NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
NR571 / NR 571 FINAL EXAM (LATEST UPDATE)
Complex Diagnosis and Management in Acute Care Practicum
Complete Review | Questions and Verified Answers | 100% Correct
Chamberlain University | Aligned with AACN Essentials of Master's Education and Adult-Gerontology Acute
Care Nurse Practitioner Competencies
150-Question Comprehensive Final Examination | Cognitive Distribution: 20% Recall | 50% Application | 30% Analysis |
Format: 80% Scenario-based, 20% Direct Knowledge | Includes 25 Clinical-Reasoning, 15 Hemodynamic/Ventilator, and 10
Pharmacology Items
Section 1: Complex Cardiovascular Disorders in Acute Care
Q1: A 58-year-old male presents to the ED with 45 minutes of crushing substernal chest pain radiating to the
left arm, diaphoresis, and dyspnea. ECG reveals ST-segment elevations of ≥2 mm in leads II, III, and aVF.
The AGACNP's MOST urgent intervention is to:
A. Administer metoprolol 5 mg IV push to reduce myocardial oxygen demand.
B. Activate the catheterization laboratory for primary PCI and administer aspirin 325 mg plus a loading dose
of a P2Y12 inhibitor. *[CORRECT]*
C. Obtain serial troponin levels every 6 hours before initiating reperfusion therapy.
D. Start a heparin infusion at 18 units/kg/hr and reassess in 4 hours.
Correct Answer: B
Rationale: STEMI in the inferior territory requires immediate reperfusion; the AACN and AHA/ACC guidelines designate
primary PCI within 90 minutes of first medical contact as the gold standard. Aspirin plus a P2Y12 inhibitor (ticagrelor or
prasugrel) is administered upstream. Beta-blockers are contraindicated in the acute phase of inferior STEMI due to the risk of
high-degree AV block, and waiting for serial troponins or initiating heparin alone delays definitive reperfusion.
Q2: A 72-year-old female with a history of hypertension and diabetes is admitted with NSTEMI. Her GRACE
score is 155, and high-sensitivity troponin has risen from 80 to 760 ng/L over 3 hours. Per NR 571 / ACC-AHA
pathways, the preferred risk stratification approach is:
A. Conservative management with medication titration and stress testing prior to discharge.
B. An early invasive strategy with coronary angiography within 24 hours. *[CORRECT]*
C. Discharge on optimal medical therapy with outpatient cardiology follow-up.
D. Thrombolytic therapy with tenecteplase within 30 minutes of arrival.
Correct Answer: B
Rationale: A GRACE score >140 plus a rising troponin profile classifies this patient as high-risk NSTEMI, mandating an early
invasive strategy with angiography within 24 hours per ACC/AHA and ESC guidelines. Conservative management is reserved
for low-risk patients. Thrombolytics are contraindicated in NSTEMI because they do not improve outcomes and increase
bleeding risk. Discharge without invasive evaluation would be unsafe given her risk profile.
Page 1 | 150-Question Comprehensive Review | 100% Verified Answers
,NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q3: A 64-year-old male is admitted with acute decompensated heart failure (HFrEF, EF 25%). BP 88/52, HR
122, RR 32, SpO2 88% on room air. Bilateral crackles, JVD to the jaw, cool extremities, and lactate 4.8
mmol/L. The AGACNP suspects cardiogenic shock. Which hemodynamic profile on a pulmonary artery
catheter would MOST strongly support this diagnosis?
A. Cardiac index 2.4 L/min/m2, PCWP 12 mmHg, SVR 800 dynes·s/cm5.
B. Cardiac index 1.6 L/min/m2, PCWP 28 mmHg, SVR 1900 dynes·s/cm5. *[CORRECT]*
C. Cardiac index 3.2 L/min/m2, PCWP 6 mmHg, SVR 600 dynes·s/cm5.
D. Cardiac index 2.0 L/min/m2, PCWP 8 mmHg, SVR 1500 dynes·s/cm5.
Correct Answer: B
Rationale: Cardiogenic shock classically demonstrates a low cardiac index (<2.2 L/min/m2), elevated PCWP (>18 mmHg)
reflecting pulmonary congestion, and a compensatorily elevated SVR from sympathetic activation. This profile confirms a
pump-failure state. Option A is normal; option C is distributive shock (warm, vasodilated); option D is hypovolemic shock with
low filling pressures. These distinctions drive vasoactive and mechanical support decisions in the AGACNP scope.
