NUR 282 Advanced Clinical / Transition Nursing Week 8 Study Guide
2026 |Galen College
1. During the primary survey of a trauma patient, what is the first priority
according to the ABCDE assessment?
A. Circulation and hemorrhage control
B. Airway maintenance with cervical spine protection
C. Breathing and ventilation
D. Disability assessment for neurological status
Answer: B
Rationale: The first priority in the primary survey is ensuring an open airway while
maintaining cervical spine stabilization to prevent further injury.
2. A nurse is caring for a patient in septic shock. Which of the following clinical
findings indicates the transition to the cold (hypodynamic) phase?
A. Warm, flushed skin
B. High cardiac output and low systemic vascular resistance
C. Bounding pulses and rapid capillary refill
D. Cool, clammy skin and decreased urine output
Answer: D
Rationale: Septic shock progresses from a warm phase (high CO, low SVR) to a cold phase
characterized by decreased cardiac output, cool/clammy skin, and signs of organ failure
like oliguria.
,3. Which triage tag color is assigned to a victim of a mass casualty incident who
has a minor fracture and is able to walk?
A. Red
B. Yellow
C. Black
D. Green
Answer: D
Rationale: Green tags are for ‘walking wounded’ victims with minor injuries who do not
require immediate treatment.
4. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. How
should the nurse interpret this score?
A. Mild head injury
B. Severe head injury needing intubation
C. Moderate head injury
D. Normal neurological function
Answer: B
Rationale: A GCS score of 8 or less is generally indicative of a severe head injury and often
necessitates airway protection via intubation.
5. Which medication is typically the first-line treatment for a patient
experiencing anaphylactic shock?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM
D. Albuterol nebulizer
Answer: C
Rationale: Intramuscular (IM) epinephrine is the drug of choice for the immediate
treatment of anaphylaxis to reverse bronchospasm and hypotension.
, 6. In a patient with Acute Respiratory Distress Syndrome (ARDS), what is the
primary pathophysiological change?
A. Decrease in pulmonary vascular resistance
B. Increased alveolar-capillary membrane permeability
C. Excessive production of surfactant
D. Hyperventilation leading to metabolic alkalosis
Answer: B
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, leading
to non-cardiogenic pulmonary edema and severe hypoxemia.
7. A nurse observes a high-pressure alarm on a patient’s mechanical ventilator.
What is a common cause of this alarm?
A. Excessive secretions or biting the ET tube
B. The patient is disconnected from the machine
C. A leak in the ventilator circuit
D. An under-inflated ET tube cuff
Answer: A
Rationale: High-pressure alarms are triggered by resistance to airflow, such as secretions,
bronchospasm, or the patient biting the tube. Leaks cause low-pressure alarms.
8. What is the most definitive clinical indicator of a tension pneumothorax?
A. Tracheal deviation toward the affected side
B. Mediastinal shift and tracheal deviation to the unaffected side
C. Resonance on percussion of the affected side
D. Increased breath sounds on the affected side
Answer: B
Rationale: In a tension pneumothorax, pressure builds up and pushes the mediastinum
and trachea toward the opposite (unaffected) side, which is a life-threatening emergency.
2026 |Galen College
1. During the primary survey of a trauma patient, what is the first priority
according to the ABCDE assessment?
A. Circulation and hemorrhage control
B. Airway maintenance with cervical spine protection
C. Breathing and ventilation
D. Disability assessment for neurological status
Answer: B
Rationale: The first priority in the primary survey is ensuring an open airway while
maintaining cervical spine stabilization to prevent further injury.
2. A nurse is caring for a patient in septic shock. Which of the following clinical
findings indicates the transition to the cold (hypodynamic) phase?
A. Warm, flushed skin
B. High cardiac output and low systemic vascular resistance
C. Bounding pulses and rapid capillary refill
D. Cool, clammy skin and decreased urine output
Answer: D
Rationale: Septic shock progresses from a warm phase (high CO, low SVR) to a cold phase
characterized by decreased cardiac output, cool/clammy skin, and signs of organ failure
like oliguria.
,3. Which triage tag color is assigned to a victim of a mass casualty incident who
has a minor fracture and is able to walk?
A. Red
B. Yellow
C. Black
D. Green
Answer: D
Rationale: Green tags are for ‘walking wounded’ victims with minor injuries who do not
require immediate treatment.
4. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. How
should the nurse interpret this score?
A. Mild head injury
B. Severe head injury needing intubation
C. Moderate head injury
D. Normal neurological function
Answer: B
Rationale: A GCS score of 8 or less is generally indicative of a severe head injury and often
necessitates airway protection via intubation.
5. Which medication is typically the first-line treatment for a patient
experiencing anaphylactic shock?
A. Diphenhydramine IV
B. Methylprednisolone IV
C. Epinephrine IM
D. Albuterol nebulizer
Answer: C
Rationale: Intramuscular (IM) epinephrine is the drug of choice for the immediate
treatment of anaphylaxis to reverse bronchospasm and hypotension.
, 6. In a patient with Acute Respiratory Distress Syndrome (ARDS), what is the
primary pathophysiological change?
A. Decrease in pulmonary vascular resistance
B. Increased alveolar-capillary membrane permeability
C. Excessive production of surfactant
D. Hyperventilation leading to metabolic alkalosis
Answer: B
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, leading
to non-cardiogenic pulmonary edema and severe hypoxemia.
7. A nurse observes a high-pressure alarm on a patient’s mechanical ventilator.
What is a common cause of this alarm?
A. Excessive secretions or biting the ET tube
B. The patient is disconnected from the machine
C. A leak in the ventilator circuit
D. An under-inflated ET tube cuff
Answer: A
Rationale: High-pressure alarms are triggered by resistance to airflow, such as secretions,
bronchospasm, or the patient biting the tube. Leaks cause low-pressure alarms.
8. What is the most definitive clinical indicator of a tension pneumothorax?
A. Tracheal deviation toward the affected side
B. Mediastinal shift and tracheal deviation to the unaffected side
C. Resonance on percussion of the affected side
D. Increased breath sounds on the affected side
Answer: B
Rationale: In a tension pneumothorax, pressure builds up and pushes the mediastinum
and trachea toward the opposite (unaffected) side, which is a life-threatening emergency.
