NR570 Exam 3 Actual Exam Style V3 | NR
570 Common Diagnosis and Management
in Acute Care Practicum | Chamberlain
1. A 68-year-old male presents with sepsis. According to the Surviving Sepsis Campaign, what
is the recommended initial fluid resuscitation volume?
A. 30 mL/kg of crystalloids
B. 20 mL/kg of colloids
C. 10 mL/kg of crystalloids
D. 500 mL bolus of normal saline
Answer: A
Rationale: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of at least 30 mL/kg of intravenous crystalloid within the first 3 hours. This
volume is intended to stabilize intravascular status and improve tissue perfusion in
patients with sepsis-induced hypoperfusion. Monitoring clinical response and markers of
perfusion like lactate is essential following this bolus.
2. Which lab value is most specific for diagnosing Acute Heart Failure in a patient with acute
dyspnea?
A. Troponin I
B. D-dimer
,C. Creatinine Kinase-MB
D. B-type Natriuretic Peptide (BNP)
Answer: D
Rationale: B-type Natriuretic Peptide (BNP) or NT-proBNP are primary biomarkers used
to differentiate cardiac from non-cardiac causes of dyspnea. Elevated levels correlate with
increased ventricular stretch and pressure, which are common in acute heart failure. A
level below 100 pg/mL has a very high negative predictive value for heart failure.
3. When managing a patient with an acute COPD exacerbation, which class of medication is
the first-line therapy for bronchodilation?
A. Short-acting Beta-agonists (SABA)
B. Inhaled Corticosteroids
C. Long-acting Muscarinic Antagonists (LAMA)
D. Methylxanthines
Answer: A
Rationale: Short-acting bronchodilators such as SABAs with or without short-acting
muscarinic antagonists (SAMA) are the initial medications for acute COPD management.
They provide rapid relief of bronchoconstriction and help improve airflow during an
exacerbation. These are often administered via nebulizer or metered-dose inhaler with a
spacer.
, 4. A patient’s ABG results are pH 7.31, PaCO2 52, and HCO3 26. How would you interpret this
acid-base imbalance?
A. Compensated Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Rationale: The pH is below 7.35, indicating acidosis, while the elevated PaCO2 identifies
the respiratory system as the cause. Since the HCO3 is within the normal range, the body
has not yet compensated for the respiratory issue. This pattern is characteristic of
uncompensated respiratory acidosis often seen in hypoventilation.
5. Which of the following is the most appropriate initial treatment for a patient with
symptomatic hyperkalemia and EKG changes?
A. Sodium Polystyrene Sulfonate
B. Intravenous Furosemide
C. Calcium Gluconate
D. Oral Potassium Binders
Answer: C
570 Common Diagnosis and Management
in Acute Care Practicum | Chamberlain
1. A 68-year-old male presents with sepsis. According to the Surviving Sepsis Campaign, what
is the recommended initial fluid resuscitation volume?
A. 30 mL/kg of crystalloids
B. 20 mL/kg of colloids
C. 10 mL/kg of crystalloids
D. 500 mL bolus of normal saline
Answer: A
Rationale: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of at least 30 mL/kg of intravenous crystalloid within the first 3 hours. This
volume is intended to stabilize intravascular status and improve tissue perfusion in
patients with sepsis-induced hypoperfusion. Monitoring clinical response and markers of
perfusion like lactate is essential following this bolus.
2. Which lab value is most specific for diagnosing Acute Heart Failure in a patient with acute
dyspnea?
A. Troponin I
B. D-dimer
,C. Creatinine Kinase-MB
D. B-type Natriuretic Peptide (BNP)
Answer: D
Rationale: B-type Natriuretic Peptide (BNP) or NT-proBNP are primary biomarkers used
to differentiate cardiac from non-cardiac causes of dyspnea. Elevated levels correlate with
increased ventricular stretch and pressure, which are common in acute heart failure. A
level below 100 pg/mL has a very high negative predictive value for heart failure.
3. When managing a patient with an acute COPD exacerbation, which class of medication is
the first-line therapy for bronchodilation?
A. Short-acting Beta-agonists (SABA)
B. Inhaled Corticosteroids
C. Long-acting Muscarinic Antagonists (LAMA)
D. Methylxanthines
Answer: A
Rationale: Short-acting bronchodilators such as SABAs with or without short-acting
muscarinic antagonists (SAMA) are the initial medications for acute COPD management.
They provide rapid relief of bronchoconstriction and help improve airflow during an
exacerbation. These are often administered via nebulizer or metered-dose inhaler with a
spacer.
, 4. A patient’s ABG results are pH 7.31, PaCO2 52, and HCO3 26. How would you interpret this
acid-base imbalance?
A. Compensated Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Uncompensated Respiratory Acidosis
Answer: D
Rationale: The pH is below 7.35, indicating acidosis, while the elevated PaCO2 identifies
the respiratory system as the cause. Since the HCO3 is within the normal range, the body
has not yet compensated for the respiratory issue. This pattern is characteristic of
uncompensated respiratory acidosis often seen in hypoventilation.
5. Which of the following is the most appropriate initial treatment for a patient with
symptomatic hyperkalemia and EKG changes?
A. Sodium Polystyrene Sulfonate
B. Intravenous Furosemide
C. Calcium Gluconate
D. Oral Potassium Binders
Answer: C
