NR574 LATEST 2026 FINAL EXAM QUESTIONS AND
SOLUTIONS GUARANTEE A+
✔✔hemophilia: DDAVP what is it used for? - ✔✔DDAVP is a synthetic vasopressin
analog that causes a transient rise in FVIII and VWF but not FIX (desmopressin acetate
tablets) (will work in type A not type B)
-can be administered intranasally, subcutaneously, or intravenously prior to elective
procedures in clients with mild hemophilia A. These clients must receive a test dose
with a documented response prior to elective administration.
✔✔A 13-year-old boy is brought to the emergency department after falling from his
bicycle. He presents with a large, painfully swollen knee; aspiration shows gross
hemarthrosis. On further questioning, the client's parents say that he bruises easily and
has frequent nosebleeds. His maternal uncle had similar bleeding difficulties. Which of
the following laboratory studies should prompt the AGACNP to suspect the presence of
hemophilia? - ✔✔Normal platelet count, prolonged aPTT, normal PT
✔✔Which of the following genetic markers are used to diagnose CML? -
✔✔Philadelphia chromosome
✔✔Jerome is a 72-year-old client who presents to the emergency department (ED) with
an acute exacerbation of chronic obstructive pulmonary disease (COPD). A review of
symptoms reveals SOB, wheezing, and increased rescue inhaler over the last 2
days.findings also include unintentional weight loss (> 10% in 6 months), fever, and
night sweats. Vital signs are as follows: temp 98.6°F; HR 90; bp130/82; rr 22; o2 sat
91% on 2L nasal cannula. physical exam reveals diminished breath sounds in both
lower lobes with expiratory wheezing. He is mildly tachypneic,does not exhibit any other
signs of increased work of breathing, and can speak in full sentences. painless, mobile,
cervical lymphadenopathy along with splenomegaly. (CBC) reveals WBC 27.0 x
109/liter; (Hgb) 10.2 g/deciliter; (Hct) 31%; platelets 90 x 109/liter; absolute neutrophils
28%, and lymphocytes 70%. What diagnoses is the cause of the abnormal CBC? -
✔✔CLL
✔✔Leukocytosis - ✔✔is the broad term for an elevated white blood cell (WBC) count,
typically above 11.0x10^9/L, on a peripheral blood smear collection.
✔✔Lymphocytosis - ✔✔high lymphocyte count, is an increase in white blood cells called
lymphocytes. Lymphocytes help fight off diseases, so it's normal to see a temporary
increase after an infection.
✔✔indicators for poor prognosis following near drowning situation. - ✔✔Submersion or
resuscitation lasting more than 25 minutes, apnea, pH < 7.41, and Glasgow coma scale
(GCS) < 5 are a prognostic signs.
,✔✔clinical findings of near drowning patient - ✔✔panic and agitation lethargy, stupor, or
coma hypothermia hypotension cyanosis pulmonary edema bradycardia or tachycardia
arrhythmia cardiac arrests secondary traumatic injuries (paresthesia, paralysis,
extremity deformity, etc.)
✔✔Management near drowning and post drowning - ✔✔-intubation/supplemental 02-
remove all wet clothes-fluid and electrolyte replacement as needed w/ serial BMP-
NG/OG for gastric decompression (if aspirated, can quickly lead to PNA) -minimum of 6-
8 hrs tele monitoring
✔✔Guiselle is an 18-year-old female who was admitted 8 hours ago after a near-
drowning incident. EMS reports that she fell into a swimming pool at a party and was
unable to swim. It was reported that a family member rescued her from underwater after
she had been submerged for approximately 2 min- utes. She arrived with oxygen at 5
Liters (L) via nasal cannula. Now, Guiselle reports shortness of breath and anxiousness.
