A+ GRADED 1
NRNP 6566 Advanced Care
of Adults in Acute Settings
I – Week 3 Knowledge
Check with Verified
Answers (2025/2026)
Instructions
Complete all questions in order.
Select the most accurate clinical response.
Study the rationale for each answer to build stronger
knowledge.
Secti
Apply these concepts when practicing Week 3 skills.
, 2
Question 1
A 62-year-old male presents to the ED with sudden onset of severe tearing chest
pain radiating to the back. Vital signs: BP 180/100 mmHg, HR 110 bpm, RR
22/min. What is the most likely diagnosis, and what is the priority initial
management? A. Acute coronary syndrome; administer aspirin and heparin. B.
Aortic dissection; control blood pressure with beta-blockers. C. Pulmonary
embolism; start anticoagulation immediately. D. Pericarditis; order an ECG and
NSAIDs.
B. Aortic dissection; control blood pressure with beta-blockers. Rationale:
Sudden tearing pain radiating to the back with hypertension is classic for
aortic dissection. Priority is blood pressure reduction to <120 mmHg systolic
using IV beta-blockers (e.g., esmolol) to decrease shear stress on the aortic
wall, preventing extension. CT angiography confirms diagnosis; surgery may
follow based on type.
Question 2
A 55-year-old female with a history of hypertension presents with acute severe
headache, nausea, and photophobia. BP 220/120 mmHg. Fundoscopic exam shows
papilledema. What is the most appropriate initial pharmacologic intervention? A.
Nitroglycerin IV infusion. B. Labetalol IV bolus. C. Hydralazine IV push. D.
Mannitol IV infusion.
B. Labetalol IV bolus. Rationale: This presentation suggests hypertensive
encephalopathy. Labetalol, an alpha/beta-blocker, is first-line for acute BP
reduction in encephalopathy, targeting 25% reduction in mean arterial
pressure over hours to avoid cerebral hypoperfusion. Avoid nitroprusside
initially due to cyanide risk; neuroimaging rules out stroke.
Question 3
NRNP 6566 Advanced Care
of Adults in Acute Settings
I – Week 3 Knowledge
Check with Verified
Answers (2025/2026)
Instructions
Complete all questions in order.
Select the most accurate clinical response.
Study the rationale for each answer to build stronger
knowledge.
Secti
Apply these concepts when practicing Week 3 skills.
, 2
Question 1
A 62-year-old male presents to the ED with sudden onset of severe tearing chest
pain radiating to the back. Vital signs: BP 180/100 mmHg, HR 110 bpm, RR
22/min. What is the most likely diagnosis, and what is the priority initial
management? A. Acute coronary syndrome; administer aspirin and heparin. B.
Aortic dissection; control blood pressure with beta-blockers. C. Pulmonary
embolism; start anticoagulation immediately. D. Pericarditis; order an ECG and
NSAIDs.
B. Aortic dissection; control blood pressure with beta-blockers. Rationale:
Sudden tearing pain radiating to the back with hypertension is classic for
aortic dissection. Priority is blood pressure reduction to <120 mmHg systolic
using IV beta-blockers (e.g., esmolol) to decrease shear stress on the aortic
wall, preventing extension. CT angiography confirms diagnosis; surgery may
follow based on type.
Question 2
A 55-year-old female with a history of hypertension presents with acute severe
headache, nausea, and photophobia. BP 220/120 mmHg. Fundoscopic exam shows
papilledema. What is the most appropriate initial pharmacologic intervention? A.
Nitroglycerin IV infusion. B. Labetalol IV bolus. C. Hydralazine IV push. D.
Mannitol IV infusion.
B. Labetalol IV bolus. Rationale: This presentation suggests hypertensive
encephalopathy. Labetalol, an alpha/beta-blocker, is first-line for acute BP
reduction in encephalopathy, targeting 25% reduction in mean arterial
pressure over hours to avoid cerebral hypoperfusion. Avoid nitroprusside
initially due to cyanide risk; neuroimaging rules out stroke.
Question 3
