NRNP 6566 Final exam Advanced Care of Adults in Acute Settings I Questions And Answers 2026/2027 Walden University

,NRNP 6566 Final exam Advanced Care of Adults in Acute Settings I
Questions And Answers 2026/2027 Walden University

NRNP 6566 Final Exam Practice Bank

Course: NRNP 6566
University: Walden University
Assessment: Final Exam
Area: Advanced Care of Adults in Acute Settings I


1.
A 62-year-old patient presents with acute respiratory distress. ABG results
are pH 7.28, PaCO₂ 55 mmHg, HCO₃⁻ 24 mEq/L. How should these results be
interpreted?

A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Uncompensated metabolic acidosis
D) Compensated respiratory alkalosis

Answer: A) Uncompensated respiratory acidosis

Rationale: The pH is acidemic, PaCO₂ is elevated, and bicarbonate remains
normal, indicating a primary respiratory acidosis without metabolic
compensation.

2.
A patient with COPD has an ABG showing pH 7.32, PaCO₂ 65 mmHg, HCO₃⁻
32 mEq/L. Which interpretation is most appropriate?

A) Uncompensated respiratory acidosis
B) Partially compensated respiratory acidosis
C) Uncompensated metabolic alkalosis
D) Respiratory alkalosis

Answer: B) Partially compensated respiratory acidosis

Rationale: The low pH and elevated PaCO₂ indicate respiratory acidosis,
while the elevated bicarbonate reflects renal compensation.

3.
Which ABG pattern is most consistent with metabolic acidosis?

A) pH 7.28, PaCO₂ 30, HCO₃⁻ 15
B) pH 7.50, PaCO₂ 30, HCO₃⁻ 24

,C) pH 7.48, PaCO₂ 48, HCO₃⁻ 34
D) pH 7.40, PaCO₂ 40, HCO₃⁻ 24

Answer: A) pH 7.28, PaCO₂ 30, HCO₃⁻ 15

Rationale: The low pH and low bicarbonate indicate metabolic acidosis. The
decreased PaCO₂ reflects respiratory compensation.

4.
A patient is hyperventilating because of severe anxiety. Which ABG finding is
expected?

A) Increased PaCO₂
B) Decreased PaCO₂
C) Increased HCO₃⁻ immediately
D) Decreased pH from metabolic acidosis

Answer: B) Decreased PaCO₂

Rationale: Hyperventilation removes carbon dioxide from the blood,
producing respiratory alkalosis.

5.
A patient with severe metabolic acidosis develops deep, rapid respirations.
Which compensatory response is occurring?

A) Hypoventilation
B) Increased bicarbonate retention
C) Increased ventilation to remove CO₂
D) Renal retention of hydrogen ions

Answer: C) Increased ventilation to remove CO₂

Rationale: The respiratory system compensates for metabolic acidosis by
increasing ventilation and lowering PaCO₂.

6.
A patient has a pH of 7.51, PaCO₂ of 28 mmHg, and HCO₃⁻ of 23 mEq/L.
Which disorder is present?

A) Respiratory alkalosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Metabolic acidosis

Answer: A) Respiratory alkalosis

, Rationale: Alkalemia with decreased PaCO₂ indicates a primary respiratory
alkalosis.

7.
Which condition most commonly produces a ventilation-perfusion mismatch?

A) Pulmonary embolism
B) Primary hypothyroidism
C) Acute cystitis
D) Iron-deficiency anemia

Answer: A) Pulmonary embolism

Rationale: A pulmonary embolus creates ventilated but inadequately
perfused alveoli, producing V/Q mismatch.

8.
A patient with pneumonia has alveoli filled with inflammatory exudate. Which
mechanism is most responsible for the resulting hypoxemia?

A) Increased inspired oxygen concentration
B) V/Q mismatch and shunting
C) Increased hemoglobin production
D) Increased alveolar ventilation

Answer: B) V/Q mismatch and shunting

Rationale: Consolidated alveoli receive inadequate ventilation despite
continued perfusion, impairing oxygen exchange.

9.
Which condition is most likely to produce a widened alveolar-arterial oxygen
gradient?

A) Pulmonary embolism
B) Pure hypoventilation from opioid overdose
C) High altitude alone
D) Normal aging

Answer: A) Pulmonary embolism

Rationale: V/Q abnormalities such as pulmonary embolism can create an
increased A–a gradient. Pure hypoventilation typically produces a normal A–a
gradient.