NRNP 6566 Week 6 Quiz V2 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 6 Quiz) | Walden University
1. A 65-year-old patient presents with acute decompensated heart failure (ADHF). Which
physical examination finding is most indicative of increased left-sided filling pressures?
A. Peripheral edema
B. Hepatojugular reflux
C. Jugular venous distension
D. Bibasilar crackles
Answer: D
Rationale: Bibasilar crackles indicate pulmonary edema resulting from elevated left-sided
filling pressures. Peripheral edema and jugular venous distension are typically associated
with right-sided heart failure and systemic congestion. In acute settings, identifying
pulmonary congestion is critical for initiating diuresis.
2. Which cardiac biomarker is considered the most specific for diagnosing myocardial
infarction due to its prolonged elevation in the blood?
A. Myoglobin
B. CK-MB
,C. Troponin I
D. Lactate dehydrogenase
Answer: C
Rationale: Troponin I is highly sensitive and specific to cardiac muscle damage and
remains elevated for several days following an event. CK-MB is less specific as it can be
found in skeletal muscle and returns to baseline much faster. Myoglobin rises early but
lacks the specificity required for a definitive cardiac diagnosis.
3. A patient with stable angina is being evaluated. What is the primary pathophysiological
difference between stable and unstable angina?
A. The location of the atherosclerotic plaque
B. The severity of chest pain reported by the patient
C. The presence of plaque rupture and thrombus formation
D. The patient’s response to supplemental oxygen
Answer: C
Rationale: Unstable angina is characterized by plaque rupture and subtotal thrombus
formation, which significantly reduces coronary blood flow at rest. Stable angina usually
involves a fixed stenosis where pain is only triggered by increased myocardial oxygen
demand. Distinguishing between these is essential for determining the urgency of
intervention.
, 4. What is the first-line pharmacologic treatment for a patient presenting with symptomatic
sinus bradycardia?
A. Epinephrine
B. Atropine
C. Amiodarone
D. Dopamine
Answer: B
Rationale: Atropine is the initial drug of choice for symptomatic bradycardia because it
blocks the vagal influence on the SA node. If atropine is ineffective, clinicians may consider
transcutaneous pacing or infusions of epinephrine or dopamine. Amiodarone is an
antiarrhythmic used for tachyarrhythmias and is not indicated here.
5. In the management of a Hypertensive Emergency, what is the recommended goal for blood
pressure reduction within the first hour?
A. Reduction of Mean Arterial Pressure (MAP) by no more than 25%
B. Reduction to 120/80 mmHg
C. Reduction of Diastolic BP to 90 mmHg
D. Reduction of Systolic BP by 50%
Answer: A
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 6 Quiz) | Walden University
1. A 65-year-old patient presents with acute decompensated heart failure (ADHF). Which
physical examination finding is most indicative of increased left-sided filling pressures?
A. Peripheral edema
B. Hepatojugular reflux
C. Jugular venous distension
D. Bibasilar crackles
Answer: D
Rationale: Bibasilar crackles indicate pulmonary edema resulting from elevated left-sided
filling pressures. Peripheral edema and jugular venous distension are typically associated
with right-sided heart failure and systemic congestion. In acute settings, identifying
pulmonary congestion is critical for initiating diuresis.
2. Which cardiac biomarker is considered the most specific for diagnosing myocardial
infarction due to its prolonged elevation in the blood?
A. Myoglobin
B. CK-MB
,C. Troponin I
D. Lactate dehydrogenase
Answer: C
Rationale: Troponin I is highly sensitive and specific to cardiac muscle damage and
remains elevated for several days following an event. CK-MB is less specific as it can be
found in skeletal muscle and returns to baseline much faster. Myoglobin rises early but
lacks the specificity required for a definitive cardiac diagnosis.
3. A patient with stable angina is being evaluated. What is the primary pathophysiological
difference between stable and unstable angina?
A. The location of the atherosclerotic plaque
B. The severity of chest pain reported by the patient
C. The presence of plaque rupture and thrombus formation
D. The patient’s response to supplemental oxygen
Answer: C
Rationale: Unstable angina is characterized by plaque rupture and subtotal thrombus
formation, which significantly reduces coronary blood flow at rest. Stable angina usually
involves a fixed stenosis where pain is only triggered by increased myocardial oxygen
demand. Distinguishing between these is essential for determining the urgency of
intervention.
, 4. What is the first-line pharmacologic treatment for a patient presenting with symptomatic
sinus bradycardia?
A. Epinephrine
B. Atropine
C. Amiodarone
D. Dopamine
Answer: B
Rationale: Atropine is the initial drug of choice for symptomatic bradycardia because it
blocks the vagal influence on the SA node. If atropine is ineffective, clinicians may consider
transcutaneous pacing or infusions of epinephrine or dopamine. Amiodarone is an
antiarrhythmic used for tachyarrhythmias and is not indicated here.
5. In the management of a Hypertensive Emergency, what is the recommended goal for blood
pressure reduction within the first hour?
A. Reduction of Mean Arterial Pressure (MAP) by no more than 25%
B. Reduction to 120/80 mmHg
C. Reduction of Diastolic BP to 90 mmHg
D. Reduction of Systolic BP by 50%
Answer: A
