NRNP 6566 Advanced Care of Adults
in Acute Settings I Final Exam |
Walden University | Latest 2023–2024
Update | Questions and Verified
Answers
This final exam for NRNP 6566 Advanced Care of Adults in Acute Settings I at Walden University
contains 80 multiple-choice, case-based, and application-style questions, reflecting the
2023/2024 curriculum. Questions test critical care, acute disease processes, diagnostics, and
treatment planning for adult patients, aligned with Critical Care Nursing Made Incredibly Easy
(5th Edition, Springhouse) and AACN Essentials of Progressive Care Nursing (5th Edition,
Burns). Each question includes four answer options (A–D), the correct answer, and a detailed
rationale explaining why the correct answer is appropriate and why the other options are
incorrect.
Critical Care (Questions 1–20)
Question 1
A 65-year-old male is admitted to the ICU with septic shock. Vital signs: BP 80/50 mmHg, HR
120 bpm, RR 28/min, temp 102°F. What is the priority intervention?
A) Administer broad-spectrum antibiotics
B) Initiate fluid resuscitation with 30 mL/kg crystalloid
C) Start vasopressors immediately
D) Order a chest X-ray
Correct Answer: B
Rationale : Fluid resuscitation is the first-line treatment for septic shock to restore perfusion
(Burns, 5th Ed., Ch. 20). Option A is incorrect because antibiotics follow fluids. Option C is
incorrect because vasopressors are after fluids. Option D is incorrect because imaging is
diagnostic.
,Question 2
A 50-year-old female in the ICU has a central line with a temperature of 101°F. What is the first
step?
A) Remove the central line
B) Obtain blood cultures from all lumens
C) Administer empiric antibiotics
D) Order a CT scan
Correct Answer: B
Rationale : Blood cultures identify the pathogen before antibiotic administration in suspected
central line infection (Springhouse, 5th Ed., Ch. 3). Option A is incorrect because removal
follows confirmation. Option C is incorrect because cultures precede antibiotics. Option D is
incorrect because CT is for abscess.
Question 3
Case : A 70-year-old male with COPD exacerbation has pH 7.28, PaCO2 60 mmHg, PaO2 55
mmHg. What is the acid-base disorder?
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B
Rationale : Low pH and high PaCO2 indicate respiratory acidosis from CO2 retention in COPD
(Burns, 5th Ed., Ch. 12). Option A is incorrect (low bicarbonate). Option C is incorrect (high pH).
Option D is incorrect (low PaCO2).
Question 4
A 55-year-old male with acute MI has ST elevation in V1–V4. What is the priority treatment?
A) Administer beta-blockers
B) Percutaneous coronary intervention (PCI)
C) Start heparin infusion
D) Order an echocardiogram
Correct Answer: B
Rationale : PCI is the definitive treatment for STEMI to restore blood flow within 90 minutes
(Springhouse, 5th Ed., Ch. 4). Option A is incorrect (adjunctive). Option C is incorrect
(anticoagulation secondary). Option D is incorrect (diagnostic).
, Question 5
A 60-year-old female with acute kidney injury (AKI) has urine output 10 mL/hr. What is the stage?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Correct Answer: C
Rationale : Stage 3 AKI is anuria or oliguria <0.3 mL/kg/hr for >24 hours (Burns, 5th Ed., Ch. 14).
Option A is incorrect (mild). Option B is incorrect (moderate). Option D is incorrect (end-stage).
Question 6
Application: A 45-year-old male with sepsis has MAP 60 mmHg after fluids. What is the first
vasopressor?
A) Dopamine
B) Norepinephrine
C) Epinephrine
D) Vasopressin
Correct Answer: B
Rationale : Norepinephrine is first-line for septic shock to maintain perfusion (Springhouse, 5th
Ed., Ch. 20). Option A is incorrect (second-line). Option C is incorrect (arrest). Option D is
incorrect (adjunctive).
Question 7
A 70-year-old male with GI bleed has hemoglobin 6.5 g/dL. What is the transfusion threshold?
A) <10 g/dL
B) <7 g/dL
C) <8 g/dL
D) <9 g/dL
Correct Answer: B
Rationale : Transfusion for hemoglobin <7 g/dL in stable GI bleed (Burns, 5th Ed., Ch. 15).
Option A is incorrect (active bleeding). Option C is incorrect (symptomatic). Option D is incorrect
(critical).
Question 8
A 55-year-old female with acute pancreatitis has Ranson's score of 4. What is the mortality risk?
