NR572 Exam 2 Actual Exam Style V2 | NR
572 Advanced Acute Care Management |
Chamberlain
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which intervention
should the nurse anticipate first?
A. Administering a loop diuretic
B. Initiating a fluid bolus of 0.9% Normal Saline
C. Starting a norepinephrine infusion
D. Restricting oral fluid intake
E. N/A
Correct Answer: B
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2-8 mmHg, indicating
hypovolemia. Fluid resuscitation is the priority to improve preload and subsequent cardiac
output. The nurse must monitor for clinical signs of improved perfusion such as increased
urine output.
2. Which hemodynamic parameter best represents the ‘afterload’ of the left ventricle?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Systemic Vascular Resistance (SVR)
,D. Pulmonary Vascular Resistance (PVR)
Correct Answer: C
Expert Explanation: Systemic Vascular Resistance (SVR) represents the resistance against
which the left ventricle must pump to eject blood. High SVR indicates vasoconstriction,
which increases the workload of the heart. Managing SVR is crucial in conditions like
hypertension or cardiogenic shock.
3. A patient with septic shock has a MAP of 55 mmHg despite fluid resuscitation. Which
vasopressor is considered the first-line choice?
A. Norepinephrine
B. Dopamine
C. Vasopressin
D. Phenylephrine
Correct Answer: A
Expert Explanation: Norepinephrine is the recommended first-line vasopressor for
maintaining a MAP of at least 65 mmHg in septic shock. It provides potent alpha-1 agonism
for vasoconstriction with some beta-1 effects for contractility. Standardizing this choice
helps reduce mortality and adverse cardiac events.
4. A patient’s ABG results are pH 7.25, PaCO2 55, HCO3 24, and PaO2 60. How should the
nurse interpret these results?
A. Metabolic Acidosis
, B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Compensated Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), indicating respiratory acidosis. The bicarbonate level is within normal limits,
suggesting no compensation has occurred yet. This condition often results from
hypoventilation or respiratory failure.
5. In ARDS, which of the following is a primary reason for using high levels of Positive End-
Expiratory Pressure (PEEP)?
A. To decrease the risk of barotrauma
B. To increase the patient’s respiratory rate
C. To prevent alveolar collapse at the end of expiration
D. To decrease the functional residual capacity
Correct Answer: C
Expert Explanation: PEEP is used to keep alveoli open (recruitment) at the end of
expiration, which improves gas exchange and oxygenation. It increases functional residual
capacity and prevents cyclic atelectasis. However, high PEEP must be monitored closely for
complications like pneumothorax or decreased cardiac output.
572 Advanced Acute Care Management |
Chamberlain
1. A patient in the ICU has a Central Venous Pressure (CVP) of 1 mmHg. Which intervention
should the nurse anticipate first?
A. Administering a loop diuretic
B. Initiating a fluid bolus of 0.9% Normal Saline
C. Starting a norepinephrine infusion
D. Restricting oral fluid intake
E. N/A
Correct Answer: B
Expert Explanation: A CVP of 1 mmHg is below the normal range of 2-8 mmHg, indicating
hypovolemia. Fluid resuscitation is the priority to improve preload and subsequent cardiac
output. The nurse must monitor for clinical signs of improved perfusion such as increased
urine output.
2. Which hemodynamic parameter best represents the ‘afterload’ of the left ventricle?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
C. Systemic Vascular Resistance (SVR)
,D. Pulmonary Vascular Resistance (PVR)
Correct Answer: C
Expert Explanation: Systemic Vascular Resistance (SVR) represents the resistance against
which the left ventricle must pump to eject blood. High SVR indicates vasoconstriction,
which increases the workload of the heart. Managing SVR is crucial in conditions like
hypertension or cardiogenic shock.
3. A patient with septic shock has a MAP of 55 mmHg despite fluid resuscitation. Which
vasopressor is considered the first-line choice?
A. Norepinephrine
B. Dopamine
C. Vasopressin
D. Phenylephrine
Correct Answer: A
Expert Explanation: Norepinephrine is the recommended first-line vasopressor for
maintaining a MAP of at least 65 mmHg in septic shock. It provides potent alpha-1 agonism
for vasoconstriction with some beta-1 effects for contractility. Standardizing this choice
helps reduce mortality and adverse cardiac events.
4. A patient’s ABG results are pH 7.25, PaCO2 55, HCO3 24, and PaO2 60. How should the
nurse interpret these results?
A. Metabolic Acidosis
, B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Compensated Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
component), indicating respiratory acidosis. The bicarbonate level is within normal limits,
suggesting no compensation has occurred yet. This condition often results from
hypoventilation or respiratory failure.
5. In ARDS, which of the following is a primary reason for using high levels of Positive End-
Expiratory Pressure (PEEP)?
A. To decrease the risk of barotrauma
B. To increase the patient’s respiratory rate
C. To prevent alveolar collapse at the end of expiration
D. To decrease the functional residual capacity
Correct Answer: C
Expert Explanation: PEEP is used to keep alveoli open (recruitment) at the end of
expiration, which improves gas exchange and oxygenation. It increases functional residual
capacity and prevents cyclic atelectasis. However, high PEEP must be monitored closely for
complications like pneumothorax or decreased cardiac output.
