Midterm Exam: NR 572/ NR572
(New 2025/ 2026 Update)
Advanced Acute Care
Management Guide| Questions
& Answers| Grade A| 100%
Correct (Verified Solutions)-
Chamberlain
1. What is the first step in acute patient assessment?
A) Obtain IV access
B) Perform a head-to-toe assessment
C) Primary survey (ABCs)
D) Review lab results
Correct ,,,,answer,,,,: C) Primary survey (ABCs: Airway, Breathing,
Circulation)
Rationale: In acute care, the priority is to identify life-threatening
conditions immediately. The primary survey follows the "ABCs" to
ensure the airway is patent, breathing is adequate, and circulation is
maintained before moving to a detailed physical exam or diagnostics .
2. How is Shock defined in advanced acute care?
A) A sudden drop in blood pressure
,B) Systemic reduction in tissue perfusion causing imbalance between
oxygen delivery and consumption
C) Failure of the heart to pump blood
D) An infection in the bloodstream
Correct ,,,,answer,,,,: B) Systemic reduction in tissue perfusion
causing imbalance between oxygen delivery and consumption
Rationale: Shock is a pathophysiology of cellular dysfunction, not just
low blood pressure. It occurs when oxygen demand exceeds supply,
leading to ischemia, necrosis, and potentially organ failure if not
reversed .
3. A patient presents with warm, dry skin, tachycardia, and
hypotension. Which type of shock is most likely?
A) Hypovolemic
B) Cardiogenic
C) Distributive
D) Obstructive
Correct ,,,,answer,,,,: C) Distributive
Rationale: Distributive shock (septic, anaphylactic, neurogenic) is
characterized by massive vasodilation. Unlike other shock states where
skin is cool and clammy, distributive shock often presents with warm,
dry skin due to increased peripheral blood flow .
4. What is the hemodynamic pattern seen in Cardiogenic Shock?
A) Decreased CO, decreased SVR, decreased preload
B) Increased CO, increased SVR, increased preload
C) Decreased CO, increased SVR, increased preload
D) Decreased CO, decreased SVR, increased preload
,Correct ,,,,answer,,,,: C) Decreased CO, increased SVR, increased
preload
Rationale: In cardiogenic shock, the heart fails as a pump (decreased
CO). The body compensates by vasoconstricting (increased SVR) to
maintain blood pressure, and fluid backs up (increased preload) due to
the pump failure .
5. Which physical exam finding helps distinguish Distributive Shock
from Hypovolemic Shock?
A) Cool, pale, moist skin
B) Jugular Vein Distension (JVD)
C) Warm, dry skin
D) Crackles in the lungs
Correct ,,,,answer,,,,: C) Warm, dry skin
Rationale: Hypovolemic and cardiogenic shock cause cool, pale, moist
skin due to reduced perfusion. In distributive shock (e.g., sepsis),
vasodilation leads to warm, flushed skin despite the low blood pressure .
6. What is the first-line fluid for resuscitation in a patient with
Septic Shock?
A) Albumin
B) Packed Red Blood Cells
C) Hetastarch
D) Crystalloids (Normal Saline or Lactated Ringer's)
Correct ,,,,answer,,,,: D) Crystalloids (Normal Saline or Lactated
Ringer's)
, Rationale: Current guidelines recommend rapid administration of
30mL/kg of crystalloids to restore intravascular volume in septic shock.
Colloids (like albumin) are not first-line .
7. A patient has a pH of 7.30, PaCO2 of 68 mm Hg, and HCO3 of 28
mmol/L. What is the interpretation?
A) Uncompensated Metabolic Acidosis
B) Partially Compensated Respiratory Acidosis
C) Fully Compensated Respiratory Alkalosis
D) Partially Compensated Metabolic Alkalosis
Correct ,,,,answer,,,,: B) Partially Compensated Respiratory
Acidosis
Rationale: The pH is low (Acidosis). PaCO2 is high (Respiratory
cause). HCO3 is high (Metabolic compensation). Because the pH is still
abnormal and all three values are abnormal, it is "Partially
Compensated" .
8. What is the normal A-a gradient?
A) 35-45 mmHg
B) 22-26 mEq/L
C) 5-10 mmHg (increases slightly with age)
D) 75-100 mmHg
Correct ,,,,answer,,,,: C) 5-10 mmHg (increases slightly with age)
Rationale: The A-a gradient (PAO2 - PaO2) measures oxygen transfer
efficiency. A normal gradient is narrow (5-10 mmHg). An elevated
gradient suggests lung pathology like V/Q mismatch or shunt .
9. A tension pneumothorax is suspected. Which assessment finding
is a LATE sign?
