NUR417 / NUR 417 EXAM 1, 2, 3 & FINAL EXAM |
ACTUAL QUESTIONS AND ANSWERS | LATEST
2026/2027 UPDATE | GRADED A+ | 100% ASSURED
PASS (CARE OF ADULT II AT CONCORDIA) EXAM
with Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Advanced Cardiovascular and Hemodynamic Monitoring
2. Acute Respiratory Failure and Mechanical Ventilation
3. Management of Complex Endocrine Emergencies
4. Neurological Critical Care and Increased Intracranial Pressure
5. Renal Replacement Therapies and Multi-System Failure
6. Trauma, Burns, and Multi-System Inflammatory Response (SIRS)
7. Oncological Emergencies and Palliative Care in the Acute Setting
1. A patient in the ICU with cardiogenic shock is being monitored with a pulmonary artery catheter.
The nurse notes a PAWP of 22 mmHg and a Cardiac Index of 1.8 L/min/m². Which intervention
is the priority?
A. Administer a 500 mL normal saline bolus
B. Initiate an inotropic infusion (e.g., dobutamine)
C. Reduce the ventilator PEEP setting
D. Start a rapid fluid resuscitation protocol
, Answer: B
CORRECT ANSWER : B
Rationale: The elevated PAWP (normal 8–12 mmHg) indicates left ventricular failure/fluid
overload, while the low CI (<2.2) indicates pump failure. Dobutamine increases contractility to
improve output; fluid boluses (A, D) would worsen pulmonary edema. PEEP reduction (C) is not
the primary treatment for pump failure.
2. A patient on mechanical ventilation is in the assist-control (AC) mode. The high-pressure alarm
sounds. Which assessment finding requires immediate nursing action?
A. Disconnection of the ventilator tubing
B. A decrease in lung compliance or airway obstruction
C. A leak in the endotracheal tube cuff
D. Increased patient sedation
Answer: B
CORRECT ANSWER : B
Rationale: High-pressure alarms indicate increased resistance to airflow or decreased lung
compliance, such as secretions, bronchospasm, or tension pneumothorax. Disconnection/leaks
(A, C) cause low-pressure alarms. Sedation (D) would likely lower the pressure.
3. A patient with DKA is receiving an insulin infusion. Serum potassium is 3.1 mEq/L. What is the
nurse's priority action?
A. Increase the insulin infusion rate to clear ketones
B. Hold insulin and contact the provider for potassium replacement
C. Continue insulin and add potassium to the IV maintenance fluids
D. Administer sodium bicarbonate immediately
Answer: B
CORRECT ANSWER : B
Rationale: Insulin shifts potassium into cells, further lowering serum levels. With a level of 3.1
mEq/L, administering insulin could trigger life-threatening arrhythmias. Insulin must be held
until potassium is replaced to a safe level (>3.3–3.5 mEq/L).
,4. A patient with a TBI has an ICP of 24 mmHg and a MAP of 70 mmHg. What is the Cerebral
Perfusion Pressure (CPP), and what is the clinical implication?
A. 94 mmHg; adequate perfusion
B. 46 mmHg; inadequate perfusion
C. 54 mmHg; borderline perfusion
D. 70 mmHg; normal perfusion
Answer: B
CORRECT ANSWER : B
Rationale: CPP = MAP - ICP (70 - 24 = 46). A CPP < 50-60 mmHg indicates inadequate
cerebral blood flow, placing the patient at high risk for secondary ischemic injury. Normal CPP
is 60–100 mmHg.
5. A patient with acute kidney injury (AKI) is initiated on continuous renal replacement therapy
(CRRT). What differentiates CRRT from standard intermittent hemodialysis?
A. CRRT is faster and removes more fluid per hour
B. CRRT provides slow, continuous clearance, better tolerated by hemodynamically
unstable patients
C. CRRT requires high-dose anticoagulation
D. CRRT is performed in the dialysis center only
Answer: B
CORRECT ANSWER : B
Rationale: CRRT is the preferred modality for hemodynamically unstable critically ill patients
because it removes solutes and fluid slowly, preventing the rapid fluid shifts common in
intermittent dialysis. Intermittent hemodialysis (A) is faster but often causes hypotension.
6. A burn patient in the emergent phase presents with circumferential full-thickness burns to the
chest. The nurse observes diminished breath sounds and high peak inspiratory pressures. What is
the expected intervention?
A. Administration of inhaled bronchodilators
B. Emergency escharotomy
, C. Increase of fluid resuscitation rate
D. Immediate endotracheal intubation
Answer: B
CORRECT ANSWER : B
Rationale: Circumferential chest burns cause the rigid eschar to restrict chest wall expansion,
leading to restrictive respiratory failure. An escharotomy relieves this constriction immediately.
Intubation (D) does not solve the underlying restrictive chest wall pressure.
7. A patient with stage IV lung cancer and a sudden diagnosis of Superior Vena Cava (SVC)
Syndrome presents with facial edema and dyspnea. What is the priority nursing intervention?
A. Administer intravenous diuretics
B. Elevate the head of the bed and prepare for radiation therapy
C. Initiate aggressive fluid resuscitation
D. Administer high-dose opioids
Answer: B
CORRECT ANSWER : B
Rationale: SVC syndrome is an oncological emergency requiring rapid decompression.
Elevating the HOB reduces venous congestion, and radiation/chemo is the definitive treatment to
shrink the tumor causing obstruction. Diuretics (A) are ineffective for venous outflow
obstruction.