A) <1%
B) **10–20%**
in Acute Settings I Final Exam |
Walden University | Latest 2023–2024
Update | Questions and Verified
Answers
This final exam for NRNP 6566 Advanced Care of Adults in Acute Settings I at Walden University
contains 80 multiple-choice, case-based, and application-style questions, reflecting the
2023/2024 curriculum. Questions test critical care, acute disease processes, diagnostics, and
treatment planning for adult patients, aligned with Critical Care Nursing Made Incredibly Easy
(5th Edition, Springhouse) and AACN Essentials of Progressive Care Nursing (5th Edition,
Burns). Each question includes four answer options (A–D), the correct answer, and a detailed
rationale explaining why the correct answer is appropriate and why the other options are
incorrect.
Critical Care (Questions 1–20)
Question 1
A 65-year-old male is admitted to the ICU with septic shock. Vital signs: BP 80/50 mmHg, HR
120 bpm, RR 28/min, temp 102°F. What is the priority intervention?
A) Administer broad-spectrum antibiotics
B) Initiate fluid resuscitation with 30 mL/kg crystalloid
C) Start vasopressors immediately
D) Order a chest X-ray
Correct Answer: B
Rationale : Fluid resuscitation is the first-line treatment for septic shock to restore perfusion
(Burns, 5th Ed., Ch. 20). Option A is incorrect because antibiotics follow fluids. Option C is
incorrect because vasopressors are after fluids. Option D is incorrect because imaging is
diagnostic.
,Question 2
A 50-year-old female in the ICU has a central line with a temperature of 101°F. What is the first
step?
A) Remove the central line
B) Obtain blood cultures from all lumens
C) Administer empiric antibiotics
D) Order a CT scan
Correct Answer: B
Rationale : Blood cultures identify the pathogen before antibiotic administration in suspected
central line infection (Springhouse, 5th Ed., Ch. 3). Option A is incorrect because removal
follows confirmation. Option C is incorrect because cultures precede antibiotics. Option D is
incorrect because CT is for abscess.
Question 3
Case : A 70-year-old male with COPD exacerbation has pH 7.28, PaCO2 60 mmHg, PaO2 55
mmHg. What is the acid-base disorder?
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: B
Rationale : Low pH and high PaCO2 indicate respiratory acidosis from CO2 retention in COPD
(Burns, 5th Ed., Ch. 12). Option A is incorrect (low bicarbonate). Option C is incorrect (high pH).
Option D is incorrect (low PaCO2).
Question 4
A 55-year-old male with acute MI has ST elevation in V1–V4. What is the priority treatment?
A) Administer beta-blockers
B) Percutaneous coronary intervention (PCI)
C) Start heparin infusion
D) Order an echocardiogram
Correct Answer: B
Rationale : PCI is the definitive treatment for STEMI to restore blood flow within 90 minutes
(Springhouse, 5th Ed., Ch. 4). Option A is incorrect (adjunctive). Option C is incorrect
(anticoagulation secondary). Option D is incorrect (diagnostic).
, Question 5
A 60-year-old female with acute kidney injury (AKI) has urine output 10 mL/hr. What is the stage?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Correct Answer: C
Rationale : Stage 3 AKI is anuria or oliguria <0.3 mL/kg/hr for >24 hours (Burns, 5th Ed., Ch. 14).
Option A is incorrect (mild). Option B is incorrect (moderate). Option D is incorrect (end-stage).
Question 6
Application: A 45-year-old male with sepsis has MAP 60 mmHg after fluids. What is the first
vasopressor?
A) Dopamine
B) Norepinephrine
C) Epinephrine
D) Vasopressin
Correct Answer: B
Rationale : Norepinephrine is first-line for septic shock to maintain perfusion (Springhouse, 5th
Ed., Ch. 20). Option A is incorrect (second-line). Option C is incorrect (arrest). Option D is
incorrect (adjunctive).
Question 7
A 70-year-old male with GI bleed has hemoglobin 6.5 g/dL. What is the transfusion threshold?
A) <10 g/dL
B) <7 g/dL
C) <8 g/dL
D) <9 g/dL
Correct Answer: B
Rationale : Transfusion for hemoglobin <7 g/dL in stable GI bleed (Burns, 5th Ed., Ch. 15).
Option A is incorrect (active bleeding). Option C is incorrect (symptomatic). Option D is incorrect
(critical).
Question 8
A 55-year-old female with acute pancreatitis has Ranson's score of 4. What is the mortality risk?
A) <1%
B) **10–20%**
