NRNP 6566 Advanced Care
of Adults in Acute Settings
I – Week 5 Knowledge
Check with Verified
Answers (2025/2026)
Instructions
. Read carefully and consider all clinical details.
Choose the answer that best reflects evidence-based practice
Review rationales for both correct and incorrect options.
Secti
Use this knowledge check to guide your Week 5 revision.
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Question 1
A 54-year-old woman is 3 days post-abdominal surgery for removal of a cancerous
mass in her abdomen. She develops acute shortness of breath associated with
tachycardia and hypotension. What is the most likely diagnosis? A. Pneumonia B.
Acute coronary syndrome C. Pulmonary embolism D. Heart failure
Answer: C. Pulmonary embolism Rationale: In postoperative patients, acute
shortness of breath with tachycardia and hypotension is classic for pulmonary
embolism (PE), a common complication due to venous thromboembolism risk
from immobility and surgery. Evidence-based guidelines (e.g., ACCP)
emphasize high suspicion in this scenario. Pneumonia (A) typically presents
with fever and productive cough; acute coronary syndrome (B) with chest
pain; heart failure (D) with gradual onset and bilateral edema. Incorrect
options delay critical anticoagulation or thrombolysis.
Question 2
A 64-year-old man diagnosed with a pulmonary embolism is currently on warfarin.
His INR is 1.8. What is the appropriate next step? A. Continue current dose and
recheck in 1 week B. Increase warfarin dose and recheck INR in 3-5 days C.
Switch to low-molecular-weight heparin immediately D. Discontinue
anticoagulation
Answer: B. Increase warfarin dose and recheck INR in 3-5 days Rationale:
Therapeutic INR for PE is 2.0-3.0; 1.8 is subtherapeutic, increasing clot risk.
Guidelines (e.g., 2019 CHEST) recommend dose adjustment and frequent
monitoring (every 3-5 days) until stable. Continuing without adjustment (A)
risks recurrence; LMWH switch (C) is for bridging or failure, not first-line;
discontinuation (D) is contraindicated. This reflects evidence-based titration
for safety.