NRNP 6566 Week 8 Quiz V2 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 8 Quiz) | Walden University
1. A 52-year-old male with a history of chronic alcohol use presents with severe, boring
epigastric pain that radiates to his back. His laboratory results show a serum lipase level of
1,200 U/L. What is the most likely diagnosis for this patient?
A. Acute Cholecystitis
B. Small Bowel Obstruction
C. Peptic Ulcer Perforation
D. Acute Pancreatitis
Answer: D
Rationale: Acute pancreatitis is frequently characterized by severe epigastric pain
radiating to the back and significant elevations in serum lipase. A lipase level greater than
three times the upper limit of normal is highly specific for this condition. Immediate
management involves aggressive fluid resuscitation, pain control, and nutritional support.
2. When evaluating a patient for sepsis, which of the following clinical findings is a
component of the Quick Sequential Organ Failure Assessment (qSOFA) score?
A. Heart rate > 100 beats per minute
,B. Systolic blood pressure ≤ 100 mmHg
C. Temperature > 38.3°C
D. White blood cell count > 12,000/mm³
Answer: B
Rationale: The qSOFA score is a bedside tool used to identify patients at risk of poor
outcomes from sepsis outside of the ICU. It includes three criteria: altered mental status,
respiratory rate ≥ 22 breaths/min, and systolic blood pressure ≤ 100 mmHg. This tool
helps clinicians quickly assess organ dysfunction and initiate life-saving interventions.
3. A patient in the intensive care unit is suspected of having septic shock. According to the
Surviving Sepsis Campaign, what is the target mean arterial pressure (MAP) for initial
resuscitation?
A. 55 mmHg
B. 75 mmHg
C. 65 mmHg
D. 85 mmHg
Answer: C
Rationale: A mean arterial pressure of at least 65 mmHg is the recommended target to
ensure adequate tissue perfusion in patients with septic shock. Achieving this target often
requires a combination of intravenous fluids and vasopressors like norepinephrine.
, Monitoring lactate levels and urine output is also essential to assess the effectiveness of
resuscitation.
4. A 65-year-old female presents with hematemesis and melena. Her BUN is 45 mg/dL and
her Creatinine is 0.9 mg/dL. What does this BUN/Creatinine ratio suggest?
A. Lower gastrointestinal bleeding
B. Upper gastrointestinal bleeding
C. Acute kidney injury
D. Congestive heart failure
Answer: B
Rationale: A BUN/Creatinine ratio greater than 20:1 or 30:1 is often indicative of an upper
gastrointestinal bleed rather than a lower one. This occurs because the digestion of blood
proteins in the upper GI tract leads to increased urea production. Clinicians should use this
ratio as a diagnostic clue while preparing for an urgent endoscopy.
5. In the management of hepatic encephalopathy, which medication is primarily used to
reduce serum ammonia levels by trapping it in the gut?
A. Rifaximin
B. Neomycin
C. Lactulose
D. Metronidazole
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 8 Quiz) | Walden University
1. A 52-year-old male with a history of chronic alcohol use presents with severe, boring
epigastric pain that radiates to his back. His laboratory results show a serum lipase level of
1,200 U/L. What is the most likely diagnosis for this patient?
A. Acute Cholecystitis
B. Small Bowel Obstruction
C. Peptic Ulcer Perforation
D. Acute Pancreatitis
Answer: D
Rationale: Acute pancreatitis is frequently characterized by severe epigastric pain
radiating to the back and significant elevations in serum lipase. A lipase level greater than
three times the upper limit of normal is highly specific for this condition. Immediate
management involves aggressive fluid resuscitation, pain control, and nutritional support.
2. When evaluating a patient for sepsis, which of the following clinical findings is a
component of the Quick Sequential Organ Failure Assessment (qSOFA) score?
A. Heart rate > 100 beats per minute
,B. Systolic blood pressure ≤ 100 mmHg
C. Temperature > 38.3°C
D. White blood cell count > 12,000/mm³
Answer: B
Rationale: The qSOFA score is a bedside tool used to identify patients at risk of poor
outcomes from sepsis outside of the ICU. It includes three criteria: altered mental status,
respiratory rate ≥ 22 breaths/min, and systolic blood pressure ≤ 100 mmHg. This tool
helps clinicians quickly assess organ dysfunction and initiate life-saving interventions.
3. A patient in the intensive care unit is suspected of having septic shock. According to the
Surviving Sepsis Campaign, what is the target mean arterial pressure (MAP) for initial
resuscitation?
A. 55 mmHg
B. 75 mmHg
C. 65 mmHg
D. 85 mmHg
Answer: C
Rationale: A mean arterial pressure of at least 65 mmHg is the recommended target to
ensure adequate tissue perfusion in patients with septic shock. Achieving this target often
requires a combination of intravenous fluids and vasopressors like norepinephrine.
, Monitoring lactate levels and urine output is also essential to assess the effectiveness of
resuscitation.
4. A 65-year-old female presents with hematemesis and melena. Her BUN is 45 mg/dL and
her Creatinine is 0.9 mg/dL. What does this BUN/Creatinine ratio suggest?
A. Lower gastrointestinal bleeding
B. Upper gastrointestinal bleeding
C. Acute kidney injury
D. Congestive heart failure
Answer: B
Rationale: A BUN/Creatinine ratio greater than 20:1 or 30:1 is often indicative of an upper
gastrointestinal bleed rather than a lower one. This occurs because the digestion of blood
proteins in the upper GI tract leads to increased urea production. Clinicians should use this
ratio as a diagnostic clue while preparing for an urgent endoscopy.
5. In the management of hepatic encephalopathy, which medication is primarily used to
reduce serum ammonia levels by trapping it in the gut?
A. Rifaximin
B. Neomycin
C. Lactulose
D. Metronidazole
