NRNP 6566 Week 10 Quiz V3 NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. A patient with a Glasgow Coma Scale (GCS) score of 7 is admitted following a motor vehicle
accident. Which immediate intervention is prioritized according to acute care standards?
A. Administration of aggressive IV fluid resuscitation
B. Insertion of an intracranial pressure monitoring device
C. Immediate transport to the CT suite for head imaging
D. Endotracheal intubation and mechanical ventilation
Answer: D
Rationale: In the acute care setting, a GCS score of 8 or less indicates the patient’s inability
to maintain a patent airway or protect it from aspiration. Securing the airway via
endotracheal intubation is the primary priority in the initial management of traumatic
brain injury. This approach follows the ATLS guidelines which are fundamental to the
NRNP 6566 curriculum.
2. Which of the following vasopressors is considered the first-line treatment for a patient in
septic shock who remains hypotensive after adequate fluid resuscitation?
A. Dopamine
,B. Vasopressin
C. Phenylephrine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is the first-choice vasopressor recommended by the Surviving
Sepsis Campaign for managing hypotension in septic shock. It provides potent alpha-1
adrenergic effects resulting in vasoconstriction while having minimal impact on heart rate.
Clinicians must ensure adequate fluid volume is restored prior to or during the initiation of
this therapy.
3. A patient exhibits sudden tracheal deviation to the left, absent breath sounds on the right,
and severe respiratory distress. What is the most likely diagnosis?
A. Simple pneumothorax
B. Hemothorax
C. Pulmonary embolism
D. Tension pneumothorax
Answer: D
Rationale: Tracheal deviation away from the affected side is a classic late sign of tension
pneumothorax, which causes a mediastinal shift. This condition represents a life-
threatening emergency that requires immediate needle decompression followed by chest
, tube insertion. Failure to intervene promptly can lead to obstructive shock and cardiac
arrest.
4. A patient with a spinal cord injury at the T4 level presents with a sudden headache,
flushing above the level of injury, and a blood pressure of 210/110 mmHg. What is the
priority intervention?
A. Checking for bladder distension or fecal impaction
B. Administering a bolus of IV antihypertensives
C. Preparing the patient for emergency spinal surgery
D. Placing the patient in a Trendelenburg position
Answer: A
Rationale: Autonomic dysreflexia is a medical emergency occurring in patients with spinal
cord injuries at or above T6. The most common triggers are noxious stimuli such as a full
bladder or impacted bowel, which cause a massive sympathetic discharge. The primary
treatment is to identify and remove the offending stimulus while sitting the patient upright
to lower blood pressure.
5. During the secondary survey of a trauma patient, which of the following actions is
performed?
A. Securing the patient’s airway
B. Performing a complete head-to-toe physical examination
C. Obtaining a definitive blood pressure reading
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. A patient with a Glasgow Coma Scale (GCS) score of 7 is admitted following a motor vehicle
accident. Which immediate intervention is prioritized according to acute care standards?
A. Administration of aggressive IV fluid resuscitation
B. Insertion of an intracranial pressure monitoring device
C. Immediate transport to the CT suite for head imaging
D. Endotracheal intubation and mechanical ventilation
Answer: D
Rationale: In the acute care setting, a GCS score of 8 or less indicates the patient’s inability
to maintain a patent airway or protect it from aspiration. Securing the airway via
endotracheal intubation is the primary priority in the initial management of traumatic
brain injury. This approach follows the ATLS guidelines which are fundamental to the
NRNP 6566 curriculum.
2. Which of the following vasopressors is considered the first-line treatment for a patient in
septic shock who remains hypotensive after adequate fluid resuscitation?
A. Dopamine
,B. Vasopressin
C. Phenylephrine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is the first-choice vasopressor recommended by the Surviving
Sepsis Campaign for managing hypotension in septic shock. It provides potent alpha-1
adrenergic effects resulting in vasoconstriction while having minimal impact on heart rate.
Clinicians must ensure adequate fluid volume is restored prior to or during the initiation of
this therapy.
3. A patient exhibits sudden tracheal deviation to the left, absent breath sounds on the right,
and severe respiratory distress. What is the most likely diagnosis?
A. Simple pneumothorax
B. Hemothorax
C. Pulmonary embolism
D. Tension pneumothorax
Answer: D
Rationale: Tracheal deviation away from the affected side is a classic late sign of tension
pneumothorax, which causes a mediastinal shift. This condition represents a life-
threatening emergency that requires immediate needle decompression followed by chest
, tube insertion. Failure to intervene promptly can lead to obstructive shock and cardiac
arrest.
4. A patient with a spinal cord injury at the T4 level presents with a sudden headache,
flushing above the level of injury, and a blood pressure of 210/110 mmHg. What is the
priority intervention?
A. Checking for bladder distension or fecal impaction
B. Administering a bolus of IV antihypertensives
C. Preparing the patient for emergency spinal surgery
D. Placing the patient in a Trendelenburg position
Answer: A
Rationale: Autonomic dysreflexia is a medical emergency occurring in patients with spinal
cord injuries at or above T6. The most common triggers are noxious stimuli such as a full
bladder or impacted bowel, which cause a massive sympathetic discharge. The primary
treatment is to identify and remove the offending stimulus while sitting the patient upright
to lower blood pressure.
5. During the secondary survey of a trauma patient, which of the following actions is
performed?
A. Securing the patient’s airway
B. Performing a complete head-to-toe physical examination
C. Obtaining a definitive blood pressure reading
