NRNP 6566 Final Quiz V3 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Final Quiz) | Walden University
1. A patient is admitted with septic shock. According to the Surviving Sepsis Campaign, which
of the following is the initial lactate threshold that triggers aggressive fluid resuscitation?
A. Lactate > 2.0 mmol/L
B. Lactate > 1.0 mmol/L
C. Lactate > 4.0 mmol/L
D. Lactate > 0.5 mmol/L
Answer: A
Rationale: A serum lactate level greater than 2 mmol/L is a key diagnostic marker for
sepsis-associated hypoperfusion. This elevation indicates that the body has shifted to
anaerobic metabolism due to inadequate oxygen delivery to the tissues. Prompt
recognition and fluid resuscitation are essential to improve clinical outcomes and reduce
mortality in these patients.
2. Which arterial blood gas (ABG) finding is most characteristic of early acute respiratory
distress syndrome (ARDS)?
A. Respiratory alkalosis with hypoxemia
,B. Respiratory acidosis with hypercapnia
C. Metabolic acidosis with normal PaO2
D. Compensated metabolic alkalosis
Answer: A
Rationale: In the early stages of ARDS, patients typically present with tachypnea as a
compensatory mechanism for worsening hypoxemia. This hyperventilation results in a
decrease in PaCO2, leading to respiratory alkalosis. As the disease progresses and the
patient fatigues, they may eventually develop respiratory acidosis and hypercapnia.
3. A 70-year-old male with a history of heart failure presents with increased dyspnea and
orthopnea. His PCWP is 24 mmHg. Which medication is most appropriate to reduce preload?
A. Furosemide
B. Norepinephrine
C. Dopamine
D. Metoprolol
Answer: A
Rationale: A pulmonary capillary wedge pressure (PCWP) of 24 mmHg indicates
significant fluid overload and elevated left ventricular end-diastolic pressure. Furosemide
is a loop diuretic that reduces preload by promoting the excretion of sodium and water by
, the kidneys. This intervention helps alleviate pulmonary congestion and improves the
patient’s respiratory status.
4. In the management of acute ischemic stroke, what is the maximum time window from ‘last
known well’ to administer intravenous alteplase (tPA) for eligible patients?
A. 2 hours
B. 4.5 hours
C. 6 hours
D. 12 hours
Answer: B
Rationale: The standard therapeutic window for administering intravenous tPA in acute
ischemic stroke is up to 4.5 hours from the onset of symptoms. Prompt administration is
critical to maximize the potential for tissue reperfusion and minimize permanent
neurological deficit. Clinicians must strictly adhere to inclusion and exclusion criteria to
ensure patient safety and treatment efficacy.
5. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg and a
mean arterial pressure (MAP) of 85 mmHg. What is the calculated Cerebral Perfusion
Pressure (CPP)?
A. 107 mmHg
B. 44 mmHg
C. 63 mmHg
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Final Quiz) | Walden University
1. A patient is admitted with septic shock. According to the Surviving Sepsis Campaign, which
of the following is the initial lactate threshold that triggers aggressive fluid resuscitation?
A. Lactate > 2.0 mmol/L
B. Lactate > 1.0 mmol/L
C. Lactate > 4.0 mmol/L
D. Lactate > 0.5 mmol/L
Answer: A
Rationale: A serum lactate level greater than 2 mmol/L is a key diagnostic marker for
sepsis-associated hypoperfusion. This elevation indicates that the body has shifted to
anaerobic metabolism due to inadequate oxygen delivery to the tissues. Prompt
recognition and fluid resuscitation are essential to improve clinical outcomes and reduce
mortality in these patients.
2. Which arterial blood gas (ABG) finding is most characteristic of early acute respiratory
distress syndrome (ARDS)?
A. Respiratory alkalosis with hypoxemia
,B. Respiratory acidosis with hypercapnia
C. Metabolic acidosis with normal PaO2
D. Compensated metabolic alkalosis
Answer: A
Rationale: In the early stages of ARDS, patients typically present with tachypnea as a
compensatory mechanism for worsening hypoxemia. This hyperventilation results in a
decrease in PaCO2, leading to respiratory alkalosis. As the disease progresses and the
patient fatigues, they may eventually develop respiratory acidosis and hypercapnia.
3. A 70-year-old male with a history of heart failure presents with increased dyspnea and
orthopnea. His PCWP is 24 mmHg. Which medication is most appropriate to reduce preload?
A. Furosemide
B. Norepinephrine
C. Dopamine
D. Metoprolol
Answer: A
Rationale: A pulmonary capillary wedge pressure (PCWP) of 24 mmHg indicates
significant fluid overload and elevated left ventricular end-diastolic pressure. Furosemide
is a loop diuretic that reduces preload by promoting the excretion of sodium and water by
, the kidneys. This intervention helps alleviate pulmonary congestion and improves the
patient’s respiratory status.
4. In the management of acute ischemic stroke, what is the maximum time window from ‘last
known well’ to administer intravenous alteplase (tPA) for eligible patients?
A. 2 hours
B. 4.5 hours
C. 6 hours
D. 12 hours
Answer: B
Rationale: The standard therapeutic window for administering intravenous tPA in acute
ischemic stroke is up to 4.5 hours from the onset of symptoms. Prompt administration is
critical to maximize the potential for tissue reperfusion and minimize permanent
neurological deficit. Clinicians must strictly adhere to inclusion and exclusion criteria to
ensure patient safety and treatment efficacy.
5. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg and a
mean arterial pressure (MAP) of 85 mmHg. What is the calculated Cerebral Perfusion
Pressure (CPP)?
A. 107 mmHg
B. 44 mmHg
C. 63 mmHg
