NR 571 Exam Updated 2026 Study Set Complex
Diagnosis & Management In Acute Care Review
Questions with Answers
Esophageal rupture***, pancreatic and malignant effusions are indicated when PF shows what? -
ANSWER-Amylase
PF triglyceride level >100 mg/dl suggests a ___________ - ANSWER-Chylothorax
Hemolysis
Gilbert's syndrome
Drugs
Hepatitis
Chemotherapy
Neonatal
Obstructive cholecystokinin
Cirrhosis with liver failure
Are causes of what? - ANSWER-Hyperbilirubinemia
Alk Phos can be elevated with pregnancy, bone disease or growing children
T/f - ANSWER-True
True test of liver function is... - ANSWER-Total protein/albumin
PT/INR
AST is not very specific for liver disease except in... - ANSWER-ETOH
To determine if the source of high Alk Phos is from the liver, you would draw a _________ -
ANSWER-GGTP
*if this is normal, the source is not due to the liver
Causes of high indirect bilirubin are due to the liver
T/f - ANSWER-False. Indirect bilirubin is unconjugated. Sources of elevated indirect bili are due
to RBC destruction.
Causes of elevated direct bilirubin levels are due to the liver
T/f - ANSWER-True. Direct bilirubin is conjugated by the liver having been bound with
glucoronic acid and made water soluble for excretion
In alcoholics, you can expect an AST:ALT ratio of ____ - ANSWER->2
,If the AST:ALT ratio is >5, the NP expects there are extra-hepatic sources of AST
T/f - ANSWER-True
In most chronic liver disease not caused by ETOH, which is most elevated?
AST or ALT? - ANSWER-ALT. This is found primarily in hepatocytes and released when cells
are injured.
Alk phos will be severely elevated in hepatobiliary disease
T/f - ANSWER-False. Although ALP will be elevated in hepatobiliary disease, it is severely
elevated in biliary disease only.
Hepatitis A is spread via - ANSWER-Fecal-oral. 90% of children acquire hep a in developing
countries
Hepatitis B is spread via - ANSWER-Sex, IVD use, occupational exposure, dialysis, blood.
Which hepatitis is the leading cause of cirrhosis and liver ca worldwide? - ANSWER-Hep B
Hep C is spread mostly via - ANSWER-IV drug abuse. It accounts for 40% of all liver disease
Hepatitis D - ANSWER-Depends on hepatitis B for replication
Positive Anti-hbc means? - ANSWER-Past or ongoing infection. Not present in vaccinated
individuals
Positive Anti-hbs indicates? - ANSWER-Antibodies are present and pt is immune from past
infection or vaccination
NASH is steatohepatitis usually present in persons with obesity, DM and hyperlipidemia
T/f - ANSWER-True
The main treatment for NASH is ____ and ________ - ANSWER-Diet and exercise
Positive hbsag (Antigen) indicates? - ANSWER-An acute infection or chronic infection
A positive igm anti-hbc indicates? - ANSWER-Acute infection
Ascites, Caput Medusa, palmar erythema, Dupuytren's contracture are all physical findings of
what? - ANSWER-Cirrhosis
Hepatitis panel
Fe/TIBC/ferritin
Cerulo plasm
,ANA, ASMA, SPEP
Alpha 1 antitrypsin
PSC-AMA
Are labs included in the work-up for what? - ANSWER-Suspected cirrhosis disease
MELD Score is used to determine what? - ANSWER-Liver transplant waitlist ranking. Score
from <9 to >40 with correlating mortality rates
Child PUGH score is used to predict surgical mortality, overall mortality and indication for
transplant
T/f - ANSWER-True. Patients are classes as A, B or C with transplant evaluation indicated for
those in class B and extremely high period mortality in class C
Idiopathic
Gallstones
ETOH
Trauma
Steroids
Mumps
Autoimmune
