1
NRNP 6566 Advanced Care of
Adults in Acute Settings I
Final Exam 2025 – Actual
Exam with 100% Verified
Answers | Walden University |
Updated
1. A 56-year-old male presents with chest pain and an ECG showing ST-elevation in
leads V1-V4. What is the most likely diagnosis?
a. Pericarditis
b. Anterior wall myocardial infarction
c. Pulmonary embolism
d. Aortic dissection
b. Anterior wall myocardial infarction
Rationale: ST-elevation in leads V1-V4 indicates an anterior wall myocardial infarction,
typically due to occlusion of the left anterior descending artery, per Walden’s curriculum
on acute cardiac conditions.
2. What is the initial intervention for a patient in hypovolemic shock?
a. Administer vasopressors
b. Initiate fluid resuscitation
c. Order a CT scan
d. Perform immediate surgery
b. Initiate fluid resuscitation
Rationale: Fluid resuscitation is the first step in hypovolemic shock to restore circulating
volume, as emphasized in Walden’s acute care management protocols.
3. A 44-year-old female with a mechanical mitral valve on warfarin is scheduled for
elective surgery. What is the recommended management of her anticoagulation?
a. Continue warfarin unchanged
b. Stop warfarin and bridge with heparin
c. Switch to aspirin
, 2
d. Discontinue all anticoagulation
b. Stop warfarin and bridge with heparin
Rationale: Bridging with heparin is required for high-risk patients with mechanical
valves to prevent thromboembolism, per Walden’s pharmacology and acute care
guidelines.
4. Which arterial blood gas result indicates acute respiratory acidosis?
a. pH 7.48, PaCO2 32 mmHg, HCO3- 24 mEq/L
b. pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L
c. pH 7.50, PaCO2 40 mmHg, HCO3- 30 mEq/L
d. pH 7.35, PaCO2 40 mmHg, HCO3- 22 mEq/L
b. pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L
Rationale: Acute respiratory acidosis is characterized by low pH and elevated PaCO2
with normal HCO3-, as taught in Walden’s ABG interpretation curriculum.
5. What is the purpose of hypoxic vasoconstriction in a ventilation-perfusion
mismatch?
a. To increase pulmonary blood flow
b. To redirect blood to well-ventilated lung areas
c. To decrease systemic oxygenation
d. To increase intracranial pressure
b. To redirect blood to well-ventilated lung areas
Rationale: Hypoxic vasoconstriction reduces blood flow to poorly ventilated lung
regions, improving oxygenation, per Walden’s pathophysiology focus.
6. A 63-year-old female on amiodarone post-cardioversion is at risk for which side
effect?
a. Hyperthyroidism
b. Pulmonary toxicity
c. Renal failure
d. Hypoglycemia
b. Pulmonary toxicity
Rationale: Amiodarone is associated with pulmonary toxicity, a critical consideration in
acute care pharmacology, per Walden’s curriculum.
7. A patient with septic shock due to a urinary tract infection requires which initial
intervention?
a. Broad-spectrum antibiotics
b. Vasopressors
c. Diuretics
d. Beta-blockers
a. Broad-spectrum antibiotics
Rationale: Early administration of broad-spectrum antibiotics is critical in septic shock to
address the underlying infection, per Walden’s acute care protocols.
8. What is the most common cause of acute kidney injury in the acute care setting?
a. Glomerulonephritis
b. Pre-renal azotemia
c. Nephrolithiasis
d. Chronic kidney disease
b. Pre-renal azotemia
, 3
Rationale: Pre-renal azotemia, often due to hypoperfusion, is the most common cause of
acute kidney injury, per Walden’s pathophysiology curriculum.
9. A 32-year-old female presents with a sore throat, fever of 101.6°F, and white
patches on her tonsils. What is the most likely diagnosis?
a. Viral pharyngitis
b. Streptococcal pharyngitis
c. Mononucleosis
d. Tonsillar cancer
b. Streptococcal pharyngitis
Rationale: White patches, fever, and sore throat suggest streptococcal pharyngitis, per
Walden’s acute care diagnostic guidelines.
10. What is the primary goal of the RUSH exam in a patient with shock?
a. To replace diagnostic peritoneal lavage
b. To identify treatable causes of shock
c. To assess for chronic heart failure
d. To evaluate for spinal injury
b. To identify treatable causes of shock
Rationale: The RUSH exam rapidly identifies treatable causes of shock, such as
hypovolemia or tamponade, per Walden’s acute care assessment protocols.
11. A patient with acute pancreatitis is admitted. What is the most common cause?
a. Alcohol use
b. Gallstones
c. Viral infection
d. Trauma
b. Gallstones
Rationale: Gallstones are the most common cause of acute pancreatitis, per Walden’s
pathophysiology curriculum.
12. Which medication is contraindicated in acute bronchitis due to ventilation-perfusion
mismatch risk?
a. Albuterol
b. Antihistamines
c. Corticosteroids
d. Antibiotics
b. Antihistamines
Rationale: Antihistamines can worsen ventilation-perfusion mismatch by drying
secretions, per Walden’s pharmacology guidelines.
13. A 70-year-old female presents with confusion, agitation, and restlessness. Her
history includes dementia. What is the most likely diagnosis?
a. Stroke
b. Delirium
c. Depression
d. Psychosis
b. Delirium
Rationale: Acute confusion in an elderly patient with dementia suggests delirium, often
triggered by an underlying condition, per Walden’s acute care curriculum.