Q4: A patient with an intra-aortic balloon pump (IABP) displays a waveform with balloon inflation occurring
during systole (after the aortic valve opens) and deflation during diastole. The AGACNP correctly identifies
this as:
A. Optimal timing; no intervention required.
B. Early inflation, which can increase afterload and worsen LV workload. *[CORRECT]*
C. Late deflation, which increases coronary perfusion pressure.
D. Balloon leak requiring immediate pump removal.
Correct Answer: B
Rationale: Early inflation — balloon expansion during systole — increases afterload by adding resistance to LV ejection,
worsening mitral regurgitation and LV stress. Correct timing inflates in diastole immediately after aortic valve closure to
augment coronary perfusion and deflates just before systole to reduce afterload. Recognition and re-timing of the balloon is an
AACN-recognized critical care competency. Late deflation increases LV afterload, not coronary perfusion.
Q5: A 69-year-old male post-Day 3 of a massive anterior STEMI develops sudden onset of dyspnea, hypoxia,
and a loud holosystolic murmur at the apex radiating to the axilla. Echocardiogram reveals a flail mitral
leaflet with severe mitral regurgitation. The AGACNP's MOST appropriate acute management priority is:
A. Increase afterload with norepinephrine to improve coronary perfusion.
B. Initiate vasopressin to reduce vasodilation.
C. Reduce afterload with nitroprusside or intra-aortic balloon pump and prepare for emergent surgical
repair. *[CORRECT]*
D. Administer IV metoprolol to lower heart rate and reduce regurgitant fraction.
Correct Answer: C
Rationale: Acute severe MR from papillary muscle rupture complicates ~1% of STEMIs and produces flash pulmonary edema
with cardiogenic shock. Afterload reduction (nitroprusside or IABP counterpulsation) reduces regurgitant fraction and forward
output, bridging the patient to emergent surgical repair. Increasing afterload worsens regurgitation; beta-blockade alone will not
stabilize a hemodynamically unstable patient and may precipitate arrest.
Page 2 | 150-Question Comprehensive Review | 100% Verified Answers
,NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q6: A 55-year-old female is admitted with new-onset atrial fibrillation with rapid ventricular response at 168
bpm, BP 78/45, altered mental status, and chest pain. Per AGACNP certification and AHA ACLS guidelines,
the FIRST action is:
A. Administer diltiazem 20 mg IV push for rate control.
B. Perform synchronized cardioversion at 120-200 joules biphasic. *[CORRECT]*
C. Administer amiodarone 150 mg IV over 10 minutes.
D. Administer adenosine 6 mg rapid IV push.
Correct Answer: B
Rationale: In a hemodynamically unstable patient with new-onset AF (hypotension, altered mental status, ischemic chest pain),
immediate synchronized cardioversion is indicated per AHA ACLS algorithms. Rate-control agents (diltiazem, amiodarone) may
precipitate cardiovascular collapse in this patient. Adenosine is used for SVT termination and may transiently reveal AF but will
not cardiovert it. Cardioversion must precede anticoagulation in unstable presentations.
Q7: A 61-year-old male with ischemic cardiomyopathy (EF 22%) is on a milrinone infusion for acute
decompensated HF. BP is now 82/48, HR 96, and lactate has risen from 2.1 to 3.9 mmol/L. The AGACNP's
BEST adjustment to the inotrope strategy is to:
A. Discontinue milrinone and initiate norepinephrine to restore MAP ≥65 mmHg. *[CORRECT]*
B. Increase milrinone dose to maximize inotropy.
C. Add dobutamine to milrinone for synergistic inotropy.
D. Administer 2 L of crystalloid bolus to augment preload.
Correct Answer: A
Rationale: Milrinone is a PDE-3 inhibitor with significant vasodilatory properties; in a patient developing progressive
hypotension and rising lactate, continued milrinone worsens shock. Norepinephrine provides alpha-mediated vasoconstriction
with modest beta-1 effect, restoring perfusion pressure without excessive tachycardia. Combining inotropes risks arrhythmia
and worsening hypotension, and fluid bolus is contraindicated in a decompensated HFrEF patient.