(New 2025/ 2026 Update)
Advanced Acute Care
Management Guide| Questions
& Answers| Grade A| 100%
Correct (Verified Solutions)-
Chamberlain
1. What is the first step in acute patient assessment?
A) Obtain IV access
B) Perform a head-to-toe assessment
C) Primary survey (ABCs)
D) Review lab results
Correct ,,,,answer,,,,: C) Primary survey (ABCs: Airway, Breathing,
Circulation)
Rationale: In acute care, the priority is to identify life-threatening
conditions immediately. The primary survey follows the "ABCs" to
ensure the airway is patent, breathing is adequate, and circulation is
maintained before moving to a detailed physical exam or diagnostics .
2. How is Shock defined in advanced acute care?
A) A sudden drop in blood pressure
,B) Systemic reduction in tissue perfusion causing imbalance between
oxygen delivery and consumption
C) Failure of the heart to pump blood
D) An infection in the bloodstream
Correct ,,,,answer,,,,: B) Systemic reduction in tissue perfusion
causing imbalance between oxygen delivery and consumption
Rationale: Shock is a pathophysiology of cellular dysfunction, not just
low blood pressure. It occurs when oxygen demand exceeds supply,
leading to ischemia, necrosis, and potentially organ failure if not
reversed .
3. A patient presents with warm, dry skin, tachycardia, and
hypotension. Which type of shock is most likely?
A) Hypovolemic
B) Cardiogenic
C) Distributive
D) Obstructive
Correct ,,,,answer,,,,: C) Distributive
Rationale: Distributive shock (septic, anaphylactic, neurogenic) is
characterized by massive vasodilation. Unlike other shock states where
skin is cool and clammy, distributive shock often presents with warm,
dry skin due to increased peripheral blood flow .
4. What is the hemodynamic pattern seen in Cardiogenic Shock?
A) Decreased CO, decreased SVR, decreased preload
B) Increased CO, increased SVR, increased preload
C) Decreased CO, increased SVR, increased preload
D) Decreased CO, decreased SVR, increased preload
,Correct ,,,,answer,,,,: C) Decreased CO, increased SVR, increased
preload
Rationale: In cardiogenic shock, the heart fails as a pump (decreased
CO). The body compensates by vasoconstricting (increased SVR) to
maintain blood pressure, and fluid backs up (increased preload) due to
the pump failure .
5. Which physical exam finding helps distinguish Distributive Shock
from Hypovolemic Shock?
A) Cool, pale, moist skin
B) Jugular Vein Distension (JVD)
C) Warm, dry skin
D) Crackles in the lungs
Correct ,,,,answer,,,,: C) Warm, dry skin
Rationale: Hypovolemic and cardiogenic shock cause cool, pale, moist
skin due to reduced perfusion. In distributive shock (e.g., sepsis),
vasodilation leads to warm, flushed skin despite the low blood pressure .
6. What is the first-line fluid for resuscitation in a patient with
Septic Shock?
A) Albumin
B) Packed Red Blood Cells
C) Hetastarch
D) Crystalloids (Normal Saline or Lactated Ringer's)
Correct ,,,,answer,,,,: D) Crystalloids (Normal Saline or Lactated
Ringer's)
, Rationale: Current guidelines recommend rapid administration of
30mL/kg of crystalloids to restore intravascular volume in septic shock.
Colloids (like albumin) are not first-line .
7. A patient has a pH of 7.30, PaCO2 of 68 mm Hg, and HCO3 of 28
mmol/L. What is the interpretation?
A) Uncompensated Metabolic Acidosis
B) Partially Compensated Respiratory Acidosis
C) Fully Compensated Respiratory Alkalosis
D) Partially Compensated Metabolic Alkalosis
Correct ,,,,answer,,,,: B) Partially Compensated Respiratory
Acidosis
Rationale: The pH is low (Acidosis). PaCO2 is high (Respiratory
cause). HCO3 is high (Metabolic compensation). Because the pH is still
abnormal and all three values are abnormal, it is "Partially
Compensated" .
8. What is the normal A-a gradient?
A) 35-45 mmHg
B) 22-26 mEq/L
C) 5-10 mmHg (increases slightly with age)
D) 75-100 mmHg
Correct ,,,,answer,,,,: C) 5-10 mmHg (increases slightly with age)
Rationale: The A-a gradient (PAO2 - PaO2) measures oxygen transfer
efficiency. A normal gradient is narrow (5-10 mmHg). An elevated
gradient suggests lung pathology like V/Q mismatch or shunt .
9. A tension pneumothorax is suspected. Which assessment finding
is a LATE sign?
