NRNP 6566 Advanced Care
of Adults in Acute Settings I –
Week 8 Knowledge Check
with Verified Answers
(2025/2026)
Instructions
•Answer all questions in sequence.
Select the most appropriate nursing or clinical
response.
Use rationales to guide your reasoning for future cases
Sectio
Treat this as preparation for Week 8 assessments.
, 2
1. A 68-year-old male presents to the emergency department with sudden-onset
severe chest pain radiating to the left arm, diaphoresis, and nausea. His ECG
shows ST-segment elevation in leads V1-V4. What is the most appropriate
initial management?
A. Administer aspirin and heparin, then monitor in the ED.
B. Prepare for immediate percutaneous coronary intervention (PCI).
C. Give sublingual nitroglycerin and beta-blockers.
D. Order a stress test for further evaluation.
Answer: B. Prepare for immediate percutaneous coronary intervention
(PCI).
In-depth rationale: This presentation is classic for an ST-elevation
myocardial infarction (STEMI), a medical emergency requiring rapid
reperfusion to minimize myocardial damage. According to the American
College of Cardiology/American Heart Association (ACC/AHA) guidelines,
primary PCI is the preferred reperfusion strategy if it can be performed
within 90 minutes of first medical contact, as it restores blood flow more
effectively than thrombolytics. Aspirin and heparin (A) are adjunctive but do
not address reperfusion. Nitroglycerin and beta-blockers (C) are used for
symptom relief but are contraindicated in unstable STEMI without prior
stabilization. A stress test (D) is inappropriate in acute STEMI, as it could
precipitate further ischemia. Early recognition and door-to-balloon time
optimization are critical for reducing mortality and preserving left
ventricular function.
2. A 45-year-old female with a history of hypertension and smoking presents
with acute shortness of breath, pleuritic chest pain, and hemoptysis. CT
pulmonary angiography confirms a pulmonary embolism (PE). What is the
priority nursing intervention in the acute setting?
A. Administer oxygen to maintain SpO2 >92%.
B. Start low-molecular-weight heparin (LMWH) immediately.
C. Encourage early ambulation to prevent DVT recurrence.
D. Order a ventilation-perfusion (V/Q) scan for confirmation.
Answer: A. Administer oxygen to maintain SpO2 >92%.