D. Hypotension and bradycardia
Answer: C
Rationale: Normal PAWP is 6-12 mmHg. A level of 22 indicates left-sided heart failure or
fluid overload, leading to pulmonary congestion (crackles).
8. During the ‘Golden Hour’ of trauma management, what is the priority
assessment for a patient arriving in the Emergency Department?
A. Obtaining a full medical history
B. Assessing for distal pulses in all extremities
C. Inserting a large-bore IV and foley catheter
D. Airway maintenance with cervical spine protection
Answer: D
Rationale: The primary survey always begins with Airway (A) and Cervical spine
stabilization to prevent further injury.
