RN Physiological Adaptation 3

Question 1

A patient presents with absent breath sounds on the left, tracheal deviation to the right, and severe respiratory distress. The nurse should prepare for:

Accepted Answer

Emergency needle decompression for tension pneumothorax

Answer

Tracheal deviation away from the affected side with absent breath sounds and respiratory distress are hallmarks of tension pneumothorax, requiring immediate needle decompression.

Question 2

Which finding in a burn patient indicates adequate fluid resuscitation during the first 24 hours?

Accepted Answer

Urine output of 0.5–1 mL/kg/hour

Answer

The Parkland formula targets urine output of 0.5–1 mL/kg/hour as the primary indicator of adequate tissue perfusion during burn resuscitation.

Question 3

A patient on mechanical ventilation has a sudden decrease in oxygen saturation and increasing peak airway pressures. The nurse's first action should be:

Accepted Answer

Disconnect from the ventilator and manually ventilate with a bag-valve mask

Answer

DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) guides troubleshooting; manual ventilation with a bag-valve mask confirms and bypasses equipment failure immediately.

Question 4

A patient with Addison's disease is admitted with hypotension, hyponatremia, and hyperkalemia during a stressful illness. The nurse anticipates:

Accepted Answer

Administration of IV hydrocortisone

Answer

Addisonian crisis results from adrenocortical insufficiency; IV hydrocortisone rapidly replaces both glucocorticoid and mineralocorticoid activity needed during stress.

Question 5

Which lab value is the most sensitive early indicator of acute pancreatitis?

Accepted Answer

Elevated serum lipase

Answer

Serum lipase remains elevated longer than amylase (up to 14 days vs. 2–3 days) and is more specific and sensitive for acute pancreatitis.

RN - Registered Nurse Practice Test

RN - Registered Nurse Practice Test

RN Physiological Adaptation 3