NRNP 6566 Advanced Care of
Adults in Acute Settings I
Final Exam 2025 – Actual
Exam with 100% Verified
Answers | Walden University |
Updated
1. A 56-year-old male presents with chest pain and an ECG showing ST-elevation in
leads V1-V4. What is the most likely diagnosis?
a. Pericarditis
b. Anterior wall myocardial infarction
c. Pulmonary embolism
d. Aortic dissection
b. Anterior wall myocardial infarction
Rationale: ST-elevation in leads V1-V4 indicates an anterior wall myocardial infarction,
typically due to occlusion of the left anterior descending artery, per Walden’s curriculum
on acute cardiac conditions.
2. What is the initial intervention for a patient in hypovolemic shock?
a. Administer vasopressors
b. Initiate fluid resuscitation
c. Order a CT scan
d. Perform immediate surgery
b. Initiate fluid resuscitation
Rationale: Fluid resuscitation is the first step in hypovolemic shock to restore circulating
volume, as emphasized in Walden’s acute care management protocols.
3. A 44-year-old female with a mechanical mitral valve on warfarin is scheduled for
elective surgery. What is the recommended management of her anticoagulation?
a. Continue warfarin unchanged
b. Stop warfarin and bridge with heparin
c. Switch to aspirin
, 2
d. Discontinue all anticoagulation
b. Stop warfarin and bridge with heparin
Rationale: Bridging with heparin is required for high-risk patients with mechanical
valves to prevent thromboembolism, per Walden’s pharmacology and acute care
guidelines.
4. Which arterial blood gas result indicates acute respiratory acidosis?
a. pH 7.48, PaCO2 32 mmHg, HCO3- 24 mEq/L
b. pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L
c. pH 7.50, PaCO2 40 mmHg, HCO3- 30 mEq/L
d. pH 7.35, PaCO2 40 mmHg, HCO3- 22 mEq/L
b. pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L
Rationale: Acute respiratory acidosis is characterized by low pH and elevated PaCO2
with normal HCO3-, as taught in Walden’s ABG interpretation curriculum.
5. What is the purpose of hypoxic vasoconstriction in a ventilation-perfusion
mismatch?
a. To increase pulmonary blood flow
b. To redirect blood to well-ventilated lung areas
c. To decrease systemic oxygenation
d. To increase intracranial pressure
b. To redirect blood to well-ventilated lung areas
Rationale: Hypoxic vasoconstriction reduces blood flow to poorly ventilated lung
regions, improving oxygenation, per Walden’s pathophysiology focus.
6. A 63-year-old female on amiodarone post-cardioversion is at risk for which side
effect?
a. Hyperthyroidism
b. Pulmonary toxicity
c. Renal failure
d. Hypoglycemia
b. Pulmonary toxicity
Rationale: Amiodarone is associated with pulmonary toxicity, a critical consideration in
acute care pharmacology, per Walden’s curriculum.
7. A patient with septic shock due to a urinary tract infection requires which initial
intervention?
a. Broad-spectrum antibiotics
b. Vasopressors
c. Diuretics
d. Beta-blockers
a. Broad-spectrum antibiotics
Rationale: Early administration of broad-spectrum antibiotics is critical in septic shock to
address the underlying infection, per Walden’s acute care protocols.
8. What is the most common cause of acute kidney injury in the acute care setting?
a. Glomerulonephritis
b. Pre-renal azotemia
c. Nephrolithiasis
d. Chronic kidney disease
b. Pre-renal azotemia
, 3
Rationale: Pre-renal azotemia, often due to hypoperfusion, is the most common cause of
acute kidney injury, per Walden’s pathophysiology curriculum.
9. A 32-year-old female presents with a sore throat, fever of 101.6°F, and white
patches on her tonsils. What is the most likely diagnosis?
a. Viral pharyngitis
b. Streptococcal pharyngitis
c. Mononucleosis
d. Tonsillar cancer
b. Streptococcal pharyngitis
Rationale: White patches, fever, and sore throat suggest streptococcal pharyngitis, per
Walden’s acute care diagnostic guidelines.
10. What is the primary goal of the RUSH exam in a patient with shock?
a. To replace diagnostic peritoneal lavage
b. To identify treatable causes of shock
c. To assess for chronic heart failure
d. To evaluate for spinal injury
b. To identify treatable causes of shock
Rationale: The RUSH exam rapidly identifies treatable causes of shock, such as
hypovolemia or tamponade, per Walden’s acute care assessment protocols.
11. A patient with acute pancreatitis is admitted. What is the most common cause?
a. Alcohol use
b. Gallstones
c. Viral infection
d. Trauma
b. Gallstones
Rationale: Gallstones are the most common cause of acute pancreatitis, per Walden’s
pathophysiology curriculum.
12. Which medication is contraindicated in acute bronchitis due to ventilation-perfusion
mismatch risk?
a. Albuterol
b. Antihistamines
c. Corticosteroids
d. Antibiotics
b. Antihistamines
Rationale: Antihistamines can worsen ventilation-perfusion mismatch by drying
secretions, per Walden’s pharmacology guidelines.
13. A 70-year-old female presents with confusion, agitation, and restlessness. Her
history includes dementia. What is the most likely diagnosis?
a. Stroke
b. Delirium
c. Depression
d. Psychosis
b. Delirium
Rationale: Acute confusion in an elderly patient with dementia suggests delirium, often
triggered by an underlying condition, per Walden’s acute care curriculum.