Q8: A patient on day 5 post-CABG presents with new-onset wide-complex tachycardia at 190 bpm, BP 70/40,
and loss of consciousness. The AGACNP should immediately:
A. Administer IV amiodarone 150 mg over 10 minutes.
B. Perform unsynchronized cardioversion at 200 joules. *[CORRECT]*
C. Administer IV adenosine 6 mg rapid push.
D. Administer IV lidocaine 1 mg/kg and reassess.
Correct Answer: B
Rationale: Pulseless VT or unstable wide-complex tachycardia with loss of consciousness requires immediate unsynchronized
cardioversion at 200 joules biphasic (equivalent to defibrillation). Synchronized cardioversion may not capture if the QRS is too
wide for the sync circuit. Amiodarone and lidocaine are antiarrhythmic adjuncts after the patient is stabilized. Adenosine is
inappropriate for wide-complex tachycardia of unknown origin.
Page 3 | 150-Question Comprehensive Review | 100% Verified Answers
, NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q9: A 70-year-old male with bioprosthetic aortic valve replacement 6 years ago presents with fever, new
diastolic murmur, and embolic phenomena. Blood cultures grow Enterococcus faecalis. The AGACNP
recognizes the diagnosis as prosthetic valve endocarditis and anticipates which initial antimicrobial regimen?
A. Ceftriaxone 2 g IV daily for 4 weeks.
B. Vancomycin plus gentamicin with or without ampicillin, tailored to susceptibility, for ≥6 weeks.
*[CORRECT]*
C. Fluconazole 400 mg daily for 6 weeks.
D. Azithromycin 500 mg daily for 5 days.
Correct Answer: B
Rationale: Prosthetic valve endocarditis caused by Enterococcus requires synergistic bactericidal therapy: ampicillin (or
vancomycin if penicillin-allergic) plus an aminoglycoside (gentamicin) for ≥6 weeks, per AHA guidelines. Ceftriaxone is
inadequate for Enterococcus; fluconazole treats fungal endocarditis (rare); azithromycin is not effective against Enterococcus.
Surgical evaluation is also indicated for prosthetic involvement, periannular extension, or persistent bacteremia.
Q10: A 67-year-old female with a biventricular ICD presents with three ICD shocks in the past 24 hours for
VT. Interrogation shows appropriate shocks for sustained monomorphic VT. The AGACNP's FIRST
pharmacologic intervention is:
A. IV propranolol 1 mg to suppress sympathetic tone.
B. IV amiodarone 150 mg bolus followed by infusion of 1 mg/min for 6 hours, then 0.5 mg/min.
*[CORRECT]*
C. IV verapamil 5 mg push to terminate the VT.
D. Sublingual nitroglycerin to reduce preload.
Correct Answer: B
Rationale: Recurrent appropriate ICD shocks for sustained VT warrant IV amiodarone to suppress the arrhythmogenic
substrate, as endorsed by the ACC/AHA/HRS guidelines for electrical storm. Beta-blockade is often combined but as
monotherapy is insufficient in this acute setting. Verapamil may worsen HFrEF and is contraindicated in wide-complex
tachycardia. Nitroglycerin has no role in VT management.
Q11: A 78-year-old male with critical aortic stenosis (AVA 0.6 cm2, mean gradient 52 mmHg) presents with
syncope. BP 92/58, HR 50, loud systolic ejection murmur at the right upper sternal border. The AGACNP
identifies the contraindicated intervention as:
A. Careful volume expansion with normal saline.
B. IV norepinephrine to maintain MAP ≥65 mmHg.
C. Aggressive diuresis with IV furosemide to reduce preload. *[CORRECT]*
D. Phenylephrine to support afterload without tachycardia.
Correct Answer: C
Rationale: Critical aortic stenosis is preload- and afterload-dependent; aggressive diuresis reduces LV filling, decreases stroke
volume, and precipitates cardiovascular collapse. These patients require careful volume expansion and vasoconstrictors
(phenylephrine, norepinephrine) to maintain perfusion without tachycardia. The definitive therapy is prompt valve replacement
(TAVR or surgical AVR), an AACN/AGACNP priority.
