NURS 5463 Exam 1 V1 | NURS 5463 Adult
Gerontology Acute Care Review | Actual
Q&A with Rationale (NURS5463 Exam 1) |
The University of Texas at Arlington
1. A 68-year-old patient presents with a blood pressure of 82/40 mmHg, heart rate of 125
bpm, Central Venous Pressure (CVP) of 2 mmHg, and a Pulmonary Capillary Wedge Pressure
(PCWP) of 4 mmHg. What is the most likely diagnosis?
A. Septic Shock
B. Cardiogenic Shock
C. Hypovolemic Shock
D. Anaphylactic Shock
Answer: C
Rationale: The hemodynamic profile shows significantly low preload markers, specifically
the CVP and PCWP. In hypovolemic shock, the loss of intravascular volume leads to
decreased venous return and low filling pressures. Management focuses on aggressive fluid
resuscitation to restore adequate perfusion to vital organs.
,2. An arterial blood gas (ABG) result shows: pH 7.26, PaCO2 56 mmHg, and HCO3 25 mEq/L.
How should the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) interpret these
results?
A. Uncompensated Respiratory Acidosis
B. Uncompensated Respiratory Alkalosis
C. Compensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Rationale: The pH is below 7.35, indicating acidosis, while the PaCO2 is elevated above 45
mmHg, which is the primary cause of the low pH. The bicarbonate level is within the
normal range, indicating that renal compensation has not yet occurred. This pattern is
diagnostic of acute, uncompensated respiratory acidosis typically caused by alveolar
hypoventilation.
3. In the state of Texas, which entity defines the scope of practice for the Advanced Practice
Registered Nurse (APRN)?
A. The American Association of Nurse Practitioners
B. The Texas Board of Nursing
C. The individual hospital’s credentialing committee
D. The American Nurses Credentialing Center
,Answer: B
Rationale: The scope of practice for APRNs is legally defined by the state’s Nurse Practice
Act and regulated by the State Board of Nursing. While national organizations provide
certification and guidelines, the state board has the final authority on licensure and
practice regulations. It is essential for the AGACNP to stay current with state-specific
administrative codes to ensure legal compliance.
4. A patient with a history of alcohol abuse presents with a potassium level of 3.0 mEq/L and
a magnesium level of 1.2 mg/dL. Despite multiple rounds of potassium replacement, the
potassium level remains low. What is the most appropriate next step?
A. Increase the dose of intravenous potassium chloride
B. Switch to oral potassium supplementation
C. Check a stat serum calcium level
D. Administer intravenous magnesium sulfate
Answer: D
Rationale: Magnesium is a necessary cofactor for the activity of the sodium-potassium
pump in cell membranes. When magnesium is depleted, the kidneys continue to excrete
potassium, and cellular uptake is impaired. Correcting the hypomagnesemia is a
prerequisite for successful potassium replenishment.
, 5. Which of the following hemodynamic parameters is most characteristic of early Septic
Shock?
A. High Systemic Vascular Resistance (SVR)
B. Low Cardiac Output (CO)
C. High Pulmonary Capillary Wedge Pressure (PCWP)
D. Low Systemic Vascular Resistance (SVR)
Answer: D
Rationale: Septic shock is a form of distributive shock characterized by massive peripheral
vasodilation caused by inflammatory mediators. This vasodilation results in a significant
decrease in Systemic Vascular Resistance (SVR) and an initial compensatory increase in
Cardiac Output. Monitoring these values helps the AGACNP differentiate sepsis from
cardiogenic or hypovolemic etiologies.
6. According to Medicare guidelines, which ‘Part’ covers the professional services provided by
an AGACNP in an inpatient hospital setting?
A. Part A
B. Part C
C. Part B
D. Part D
Answer: C
Gerontology Acute Care Review | Actual
Q&A with Rationale (NURS5463 Exam 1) |
The University of Texas at Arlington
1. A 68-year-old patient presents with a blood pressure of 82/40 mmHg, heart rate of 125
bpm, Central Venous Pressure (CVP) of 2 mmHg, and a Pulmonary Capillary Wedge Pressure
(PCWP) of 4 mmHg. What is the most likely diagnosis?
A. Septic Shock
B. Cardiogenic Shock
C. Hypovolemic Shock
D. Anaphylactic Shock
Answer: C
Rationale: The hemodynamic profile shows significantly low preload markers, specifically
the CVP and PCWP. In hypovolemic shock, the loss of intravascular volume leads to
decreased venous return and low filling pressures. Management focuses on aggressive fluid
resuscitation to restore adequate perfusion to vital organs.
,2. An arterial blood gas (ABG) result shows: pH 7.26, PaCO2 56 mmHg, and HCO3 25 mEq/L.
How should the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) interpret these
results?
A. Uncompensated Respiratory Acidosis
B. Uncompensated Respiratory Alkalosis
C. Compensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Rationale: The pH is below 7.35, indicating acidosis, while the PaCO2 is elevated above 45
mmHg, which is the primary cause of the low pH. The bicarbonate level is within the
normal range, indicating that renal compensation has not yet occurred. This pattern is
diagnostic of acute, uncompensated respiratory acidosis typically caused by alveolar
hypoventilation.
3. In the state of Texas, which entity defines the scope of practice for the Advanced Practice
Registered Nurse (APRN)?
A. The American Association of Nurse Practitioners
B. The Texas Board of Nursing
C. The individual hospital’s credentialing committee
D. The American Nurses Credentialing Center
,Answer: B
Rationale: The scope of practice for APRNs is legally defined by the state’s Nurse Practice
Act and regulated by the State Board of Nursing. While national organizations provide
certification and guidelines, the state board has the final authority on licensure and
practice regulations. It is essential for the AGACNP to stay current with state-specific
administrative codes to ensure legal compliance.
4. A patient with a history of alcohol abuse presents with a potassium level of 3.0 mEq/L and
a magnesium level of 1.2 mg/dL. Despite multiple rounds of potassium replacement, the
potassium level remains low. What is the most appropriate next step?
A. Increase the dose of intravenous potassium chloride
B. Switch to oral potassium supplementation
C. Check a stat serum calcium level
D. Administer intravenous magnesium sulfate
Answer: D
Rationale: Magnesium is a necessary cofactor for the activity of the sodium-potassium
pump in cell membranes. When magnesium is depleted, the kidneys continue to excrete
potassium, and cellular uptake is impaired. Correcting the hypomagnesemia is a
prerequisite for successful potassium replenishment.
, 5. Which of the following hemodynamic parameters is most characteristic of early Septic
Shock?
A. High Systemic Vascular Resistance (SVR)
B. Low Cardiac Output (CO)
C. High Pulmonary Capillary Wedge Pressure (PCWP)
D. Low Systemic Vascular Resistance (SVR)
Answer: D
Rationale: Septic shock is a form of distributive shock characterized by massive peripheral
vasodilation caused by inflammatory mediators. This vasodilation results in a significant
decrease in Systemic Vascular Resistance (SVR) and an initial compensatory increase in
Cardiac Output. Monitoring these values helps the AGACNP differentiate sepsis from
cardiogenic or hypovolemic etiologies.
6. According to Medicare guidelines, which ‘Part’ covers the professional services provided by
an AGACNP in an inpatient hospital setting?
A. Part A
B. Part C
C. Part B
D. Part D
Answer: C
