1
, NSG 430 Exam 4 | (2026) Adult Health Exam
Questions | Nursing (PDF)
1. A patient in hypovolemic shock has a BP of 82/50 mm
Hg, HR 130 bpm, and cool, clammy skin. Which IV fluid
should the nurse administer first?
A. 3% saline
B. 5% dextrose in water
C. Lactated Ringer’s solution
D. 0.45% saline
Answer: C
Rationale: Lactated Ringer’s is an isotonic crystalloid that
rapidly expands intravascular volume, the priority in
hypovolemic shock. Dextrose solutions (B) do not stay in
the vascular space. Hypotonic solutions (D) shift fluid into
cells. Hypertonic saline (A) is not first-line.
2. Which hemodynamic profile is expected in a patient
with cardiogenic shock?
2
,A. High cardiac index, low PAWP
B. Low cardiac index, high PAWP
C. High cardiac index, high PAWP
D. Low cardiac index, low PAWP
Answer: B
Rationale: Cardiogenic shock = pump failure →
decreased cardiac output (low CI) and backward failure
→ increased pulmonary artery wedge pressure (PAWP)
from fluid backup.
3. A patient with septic shock has a norepinephrine
infusion. The IV site becomes pale and cool. What is the
priority action?
A. Apply warm compresses
B. Stop the infusion immediately
C. Notify the provider
D. Decrease the infusion rate
3
, Answer: B k
Rationale: Pale, cool skin indicates extravasation or
k k k k k k
severe vasoconstriction. Stop infusion immediately to
k k k k k k
prevent tissue necrosis. Then notify provider.
k k k k k k
4. Which laboratory value is most concerning in suspected
k k k k k k k
septic shock?
k k
A. WBC 15,000/μ L k k
B. Serum lactate 4.2 mmol/L k k k
C. Procalcitonin 0.1 ng/mL k k
D. Platelets 180,000/μ L k k
Answer: B
k k
Rationale: Lactate >2 mmol/L indicates tissue hypoxia
k k k k k k
and is a key criterion for septic shock (Surviving Sepsis
k k k k k k k k k k
Campaign).
k
5. In distributive shock, which finding is expected?
k k k k k k
A. Narrow pulse pressure k k
4
, NSG 430 Exam 4 | (2026) Adult Health Exam
Questions | Nursing (PDF)
1. A patient in hypovolemic shock has a BP of 82/50 mm
Hg, HR 130 bpm, and cool, clammy skin. Which IV fluid
should the nurse administer first?
A. 3% saline
B. 5% dextrose in water
C. Lactated Ringer’s solution
D. 0.45% saline
Answer: C
Rationale: Lactated Ringer’s is an isotonic crystalloid that
rapidly expands intravascular volume, the priority in
hypovolemic shock. Dextrose solutions (B) do not stay in
the vascular space. Hypotonic solutions (D) shift fluid into
cells. Hypertonic saline (A) is not first-line.
2. Which hemodynamic profile is expected in a patient
with cardiogenic shock?
2
,A. High cardiac index, low PAWP
B. Low cardiac index, high PAWP
C. High cardiac index, high PAWP
D. Low cardiac index, low PAWP
Answer: B
Rationale: Cardiogenic shock = pump failure →
decreased cardiac output (low CI) and backward failure
→ increased pulmonary artery wedge pressure (PAWP)
from fluid backup.
3. A patient with septic shock has a norepinephrine
infusion. The IV site becomes pale and cool. What is the
priority action?
A. Apply warm compresses
B. Stop the infusion immediately
C. Notify the provider
D. Decrease the infusion rate
3
, Answer: B k
Rationale: Pale, cool skin indicates extravasation or
k k k k k k
severe vasoconstriction. Stop infusion immediately to
k k k k k k
prevent tissue necrosis. Then notify provider.
k k k k k k
4. Which laboratory value is most concerning in suspected
k k k k k k k
septic shock?
k k
A. WBC 15,000/μ L k k
B. Serum lactate 4.2 mmol/L k k k
C. Procalcitonin 0.1 ng/mL k k
D. Platelets 180,000/μ L k k
Answer: B
k k
Rationale: Lactate >2 mmol/L indicates tissue hypoxia
k k k k k k
and is a key criterion for septic shock (Surviving Sepsis
k k k k k k k k k k
Campaign).
k
5. In distributive shock, which finding is expected?
k k k k k k
A. Narrow pulse pressure k k
4
