NR572 Final Exam Actual Exam Style V1 |
NR 572 Advanced Acute Care Management
| Chamberlain
1. What is the initial recommended fluid bolus for a patient in septic shock according to the
Surviving Sepsis Campaign?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Correct Answer: A
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of at least 30 mL/kg of intravenous crystalloid. This should be started within
the first 3 hours of recognizing sepsis or septic shock. Adequate fluid resuscitation is
critical for improving tissue perfusion and managing hypotension.
2. Which hemodynamic parameter is most indicative of fluid volume status in the right side of
the heart?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Pulmonary Artery Wedge Pressure (PAWP)
,D. Central Venous Pressure (CVP)
Correct Answer: D
Expert Explanation: Central Venous Pressure (CVP) reflects the pressure in the right
atrium and is used to estimate right-sided heart volume status. Normal values typically
range from 2 to 6 mmHg in a healthy individual. It serves as a guide for fluid replacement
therapy in acutely ill patients.
3. A patient with a pH of 7.25, PaCO2 of 55, and HCO3 of 24 is experiencing which acid-base
imbalance?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Correct Answer: A
Expert Explanation: The low pH indicates acidosis, while the elevated PaCO2 level above
45 mmHg indicates a respiratory cause. Because the bicarbonate level is within the normal
range, the imbalance is primarily respiratory. This condition often results from
hypoventilation or impaired gas exchange in the lungs.
4. What is the primary purpose of Positive End-Expiratory Pressure (PEEP) in mechanical
ventilation?
A. To decrease the work of breathing during inspiration
, B. To increase the respiratory rate of the patient
C. To keep the alveoli open at the end of expiration
D. To decrease the risk of barotrauma
Correct Answer: C
Expert Explanation: PEEP is applied to maintain a positive pressure in the lungs at the
end of expiration to prevent alveolar collapse. By keeping the alveoli open, it improves
oxygenation and increases the functional residual capacity. It is particularly useful in
treating conditions like Acute Respiratory Distress Syndrome (ARDS).
5. In which type of shock would you expect to see a decreased heart rate (bradycardia) rather
than tachycardia?
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Correct Answer: D
Expert Explanation: Neurogenic shock results from the loss of sympathetic tone, which
leads to massive vasodilation and bradycardia. Unlike other forms of shock where the heart
rate increases to compensate for low blood pressure, neurogenic shock prevents this
NR 572 Advanced Acute Care Management
| Chamberlain
1. What is the initial recommended fluid bolus for a patient in septic shock according to the
Surviving Sepsis Campaign?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Correct Answer: A
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of at least 30 mL/kg of intravenous crystalloid. This should be started within
the first 3 hours of recognizing sepsis or septic shock. Adequate fluid resuscitation is
critical for improving tissue perfusion and managing hypotension.
2. Which hemodynamic parameter is most indicative of fluid volume status in the right side of
the heart?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Pulmonary Artery Wedge Pressure (PAWP)
,D. Central Venous Pressure (CVP)
Correct Answer: D
Expert Explanation: Central Venous Pressure (CVP) reflects the pressure in the right
atrium and is used to estimate right-sided heart volume status. Normal values typically
range from 2 to 6 mmHg in a healthy individual. It serves as a guide for fluid replacement
therapy in acutely ill patients.
3. A patient with a pH of 7.25, PaCO2 of 55, and HCO3 of 24 is experiencing which acid-base
imbalance?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Correct Answer: A
Expert Explanation: The low pH indicates acidosis, while the elevated PaCO2 level above
45 mmHg indicates a respiratory cause. Because the bicarbonate level is within the normal
range, the imbalance is primarily respiratory. This condition often results from
hypoventilation or impaired gas exchange in the lungs.
4. What is the primary purpose of Positive End-Expiratory Pressure (PEEP) in mechanical
ventilation?
A. To decrease the work of breathing during inspiration
, B. To increase the respiratory rate of the patient
C. To keep the alveoli open at the end of expiration
D. To decrease the risk of barotrauma
Correct Answer: C
Expert Explanation: PEEP is applied to maintain a positive pressure in the lungs at the
end of expiration to prevent alveolar collapse. By keeping the alveoli open, it improves
oxygenation and increases the functional residual capacity. It is particularly useful in
treating conditions like Acute Respiratory Distress Syndrome (ARDS).
5. In which type of shock would you expect to see a decreased heart rate (bradycardia) rather
than tachycardia?
A. Hypovolemic shock
B. Septic shock
C. Cardiogenic shock
D. Neurogenic shock
Correct Answer: D
Expert Explanation: Neurogenic shock results from the loss of sympathetic tone, which
leads to massive vasodilation and bradycardia. Unlike other forms of shock where the heart
rate increases to compensate for low blood pressure, neurogenic shock prevents this
