A+ GRADED 1
NRNP 6566 Advanced Care
of Adults in Acute Settings
I – Week 7 Knowledge
Check with Verified
Answers (2025/2026)
Instructions
Read each scenario carefully before answering.
Choose the most clinically appropriate response.
After each question, review the rationale to confirm your
understanding.
Sectio
Apply this knowledge to real-world acute care settings.
, 2
Question 1
A 59-year-old man with a history of COPD is admitted to the ICU for an acute
exacerbation and is intubated earlier in the day. The nurse notes that the patient
appears anxious and is "fighting" the ventilator. What is the most appropriate
initial action?
A. Increase the FiO2 to 100% B. Administer a sedative such as propofol C.
Perform immediate endotracheal suctioning D. Switch to pressure-controlled
ventilation
B. Administer a sedative such as propofol Rationale: Patient-ventilator
dyssynchrony, indicated by anxiety and fighting the ventilator, is best managed
initially with sedation to promote comfort and synchronization. Propofol provides
rapid onset sedation in intubated ICU patients. Increasing FiO2 addresses
oxygenation but not dyssynchrony, suctioning is for secretions, and mode switch
may be later if needed.
Question 2
A patient with respiratory failure is on mechanical ventilation with a PEEP of 10
cm H2O. Hemodynamic monitoring shows increasing pulmonary capillary wedge
pressure (PCWP). Which change in ventilator settings may be required?
A. Decrease the tidal volume B. Increase the respiratory rate C. Decrease the PEEP
D. Switch to high-frequency oscillatory ventilation
C. Decrease the PEEP Rationale: Elevated PCWP suggests left ventricular
dysfunction or fluid overload, where high PEEP can worsen hemodynamics by
increasing intrathoracic pressure and reducing venous return. Decreasing PEEP
alleviates this. Tidal volume and rate adjustments address ventilation, while HFOV
is for refractory cases.
Question 3
NRNP 6566 Advanced Care
of Adults in Acute Settings
I – Week 7 Knowledge
Check with Verified
Answers (2025/2026)
Instructions
Read each scenario carefully before answering.
Choose the most clinically appropriate response.
After each question, review the rationale to confirm your
understanding.
Sectio
Apply this knowledge to real-world acute care settings.
, 2
Question 1
A 59-year-old man with a history of COPD is admitted to the ICU for an acute
exacerbation and is intubated earlier in the day. The nurse notes that the patient
appears anxious and is "fighting" the ventilator. What is the most appropriate
initial action?
A. Increase the FiO2 to 100% B. Administer a sedative such as propofol C.
Perform immediate endotracheal suctioning D. Switch to pressure-controlled
ventilation
B. Administer a sedative such as propofol Rationale: Patient-ventilator
dyssynchrony, indicated by anxiety and fighting the ventilator, is best managed
initially with sedation to promote comfort and synchronization. Propofol provides
rapid onset sedation in intubated ICU patients. Increasing FiO2 addresses
oxygenation but not dyssynchrony, suctioning is for secretions, and mode switch
may be later if needed.
Question 2
A patient with respiratory failure is on mechanical ventilation with a PEEP of 10
cm H2O. Hemodynamic monitoring shows increasing pulmonary capillary wedge
pressure (PCWP). Which change in ventilator settings may be required?
A. Decrease the tidal volume B. Increase the respiratory rate C. Decrease the PEEP
D. Switch to high-frequency oscillatory ventilation
C. Decrease the PEEP Rationale: Elevated PCWP suggests left ventricular
dysfunction or fluid overload, where high PEEP can worsen hemodynamics by
increasing intrathoracic pressure and reducing venous return. Decreasing PEEP
alleviates this. Tidal volume and rate adjustments address ventilation, while HFOV
is for refractory cases.
Question 3