She has difficulty talking in complete
sentences. Vital signs are : Blood pressure 122/72; Heart rate 122; Respiratory rate 32;
Oxygen saturation 88% on 5 L oxygen. What is the most likely underlying cause of
Guiselle's distress? - ✔✔Adult respiratory distress syndrome (ARDS)
✔✔LaVelle was brought to the emergency department by EMS. He arrived on a
backboard with a cervical collar in place. LaVelle was found submergedin a pool by a
family member; the circumstances surrounding the event are unknown. The family
reports that LaVelle is a good swimmer and often swims in the home pool alone. You
note that his breaths are shallow and slow. Heis minimally conscious and does not
answer questions or follow commands. Pupils are 2 mm and slow to react. Vital signs
are Blood pressure 98/42; Heart rate 138; Respiratory rate 10; Oxygen saturation 88 on
100% non-rebreather mask. What is the AGACNP's most appropriate action for
LaVelle? - ✔✔Intubation and mechanical ventilation
✔✔risk factors for drowning - ✔✔summer months access to water
children lower socioeconomic status ethnic minority rural population inability to swim or
overestimation of swimming capabilities risk-taking behaviors alcohol or drug use, near
or in the water medical conditions (epilepsy, stroke, myocardial infarction [MI], etc.)
hypothermia
✔✔dry drowning time frame - ✔✔less than an hour after inhaling water.
✔✔secondary drowning - ✔✔- sometimes called "delayed drowning," or "silent drown-
ing.- occurs following a submersion incident in which the guest appears fine at first but
within 24 hours shows signs of drowning
✔✔mild hypothermia - ✔✔32.2° C - 35° C (86-95F)initial thermoregulatory response
correlates with excitation -shivering- hypertension-tachycardia- tachypnea-
vasoconstriction fatigue, impaired judgment, and apathy follow the initial response
, ✔✔moderate hypothermia - ✔✔28° C - 32.1° C (82.4-89.7F)bradycardiaatrial
dysrhythmias bradypneadecreased level of consciousness (LOC) and hyporeflexia
hypotension mydriasis
shivering may stop decreased renal blood flow
✔✔severe hypothermia - ✔✔Severe< 28° C (82F) apnea coma anuria acute pulmonary
edema ventricular dysrhythmias cardiopulmonary arrest death
✔✔As the body is rewarmed, vasodilation occurs facilitating the rapid return of cold
peripheral blood to the heart. This blood contains lactic acid from inadequate tissue
perfusion that has pooled in the periphery. These effects may cause the client to
deteriorate briefly before improvement, a phenomenon called - ✔✔"rewarming acidosis"
or "rewarming shock".
✔✔Frostbite - ✔✔Actual freezing of tissue fluid resulting in damage to the skin and
underlying tissue -typically hands and feet
✔✔Frostbite symptoms - ✔✔feeling of burning and pain, followed by progressive loss of
sensationSkin affected varies in appearance and ranges from pale and non-blanchable
to purple with blisters to black and necrotic.
✔✔Frostbite treatment - ✔✔Rapid rewarming with warm water (do NOT wait) -99-104F-
for 30-60 minutes-do not use hot air
✔✔dehydration is encountered commonly w/ chronic hypothermia and most will benefit
from IV crystalloid bolus. NS or LR? WHY? - ✔✔NS is preferred.
-the liver in hypothermic pt ineffectively metabolizes lactate
✔✔Passive external rewarming - ✔✔Passive external rewarming can be used alone for
mild hypothermia.Warmed blankets are used to insulate the client's body heat.Room
temperature should be maintained between 80-82° Fahrenheit (F). Doors should be
kept closed to keep heat in and keep temperatures consistent.The disadvantage to
passive external rewarming is that the core temperature rises very slowly.
✔✔Active external rewarming - ✔✔Active external rewarming may be combined with
passive external methods.-Heating blankets include pads that circulate warm water and
electric blankets that provide warmth on a timer.-Circulating warm whirlpool baths may
be used if available. This treatment is most beneficial in clients with hypothermia and
frostbite.-Forced warm air is one of the most common methods of warming clients in the
hospital, especially after surgery. Special "blanket" covers with perforations are used
that allow the circulation of warm air to flow over the client.