Page 4 | 150-Question Comprehensive Review | 100% Verified Answers
NR571 / NR 571 FINAL EXAM (LATEST UPDATE)
Complex Diagnosis and Management in Acute Care Practicum
Complete Review | Questions and Verified Answers | 100% Correct
Chamberlain University | Aligned with AACN Essentials of Master's Education and Adult-Gerontology Acute
Care Nurse Practitioner Competencies
150-Question Comprehensive Final Examination | Cognitive Distribution: 20% Recall | 50% Application | 30% Analysis |
Format: 80% Scenario-based, 20% Direct Knowledge | Includes 25 Clinical-Reasoning, 15 Hemodynamic/Ventilator, and 10
Pharmacology Items
Section 1: Complex Cardiovascular Disorders in Acute Care
Q1: A 58-year-old male presents to the ED with 45 minutes of crushing substernal chest pain radiating to the
left arm, diaphoresis, and dyspnea. ECG reveals ST-segment elevations of ≥2 mm in leads II, III, and aVF.
The AGACNP's MOST urgent intervention is to:
A. Administer metoprolol 5 mg IV push to reduce myocardial oxygen demand.
B. Activate the catheterization laboratory for primary PCI and administer aspirin 325 mg plus a loading dose
of a P2Y12 inhibitor. *[CORRECT]*
C. Obtain serial troponin levels every 6 hours before initiating reperfusion therapy.
D. Start a heparin infusion at 18 units/kg/hr and reassess in 4 hours.
Correct Answer: B
Rationale: STEMI in the inferior territory requires immediate reperfusion; the AACN and AHA/ACC guidelines designate
primary PCI within 90 minutes of first medical contact as the gold standard. Aspirin plus a P2Y12 inhibitor (ticagrelor or
prasugrel) is administered upstream. Beta-blockers are contraindicated in the acute phase of inferior STEMI due to the risk of
high-degree AV block, and waiting for serial troponins or initiating heparin alone delays definitive reperfusion.
Q2: A 72-year-old female with a history of hypertension and diabetes is admitted with NSTEMI. Her GRACE
score is 155, and high-sensitivity troponin has risen from 80 to 760 ng/L over 3 hours. Per NR 571 / ACC-AHA
pathways, the preferred risk stratification approach is:
A. Conservative management with medication titration and stress testing prior to discharge.
B. An early invasive strategy with coronary angiography within 24 hours. *[CORRECT]*
C. Discharge on optimal medical therapy with outpatient cardiology follow-up.
D. Thrombolytic therapy with tenecteplase within 30 minutes of arrival.
Correct Answer: B
Rationale: A GRACE score >140 plus a rising troponin profile classifies this patient as high-risk NSTEMI, mandating an early
invasive strategy with angiography within 24 hours per ACC/AHA and ESC guidelines. Conservative management is reserved
for low-risk patients. Thrombolytics are contraindicated in NSTEMI because they do not improve outcomes and increase
bleeding risk. Discharge without invasive evaluation would be unsafe given her risk profile.
Page 1 | 150-Question Comprehensive Review | 100% Verified Answers
,NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q3: A 64-year-old male is admitted with acute decompensated heart failure (HFrEF, EF 25%). BP 88/52, HR
122, RR 32, SpO2 88% on room air. Bilateral crackles, JVD to the jaw, cool extremities, and lactate 4.8
mmol/L. The AGACNP suspects cardiogenic shock. Which hemodynamic profile on a pulmonary artery
catheter would MOST strongly support this diagnosis?
A. Cardiac index 2.4 L/min/m2, PCWP 12 mmHg, SVR 800 dynes·s/cm5.
B. Cardiac index 1.6 L/min/m2, PCWP 28 mmHg, SVR 1900 dynes·s/cm5. *[CORRECT]*
C. Cardiac index 3.2 L/min/m2, PCWP 6 mmHg, SVR 600 dynes·s/cm5.
D. Cardiac index 2.0 L/min/m2, PCWP 8 mmHg, SVR 1500 dynes·s/cm5.
Correct Answer: B
Rationale: Cardiogenic shock classically demonstrates a low cardiac index (<2.2 L/min/m2), elevated PCWP (>18 mmHg)
reflecting pulmonary congestion, and a compensatorily elevated SVR from sympathetic activation. This profile confirms a
pump-failure state. Option A is normal; option C is distributive shock (warm, vasodilated); option D is hypovolemic shock with
low filling pressures. These distinctions drive vasoactive and mechanical support decisions in the AGACNP scope.
