NR572 Exam 4 Actual Exam Style V2 | NR
572 Advanced Acute Care Management |
Chamberlain
1. A patient is admitted with severe acute pancreatitis. Which laboratory value is most
specific for diagnosing this condition?
A. Serum Amylase
B. Serum Calcium
C. Serum Lipase
D. Serum Bilirubin
Answer: C
Rationale: Serum lipase is more specific to the pancreas than amylase and remains
elevated for a longer duration. While amylase rises early, it can be influenced by other
conditions such as salivary gland issues. Lipase levels greater than three times the upper
limit of normal are highly suggestive of acute pancreatitis.
2. Using the Parkland formula, calculate the total fluid volume needed in the first 24 hours for
a 70 kg patient with 40% total body surface area (TBSA) burns.
A. 5,600 mL
B. 11,200 mL
C. 8,400 mL
,D. 14,000 mL
Answer: B
Rationale: The Parkland formula is 4 mL x weight (kg) x % TBSA. For this patient, the
calculation is 4 mL x 70 kg x 40, which equals 11,200 mL. Half of this volume must be
administered within the first 8 hours after the burn occurred.
3. Which clinical finding is part of Beck’s triad, indicating cardiac tamponade?
A. Hypertension
B. Flat neck veins
C. Bradycardia
D. Muffled heart sounds
Answer: D
Rationale: Beck’s triad consists of hypotension, muffled heart sounds, and jugular venous
distention. These signs occur because fluid in the pericardial sac restricts heart expansion
and venous return. This condition is a medical emergency requiring immediate
pericardiocentesis to relieve pressure.
4. A patient with liver cirrhosis presents with encephalopathy. Which medication is the
primary treatment to reduce ammonia levels?
A. Spironolactone
B. Lactulose
, C. Propranolol
D. Ondansetron
Answer: B
Rationale: Lactulose works by acidifying the colon, which converts ammonia into
ammonium that can be excreted. The goal of therapy is usually to achieve 2 to 3 soft bowel
movements per day. This reduction in ammonia levels helps improve neurological status
and cognitive function in cirrhotic patients.
5. Which stage of shock is characterized by a shift from aerobic to anaerobic metabolism,
resulting in lactic acid buildup?
A. Refractory Stage
B. Compensatory Stage
C. Progressive Stage
D. Initial Stage
Answer: D
Rationale: In the initial stage of shock, cellular-level changes occur where metabolism
shifts because oxygen delivery is insufficient. This results in the production of lactic acid,
although clinical signs may be subtle at this point. Early recognition during this stage is
vital to prevent progression to more severe organ damage.
572 Advanced Acute Care Management |
Chamberlain
1. A patient is admitted with severe acute pancreatitis. Which laboratory value is most
specific for diagnosing this condition?
A. Serum Amylase
B. Serum Calcium
C. Serum Lipase
D. Serum Bilirubin
Answer: C
Rationale: Serum lipase is more specific to the pancreas than amylase and remains
elevated for a longer duration. While amylase rises early, it can be influenced by other
conditions such as salivary gland issues. Lipase levels greater than three times the upper
limit of normal are highly suggestive of acute pancreatitis.
2. Using the Parkland formula, calculate the total fluid volume needed in the first 24 hours for
a 70 kg patient with 40% total body surface area (TBSA) burns.
A. 5,600 mL
B. 11,200 mL
C. 8,400 mL
,D. 14,000 mL
Answer: B
Rationale: The Parkland formula is 4 mL x weight (kg) x % TBSA. For this patient, the
calculation is 4 mL x 70 kg x 40, which equals 11,200 mL. Half of this volume must be
administered within the first 8 hours after the burn occurred.
3. Which clinical finding is part of Beck’s triad, indicating cardiac tamponade?
A. Hypertension
B. Flat neck veins
C. Bradycardia
D. Muffled heart sounds
Answer: D
Rationale: Beck’s triad consists of hypotension, muffled heart sounds, and jugular venous
distention. These signs occur because fluid in the pericardial sac restricts heart expansion
and venous return. This condition is a medical emergency requiring immediate
pericardiocentesis to relieve pressure.
4. A patient with liver cirrhosis presents with encephalopathy. Which medication is the
primary treatment to reduce ammonia levels?
A. Spironolactone
B. Lactulose
, C. Propranolol
D. Ondansetron
Answer: B
Rationale: Lactulose works by acidifying the colon, which converts ammonia into
ammonium that can be excreted. The goal of therapy is usually to achieve 2 to 3 soft bowel
movements per day. This reduction in ammonia levels helps improve neurological status
and cognitive function in cirrhotic patients.
5. Which stage of shock is characterized by a shift from aerobic to anaerobic metabolism,
resulting in lactic acid buildup?
A. Refractory Stage
B. Compensatory Stage
C. Progressive Stage
D. Initial Stage
Answer: D
Rationale: In the initial stage of shock, cellular-level changes occur where metabolism
shifts because oxygen delivery is insufficient. This results in the production of lactic acid,
although clinical signs may be subtle at this point. Early recognition during this stage is
vital to prevent progression to more severe organ damage.