✔✔Active internal rewarming - ✔✔-An esophageal warming probe can be used to heat
the core blood supply through warmed circulating water.-Central venous warming
SOLUTIONS GUARANTEE A+
✔✔hemophilia: DDAVP what is it used for? - ✔✔DDAVP is a synthetic vasopressin
analog that causes a transient rise in FVIII and VWF but not FIX (desmopressin acetate
tablets) (will work in type A not type B)
-can be administered intranasally, subcutaneously, or intravenously prior to elective
procedures in clients with mild hemophilia A. These clients must receive a test dose
with a documented response prior to elective administration.
✔✔A 13-year-old boy is brought to the emergency department after falling from his
bicycle. He presents with a large, painfully swollen knee; aspiration shows gross
hemarthrosis. On further questioning, the client's parents say that he bruises easily and
has frequent nosebleeds. His maternal uncle had similar bleeding difficulties. Which of
the following laboratory studies should prompt the AGACNP to suspect the presence of
hemophilia? - ✔✔Normal platelet count, prolonged aPTT, normal PT
✔✔Which of the following genetic markers are used to diagnose CML? -
✔✔Philadelphia chromosome
✔✔Jerome is a 72-year-old client who presents to the emergency department (ED) with
an acute exacerbation of chronic obstructive pulmonary disease (COPD). A review of
symptoms reveals SOB, wheezing, and increased rescue inhaler over the last 2
days.findings also include unintentional weight loss (> 10% in 6 months), fever, and
night sweats. Vital signs are as follows: temp 98.6°F; HR 90; bp130/82; rr 22; o2 sat
91% on 2L nasal cannula. physical exam reveals diminished breath sounds in both
lower lobes with expiratory wheezing. He is mildly tachypneic,does not exhibit any other
signs of increased work of breathing, and can speak in full sentences. painless, mobile,
cervical lymphadenopathy along with splenomegaly. (CBC) reveals WBC 27.0 x
109/liter; (Hgb) 10.2 g/deciliter; (Hct) 31%; platelets 90 x 109/liter; absolute neutrophils
28%, and lymphocytes 70%. What diagnoses is the cause of the abnormal CBC? -
✔✔CLL
✔✔Leukocytosis - ✔✔is the broad term for an elevated white blood cell (WBC) count,
typically above 11.0x10^9/L, on a peripheral blood smear collection.
✔✔Lymphocytosis - ✔✔high lymphocyte count, is an increase in white blood cells called
lymphocytes. Lymphocytes help fight off diseases, so it's normal to see a temporary
increase after an infection.
✔✔indicators for poor prognosis following near drowning situation. - ✔✔Submersion or
resuscitation lasting more than 25 minutes, apnea, pH < 7.41, and Glasgow coma scale
(GCS) < 5 are a prognostic signs.
,✔✔clinical findings of near drowning patient - ✔✔panic and agitation lethargy, stupor, or
coma hypothermia hypotension cyanosis pulmonary edema bradycardia or tachycardia
arrhythmia cardiac arrests secondary traumatic injuries (paresthesia, paralysis,
extremity deformity, etc.)
✔✔Management near drowning and post drowning - ✔✔-intubation/supplemental 02-
remove all wet clothes-fluid and electrolyte replacement as needed w/ serial BMP-
NG/OG for gastric decompression (if aspirated, can quickly lead to PNA) -minimum of 6-
8 hrs tele monitoring
✔✔Guiselle is an 18-year-old female who was admitted 8 hours ago after a near-
drowning incident. EMS reports that she fell into a swimming pool at a party and was
unable to swim. It was reported that a family member rescued her from underwater after
she had been submerged for approximately 2 min- utes. She arrived with oxygen at 5
Liters (L) via nasal cannula. Now, Guiselle reports shortness of breath and anxiousness.
