NRNP 6566 Final Quiz V2 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Final Quiz) | Walden University
1. A 68-year-old patient with suspected sepsis has a respiratory rate of 24 breaths per minute,
a Systolic BP of 95 mmHg, and new-onset confusion. Which tool is most appropriate for rapid
bedside assessment of this patient’s risk for poor outcomes?
A. qSOFA Score
B. SIRS Criteria
C. APACHE II Score
D. SOFA Score
Answer: A
Rationale: The qSOFA score is a rapid bedside clinical tool used to identify patients outside
the intensive care unit who are at high risk for poor outcomes. It evaluates three specific
criteria: altered mental status, respiratory rate of 22/min or greater, and systolic blood
pressure of 100 mmHg or less. Meeting at least two of these criteria indicates a high risk of
prolonged ICU stay or mortality.
2. When calculating the Mean Arterial Pressure (MAP) for a patient with a blood pressure
reading of 100/70 mmHg, what is the resulting value?
A. 75 mmHg
,B. 85 mmHg
C. 90 mmHg
D. 80 mmHg
Answer: D
Rationale: The formula for Mean Arterial Pressure is (Systolic BP + 2 * Diastolic BP) / 3.
For a BP of 100/70, the calculation is (100 + 140) / 3, which equals 80. Maintaining a MAP
above 65 mmHg is critical for ensuring adequate organ perfusion in acute care settings.
3. A patient in the ICU develops sudden shortness of breath and pleuritic chest pain; the
Nurse Practitioner suspects a pulmonary embolism. What is the gold standard diagnostic test
for confirming this diagnosis?
A. CT Angiography (CTA)
B. Chest X-ray
C. D-dimer assay
D. Ventilation-Perfusion (V/Q) Scan
Answer: A
Rationale: CT Angiography is currently considered the gold standard for diagnosing
pulmonary embolism due to its high sensitivity and specificity. While D-dimer is useful for
ruling out PE in low-risk patients, it cannot confirm the diagnosis. V/Q scans are typically
reserved for patients who have contraindications to the contrast dye used in CTA.
, 4. An adult patient presents with a serum glucose of 750 mg/dL, a serum osmolality of 340
mOsm/kg, and no significant ketones in the urine. Which condition is most likely?
A. Diabetic Ketoacidosis (DKA)
B. Hyperglycemic Hyperosmolar State (HHS)
C. Diabetes Insipidus
D. Starvation Ketosis
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia and hyperosmolality without
the significant ketoacidosis found in DKA. It most commonly occurs in Type 2 diabetic
patients who are elderly or have underlying infections. The lack of ketones is due to the
presence of enough insulin to prevent lipolysis but not enough to control glucose levels.
5. During the first hour of sepsis management, which fluid resuscitation volume is
recommended by the Surviving Sepsis Campaign guidelines for a patient with hypotension or
lactate >4 mmol/L?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Answer: A
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Final Quiz) | Walden University
1. A 68-year-old patient with suspected sepsis has a respiratory rate of 24 breaths per minute,
a Systolic BP of 95 mmHg, and new-onset confusion. Which tool is most appropriate for rapid
bedside assessment of this patient’s risk for poor outcomes?
A. qSOFA Score
B. SIRS Criteria
C. APACHE II Score
D. SOFA Score
Answer: A
Rationale: The qSOFA score is a rapid bedside clinical tool used to identify patients outside
the intensive care unit who are at high risk for poor outcomes. It evaluates three specific
criteria: altered mental status, respiratory rate of 22/min or greater, and systolic blood
pressure of 100 mmHg or less. Meeting at least two of these criteria indicates a high risk of
prolonged ICU stay or mortality.
2. When calculating the Mean Arterial Pressure (MAP) for a patient with a blood pressure
reading of 100/70 mmHg, what is the resulting value?
A. 75 mmHg
,B. 85 mmHg
C. 90 mmHg
D. 80 mmHg
Answer: D
Rationale: The formula for Mean Arterial Pressure is (Systolic BP + 2 * Diastolic BP) / 3.
For a BP of 100/70, the calculation is (100 + 140) / 3, which equals 80. Maintaining a MAP
above 65 mmHg is critical for ensuring adequate organ perfusion in acute care settings.
3. A patient in the ICU develops sudden shortness of breath and pleuritic chest pain; the
Nurse Practitioner suspects a pulmonary embolism. What is the gold standard diagnostic test
for confirming this diagnosis?
A. CT Angiography (CTA)
B. Chest X-ray
C. D-dimer assay
D. Ventilation-Perfusion (V/Q) Scan
Answer: A
Rationale: CT Angiography is currently considered the gold standard for diagnosing
pulmonary embolism due to its high sensitivity and specificity. While D-dimer is useful for
ruling out PE in low-risk patients, it cannot confirm the diagnosis. V/Q scans are typically
reserved for patients who have contraindications to the contrast dye used in CTA.
, 4. An adult patient presents with a serum glucose of 750 mg/dL, a serum osmolality of 340
mOsm/kg, and no significant ketones in the urine. Which condition is most likely?
A. Diabetic Ketoacidosis (DKA)
B. Hyperglycemic Hyperosmolar State (HHS)
C. Diabetes Insipidus
D. Starvation Ketosis
Answer: B
Rationale: HHS is characterized by extreme hyperglycemia and hyperosmolality without
the significant ketoacidosis found in DKA. It most commonly occurs in Type 2 diabetic
patients who are elderly or have underlying infections. The lack of ketones is due to the
presence of enough insulin to prevent lipolysis but not enough to control glucose levels.
5. During the first hour of sepsis management, which fluid resuscitation volume is
recommended by the Surviving Sepsis Campaign guidelines for a patient with hypotension or
lactate >4 mmol/L?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Answer: A