8. Which hemodynamic parameter is most reflective of preload in the right side of the heart?
A. PAWP
B. CVP (Central Venous Pressure)
C. SVR (Systemic Vascular Resistance)
D. Cardiac Output
Answer: B
CORRECT ANSWER : B
ACTUAL QUESTIONS AND ANSWERS | LATEST
2026/2027 UPDATE | GRADED A+ | 100% ASSURED
PASS (CARE OF ADULT II AT CONCORDIA) EXAM
with Questions and Answers/Plus a Rationale Updated
2026 A+/Instant Download PDF
EXAM COVERAGE
1. Advanced Cardiovascular and Hemodynamic Monitoring
2. Acute Respiratory Failure and Mechanical Ventilation
3. Management of Complex Endocrine Emergencies
4. Neurological Critical Care and Increased Intracranial Pressure
5. Renal Replacement Therapies and Multi-System Failure
6. Trauma, Burns, and Multi-System Inflammatory Response (SIRS)
7. Oncological Emergencies and Palliative Care in the Acute Setting
1. A patient in the ICU with cardiogenic shock is being monitored with a pulmonary artery catheter.
The nurse notes a PAWP of 22 mmHg and a Cardiac Index of 1.8 L/min/m². Which intervention
is the priority?
A. Administer a 500 mL normal saline bolus
B. Initiate an inotropic infusion (e.g., dobutamine)
C. Reduce the ventilator PEEP setting
D. Start a rapid fluid resuscitation protocol
, Answer: B
CORRECT ANSWER : B
Rationale: The elevated PAWP (normal 8–12 mmHg) indicates left ventricular failure/fluid
overload, while the low CI (<2.2) indicates pump failure. Dobutamine increases contractility to
improve output; fluid boluses (A, D) would worsen pulmonary edema. PEEP reduction (C) is not
the primary treatment for pump failure.
2. A patient on mechanical ventilation is in the assist-control (AC) mode. The high-pressure alarm
sounds. Which assessment finding requires immediate nursing action?
A. Disconnection of the ventilator tubing
B. A decrease in lung compliance or airway obstruction
C. A leak in the endotracheal tube cuff
D. Increased patient sedation
Answer: B
CORRECT ANSWER : B
Rationale: High-pressure alarms indicate increased resistance to airflow or decreased lung
compliance, such as secretions, bronchospasm, or tension pneumothorax. Disconnection/leaks
(A, C) cause low-pressure alarms. Sedation (D) would likely lower the pressure.
3. A patient with DKA is receiving an insulin infusion. Serum potassium is 3.1 mEq/L. What is the
nurse's priority action?
A. Increase the insulin infusion rate to clear ketones
B. Hold insulin and contact the provider for potassium replacement
C. Continue insulin and add potassium to the IV maintenance fluids
D. Administer sodium bicarbonate immediately
Answer: B
CORRECT ANSWER : B
Rationale: Insulin shifts potassium into cells, further lowering serum levels. With a level of 3.1
mEq/L, administering insulin could trigger life-threatening arrhythmias. Insulin must be held
until potassium is replaced to a safe level (>3.3–3.5 mEq/L).
,4. A patient with a TBI has an ICP of 24 mmHg and a MAP of 70 mmHg. What is the Cerebral
Perfusion Pressure (CPP), and what is the clinical implication?
A. 94 mmHg; adequate perfusion
B. 46 mmHg; inadequate perfusion
C. 54 mmHg; borderline perfusion
D. 70 mmHg; normal perfusion
Answer: B
CORRECT ANSWER : B
Rationale: CPP = MAP - ICP (70 - 24 = 46). A CPP < 50-60 mmHg indicates inadequate
cerebral blood flow, placing the patient at high risk for secondary ischemic injury. Normal CPP
is 60–100 mmHg.
5. A patient with acute kidney injury (AKI) is initiated on continuous renal replacement therapy
(CRRT). What differentiates CRRT from standard intermittent hemodialysis?
A. CRRT is faster and removes more fluid per hour
B. CRRT provides slow, continuous clearance, better tolerated by hemodynamically
unstable patients
C. CRRT requires high-dose anticoagulation
D. CRRT is performed in the dialysis center only
Answer: B
CORRECT ANSWER : B
Rationale: CRRT is the preferred modality for hemodynamically unstable critically ill patients
because it removes solutes and fluid slowly, preventing the rapid fluid shifts common in
intermittent dialysis. Intermittent hemodialysis (A) is faster but often causes hypotension.
6. A burn patient in the emergent phase presents with circumferential full-thickness burns to the
chest. The nurse observes diminished breath sounds and high peak inspiratory pressures. What is
the expected intervention?
A. Administration of inhaled bronchodilators
B. Emergency escharotomy
, C. Increase of fluid resuscitation rate
D. Immediate endotracheal intubation
Answer: B
CORRECT ANSWER : B
Rationale: Circumferential chest burns cause the rigid eschar to restrict chest wall expansion,
leading to restrictive respiratory failure. An escharotomy relieves this constriction immediately.
Intubation (D) does not solve the underlying restrictive chest wall pressure.
7. A patient with stage IV lung cancer and a sudden diagnosis of Superior Vena Cava (SVC)
Syndrome presents with facial edema and dyspnea. What is the priority nursing intervention?
A. Administer intravenous diuretics
B. Elevate the head of the bed and prepare for radiation therapy
C. Initiate aggressive fluid resuscitation
D. Administer high-dose opioids
Answer: B
CORRECT ANSWER : B
Rationale: SVC syndrome is an oncological emergency requiring rapid decompression.
Elevating the HOB reduces venous congestion, and radiation/chemo is the definitive treatment to
shrink the tumor causing obstruction. Diuretics (A) are ineffective for venous outflow
obstruction.
8. Which hemodynamic parameter is most reflective of preload in the right side of the heart?
A. PAWP
B. CVP (Central Venous Pressure)
C. SVR (Systemic Vascular Resistance)
D. Cardiac Output
Answer: B
CORRECT ANSWER : B