Scorpian sting
Hyper Ca or Trigs
ERCP
Drugs (thiazides, sulfonamides, ACEI, NSAIDS, azathioprine)
Are causes of what? - ANSWER-Pancreatitis. IGE SMASHED
Gilbert's syndrome is an inherited deficiency in the enzymes for ________________ without
elevations in other lab values - ANSWER-Bilirubin
Lipase is more specific and sensitive then Emily's in relation to pancreatitis
T/f - ANSWER-True
PAO2<60
Age> 55
Neutrophilia, wbcs > 16.0
Calcium <8
Renal function, BUN increase >5
Enzymes, LDH >350, AST >250
Acidosis, base deficit >4
Sugar, blood glucose >200
, Are all used to assess the severity of pancreatitis. These are collectively known as what? -
ANSWER-Ranson Criteria
When initiating TPN for a patient with pancreatitis, the NP knows to avoid what? - ANSWER-
Lipids
TIGARO:
Toxic Metabolite (etoh)
Idiopathic
Genetic
Autoimmune
Recurrent and severe acute pancreatitis
Obstruction
Are all causes of what? - ANSWER-Chronic pancreatitis
Nr 571
What is high sensitivity troponin and when to use? - ANSWER-first line test for cardiac cell
damage
Used for initial injury
What is CKMB - ANSWER-CK isoenzyme specific to cardiac muscle tissue (MI)
When should CKMB be used? - ANSWER-for suspicion of secondary ischemia after an initial
infarct
Normal level for Troponin I - ANSWER-<0.04
Normal level for CKMB - ANSWER-3-5% of total CK
What is BNP - ANSWER-B-type natriuretic peptide
Normal BNP levels - ANSWER-<100 pg/ml
Differential for chest pain - ANSWER-Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion, pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
Diagnosis & Management In Acute Care Review
Questions with Answers
Esophageal rupture***, pancreatic and malignant effusions are indicated when PF shows what? -
ANSWER-Amylase
PF triglyceride level >100 mg/dl suggests a ___________ - ANSWER-Chylothorax
Hemolysis
Gilbert's syndrome
Drugs
Hepatitis
Chemotherapy
Neonatal
Obstructive cholecystokinin
Cirrhosis with liver failure
Are causes of what? - ANSWER-Hyperbilirubinemia
Alk Phos can be elevated with pregnancy, bone disease or growing children
T/f - ANSWER-True
True test of liver function is... - ANSWER-Total protein/albumin
PT/INR
AST is not very specific for liver disease except in... - ANSWER-ETOH
To determine if the source of high Alk Phos is from the liver, you would draw a _________ -
ANSWER-GGTP
*if this is normal, the source is not due to the liver
Causes of high indirect bilirubin are due to the liver
T/f - ANSWER-False. Indirect bilirubin is unconjugated. Sources of elevated indirect bili are due
to RBC destruction.
Causes of elevated direct bilirubin levels are due to the liver
T/f - ANSWER-True. Direct bilirubin is conjugated by the liver having been bound with
glucoronic acid and made water soluble for excretion
In alcoholics, you can expect an AST:ALT ratio of ____ - ANSWER->2
,If the AST:ALT ratio is >5, the NP expects there are extra-hepatic sources of AST
T/f - ANSWER-True
In most chronic liver disease not caused by ETOH, which is most elevated?
AST or ALT? - ANSWER-ALT. This is found primarily in hepatocytes and released when cells
are injured.
Alk phos will be severely elevated in hepatobiliary disease
T/f - ANSWER-False. Although ALP will be elevated in hepatobiliary disease, it is severely
elevated in biliary disease only.
Hepatitis A is spread via - ANSWER-Fecal-oral. 90% of children acquire hep a in developing
countries
Hepatitis B is spread via - ANSWER-Sex, IVD use, occupational exposure, dialysis, blood.
