NUR 282 Advanced Clinical and Transition Nursing Exam 7 2026
|Galen College
1. Which assessment finding is most characteristic of a patient in the early stage
of Acute Respiratory Distress Syndrome (ARDS)?
A. Hypercapnia and acidosis
B. Presence of diffuse crackles
C. Refractory hypoxemia
D. Frothy pink sputum
Answer: C
Rationale: Refractory hypoxemia, where oxygen levels remain low despite increasing
concentrations of delivered oxygen, is the hallmark of ARDS.
2. A nurse is caring for a patient with a Mean Arterial Pressure (MAP) of 55
mmHg. What is the priority intervention?
A. Document the finding as normal
B. Administer a PRN sedative
C. Perform a neurological assessment
D. Increase the rate of IV fluids or start vasopressors
Answer: D
Rationale: A MAP below 65 mmHg indicates inadequate tissue perfusion. The priority is to
restore blood pressure through fluid resuscitation or vasoactive medications.
,3. 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. 5,600 mL
B. 8,400 mL
C. 14,000 mL
D. 11,200 mL
Answer: D
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
4. Which heart rhythm requires immediate unsynchronized defibrillation?
A. Atrial Fibrillation
B. Ventricular Fibrillation
C. Supraventricular Tachycardia
D. Sinus Bradycardia
Answer: B
Rationale: Ventricular Fibrillation is a lethal rhythm that requires immediate defibrillation
to restore a perfusing rhythm.
5. A patient with liver cirrhosis has high ammonia levels. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose is used to trap ammonia in the gut and expel it via the stool, reducing
hepatic encephalopathy symptoms.
, 6. In the ‘Resuscitative Phase’ of burn management, what is the most important
laboratory value to monitor?
A. Serum Potassium
B. Hematocrit
C. White Blood Cell Count
D. Albumin
Answer: A
Rationale: Hyperkalemia is common in the resuscitative phase due to massive cell
destruction releasing potassium into the extracellular fluid.
7. What is the first step in the primary survey of a trauma patient?
A. Breathing and ventilation
B. Circulation and hemorrhage control
C. Airway maintenance with cervical spine protection
D. Disability and neurological status
Answer: C
Rationale: According to the ABCDE priority, establishing a patent airway while protecting
the cervical spine is the first priority.
8. A patient’s ventilator alarm sounds, indicating ‘High Pressure.’ What is a
possible cause?
A. A leak in the circuit
B. The cuff on the ET tube has deflated
C. The patient is disconnected from the ventilator
D. The patient is biting the endotracheal tube
Answer: D
Rationale: High-pressure alarms are triggered by obstructions, such as biting the tube,
secretions, or kinking of the tubing.
|Galen College
1. Which assessment finding is most characteristic of a patient in the early stage
of Acute Respiratory Distress Syndrome (ARDS)?
A. Hypercapnia and acidosis
B. Presence of diffuse crackles
C. Refractory hypoxemia
D. Frothy pink sputum
Answer: C
Rationale: Refractory hypoxemia, where oxygen levels remain low despite increasing
concentrations of delivered oxygen, is the hallmark of ARDS.
2. A nurse is caring for a patient with a Mean Arterial Pressure (MAP) of 55
mmHg. What is the priority intervention?
A. Document the finding as normal
B. Administer a PRN sedative
C. Perform a neurological assessment
D. Increase the rate of IV fluids or start vasopressors
Answer: D
Rationale: A MAP below 65 mmHg indicates inadequate tissue perfusion. The priority is to
restore blood pressure through fluid resuscitation or vasoactive medications.
,3. 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. 5,600 mL
B. 8,400 mL
C. 14,000 mL
D. 11,200 mL
Answer: D
Rationale: Parkland Formula: 4 mL x kg x %TBSA. 4 x 70 x 40 = 11,200 mL.
4. Which heart rhythm requires immediate unsynchronized defibrillation?
A. Atrial Fibrillation
B. Ventricular Fibrillation
C. Supraventricular Tachycardia
D. Sinus Bradycardia
Answer: B
Rationale: Ventricular Fibrillation is a lethal rhythm that requires immediate defibrillation
to restore a perfusing rhythm.
5. A patient with liver cirrhosis has high ammonia levels. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Vitamin K
D. Lactulose
Answer: D
Rationale: Lactulose is used to trap ammonia in the gut and expel it via the stool, reducing
hepatic encephalopathy symptoms.
, 6. In the ‘Resuscitative Phase’ of burn management, what is the most important
laboratory value to monitor?
A. Serum Potassium
B. Hematocrit
C. White Blood Cell Count
D. Albumin
Answer: A
Rationale: Hyperkalemia is common in the resuscitative phase due to massive cell
destruction releasing potassium into the extracellular fluid.
7. What is the first step in the primary survey of a trauma patient?
A. Breathing and ventilation
B. Circulation and hemorrhage control
C. Airway maintenance with cervical spine protection
D. Disability and neurological status
Answer: C
Rationale: According to the ABCDE priority, establishing a patent airway while protecting
the cervical spine is the first priority.
8. A patient’s ventilator alarm sounds, indicating ‘High Pressure.’ What is a
possible cause?
A. A leak in the circuit
B. The cuff on the ET tube has deflated
C. The patient is disconnected from the ventilator
D. The patient is biting the endotracheal tube
Answer: D
Rationale: High-pressure alarms are triggered by obstructions, such as biting the tube,
secretions, or kinking of the tubing.
