NRNP6566 Week 7 Knowledge Check - Walden
University AGACNP Program 2026-2027 -
Advanced Acute Care Adults
30 items | 100 % ICU data interpretation/action | 45 min
SECTION 1 Hemodynamics & Shock (Q 1 – 10)
Q1
Septic shock, noradrenaline 0.3 µg/kg/min MAP 65 mmHg, CVP 14 mmHg, echo: dilated
hypokinetic RV, D-shaped septum. Next critical therapy?
A. ↑ noradrenaline
B. Add vasopressin
C. Inhaled epoprostenol ± dobutamine
D. 500 mL fluid bolus
Answer: C – acute cor pulmonale: ↓ RV afterload + inotropy; fluids worsen RV dilation.
Q2
Arterial line tracing: rounded upstroke, loss of dicrotic notch, reads SBP 180 mmHg.
First action?
A. Give antihypertensive
, B. Check for damping (kinks, air, flush)
C. Confirm with NIBP
D. Order echo
Answer: B – damped waveform = artifact; troubleshoot before treating.
Q3
Septic shock, ScvO₂ 58 %, Hgb 8 g/dL, MAP 70 mmHg, lactate 4 mmol/L. Next step?
A. ↑ noradrenaline
B. Transfuse 1 unit PRBC
C. Start dobutamine
D. Check ABG
Answer: B – ScvO₂ < 65 % + Hgb < 10 → transfusion improves O₂ delivery.
Q4
Which finding BEST indicates fluid responsiveness in spontaneously breathing patient?
A. CVP 5 mmHg
B. ΔPP 15 %
C. Passive leg raise ↑ CO 10 %
D. MAP 60 mmHg
Answer: C – PLR-induced ↑ CO ≥ 10 % = reliable dynamic predictor.
University AGACNP Program 2026-2027 -
Advanced Acute Care Adults
30 items | 100 % ICU data interpretation/action | 45 min
SECTION 1 Hemodynamics & Shock (Q 1 – 10)
Q1
Septic shock, noradrenaline 0.3 µg/kg/min MAP 65 mmHg, CVP 14 mmHg, echo: dilated
hypokinetic RV, D-shaped septum. Next critical therapy?
A. ↑ noradrenaline
B. Add vasopressin
C. Inhaled epoprostenol ± dobutamine
D. 500 mL fluid bolus
Answer: C – acute cor pulmonale: ↓ RV afterload + inotropy; fluids worsen RV dilation.
Q2
Arterial line tracing: rounded upstroke, loss of dicrotic notch, reads SBP 180 mmHg.
First action?
A. Give antihypertensive
, B. Check for damping (kinks, air, flush)
C. Confirm with NIBP
D. Order echo
Answer: B – damped waveform = artifact; troubleshoot before treating.
Q3
Septic shock, ScvO₂ 58 %, Hgb 8 g/dL, MAP 70 mmHg, lactate 4 mmol/L. Next step?
A. ↑ noradrenaline
B. Transfuse 1 unit PRBC
C. Start dobutamine
D. Check ABG
Answer: B – ScvO₂ < 65 % + Hgb < 10 → transfusion improves O₂ delivery.
Q4
Which finding BEST indicates fluid responsiveness in spontaneously breathing patient?
A. CVP 5 mmHg
B. ΔPP 15 %
C. Passive leg raise ↑ CO 10 %
D. MAP 60 mmHg
Answer: C – PLR-induced ↑ CO ≥ 10 % = reliable dynamic predictor.