Which hepatitis is the leading cause of cirrhosis and liver ca worldwide? - ANSWER-Hep B
Hep C is spread mostly via - ANSWER-IV drug abuse. It accounts for 40% of all liver disease
Hepatitis D - ANSWER-Depends on hepatitis B for replication
Positive Anti-hbc means? - ANSWER-Past or ongoing infection. Not present in vaccinated
individuals
Positive Anti-hbs indicates? - ANSWER-Antibodies are present and pt is immune from past
infection or vaccination
NASH is steatohepatitis usually present in persons with obesity, DM and hyperlipidemia
T/f - ANSWER-True
The main treatment for NASH is ____ and ________ - ANSWER-Diet and exercise
Positive hbsag (Antigen) indicates? - ANSWER-An acute infection or chronic infection
A positive igm anti-hbc indicates? - ANSWER-Acute infection
Ascites, Caput Medusa, palmar erythema, Dupuytren's contracture are all physical findings of
what? - ANSWER-Cirrhosis
Hepatitis panel
Fe/TIBC/ferritin
Cerulo plasm
,ANA, ASMA, SPEP
Alpha 1 antitrypsin
PSC-AMA
Are labs included in the work-up for what? - ANSWER-Suspected cirrhosis disease
MELD Score is used to determine what? - ANSWER-Liver transplant waitlist ranking. Score
from <9 to >40 with correlating mortality rates
Child PUGH score is used to predict surgical mortality, overall mortality and indication for
transplant
T/f - ANSWER-True. Patients are classes as A, B or C with transplant evaluation indicated for
those in class B and extremely high period mortality in class C
Idiopathic
Gallstones
ETOH
Trauma
Steroids
Mumps
Autoimmune
Scorpian sting
Hyper Ca or Trigs
ERCP
Drugs (thiazides, sulfonamides, ACEI, NSAIDS, azathioprine)
Are causes of what? - ANSWER-Pancreatitis. IGE SMASHED
Gilbert's syndrome is an inherited deficiency in the enzymes for ________________ without
elevations in other lab values - ANSWER-Bilirubin
Lipase is more specific and sensitive then Emily's in relation to pancreatitis
T/f - ANSWER-True
PAO2<60
Age> 55
Neutrophilia, wbcs > 16.0
Calcium <8
Renal function, BUN increase >5
Enzymes, LDH >350, AST >250
Acidosis, base deficit >4
Sugar, blood glucose >200
, Are all used to assess the severity of pancreatitis. These are collectively known as what? -
ANSWER-Ranson Criteria
When initiating TPN for a patient with pancreatitis, the NP knows to avoid what? - ANSWER-
Lipids
TIGARO:
Toxic Metabolite (etoh)
Idiopathic
Genetic
Autoimmune
Recurrent and severe acute pancreatitis
Obstruction
Are all causes of what? - ANSWER-Chronic pancreatitis
Nr 571
What is high sensitivity troponin and when to use? - ANSWER-first line test for cardiac cell
damage
Used for initial injury
What is CKMB - ANSWER-CK isoenzyme specific to cardiac muscle tissue (MI)
When should CKMB be used? - ANSWER-for suspicion of secondary ischemia after an initial
infarct
Normal level for Troponin I - ANSWER-<0.04
Normal level for CKMB - ANSWER-3-5% of total CK
What is BNP - ANSWER-B-type natriuretic peptide
Normal BNP levels - ANSWER-<100 pg/ml
Differential for chest pain - ANSWER-Consider:
Myocardium- angina, MI, myocarditis, heart failure
Pericardium- pericarditis
Aorta- dissecting aortic aneurysm
Trachea and bronchi- bronchitis
Parietal pleura- pericarditis, pneumonia, pneumothorax, pleural effusion, pulmonary embolus
Chest wall- costochondritis, herpes zoster
Esophagus- reflux, esophageal spasm, esophageal tear
Referred pain from elsewhere- cervical arthritis, biliary colic, gastritis
Psych: anxiety attacks
