NRNP 6566 Week 4 Quiz V2 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 4 Quiz) | Walden University
1. A patient’s ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Answer: C
Rationale: The leads II, III, and aVF represent the inferior wall of the heart. The right
coronary artery (RCA) is typically the vessel that supplies blood to this specific region in
most individuals. Identifying the location of an MI helps the clinician anticipate potential
complications such as bradycardia or right ventricular failure.
2. When interpreting hemodynamic parameters, a high Pulmonary Capillary Wedge Pressure
(PCWP) typically indicates which of the following?
A. Hypovolemic shock
B. Left ventricular failure
,C. Pulmonary embolism
D. Right ventricular failure
Answer: B
Rationale: PCWP is a reflection of the pressure in the left atrium and the end-diastolic
pressure of the left ventricle. An elevated PCWP suggests that the left ventricle is unable to
pump efficiently, leading to blood backing up into the pulmonary circulation. This finding is
a hallmark of cardiogenic shock or congestive heart failure involving the left side.
3. Which heart sound is most commonly associated with fluid volume overload in a patient
with heart failure?
A. S4
B. Friction rub
C. Systolic click
D. S3
Answer: D
Rationale: The S3 heart sound, also known as a ventricular gallop, occurs early in diastole
during the rapid ventricular filling phase. It is frequently heard in adult patients with heart
failure or fluid overload when blood enters an overfilled or noncompliant ventricle. Clinical
detection of S3 serves as a significant indicator for the need to adjust diuretic therapy.
, 4. A patient with a history of atrial fibrillation presents with sudden onset of shortness of
breath and pleuritic chest pain. What is the most immediate priority?
A. Digoxin level check
B. Administration of a beta-blocker
C. Cardioversion
D. Assessment for Pulmonary Embolism
Answer: D
Rationale: Atrial fibrillation increases the risk of thrombus formation in the atria, which
can lead to systemic or pulmonary embolization. Sudden respiratory distress and chest
pain are classic symptoms of a pulmonary embolism (PE) in this high-risk population.
Immediate diagnostic workup, including a CT pulmonary angiogram or V/Q scan, is
necessary to confirm the diagnosis and start anticoagulation.
5. In the management of acute coronary syndrome (ACS), what is the primary purpose of
administering Nitroglycerin?
A. To reduce preload and afterload through vasodilation
B. To increase myocardial contractility
C. To decrease heart rate
D. To provide systemic anticoagulation
Answer: A
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 4 Quiz) | Walden University
1. A patient’s ECG shows ST-segment elevation in leads II, III, and aVF. Which coronary artery
is most likely occluded?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery
Answer: C
Rationale: The leads II, III, and aVF represent the inferior wall of the heart. The right
coronary artery (RCA) is typically the vessel that supplies blood to this specific region in
most individuals. Identifying the location of an MI helps the clinician anticipate potential
complications such as bradycardia or right ventricular failure.
2. When interpreting hemodynamic parameters, a high Pulmonary Capillary Wedge Pressure
(PCWP) typically indicates which of the following?
A. Hypovolemic shock
B. Left ventricular failure
,C. Pulmonary embolism
D. Right ventricular failure
Answer: B
Rationale: PCWP is a reflection of the pressure in the left atrium and the end-diastolic
pressure of the left ventricle. An elevated PCWP suggests that the left ventricle is unable to
pump efficiently, leading to blood backing up into the pulmonary circulation. This finding is
a hallmark of cardiogenic shock or congestive heart failure involving the left side.
3. Which heart sound is most commonly associated with fluid volume overload in a patient
with heart failure?
A. S4
B. Friction rub
C. Systolic click
D. S3
Answer: D
Rationale: The S3 heart sound, also known as a ventricular gallop, occurs early in diastole
during the rapid ventricular filling phase. It is frequently heard in adult patients with heart
failure or fluid overload when blood enters an overfilled or noncompliant ventricle. Clinical
detection of S3 serves as a significant indicator for the need to adjust diuretic therapy.
, 4. A patient with a history of atrial fibrillation presents with sudden onset of shortness of
breath and pleuritic chest pain. What is the most immediate priority?
A. Digoxin level check
B. Administration of a beta-blocker
C. Cardioversion
D. Assessment for Pulmonary Embolism
Answer: D
Rationale: Atrial fibrillation increases the risk of thrombus formation in the atria, which
can lead to systemic or pulmonary embolization. Sudden respiratory distress and chest
pain are classic symptoms of a pulmonary embolism (PE) in this high-risk population.
Immediate diagnostic workup, including a CT pulmonary angiogram or V/Q scan, is
necessary to confirm the diagnosis and start anticoagulation.
5. In the management of acute coronary syndrome (ACS), what is the primary purpose of
administering Nitroglycerin?
A. To reduce preload and afterload through vasodilation
B. To increase myocardial contractility
C. To decrease heart rate
D. To provide systemic anticoagulation
Answer: A
