NR571 / NR 571 Final Exam: Complex Diagnosis and
Management in Acute Care Practicum – Chamberlain
Actual Exam Questions & Verified Answers | 100%
Correct | Pass Guaranteed - A+ Graded
Hemodynamics, Shock & Sepsis Management
Q1: What is the normal range for central venous pressure (CVP) in a spontaneously
breathing patient?
A. 0–2 mmHg
B. 2–6 mmHg [CORRECT]
C. 8–12 mmHg
D. 12–18 mmHg
Correct Answer: B
Rationale: The best answer is B. A normal CVP typically runs between 2 and 6 mmHg in
spontaneously breathing patients, though mechanically ventilated patients may run
slightly higher. Remember that CVP gives us a rough estimate of preload and
intravascular volume status, but it is not the whole picture.
Q2: Which three components make up the quick SOFA (qSOFA) score?
A. Heart rate >100, temperature >38°C, respiratory rate >20
B. Systolic BP ≤100, respiratory rate ≥22, altered mental status [CORRECT]
C. Lactate >2, platelets <150, creatinine >1.5
D. MAP <65, urine output <0.5, FiO2 >40%
Correct Answer: B
Rationale: The best answer is B. qSOFA uses systolic blood pressure of 100 or less,
respiratory rate of 22 or higher, and altered mentation to identify patients at risk for poor
outcomes from suspected infection. Remember that qSOFA is a bedside screening tool,
not a diagnostic criterion for sepsis itself.
,Q3: In a patient with septic shock, what is the minimum mean arterial pressure (MAP)
target recommended by the Surviving Sepsis Campaign?
A. 55 mmHg
B. 60 mmHg
C. 65 mmHg [CORRECT]
D. 80 mmHg
Correct Answer: C
Rationale: The best answer is C. We generally aim for a MAP of at least 65 mmHg in
septic shock to maintain adequate tissue perfusion. Remember that individual patients
may need higher targets if they have chronic hypertension, but 65 is the standard
starting goal.
Q4: Which vasoactive agent is recommended as first-line for septic shock?
A. Phenylephrine
B. Epinephrine
C. Norepinephrine [CORRECT]
D. Vasopressin
Correct Answer: C
Rationale: The best answer is C. Norepinephrine is the preferred first-line vasopressor
for septic shock because it effectively increases MAP through vasoconstriction while
maintaining some inotropic support. Remember that we add vasopressin or epinephrine
when norepinephrine requirements escalate.
Q5: Which hemodynamic parameter best reflects left ventricular afterload?
A. Central venous pressure
B. Pulmonary artery wedge pressure
C. Systemic vascular resistance [CORRECT]
D. Cardiac output
Correct Answer: C
Rationale: The best answer is C. Systemic vascular resistance represents the resistance
the left ventricle must overcome to eject blood, making it the key measure of afterload.
Remember that afterload reduction is a cornerstone of managing cardiogenic shock
and acute heart failure.
, Q6: A 55-year-old woman with pancreatitis is hypotensive with the following
hemodynamics: CVP 3 mmHg, CI 5.1 L/min/m², SVR 580 dynes·sec/cm⁵. Which type of
shock is most likely?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock [CORRECT]
D. Obstructive shock
Correct Answer: C
Rationale: The best answer is C. The low CVP, high cardiac index, and markedly reduced
SVR fit the classic profile of distributive shock from systemic vasodilation. Remember
that in distributive shock, the primary problem is massive vasodilation causing relative
hypovolemia despite a hyperdynamic state.
Q7: A 72-year-old man with an acute anterior STEMI develops hypotension, cool
extremities, and oliguria. His hemodynamics show CVP 16 mmHg, CI 1.9 L/min/m², SVR
1,400 dynes·sec/cm⁵. Which shock state is present?
A. Septic shock
B. Cardiogenic shock [CORRECT]
C. Neurogenic shock
D. Anaphylactic shock
Correct Answer: B
Rationale: The best answer is B. The elevated CVP, very low cardiac index, and high SVR
indicate pump failure with compensatory vasoconstriction, which is classic cardiogenic
shock. Remember that after an anterior MI, this pattern suggests extensive left
ventricular damage and may require inotropic support or mechanical circulatory
assistance.
Q8: A trauma patient arrives hypotensive after a motor vehicle accident. His
hemodynamics show CVP 2 mmHg, CI 2.1 L/min/m², SVR 1,500 dynes·sec/cm⁵. He has
not yet received fluids. Which shock type is most likely?
