NR572 Exam 4 Actual Exam Style V1 | NR
572 Advanced Acute Care Management |
Chamberlain
1. What is the recommended initial crystalloid fluid bolus for a patient diagnosed with septic
shock?
A. 10 mL/kg
B. 20 mL/kg
C. 30 mL/kg
D. 50 mL/kg
Correct Answer: C
Expert Explanation: Initial fluid resuscitation for sepsis should begin with 30 mL/kg of
intravenous crystalloid fluid. This intervention is recommended by the Surviving Sepsis
Campaign to address hypoperfusion in the first hour. Prompt fluid administration helps
stabilize blood pressure and improve organ perfusion.
2. Which vasoactive medication is considered the first-line choice for patients in septic shock
who remain hypotensive after fluid resuscitation?
A. Dopamine
B. Norepinephrine
C. Epinephrine
,D. Vasopressin
Correct Answer: B
Expert Explanation: Norepinephrine is the primary vasopressor recommended for
managing septic shock. It effectively increases mean arterial pressure by stimulating alpha-
adrenergic receptors. It is preferred over dopamine due to a lower risk of arrhythmias.
3. In the assessment of sepsis, what does an elevated serum lactate level primarily indicate?
A. Adequate oxygen delivery
B. Hyperventilation syndrome
C. Tissue hypoxia and hypoperfusion
D. Renal compensation for acidosis
Correct Answer: C
Expert Explanation: Elevated lactate levels are a marker of anaerobic metabolism and
cellular hypoperfusion. High lactate is often used as a prognostic indicator in critically ill
patients. It signifies that the tissues are not receiving enough oxygen to meet metabolic
demands.
4. How is septic shock differentiated from sepsis in clinical practice?
A. By the need for vasopressors to maintain a MAP of 65 mmHg
B. By an elevated white blood cell count
C. By the presence of a fever
, D. By the presence of a positive blood culture
Correct Answer: A
Expert Explanation: Septic shock is a subset of sepsis characterized by profound
circulatory and cellular abnormalities. It is clinically identified by the persistent need for
vasopressors despite adequate fluid resuscitation. This state is also associated with a
serum lactate level greater than 2 mmol/L.
5. Which hemodynamic finding is characteristic of hypovolemic shock?
A. High Central Venous Pressure (CVP)
B. High Pulmonary Capillary Wedge Pressure (PCWP)
C. Increased Cardiac Output
D. Increased Systemic Vascular Resistance (SVR)
Correct Answer: D
Expert Explanation: In hypovolemic shock, the body compensates for low volume by
increasing systemic vascular resistance through vasoconstriction. This is a physiological
attempt to maintain blood pressure to vital organs. Central venous pressure and cardiac
output are typically low in this state.
6. What is the hallmark hemodynamic finding in cardiogenic shock?
A. Low Systemic Vascular Resistance (SVR)
B. Low Central Venous Pressure (CVP)
572 Advanced Acute Care Management |
Chamberlain
1. What is the recommended initial crystalloid fluid bolus for a patient diagnosed with septic
shock?
A. 10 mL/kg
B. 20 mL/kg
C. 30 mL/kg
D. 50 mL/kg
Correct Answer: C
Expert Explanation: Initial fluid resuscitation for sepsis should begin with 30 mL/kg of
intravenous crystalloid fluid. This intervention is recommended by the Surviving Sepsis
Campaign to address hypoperfusion in the first hour. Prompt fluid administration helps
stabilize blood pressure and improve organ perfusion.
2. Which vasoactive medication is considered the first-line choice for patients in septic shock
who remain hypotensive after fluid resuscitation?
A. Dopamine
B. Norepinephrine
C. Epinephrine
,D. Vasopressin
Correct Answer: B
Expert Explanation: Norepinephrine is the primary vasopressor recommended for
managing septic shock. It effectively increases mean arterial pressure by stimulating alpha-
adrenergic receptors. It is preferred over dopamine due to a lower risk of arrhythmias.
3. In the assessment of sepsis, what does an elevated serum lactate level primarily indicate?
A. Adequate oxygen delivery
B. Hyperventilation syndrome
C. Tissue hypoxia and hypoperfusion
D. Renal compensation for acidosis
Correct Answer: C
Expert Explanation: Elevated lactate levels are a marker of anaerobic metabolism and
cellular hypoperfusion. High lactate is often used as a prognostic indicator in critically ill
patients. It signifies that the tissues are not receiving enough oxygen to meet metabolic
demands.
4. How is septic shock differentiated from sepsis in clinical practice?
A. By the need for vasopressors to maintain a MAP of 65 mmHg
B. By an elevated white blood cell count
C. By the presence of a fever
, D. By the presence of a positive blood culture
Correct Answer: A
Expert Explanation: Septic shock is a subset of sepsis characterized by profound
circulatory and cellular abnormalities. It is clinically identified by the persistent need for
vasopressors despite adequate fluid resuscitation. This state is also associated with a
serum lactate level greater than 2 mmol/L.
5. Which hemodynamic finding is characteristic of hypovolemic shock?
A. High Central Venous Pressure (CVP)
B. High Pulmonary Capillary Wedge Pressure (PCWP)
C. Increased Cardiac Output
D. Increased Systemic Vascular Resistance (SVR)
Correct Answer: D
Expert Explanation: In hypovolemic shock, the body compensates for low volume by
increasing systemic vascular resistance through vasoconstriction. This is a physiological
attempt to maintain blood pressure to vital organs. Central venous pressure and cardiac
output are typically low in this state.
6. What is the hallmark hemodynamic finding in cardiogenic shock?
A. Low Systemic Vascular Resistance (SVR)
B. Low Central Venous Pressure (CVP)