Q4: A patient with an intra-aortic balloon pump (IABP) displays a waveform with balloon inflation occurring
during systole (after the aortic valve opens) and deflation during diastole. The AGACNP correctly identifies
this as:
A. Optimal timing; no intervention required.
B. Early inflation, which can increase afterload and worsen LV workload. *[CORRECT]*
C. Late deflation, which increases coronary perfusion pressure.
D. Balloon leak requiring immediate pump removal.
Correct Answer: B
Rationale: Early inflation — balloon expansion during systole — increases afterload by adding resistance to LV ejection,
worsening mitral regurgitation and LV stress. Correct timing inflates in diastole immediately after aortic valve closure to
augment coronary perfusion and deflates just before systole to reduce afterload. Recognition and re-timing of the balloon is an
AACN-recognized critical care competency. Late deflation increases LV afterload, not coronary perfusion.
Q5: A 69-year-old male post-Day 3 of a massive anterior STEMI develops sudden onset of dyspnea, hypoxia,
and a loud holosystolic murmur at the apex radiating to the axilla. Echocardiogram reveals a flail mitral
leaflet with severe mitral regurgitation. The AGACNP's MOST appropriate acute management priority is:
A. Increase afterload with norepinephrine to improve coronary perfusion.
B. Initiate vasopressin to reduce vasodilation.
C. Reduce afterload with nitroprusside or intra-aortic balloon pump and prepare for emergent surgical
repair. *[CORRECT]*
D. Administer IV metoprolol to lower heart rate and reduce regurgitant fraction.
Correct Answer: C
Rationale: Acute severe MR from papillary muscle rupture complicates ~1% of STEMIs and produces flash pulmonary edema
with cardiogenic shock. Afterload reduction (nitroprusside or IABP counterpulsation) reduces regurgitant fraction and forward
output, bridging the patient to emergent surgical repair. Increasing afterload worsens regurgitation; beta-blockade alone will not
stabilize a hemodynamically unstable patient and may precipitate arrest.
Page 2 | 150-Question Comprehensive Review | 100% Verified Answers
,NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q6: A 55-year-old female is admitted with new-onset atrial fibrillation with rapid ventricular response at 168
bpm, BP 78/45, altered mental status, and chest pain. Per AGACNP certification and AHA ACLS guidelines,
the FIRST action is:
A. Administer diltiazem 20 mg IV push for rate control.
B. Perform synchronized cardioversion at 120-200 joules biphasic. *[CORRECT]*
C. Administer amiodarone 150 mg IV over 10 minutes.
D. Administer adenosine 6 mg rapid IV push.
Correct Answer: B
Rationale: In a hemodynamically unstable patient with new-onset AF (hypotension, altered mental status, ischemic chest pain),
immediate synchronized cardioversion is indicated per AHA ACLS algorithms. Rate-control agents (diltiazem, amiodarone) may
precipitate cardiovascular collapse in this patient. Adenosine is used for SVT termination and may transiently reveal AF but will
not cardiovert it. Cardioversion must precede anticoagulation in unstable presentations.
Q7: A 61-year-old male with ischemic cardiomyopathy (EF 22%) is on a milrinone infusion for acute
decompensated HF. BP is now 82/48, HR 96, and lactate has risen from 2.1 to 3.9 mmol/L. The AGACNP's
BEST adjustment to the inotrope strategy is to:
A. Discontinue milrinone and initiate norepinephrine to restore MAP ≥65 mmHg. *[CORRECT]*
B. Increase milrinone dose to maximize inotropy.
C. Add dobutamine to milrinone for synergistic inotropy.
D. Administer 2 L of crystalloid bolus to augment preload.
Correct Answer: A
Rationale: Milrinone is a PDE-3 inhibitor with significant vasodilatory properties; in a patient developing progressive
hypotension and rising lactate, continued milrinone worsens shock. Norepinephrine provides alpha-mediated vasoconstriction
with modest beta-1 effect, restoring perfusion pressure without excessive tachycardia. Combining inotropes risks arrhythmia
and worsening hypotension, and fluid bolus is contraindicated in a decompensated HFrEF patient.
