NR572 Exam 3 Actual Exam Style V2 | NR
572 Advanced Acute Care Management |
Chamberlain
1. According to the Surviving Sepsis Campaign, what is the recommended initial fluid bolus
for a patient with sepsis-induced hypotension or a lactate level ≥ 4 mmol/L?
A. 10 mL/kg of crystalloid
B. 20 mL/kg of colloid
C. 30 mL/kg of crystalloid
D. 50 mL/kg of crystalloid
Correct Answer: C
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of 30 mL/kg of crystalloid solution. This volume should be administered
within the first 3 hours of presentation to address hypovolemia. Early and aggressive fluid
resuscitation is vital for restoring tissue perfusion and improving patient outcomes.
2. In the management of Acute Respiratory Distress Syndrome (ARDS), which tidal volume
setting is considered a lung-protective strategy?
A. 4-8 mL/kg of predicted body weight
B. 10-12 mL/kg of predicted body weight
C. 12-15 mL/kg of actual body weight
,D. 8-10 mL/kg of actual body weight
Correct Answer: A
Expert Explanation: Lung-protective ventilation for ARDS involves using low tidal
volumes, typically starting at 6 mL/kg of predicted body weight. This approach helps
prevent ventilator-induced lung injury such as volutrauma and barotrauma. Limiting tidal
volumes has been shown to significantly reduce mortality in patients with severe
respiratory failure.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which of the following is the
priority intervention after ensuring airway stability?
A. Aggressive intravenous fluid resuscitation
B. Administering subcutaneous long-acting insulin
C. Starting an intravenous insulin drip
D. Giving intravenous sodium bicarbonate
Correct Answer: A
Expert Explanation: Fluid resuscitation is the first and most critical step in managing DKA
to restore circulatory volume and improve renal perfusion. Insulin should only be started
after fluid replacement has begun and the potassium level is known to be above 3.3 mEq/L.
Correcting the volume deficit helps lower blood glucose levels even before insulin therapy
is fully active.
, 4. Which laboratory finding is most characteristic of Disseminated Intravascular Coagulation
(DIC)?
A. Decreased D-dimer levels
B. Increased fibrinogen levels
C. Increased platelet count
D. Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT)
Correct Answer: D
Expert Explanation: DIC is characterized by the systemic activation of coagulation, which
exhausts clotting factors and leads to prolonged PT and aPTT. Additionally, you would
typically see a decrease in fibrinogen and platelets along with elevated D-dimer levels.
These laboratory changes reflect the simultaneous processes of excessive clotting and
excessive bleeding occurring in the body.
5. What is the gold standard diagnostic test for confirming a Pulmonary Embolism (PE) in a
stable patient?
A. Chest X-ray
B. D-dimer assay
C. Computed Tomography Pulmonary Angiogram (CTPA)
D. Venous Doppler of the lower extremities
Correct Answer: C
572 Advanced Acute Care Management |
Chamberlain
1. According to the Surviving Sepsis Campaign, what is the recommended initial fluid bolus
for a patient with sepsis-induced hypotension or a lactate level ≥ 4 mmol/L?
A. 10 mL/kg of crystalloid
B. 20 mL/kg of colloid
C. 30 mL/kg of crystalloid
D. 50 mL/kg of crystalloid
Correct Answer: C
Expert Explanation: The Surviving Sepsis Campaign guidelines recommend an initial fluid
resuscitation of 30 mL/kg of crystalloid solution. This volume should be administered
within the first 3 hours of presentation to address hypovolemia. Early and aggressive fluid
resuscitation is vital for restoring tissue perfusion and improving patient outcomes.
2. In the management of Acute Respiratory Distress Syndrome (ARDS), which tidal volume
setting is considered a lung-protective strategy?
A. 4-8 mL/kg of predicted body weight
B. 10-12 mL/kg of predicted body weight
C. 12-15 mL/kg of actual body weight
,D. 8-10 mL/kg of actual body weight
Correct Answer: A
Expert Explanation: Lung-protective ventilation for ARDS involves using low tidal
volumes, typically starting at 6 mL/kg of predicted body weight. This approach helps
prevent ventilator-induced lung injury such as volutrauma and barotrauma. Limiting tidal
volumes has been shown to significantly reduce mortality in patients with severe
respiratory failure.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which of the following is the
priority intervention after ensuring airway stability?
A. Aggressive intravenous fluid resuscitation
B. Administering subcutaneous long-acting insulin
C. Starting an intravenous insulin drip
D. Giving intravenous sodium bicarbonate
Correct Answer: A
Expert Explanation: Fluid resuscitation is the first and most critical step in managing DKA
to restore circulatory volume and improve renal perfusion. Insulin should only be started
after fluid replacement has begun and the potassium level is known to be above 3.3 mEq/L.
Correcting the volume deficit helps lower blood glucose levels even before insulin therapy
is fully active.
, 4. Which laboratory finding is most characteristic of Disseminated Intravascular Coagulation
(DIC)?
A. Decreased D-dimer levels
B. Increased fibrinogen levels
C. Increased platelet count
D. Prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT)
Correct Answer: D
Expert Explanation: DIC is characterized by the systemic activation of coagulation, which
exhausts clotting factors and leads to prolonged PT and aPTT. Additionally, you would
typically see a decrease in fibrinogen and platelets along with elevated D-dimer levels.
These laboratory changes reflect the simultaneous processes of excessive clotting and
excessive bleeding occurring in the body.
5. What is the gold standard diagnostic test for confirming a Pulmonary Embolism (PE) in a
stable patient?
A. Chest X-ray
B. D-dimer assay
C. Computed Tomography Pulmonary Angiogram (CTPA)
D. Venous Doppler of the lower extremities
Correct Answer: C
