NR 572 Advanced Acute Care
Management | Chamberlain
1. In the early stages of septic shock, which hemodynamic finding is most characteristic of the
hyperdynamic state?
A. Decreased Cardiac Output (CO)
B. Increased Systemic Vascular Resistance (SVR)
C. Increased Cardiac Index (CI)
D. Elevated Central Venous Pressure (CVP)
Answer: C
Rationale: Early septic shock is characterized by a hyperdynamic state where the cardiac
index is typically elevated. This occurs due to profound peripheral vasodilation and a
compensatory increase in heart rate. The systemic vascular resistance is usually low in this
phase of distributive shock.
2. A patient with Acute Respiratory Distress Syndrome (ARDS) requires mechanical
ventilation. What is the primary purpose of applying Positive End-Expiratory Pressure (PEEP)?
A. To decrease the work of breathing
B. To prevent respiratory alkalosis
C. To increase the tidal volume delivered to the patient
,D. To prevent alveolar collapse and improve oxygenation
Answer: D
Rationale: The application of PEEP in ARDS is designed to keep the alveoli open at the end
of expiration. This process recruits collapsed lung units and increases the functional
residual capacity of the lungs. By improving the surface area for gas exchange, PEEP
significantly enhances systemic oxygenation.
3. Which clinical indicator is a component of Cushing’s Triad, suggesting increased intracranial
pressure (ICP)?
A. Tachycardia
B. Bradycardia
C. Hypotension
D. Narrowing pulse pressure
Answer: B
Rationale: Cushing’s Triad is a late sign of increased intracranial pressure and impending
brain herniation. It consists of bradycardia, hypertension with a widened pulse pressure,
and irregular respiratory patterns. Identifying these signs is critical for immediate
neurosurgical or medical intervention.
4. A patient presents with Diabetic Ketoacidosis (DKA). Which of the following is the first
priority in the initial management of this patient?
A. Intravenous insulin bolus
, B. Bicarbonate infusion
C. Fluid resuscitation with Normal Saline
D. Potassium replacement
Answer: C
Rationale: Initial management of DKA focuses on correcting the severe dehydration
through rapid fluid resuscitation. Restoring intravascular volume improves renal perfusion
and begins to dilute the blood glucose levels. Insulin therapy is typically initiated only after
fluid resuscitation has begun and potassium levels are confirmed.
5. When interpreting hemodynamic data for a patient in cardiogenic shock, which finding is
most likely?
A. Low Pulmonary Artery Wedge Pressure (PAWP)
B. High Systemic Vascular Resistance (SVR)
C. High Cardiac Index (CI)
D. Low Central Venous Pressure (CVP)
Answer: B
Rationale: In cardiogenic shock, the heart’s pumping ability is severely impaired, leading
to a low cardiac index. The body compensates for the low output by increasing systemic
vascular resistance through vasoconstriction to maintain blood pressure. Additionally,