NUR 282 Exam 7 Study Guide - Advanced Clinical / Transition Nursing
2026 |Galen College
1. A patient with a traumatic brain injury displays a widening pulse pressure,
bradycardia, and irregular respirations. The nurse recognizes this as:
A. Beck’s Triad
B. Cushing’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: B
Rationale: Cushing’s Triad (hypertension with widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure (IICP).
2. In mass casualty triage, which color tag is assigned to a patient who has a
sucking chest wound and requires immediate intervention to survive?
A. Green
B. Black
C. Yellow
D. Red
Answer: D
Rationale: Red tags are for ‘Immediate’ priority; these patients have life-threatening
injuries but high chances of survival if treated immediately.
,3. The nurse is caring for a patient in hypovolemic shock. Which intravenous
fluid is most appropriate for initial rapid volume expansion?
A. 0.45% Normal Saline
B. Dextrose 5% in Water
C. 3% Sodium Chloride
D. 0.9% Normal Saline
Answer: D
Rationale: Isotonic crystalloids like 0.9% Normal Saline or Lactated Ringer’s are preferred
for rapid volume expansion in shock.
4. A patient is admitted with suspected Septic Shock. According to the Sepsis
Bundle, what is the recommended initial fluid bolus for hypotension or lactate ≥
4 mmol/L?
A. 10 mL/kg
B. 20 mL/kg
C. 30 mL/kg
D. 50 mL/kg
Answer: C
Rationale: The Surviving Sepsis Campaign recommends an initial fluid bolus of 30 mL/kg
of crystalloid for sepsis-induced hypoperfusion.
5. Which assessment finding is most characteristic of neurogenic shock
compared to other types of shock?
A. Tachycardia
B. Increased Cardiac Output
C. Cool, clammy skin
D. Bradycardia
Answer: D
, Rationale: Neurogenic shock is unique because it causes bradycardia due to the loss of
sympathetic tone; most other shocks cause compensatory tachycardia.
6. A patient with a spinal cord injury at T4 reports a severe headache and nasal
congestion. The BP is 190/100 mmHg. What is the nurse’s priority action?
A. Administer PRN antihypertensives
B. Place the patient in a supine position
C. Check for bladder distention or fecal impaction
D. Increase the IV fluid rate
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to sit the patient up
and identify/remove the noxious stimulus, usually a full bladder or bowel.
7. When assessing a patient’s Glasgow Coma Scale (GCS), the patient opens eyes
to sound, uses inappropriate words, and withdraws from pain. What is the
score?
A. 8
B. 10
C. 12
D. 14
Answer: B
Rationale: Eyes to sound (3), Inappropriate words (3), Withdraws from pain (4). 3+3+4 =
10.
2026 |Galen College
1. A patient with a traumatic brain injury displays a widening pulse pressure,
bradycardia, and irregular respirations. The nurse recognizes this as:
A. Beck’s Triad
B. Cushing’s Triad
C. Virchow’s Triad
D. Horner’s Syndrome
Answer: B
Rationale: Cushing’s Triad (hypertension with widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure (IICP).
2. In mass casualty triage, which color tag is assigned to a patient who has a
sucking chest wound and requires immediate intervention to survive?
A. Green
B. Black
C. Yellow
D. Red
Answer: D
Rationale: Red tags are for ‘Immediate’ priority; these patients have life-threatening
injuries but high chances of survival if treated immediately.
,3. The nurse is caring for a patient in hypovolemic shock. Which intravenous
fluid is most appropriate for initial rapid volume expansion?
A. 0.45% Normal Saline
B. Dextrose 5% in Water
C. 3% Sodium Chloride
D. 0.9% Normal Saline
Answer: D
Rationale: Isotonic crystalloids like 0.9% Normal Saline or Lactated Ringer’s are preferred
for rapid volume expansion in shock.
4. A patient is admitted with suspected Septic Shock. According to the Sepsis
Bundle, what is the recommended initial fluid bolus for hypotension or lactate ≥
4 mmol/L?
A. 10 mL/kg
B. 20 mL/kg
C. 30 mL/kg
D. 50 mL/kg
Answer: C
Rationale: The Surviving Sepsis Campaign recommends an initial fluid bolus of 30 mL/kg
of crystalloid for sepsis-induced hypoperfusion.
5. Which assessment finding is most characteristic of neurogenic shock
compared to other types of shock?
A. Tachycardia
B. Increased Cardiac Output
C. Cool, clammy skin
D. Bradycardia
Answer: D
, Rationale: Neurogenic shock is unique because it causes bradycardia due to the loss of
sympathetic tone; most other shocks cause compensatory tachycardia.
6. A patient with a spinal cord injury at T4 reports a severe headache and nasal
congestion. The BP is 190/100 mmHg. What is the nurse’s priority action?
A. Administer PRN antihypertensives
B. Place the patient in a supine position
C. Check for bladder distention or fecal impaction
D. Increase the IV fluid rate
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to sit the patient up
and identify/remove the noxious stimulus, usually a full bladder or bowel.
7. When assessing a patient’s Glasgow Coma Scale (GCS), the patient opens eyes
to sound, uses inappropriate words, and withdraws from pain. What is the
score?
A. 8
B. 10
C. 12
D. 14
Answer: B
Rationale: Eyes to sound (3), Inappropriate words (3), Withdraws from pain (4). 3+3+4 =
10.
