NU 578 Unit 3 Exam (2026/2027) (PDF) |
Advanced Nursing | University of South
Alabama Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
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A 65-year-old male presents with crushing chest pain, diaphoresis,
and ST-segment elevation in leads II, III, and aVF. Which of the
following is the most immediate priority?
A) Administer aspirin 325 mg chewed
B) Obtain a 12-lead ECG
C) Establish IV access
D) Assess vital signs
Ans: B. Rationale: While all interventions are crucial in acute
coronary syndrome (ACS), the 12-lead ECG is the most immediate
priority for a patient presenting with suspected STEMI to confirm the
diagnosis and determine candidacy for emergent reperfusion
therapy (PCI or fibrinolytics), as time is muscle.
Which hemodynamic parameter is most indicative of cardiogenic
shock?
A) Decreased cardiac index (CI) and increased systemic vascular
resistance (SVR)
B) Increased cardiac index (CI) and decreased systemic vascular
resistance (SVR)
C) Decreased cardiac index (CI) and decreased systemic vascular
resistance (SVR)
D) Increased cardiac index (CI) and increased systemic vascular
resistance (SVR)
Ans: A. Rationale: Cardiogenic shock is characterized by the heart's
inability to pump effectively, leading to a decreased cardiac index.
The body compensates by increasing SVR (vasoconstriction) to
maintain blood pressure, which further worsens the workload on the
failing heart.
, A patient with a history of heart failure presents with acute
decompensated heart failure (ADHF) and a blood pressure of
180/100 mmHg. Which medication is the most appropriate first-line
vasodilator?
A) IV sodium nitroprusside
B) IV nitroglycerin
C) Oral losartan
D) IV hydralazine
Ans: B. Rationale: IV nitroglycerin is preferred in ADHF with high
blood pressure and ischemia because it rapidly decreases preload
and coronary vasospasm. Nitroprusside is a more potent arterial
dilator but carries a risk of coronary steal syndrome in ischemic
patients.
The most reliable indicator of adequate fluid resuscitation in a
patient with septic shock is:
A) Central venous pressure (CVP) of 8-12 mmHg
B) Mean arterial pressure (MAP) ≥ 65 mmHg
C) Central venous oxygen saturation (ScvO2) ≥ 70%
D) Urine output > 0.5 mL/kg/hr
Ans: C. Rationale: While MAP, CVP, and urine output are targets in
the Surviving Sepsis Campaign, an ScvO2 ≥ 70% specifically
indicates that tissue oxygen delivery is adequately meeting tissue
oxygen demand, serving as a reliable marker of effective
resuscitation.
A patient on a mechanical ventilator develops acute onset of
profound hypoxia, hypotension, and absent breath sounds on the
right side. What is the immediate intervention?
A) Increase tidal volume
B) Perform needle decompression at the 2nd intercostal space mid-
clavicular line
Advanced Nursing | University of South
Alabama Questions and Ansẉers with
Rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
A 65-year-old male presents with crushing chest pain, diaphoresis,
and ST-segment elevation in leads II, III, and aVF. Which of the
following is the most immediate priority?
A) Administer aspirin 325 mg chewed
B) Obtain a 12-lead ECG
C) Establish IV access
D) Assess vital signs
Ans: B. Rationale: While all interventions are crucial in acute
coronary syndrome (ACS), the 12-lead ECG is the most immediate
priority for a patient presenting with suspected STEMI to confirm the
diagnosis and determine candidacy for emergent reperfusion
therapy (PCI or fibrinolytics), as time is muscle.
Which hemodynamic parameter is most indicative of cardiogenic
shock?
A) Decreased cardiac index (CI) and increased systemic vascular
resistance (SVR)
B) Increased cardiac index (CI) and decreased systemic vascular
resistance (SVR)
C) Decreased cardiac index (CI) and decreased systemic vascular
resistance (SVR)
D) Increased cardiac index (CI) and increased systemic vascular
resistance (SVR)
Ans: A. Rationale: Cardiogenic shock is characterized by the heart's
inability to pump effectively, leading to a decreased cardiac index.
The body compensates by increasing SVR (vasoconstriction) to
maintain blood pressure, which further worsens the workload on the
failing heart.
, A patient with a history of heart failure presents with acute
decompensated heart failure (ADHF) and a blood pressure of
180/100 mmHg. Which medication is the most appropriate first-line
vasodilator?
A) IV sodium nitroprusside
B) IV nitroglycerin
C) Oral losartan
D) IV hydralazine
Ans: B. Rationale: IV nitroglycerin is preferred in ADHF with high
blood pressure and ischemia because it rapidly decreases preload
and coronary vasospasm. Nitroprusside is a more potent arterial
dilator but carries a risk of coronary steal syndrome in ischemic
patients.
The most reliable indicator of adequate fluid resuscitation in a
patient with septic shock is:
A) Central venous pressure (CVP) of 8-12 mmHg
B) Mean arterial pressure (MAP) ≥ 65 mmHg
C) Central venous oxygen saturation (ScvO2) ≥ 70%
D) Urine output > 0.5 mL/kg/hr
Ans: C. Rationale: While MAP, CVP, and urine output are targets in
the Surviving Sepsis Campaign, an ScvO2 ≥ 70% specifically
indicates that tissue oxygen delivery is adequately meeting tissue
oxygen demand, serving as a reliable marker of effective
resuscitation.
A patient on a mechanical ventilator develops acute onset of
profound hypoxia, hypotension, and absent breath sounds on the
right side. What is the immediate intervention?
A) Increase tidal volume
B) Perform needle decompression at the 2nd intercostal space mid-
clavicular line
