NR572 Exam 2 Actual Exam Style V1 | NR
572 Advanced Acute Care Management |
Chamberlain
1. What is the primary calculation used to determine Mean Arterial Pressure (MAP)?
A. (Systolic BP + Diastolic BP) / 2
B. Systolic BP - Diastolic BP
C. (2 x Systolic BP + Diastolic BP) / 3
D. (2 x Diastolic BP + Systolic BP) / 3
Correct Answer: D
Expert Explanation: The formula for calculating Mean Arterial Pressure (MAP) is (2 x
Diastolic BP + Systolic BP) divided by 3. This formula is used because the heart spends
twice as long in the diastolic phase as in the systolic phase. A MAP of at least 65 mmHg is
generally required to maintain adequate perfusion to vital organs.
2. Which clinical sign is most characteristic of right-sided heart failure?
A. Pulmonary crackles
B. Pink frothy sputum
C. Jugular venous distension (JVD)
D. Paroxysmal nocturnal dyspnea
Correct Answer: C
,Expert Explanation: Right-sided heart failure leads to a backup of blood into the systemic
venous circulation. This results in physical findings such as jugular venous distension,
peripheral edema, and hepatomegaly. Pulmonary symptoms like crackles and frothy
sputum are more indicative of left-sided heart failure.
3. In the management of hypovolemic shock, what is the first-line treatment to restore
volume?
A. Isotonic crystalloids like Normal Saline
B. Vasopressors like Norepinephrine
C. Inotropic agents like Dobutamine
D. Loop diuretics like Furosemide
Correct Answer: A
Expert Explanation: Restoring circulating volume is the priority in treating hypovolemic
shock to ensure organ perfusion. Isotonic crystalloids, such as Normal Saline or Lactated
Ringer’s, are the preferred initial fluids for resuscitation. Vasopressors should only be
considered after adequate fluid volume has been replaced if the patient remains
hypotensive.
4. What is the hallmark hemodynamic finding in cardiogenic shock?
A. Decreased cardiac output and high PCWP
B. Increased cardiac output and low CVP
C. Decreased systemic vascular resistance
, D. Low central venous pressure
Correct Answer: A
Expert Explanation: Cardiogenic shock occurs when the heart fails as a pump, leading to a
low cardiac output despite adequate volume. This failure causes blood to back up into the
lungs, which is reflected by an elevated Pulmonary Capillary Wedge Pressure (PCWP).
Patients in cardiogenic shock also typically exhibit a high systemic vascular resistance as
the body attempts to compensate for low output.
5. Which ABG result is consistent with a patient experiencing acute respiratory failure with
hypercapnia?
A. pH 7.25, PaCO2 60, HCO3 26
B. pH 7.35, PaCO2 40, HCO3 22
C. pH 7.48, PaCO2 30, HCO3 24
D. pH 7.50, PaCO2 45, HCO3 35
Correct Answer: A
Expert Explanation: Acute respiratory failure with hypercapnia is defined by an elevated
PaCO2 level, usually above 45-50 mmHg. This retention of carbon dioxide leads to a drop in
blood pH, resulting in respiratory acidosis. A pH of 7.25 and a PaCO2 of 60 indicates
significant ventilatory failure.
6. Which diagnostic lab value is most specific for identifying an acute myocardial infarction?
A. Troponin I or T
572 Advanced Acute Care Management |
Chamberlain
1. What is the primary calculation used to determine Mean Arterial Pressure (MAP)?
A. (Systolic BP + Diastolic BP) / 2
B. Systolic BP - Diastolic BP
C. (2 x Systolic BP + Diastolic BP) / 3
D. (2 x Diastolic BP + Systolic BP) / 3
Correct Answer: D
Expert Explanation: The formula for calculating Mean Arterial Pressure (MAP) is (2 x
Diastolic BP + Systolic BP) divided by 3. This formula is used because the heart spends
twice as long in the diastolic phase as in the systolic phase. A MAP of at least 65 mmHg is
generally required to maintain adequate perfusion to vital organs.
2. Which clinical sign is most characteristic of right-sided heart failure?
A. Pulmonary crackles
B. Pink frothy sputum
C. Jugular venous distension (JVD)
D. Paroxysmal nocturnal dyspnea
Correct Answer: C
,Expert Explanation: Right-sided heart failure leads to a backup of blood into the systemic
venous circulation. This results in physical findings such as jugular venous distension,
peripheral edema, and hepatomegaly. Pulmonary symptoms like crackles and frothy
sputum are more indicative of left-sided heart failure.
3. In the management of hypovolemic shock, what is the first-line treatment to restore
volume?
A. Isotonic crystalloids like Normal Saline
B. Vasopressors like Norepinephrine
C. Inotropic agents like Dobutamine
D. Loop diuretics like Furosemide
Correct Answer: A
Expert Explanation: Restoring circulating volume is the priority in treating hypovolemic
shock to ensure organ perfusion. Isotonic crystalloids, such as Normal Saline or Lactated
Ringer’s, are the preferred initial fluids for resuscitation. Vasopressors should only be
considered after adequate fluid volume has been replaced if the patient remains
hypotensive.
4. What is the hallmark hemodynamic finding in cardiogenic shock?
A. Decreased cardiac output and high PCWP
B. Increased cardiac output and low CVP
C. Decreased systemic vascular resistance
, D. Low central venous pressure
Correct Answer: A
Expert Explanation: Cardiogenic shock occurs when the heart fails as a pump, leading to a
low cardiac output despite adequate volume. This failure causes blood to back up into the
lungs, which is reflected by an elevated Pulmonary Capillary Wedge Pressure (PCWP).
Patients in cardiogenic shock also typically exhibit a high systemic vascular resistance as
the body attempts to compensate for low output.
5. Which ABG result is consistent with a patient experiencing acute respiratory failure with
hypercapnia?
A. pH 7.25, PaCO2 60, HCO3 26
B. pH 7.35, PaCO2 40, HCO3 22
C. pH 7.48, PaCO2 30, HCO3 24
D. pH 7.50, PaCO2 45, HCO3 35
Correct Answer: A
Expert Explanation: Acute respiratory failure with hypercapnia is defined by an elevated
PaCO2 level, usually above 45-50 mmHg. This retention of carbon dioxide leads to a drop in
blood pH, resulting in respiratory acidosis. A pH of 7.25 and a PaCO2 of 60 indicates
significant ventilatory failure.
6. Which diagnostic lab value is most specific for identifying an acute myocardial infarction?
A. Troponin I or T
