NRNP 6566 Week 10 Quiz V2 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. A 68-year-old male is admitted with septic shock. Despite fluid resuscitation of 30 mL/kg,
his mean arterial pressure (MAP) remains at 55 mmHg. What is the first-line vasopressor of
choice according to the Surviving Sepsis Campaign guidelines?
A. Vasopressin
B. Norepinephrine
C. Dopamine
D. Epinephrine
Answer: B
Rationale: Norepinephrine is the recommended first-line vasopressor for maintaining a
target MAP of 65 mmHg in patients with septic shock. It has a more potent alpha-1 agonist
effect compared to dopamine, resulting in more reliable vasoconstriction with less
tachycardia. Research indicates that norepinephrine usage is associated with better
outcomes and fewer arrhythmic events in this patient population.
2. A patient in the ICU is being monitored for Multiple Organ Dysfunction Syndrome (MODS).
Which of the following describes the most common sequence of organ failure in MODS?
A. Lungs, then Renal, then Hepatic
,B. Hepatic, then Hematologic, then Renal
C. Renal, then Hepatic, then Lungs
D. Cardiovascular, then Renal, then CNS
Answer: A
Rationale: In most cases of MODS, the lungs are the first organ system to show signs of
failure, often manifesting as ARDS. This is frequently followed by renal failure and then
hepatic or gastrointestinal dysfunction as the inflammatory cascade continues.
Understanding this progression helps the acute care nurse practitioner anticipate
complications and implement supportive care early.
3. Which clinical finding is part of the ‘Beck’s Triad,’ indicating a diagnosis of cardiac
tamponade in a trauma patient?
A. Hypertension, bradycardia, and irregular respirations
B. Hypotension, muffled heart sounds, and jugular venous distention
C. Tachycardia, hypotension, and diminished breath sounds
D. Narrow pulse pressure, hyperresonance on percussion, and tracheal deviation
Answer: B
Rationale: Beck’s Triad consists of hypotension, muffled heart sounds, and elevated
jugular venous pressure, which are classic indicators of acute cardiac tamponade. These
signs occur because the fluid in the pericardial sac restricts cardiac filling and reduces
,stroke volume. Immediate pericardiocentesis or a pericardial window is often required to
relieve the pressure and stabilize the patient.
4. A patient presents with Systemic Inflammatory Response Syndrome (SIRS). Which of the
following criteria is required to meet the SIRS definition?
A. Lactate > 4 mmol/L
B. Temperature > 38°C or < 36°C
C. Systolic Blood Pressure < 90 mmHg
D. Positive blood cultures
Answer: B
Rationale: SIRS is defined by the presence of at least two criteria, one of which is a
temperature greater than 38°C or less than 36°C. Other criteria include a heart rate > 90
bpm, respiratory rate > 20, or a WBC count > 12,000 or < 4,000. While SIRS is no longer the
primary definition for sepsis, it remains an important clinical tool for identifying patients
with a generalized inflammatory state.
5. Which of the following interventions is a priority for a patient suspected of having
Disseminated Intravascular Coagulation (DIC)?
A. Immediate administration of high-dose Heparin
B. Strict fluid restriction to prevent edema
C. Treating the underlying cause of the DIC
, D. Administering oral anticoagulants
Answer: C
Rationale: The primary management strategy for DIC is to identify and treat the
underlying trigger, such as sepsis, trauma, or malignancy. Without addressing the root
cause, the consumption of clotting factors and subsequent bleeding cannot be effectively
halted. Supportive therapies like blood products are used only when there is active
bleeding or a high risk of hemorrhage.
6. A patient with a traumatic brain injury (TBI) has a Glasgow Coma Scale (GCS) score of 7.
How is this injury classified?
A. Mild
B. Moderate
C. Critical
D. Severe
Answer: D
Rationale: A GCS score of 8 or less is generally classified as a severe brain injury and
typically necessitates endotracheal intubation for airway protection. A score of 9-12 is
considered moderate, and 13-15 is mild. The NP must monitor these scores closely as they
serve as a standard indicator for neurological status and prognosis.
