NRNP 6566 Week 10 Quiz V1 | NRNP 6566
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. Which of the following clinical findings is a prerequisite before proceeding with a formal
clinical brain death examination?
A. Evidence of a metabolic cause for the coma
B. Serum sodium level less than 120 mEq/L
C. Core body temperature equal to or greater than 36.5 degrees Celsius
D. Systolic blood pressure of at least 90 mmHg
Answer: C
Rationale: Before performing a brain death exam, the clinician must ensure there are no
confounding factors such as hypothermia or drug intoxication. A core temperature of at
least 36.5°C is required to ensure that the neurological findings are not suppressed by low
body heat. Additionally, metabolic derangements must be corrected to provide an accurate
assessment of brainstem function.
2. An adult patient with a severe Traumatic Brain Injury (TBI) has an ICP of 25 mmHg and a
MAP of 75 mmHg. What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 100 mmHg
,B. 50 mmHg
C. 60 mmHg
D. 3.33 mmHg
Answer: B
Rationale: Cerebral Perfusion Pressure is calculated using the formula CPP = MAP - ICP. In
this scenario, 75 mmHg minus 25 mmHg equals 50 mmHg, which is below the
recommended threshold of 60 to 70 mmHg. Maintaining adequate CPP is critical for
preventing secondary ischemic injury to the brain tissue.
3. Which type of organ transplant rejection occurs within minutes to hours after the graft is
revascularized due to pre-existing antibodies?
A. Acute cellular rejection
B. Hyperacute rejection
C. Chronic rejection
D. Antibody-mediated rejection
Answer: B
Rationale: Hyperacute rejection is a Type II hypersensitivity reaction caused by pre-
formed recipient antibodies against the donor’s HLA or ABO antigens. This leads to
immediate thrombosis and necrosis of the graft, often requiring immediate removal. This
reaction is now rare due to improved cross-matching protocols before transplantation.
, 4. When managing a patient with autonomic dysreflexia, which of the following is the most
appropriate initial action by the nurse practitioner?
A. Administer IV hydralazine
B. Sit the patient upright and loosen restrictive clothing
C. Perform a digital rectal exam immediately
D. Lower the head of the bed to the Trendelenburg position
Answer: B
Rationale: The first step in managing autonomic dysreflexia is to sit the patient upright to
utilize orthostatic pressure to lower the dangerously high blood pressure. Restrictive
clothing should be loosened to remove potential noxious stimuli that trigger the
sympathetic surge. Only after these immediate measures should the NP investigate triggers
like bladder distension or fecal impaction.
5. Which of the following is a characteristic feature of palliative care but NOT necessarily
hospice care?
A. Focus on symptom management and quality of life
B. Reserved for patients with a prognosis of 6 months or less
C. Can be provided concurrently with curative or life-prolonging treatment
D. Requires the patient to waive all aggressive therapies
Answer: C
Advanced Care of Adults in Acute Settings
| Actual Q&A with Rationale (NRNP6566
Week 10 Quiz) | Walden University
1. Which of the following clinical findings is a prerequisite before proceeding with a formal
clinical brain death examination?
A. Evidence of a metabolic cause for the coma
B. Serum sodium level less than 120 mEq/L
C. Core body temperature equal to or greater than 36.5 degrees Celsius
D. Systolic blood pressure of at least 90 mmHg
Answer: C
Rationale: Before performing a brain death exam, the clinician must ensure there are no
confounding factors such as hypothermia or drug intoxication. A core temperature of at
least 36.5°C is required to ensure that the neurological findings are not suppressed by low
body heat. Additionally, metabolic derangements must be corrected to provide an accurate
assessment of brainstem function.
2. An adult patient with a severe Traumatic Brain Injury (TBI) has an ICP of 25 mmHg and a
MAP of 75 mmHg. What is the calculated Cerebral Perfusion Pressure (CPP)?
A. 100 mmHg
,B. 50 mmHg
C. 60 mmHg
D. 3.33 mmHg
Answer: B
Rationale: Cerebral Perfusion Pressure is calculated using the formula CPP = MAP - ICP. In
this scenario, 75 mmHg minus 25 mmHg equals 50 mmHg, which is below the
recommended threshold of 60 to 70 mmHg. Maintaining adequate CPP is critical for
preventing secondary ischemic injury to the brain tissue.
3. Which type of organ transplant rejection occurs within minutes to hours after the graft is
revascularized due to pre-existing antibodies?
A. Acute cellular rejection
B. Hyperacute rejection
C. Chronic rejection
D. Antibody-mediated rejection
Answer: B
Rationale: Hyperacute rejection is a Type II hypersensitivity reaction caused by pre-
formed recipient antibodies against the donor’s HLA or ABO antigens. This leads to
immediate thrombosis and necrosis of the graft, often requiring immediate removal. This
reaction is now rare due to improved cross-matching protocols before transplantation.
, 4. When managing a patient with autonomic dysreflexia, which of the following is the most
appropriate initial action by the nurse practitioner?
A. Administer IV hydralazine
B. Sit the patient upright and loosen restrictive clothing
C. Perform a digital rectal exam immediately
D. Lower the head of the bed to the Trendelenburg position
Answer: B
Rationale: The first step in managing autonomic dysreflexia is to sit the patient upright to
utilize orthostatic pressure to lower the dangerously high blood pressure. Restrictive
clothing should be loosened to remove potential noxious stimuli that trigger the
sympathetic surge. Only after these immediate measures should the NP investigate triggers
like bladder distension or fecal impaction.
5. Which of the following is a characteristic feature of palliative care but NOT necessarily
hospice care?
A. Focus on symptom management and quality of life
B. Reserved for patients with a prognosis of 6 months or less
C. Can be provided concurrently with curative or life-prolonging treatment
D. Requires the patient to waive all aggressive therapies
Answer: C