A. Cardiogenic shock
B. Hypovolemic shock [CORRECT]
C. Distributive shock
D. Septic shock
Correct Answer: B
Management in Acute Care Practicum – Chamberlain
Actual Exam Questions & Verified Answers | 100%
Correct | Pass Guaranteed - A+ Graded
Hemodynamics, Shock & Sepsis Management
Q1: What is the normal range for central venous pressure (CVP) in a spontaneously
breathing patient?
A. 0–2 mmHg
B. 2–6 mmHg [CORRECT]
C. 8–12 mmHg
D. 12–18 mmHg
Correct Answer: B
Rationale: The best answer is B. A normal CVP typically runs between 2 and 6 mmHg in
spontaneously breathing patients, though mechanically ventilated patients may run
slightly higher. Remember that CVP gives us a rough estimate of preload and
intravascular volume status, but it is not the whole picture.
Q2: Which three components make up the quick SOFA (qSOFA) score?
A. Heart rate >100, temperature >38°C, respiratory rate >20
B. Systolic BP ≤100, respiratory rate ≥22, altered mental status [CORRECT]
C. Lactate >2, platelets <150, creatinine >1.5
D. MAP <65, urine output <0.5, FiO2 >40%
Correct Answer: B
Rationale: The best answer is B. qSOFA uses systolic blood pressure of 100 or less,
respiratory rate of 22 or higher, and altered mentation to identify patients at risk for poor
outcomes from suspected infection. Remember that qSOFA is a bedside screening tool,
not a diagnostic criterion for sepsis itself.
,Q3: In a patient with septic shock, what is the minimum mean arterial pressure (MAP)
target recommended by the Surviving Sepsis Campaign?
A. 55 mmHg
B. 60 mmHg
C. 65 mmHg [CORRECT]
D. 80 mmHg
Correct Answer: C
Rationale: The best answer is C. We generally aim for a MAP of at least 65 mmHg in
septic shock to maintain adequate tissue perfusion. Remember that individual patients
may need higher targets if they have chronic hypertension, but 65 is the standard
starting goal.
Q4: Which vasoactive agent is recommended as first-line for septic shock?
A. Phenylephrine
B. Epinephrine
C. Norepinephrine [CORRECT]
D. Vasopressin
Correct Answer: C
Rationale: The best answer is C. Norepinephrine is the preferred first-line vasopressor
for septic shock because it effectively increases MAP through vasoconstriction while
maintaining some inotropic support. Remember that we add vasopressin or epinephrine
when norepinephrine requirements escalate.
Q5: Which hemodynamic parameter best reflects left ventricular afterload?
A. Central venous pressure
B. Pulmonary artery wedge pressure
C. Systemic vascular resistance [CORRECT]
D. Cardiac output
Correct Answer: C
Rationale: The best answer is C. Systemic vascular resistance represents the resistance
the left ventricle must overcome to eject blood, making it the key measure of afterload.
Remember that afterload reduction is a cornerstone of managing cardiogenic shock
and acute heart failure.
, Q6: A 55-year-old woman with pancreatitis is hypotensive with the following
hemodynamics: CVP 3 mmHg, CI 5.1 L/min/m², SVR 580 dynes·sec/cm⁵. Which type of
shock is most likely?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock [CORRECT]
D. Obstructive shock
Correct Answer: C
Rationale: The best answer is C. The low CVP, high cardiac index, and markedly reduced
SVR fit the classic profile of distributive shock from systemic vasodilation. Remember
that in distributive shock, the primary problem is massive vasodilation causing relative
hypovolemia despite a hyperdynamic state.
Q7: A 72-year-old man with an acute anterior STEMI develops hypotension, cool
extremities, and oliguria. His hemodynamics show CVP 16 mmHg, CI 1.9 L/min/m², SVR
1,400 dynes·sec/cm⁵. Which shock state is present?
A. Septic shock
B. Cardiogenic shock [CORRECT]
C. Neurogenic shock
D. Anaphylactic shock
Correct Answer: B
Rationale: The best answer is B. The elevated CVP, very low cardiac index, and high SVR
indicate pump failure with compensatory vasoconstriction, which is classic cardiogenic
shock. Remember that after an anterior MI, this pattern suggests extensive left
ventricular damage and may require inotropic support or mechanical circulatory
assistance.
Q8: A trauma patient arrives hypotensive after a motor vehicle accident. His
hemodynamics show CVP 2 mmHg, CI 2.1 L/min/m², SVR 1,500 dynes·sec/cm⁵. He has
not yet received fluids. Which shock type is most likely?
A. Cardiogenic shock
B. Hypovolemic shock [CORRECT]
C. Distributive shock
D. Septic shock
Correct Answer: B