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. A 68-year-old male is admitted with septic shock. Despite fluid resuscitation of 30 mL/kg,
his mean arterial pressure (MAP) remains at 55 mmHg. What is the first-line vasopressor of
choice according to the Surviving Sepsis Campaign guidelines?
A. Vasopressin
B. Norepinephrine
C. Dopamine
D. Epinephrine
Answer: B
Rationale: Norepinephrine is the recommended first-line vasopressor for maintaining a
target MAP of 65 mmHg in patients with septic shock. It has a more potent alpha-1 agonist
effect compared to dopamine, resulting in more reliable vasoconstriction with less
tachycardia. Research indicates that norepinephrine usage is associated with better
outcomes and fewer arrhythmic events in this patient population.
2. A patient in the ICU is being monitored for Multiple Organ Dysfunction Syndrome (MODS).
Which of the following describes the most common sequence of organ failure in MODS?
A. Lungs, then Renal, then Hepatic
,B. Hepatic, then Hematologic, then Renal
C. Renal, then Hepatic, then Lungs
D. Cardiovascular, then Renal, then CNS
Answer: A
Rationale: In most cases of MODS, the lungs are the first organ system to show signs of
failure, often manifesting as ARDS. This is frequently followed by renal failure and then
hepatic or gastrointestinal dysfunction as the inflammatory cascade continues.
Understanding this progression helps the acute care nurse practitioner anticipate
complications and implement supportive care early.
3. Which clinical finding is part of the ‘Beck’s Triad,’ indicating a diagnosis of cardiac
tamponade in a trauma patient?
A. Hypertension, bradycardia, and irregular respirations
B. Hypotension, muffled heart sounds, and jugular venous distention
C. Tachycardia, hypotension, and diminished breath sounds
D. Narrow pulse pressure, hyperresonance on percussion, and tracheal deviation
Answer: B
Rationale: Beck’s Triad consists of hypotension, muffled heart sounds, and elevated
jugular venous pressure, which are classic indicators of acute cardiac tamponade. These
signs occur because the fluid in the pericardial sac restricts cardiac filling and reduces
,stroke volume. Immediate pericardiocentesis or a pericardial window is often required to
relieve the pressure and stabilize the patient.
4. A patient presents with Systemic Inflammatory Response Syndrome (SIRS). Which of the
following criteria is required to meet the SIRS definition?
A. Lactate > 4 mmol/L
B. Temperature > 38°C or < 36°C
C. Systolic Blood Pressure < 90 mmHg
D. Positive blood cultures
Answer: B
Rationale: SIRS is defined by the presence of at least two criteria, one of which is a
temperature greater than 38°C or less than 36°C. Other criteria include a heart rate > 90
bpm, respiratory rate > 20, or a WBC count > 12,000 or < 4,000. While SIRS is no longer the
primary definition for sepsis, it remains an important clinical tool for identifying patients
with a generalized inflammatory state.
5. Which of the following interventions is a priority for a patient suspected of having
Disseminated Intravascular Coagulation (DIC)?
A. Immediate administration of high-dose Heparin
B. Strict fluid restriction to prevent edema
C. Treating the underlying cause of the DIC
, D. Administering oral anticoagulants
Answer: C
Rationale: The primary management strategy for DIC is to identify and treat the
underlying trigger, such as sepsis, trauma, or malignancy. Without addressing the root
cause, the consumption of clotting factors and subsequent bleeding cannot be effectively
halted. Supportive therapies like blood products are used only when there is active
bleeding or a high risk of hemorrhage.
6. A patient with a traumatic brain injury (TBI) has a Glasgow Coma Scale (GCS) score of 7.
How is this injury classified?
A. Mild
B. Moderate
C. Critical
D. Severe
Answer: D
Rationale: A GCS score of 8 or less is generally classified as a severe brain injury and
typically necessitates endotracheal intubation for airway protection. A score of 9-12 is
considered moderate, and 13-15 is mild. The NP must monitor these scores closely as they
serve as a standard indicator for neurological status and prognosis.
