NRNP6566 Week 7 Knowledge Check - Walden University AGACNP Program - Advanced Acute Care Adults

NRNP6566 Week 7 Knowledge Check - Walden
University AGACNP Program 2026-2027 -
Advanced Acute Care Adults


30 items | 100 % ICU data interpretation/action | 45 min



SECTION 1 Hemodynamics & Shock (Q 1 – 10)

Q1

Septic shock, noradrenaline 0.3 µg/kg/min MAP 65 mmHg, CVP 14 mmHg, echo: dilated
hypokinetic RV, D-shaped septum. Next critical therapy?

A. ↑ noradrenaline

B. Add vasopressin

C. Inhaled epoprostenol ± dobutamine

D. 500 mL fluid bolus

Answer: C – acute cor pulmonale: ↓ RV afterload + inotropy; fluids worsen RV dilation.

Q2

Arterial line tracing: rounded upstroke, loss of dicrotic notch, reads SBP 180 mmHg.
First action?

A. Give antihypertensive

, B. Check for damping (kinks, air, flush)

C. Confirm with NIBP

D. Order echo

Answer: B – damped waveform = artifact; troubleshoot before treating.

Q3

Septic shock, ScvO₂ 58 %, Hgb 8 g/dL, MAP 70 mmHg, lactate 4 mmol/L. Next step?

A. ↑ noradrenaline

B. Transfuse 1 unit PRBC

C. Start dobutamine

D. Check ABG

Answer: B – ScvO₂ < 65 % + Hgb < 10 → transfusion improves O₂ delivery.

Q4

Which finding BEST indicates fluid responsiveness in spontaneously breathing patient?

A. CVP 5 mmHg

B. ΔPP 15 %

C. Passive leg raise ↑ CO 10 %

D. MAP 60 mmHg

Answer: C – PLR-induced ↑ CO ≥ 10 % = reliable dynamic predictor.