Q8: A patient on day 5 post-CABG presents with new-onset wide-complex tachycardia at 190 bpm, BP 70/40,
and loss of consciousness. The AGACNP should immediately:
A. Administer IV amiodarone 150 mg over 10 minutes.
B. Perform unsynchronized cardioversion at 200 joules. *[CORRECT]*
C. Administer IV adenosine 6 mg rapid push.
D. Administer IV lidocaine 1 mg/kg and reassess.
Correct Answer: B
Rationale: Pulseless VT or unstable wide-complex tachycardia with loss of consciousness requires immediate unsynchronized
cardioversion at 200 joules biphasic (equivalent to defibrillation). Synchronized cardioversion may not capture if the QRS is too
wide for the sync circuit. Amiodarone and lidocaine are antiarrhythmic adjuncts after the patient is stabilized. Adenosine is
inappropriate for wide-complex tachycardia of unknown origin.
Page 3 | 150-Question Comprehensive Review | 100% Verified Answers
, NR 571 Final Exam | Complex Diagnosis & Management in Acute Care Practicum Chamberlain University | 2026/2027
Q9: A 70-year-old male with bioprosthetic aortic valve replacement 6 years ago presents with fever, new
diastolic murmur, and embolic phenomena. Blood cultures grow Enterococcus faecalis. The AGACNP
recognizes the diagnosis as prosthetic valve endocarditis and anticipates which initial antimicrobial regimen?
A. Ceftriaxone 2 g IV daily for 4 weeks.
B. Vancomycin plus gentamicin with or without ampicillin, tailored to susceptibility, for ≥6 weeks.
*[CORRECT]*
C. Fluconazole 400 mg daily for 6 weeks.
D. Azithromycin 500 mg daily for 5 days.
Correct Answer: B
Rationale: Prosthetic valve endocarditis caused by Enterococcus requires synergistic bactericidal therapy: ampicillin (or
vancomycin if penicillin-allergic) plus an aminoglycoside (gentamicin) for ≥6 weeks, per AHA guidelines. Ceftriaxone is
inadequate for Enterococcus; fluconazole treats fungal endocarditis (rare); azithromycin is not effective against Enterococcus.
Surgical evaluation is also indicated for prosthetic involvement, periannular extension, or persistent bacteremia.
Q10: A 67-year-old female with a biventricular ICD presents with three ICD shocks in the past 24 hours for
VT. Interrogation shows appropriate shocks for sustained monomorphic VT. The AGACNP's FIRST
pharmacologic intervention is:
A. IV propranolol 1 mg to suppress sympathetic tone.
B. IV amiodarone 150 mg bolus followed by infusion of 1 mg/min for 6 hours, then 0.5 mg/min.
*[CORRECT]*
C. IV verapamil 5 mg push to terminate the VT.
D. Sublingual nitroglycerin to reduce preload.
Correct Answer: B
Rationale: Recurrent appropriate ICD shocks for sustained VT warrant IV amiodarone to suppress the arrhythmogenic
substrate, as endorsed by the ACC/AHA/HRS guidelines for electrical storm. Beta-blockade is often combined but as
monotherapy is insufficient in this acute setting. Verapamil may worsen HFrEF and is contraindicated in wide-complex
tachycardia. Nitroglycerin has no role in VT management.
Q11: A 78-year-old male with critical aortic stenosis (AVA 0.6 cm2, mean gradient 52 mmHg) presents with
syncope. BP 92/58, HR 50, loud systolic ejection murmur at the right upper sternal border. The AGACNP
identifies the contraindicated intervention as:
A. Careful volume expansion with normal saline.
B. IV norepinephrine to maintain MAP ≥65 mmHg.
C. Aggressive diuresis with IV furosemide to reduce preload. *[CORRECT]*
D. Phenylephrine to support afterload without tachycardia.
Correct Answer: C
Rationale: Critical aortic stenosis is preload- and afterload-dependent; aggressive diuresis reduces LV filling, decreases stroke
volume, and precipitates cardiovascular collapse. These patients require careful volume expansion and vasoconstrictors
(phenylephrine, norepinephrine) to maintain perfusion without tachycardia. The definitive therapy is prompt valve replacement
(TAVR or surgical AVR), an AACN/AGACNP priority.
Page 4 | 150-Question Comprehensive Review | 100% Verified Answers
