NR571 Exam 4 Actual Exam Style V1 |
NR571 Exam 4
1. According to the qSOFA criteria, which of the following is a clinical sign of sepsis?
A. Systolic blood pressure of 110 mmHg or higher
B. Respiratory rate of 22 breaths per minute or higher
C. Heart rate of 100 beats per minute or higher
D. Urinary output less than 30 mL per hour
Correct Answer: B
Expert Explanation: The qSOFA score is used to identify patients at risk for sepsis outside
of the ICU setting. It consists of three criteria: altered mental status, systolic blood pressure
of 100 mmHg or less, and respiratory rate of 22 or higher. A score of 2 or more is
associated with increased mortality risk.
2. Which diagnostic finding is essential for the diagnosis of ARDS according to the Berlin
definition?
A. Pulmonary artery wedge pressure greater than 18 mmHg
B. PaO2/FiO2 ratio less than 300 with PEEP of 5 cmH2O or more
C. Unilateral infiltrates on chest X-ray
D. Left ventricular failure as the primary cause of edema
Correct Answer: B
,Expert Explanation: The Berlin definition for ARDS requires acute onset within one week
of a clinical insult. It also necessitates bilateral opacities on imaging not fully explained by
effusions or heart failure. The severity is categorized by the P/F ratio, with less than 300
being the minimum threshold for diagnosis.
3. In the management of hypovolemic shock, what is the initial priority intervention?
A. Starting a vasopressor like norepinephrine
B. Administering a bolus of 50% dextrose
C. Intubation and mechanical ventilation
D. Rapid fluid resuscitation with isotonic crystalloids
Correct Answer: D
Expert Explanation: Hypovolemic shock is characterized by a significant loss of
intravascular volume. The primary goal is to restore circulating volume to ensure adequate
tissue perfusion. Large-bore IV access and isotonic crystalloids like Normal Saline or
Lactated Ringer’s are the standard initial treatments.
4. A patient with cardiogenic shock likely exhibits which hemodynamic profile?
A. Low Cardiac Output and Low Pulmonary Artery Wedge Pressure
B. Low Cardiac Output and High Pulmonary Artery Wedge Pressure
C. High Cardiac Output and High Systemic Vascular Resistance
D. High Cardiac Output and Low Systemic Vascular Resistance
, Correct Answer: B
Expert Explanation: Cardiogenic shock involves pump failure leading to decreased cardiac
output and tissue hypoxia. Because the heart cannot pump effectively, fluid backs up into
the lungs, increasing the wedge pressure. Systemic vascular resistance usually increases as
a compensatory mechanism to maintain blood pressure.
5. What is the hallmark laboratory finding in Diabetic Ketoacidosis (DKA)?
A. Serum glucose greater than 600 mg/dL
B. Normal arterial pH with low bicarbonate
C. Serum osmolality greater than 320 mOsm/kg
D. Anion gap metabolic acidosis
Correct Answer: D
Expert Explanation: DKA is characterized by hyperglycemia, ketosis, and metabolic
acidosis. The accumulation of ketoacids leads to a wide anion gap acidosis, typically with a
pH below 7.30. In contrast, HHS usually presents with much higher glucose levels and no
significant acidosis.
6. In a patient presenting with Hyperosmolar Hyperglycemic State (HHS), what is the primary
goal of treatment?
A. Aggressive potassium restriction
B. Fluid resuscitation to correct dehydration
NR571 Exam 4
1. According to the qSOFA criteria, which of the following is a clinical sign of sepsis?
A. Systolic blood pressure of 110 mmHg or higher
B. Respiratory rate of 22 breaths per minute or higher
C. Heart rate of 100 beats per minute or higher
D. Urinary output less than 30 mL per hour
Correct Answer: B
Expert Explanation: The qSOFA score is used to identify patients at risk for sepsis outside
of the ICU setting. It consists of three criteria: altered mental status, systolic blood pressure
of 100 mmHg or less, and respiratory rate of 22 or higher. A score of 2 or more is
associated with increased mortality risk.
2. Which diagnostic finding is essential for the diagnosis of ARDS according to the Berlin
definition?
A. Pulmonary artery wedge pressure greater than 18 mmHg
B. PaO2/FiO2 ratio less than 300 with PEEP of 5 cmH2O or more
C. Unilateral infiltrates on chest X-ray
D. Left ventricular failure as the primary cause of edema
Correct Answer: B
,Expert Explanation: The Berlin definition for ARDS requires acute onset within one week
of a clinical insult. It also necessitates bilateral opacities on imaging not fully explained by
effusions or heart failure. The severity is categorized by the P/F ratio, with less than 300
being the minimum threshold for diagnosis.
3. In the management of hypovolemic shock, what is the initial priority intervention?
A. Starting a vasopressor like norepinephrine
B. Administering a bolus of 50% dextrose
C. Intubation and mechanical ventilation
D. Rapid fluid resuscitation with isotonic crystalloids
Correct Answer: D
Expert Explanation: Hypovolemic shock is characterized by a significant loss of
intravascular volume. The primary goal is to restore circulating volume to ensure adequate
tissue perfusion. Large-bore IV access and isotonic crystalloids like Normal Saline or
Lactated Ringer’s are the standard initial treatments.
4. A patient with cardiogenic shock likely exhibits which hemodynamic profile?
A. Low Cardiac Output and Low Pulmonary Artery Wedge Pressure
B. Low Cardiac Output and High Pulmonary Artery Wedge Pressure
C. High Cardiac Output and High Systemic Vascular Resistance
D. High Cardiac Output and Low Systemic Vascular Resistance
, Correct Answer: B
Expert Explanation: Cardiogenic shock involves pump failure leading to decreased cardiac
output and tissue hypoxia. Because the heart cannot pump effectively, fluid backs up into
the lungs, increasing the wedge pressure. Systemic vascular resistance usually increases as
a compensatory mechanism to maintain blood pressure.
5. What is the hallmark laboratory finding in Diabetic Ketoacidosis (DKA)?
A. Serum glucose greater than 600 mg/dL
B. Normal arterial pH with low bicarbonate
C. Serum osmolality greater than 320 mOsm/kg
D. Anion gap metabolic acidosis
Correct Answer: D
Expert Explanation: DKA is characterized by hyperglycemia, ketosis, and metabolic
acidosis. The accumulation of ketoacids leads to a wide anion gap acidosis, typically with a
pH below 7.30. In contrast, HHS usually presents with much higher glucose levels and no
significant acidosis.
6. In a patient presenting with Hyperosmolar Hyperglycemic State (HHS), what is the primary
goal of treatment?
A. Aggressive potassium restriction
B. Fluid resuscitation to correct dehydration