She has difficulty talking in complete
sentences. Vital signs are : Blood pressure 122/72; Heart rate 122; Respiratory rate 32;
Oxygen saturation 88% on 5 L oxygen. What is the most likely underlying cause of
Guiselle's distress? - ✔✔Adult respiratory distress syndrome (ARDS)
✔✔LaVelle was brought to the emergency department by EMS. He arrived on a
backboard with a cervical collar in place. LaVelle was found submergedin a pool by a
family member; the circumstances surrounding the event are unknown. The family
reports that LaVelle is a good swimmer and often swims in the home pool alone. You
note that his breaths are shallow and slow. Heis minimally conscious and does not
answer questions or follow commands. Pupils are 2 mm and slow to react. Vital signs
are Blood pressure 98/42; Heart rate 138; Respiratory rate 10; Oxygen saturation 88 on
100% non-rebreather mask. What is the AGACNP's most appropriate action for
LaVelle? - ✔✔Intubation and mechanical ventilation
✔✔risk factors for drowning - ✔✔summer months access to water
children lower socioeconomic status ethnic minority rural population inability to swim or
overestimation of swimming capabilities risk-taking behaviors alcohol or drug use, near
or in the water medical conditions (epilepsy, stroke, myocardial infarction [MI], etc.)
hypothermia
✔✔dry drowning time frame - ✔✔less than an hour after inhaling water.
✔✔secondary drowning - ✔✔- sometimes called "delayed drowning," or "silent drown-
ing.- occurs following a submersion incident in which the guest appears fine at first but
within 24 hours shows signs of drowning
✔✔mild hypothermia - ✔✔32.2° C - 35° C (86-95F)initial thermoregulatory response
correlates with excitation -shivering- hypertension-tachycardia- tachypnea-
vasoconstriction fatigue, impaired judgment, and apathy follow the initial response
, ✔✔moderate hypothermia - ✔✔28° C - 32.1° C (82.4-89.7F)bradycardiaatrial
dysrhythmias bradypneadecreased level of consciousness (LOC) and hyporeflexia
hypotension mydriasis
shivering may stop decreased renal blood flow
✔✔severe hypothermia - ✔✔Severe< 28° C (82F) apnea coma anuria acute pulmonary
edema ventricular dysrhythmias cardiopulmonary arrest death
✔✔As the body is rewarmed, vasodilation occurs facilitating the rapid return of cold
peripheral blood to the heart. This blood contains lactic acid from inadequate tissue
perfusion that has pooled in the periphery. These effects may cause the client to
deteriorate briefly before improvement, a phenomenon called - ✔✔"rewarming acidosis"
or "rewarming shock".
✔✔Frostbite - ✔✔Actual freezing of tissue fluid resulting in damage to the skin and
underlying tissue -typically hands and feet
✔✔Frostbite symptoms - ✔✔feeling of burning and pain, followed by progressive loss of
sensationSkin affected varies in appearance and ranges from pale and non-blanchable
to purple with blisters to black and necrotic.
✔✔Frostbite treatment - ✔✔Rapid rewarming with warm water (do NOT wait) -99-104F-
for 30-60 minutes-do not use hot air
✔✔dehydration is encountered commonly w/ chronic hypothermia and most will benefit
from IV crystalloid bolus. NS or LR? WHY? - ✔✔NS is preferred.
-the liver in hypothermic pt ineffectively metabolizes lactate
✔✔Passive external rewarming - ✔✔Passive external rewarming can be used alone for
mild hypothermia.Warmed blankets are used to insulate the client's body heat.Room
temperature should be maintained between 80-82° Fahrenheit (F). Doors should be
kept closed to keep heat in and keep temperatures consistent.The disadvantage to
passive external rewarming is that the core temperature rises very slowly.
✔✔Active external rewarming - ✔✔Active external rewarming may be combined with
passive external methods.-Heating blankets include pads that circulate warm water and
electric blankets that provide warmth on a timer.-Circulating warm whirlpool baths may
be used if available. This treatment is most beneficial in clients with hypothermia and
frostbite.-Forced warm air is one of the most common methods of warming clients in the
hospital, especially after surgery. Special "blanket" covers with perforations are used
that allow the circulation of warm air to flow over the client.
✔✔Active internal rewarming - ✔✔-An esophageal warming probe can be used to heat
the core blood supply through warmed circulating water.-Central venous warming
