1|Page
NR 574 ACUTE CARE PRACTICUM I FINAL EXAM
2026/2027 COMPREHENSIVE TEST BANK - 500
VERIFIED QUESTIONS WITH ANSWERS AND
RATIONALES Chamberlain University | Academic Year
| Most Recent Edition
Objective findings in a patient with intestinal obstruction? -
Answer-Key physical exam findings may include:
Fever (systemic inflammation or strangulation)
High-pitched, tinkling, bowel sounds (may be hypoactive
or absent with complete obstruction) Abdominal distention
(more significant with distal obstruction due to the greater
volume of intraluminal fluid accumulation)Mild abdominal
tenderness but no peritoneal findingsTender abdominal or
groin masses (can represent incarcerated hernia) Signs of
shock (tachycardia, hypotension, oliguria)
Significant abdominal tenderness with palpation should
increase the NP's suspicion for? - Answer-ischemia,
peritonitis, or necrosis.
why is a serum lactate useful in dx a bowel obstruction? -
Answer-Serum lactate (increased serum lactate should
raise concern for strangulated obstruction)
,2|Page
what diagnostic imaging should be used for bowel
obstruction? - Answer-plain film xray
what will a plain film xray show if a patient has a bowel
obstruction? - Answer-Obstruction will reveal dilated loops
of bowel and visible air-fluid levels which should prompt
further studies.A horizontal pattern of dilated small bowel
loops can be seen with small bowel obstruction (SBO)
Should barium contrast be given to a patient with a bowel
obstruction? - Answer-NO! Imaging studies requiring
administration of barium are contraindicated in cases of
high- grade or complete obstruction.
What does barium contrast do within the body with a
bowel obstruction? - Answer-Barium should NEVER be
given orally to a client until the diagnosis of obstruction
has been excluded completely as retained barium can
cause concretions which create an additional source of
blockage which can require surgical intervention in clients
who may have otherwise recovered. Retained barium also
severely limits the ability to interpret subsequent
angiography or cross-sectional imaging.
,3|Page
Treatment of bowel obstruction - Answer-Gen surg
consult, NG tube (intermittent suction) for decompression,
fluid rescusitation, electrolyte management as indicated,
complete obstruction= immediate surgical intervention
Superior Vena Cava Syndrome (SVCS) - Answer-SVCS is
the clinical manifestation of SVC obstruction with severe
reduction in venous return from the head, neck, and upper
extremities.
How often should a CK level be drawn and why? -
Answer-least every 6-12 hours to establish a peak level
and then subsequently a downward trend.
Sylvie is a 26-year-old who presents to the emergency
department (ED) after just finishing a full marathon. She
complains of feeling lightheaded, nauseous, and has
vomited twice since completing the race. Her legs feel
tired, weak, and sore which she attributes to running 26.2
miles. She reports that she didn't stop to rehydrate as
much as she would have liked because she was intent on
finishing with her personal best time. She became very
concerned when she went to use the restroom and noticed
, 4|Page
that her urine was dark - almost like tea. The AGACNP
suspects rhabdomyolysis. Which test is needed to confirm
the diagnosis? - Answer-serum creatine kinase
Sylvie's EKG shows markedly elevated T waves and
prolongation of the PR and QRS intervals. The AGACNP
should anticipate which of the following results? - Answer-
hyperkalemia
Risk factors for acute intestinal obstruction? - Answer-
Adhesions from previous abdominal surgery Internal or
external hernias Foreign bodies Feces
Congenital issues (atresia, stenosis, cyst formation,
intestinal duplication, and mal- rotation) Trauma
(hematoma formation)Inflammation (inflammatory bowel
disease, diverticulitis, radiation, and tuberculosis)
Neoplasms including carcinomatosis, colon cancer,
primary small bowel cancer, and extraintestinal
malignancies such as ovarian cancer
Endometriosis Volvulus Ischemic injury Intussusception
Intraperitoneal abscess
Subjective findings of acute intestinal obstruction -
Answer-colicky abdominal pain (cramping periumbilical
NR 574 ACUTE CARE PRACTICUM I FINAL EXAM
2026/2027 COMPREHENSIVE TEST BANK - 500
VERIFIED QUESTIONS WITH ANSWERS AND
RATIONALES Chamberlain University | Academic Year
| Most Recent Edition
Objective findings in a patient with intestinal obstruction? -
Answer-Key physical exam findings may include:
Fever (systemic inflammation or strangulation)
High-pitched, tinkling, bowel sounds (may be hypoactive
or absent with complete obstruction) Abdominal distention
(more significant with distal obstruction due to the greater
volume of intraluminal fluid accumulation)Mild abdominal
tenderness but no peritoneal findingsTender abdominal or
groin masses (can represent incarcerated hernia) Signs of
shock (tachycardia, hypotension, oliguria)
Significant abdominal tenderness with palpation should
increase the NP's suspicion for? - Answer-ischemia,
peritonitis, or necrosis.
why is a serum lactate useful in dx a bowel obstruction? -
Answer-Serum lactate (increased serum lactate should
raise concern for strangulated obstruction)
,2|Page
what diagnostic imaging should be used for bowel
obstruction? - Answer-plain film xray
what will a plain film xray show if a patient has a bowel
obstruction? - Answer-Obstruction will reveal dilated loops
of bowel and visible air-fluid levels which should prompt
further studies.A horizontal pattern of dilated small bowel
loops can be seen with small bowel obstruction (SBO)
Should barium contrast be given to a patient with a bowel
obstruction? - Answer-NO! Imaging studies requiring
administration of barium are contraindicated in cases of
high- grade or complete obstruction.
What does barium contrast do within the body with a
bowel obstruction? - Answer-Barium should NEVER be
given orally to a client until the diagnosis of obstruction
has been excluded completely as retained barium can
cause concretions which create an additional source of
blockage which can require surgical intervention in clients
who may have otherwise recovered. Retained barium also
severely limits the ability to interpret subsequent
angiography or cross-sectional imaging.
,3|Page
Treatment of bowel obstruction - Answer-Gen surg
consult, NG tube (intermittent suction) for decompression,
fluid rescusitation, electrolyte management as indicated,
complete obstruction= immediate surgical intervention
Superior Vena Cava Syndrome (SVCS) - Answer-SVCS is
the clinical manifestation of SVC obstruction with severe
reduction in venous return from the head, neck, and upper
extremities.
How often should a CK level be drawn and why? -
Answer-least every 6-12 hours to establish a peak level
and then subsequently a downward trend.
Sylvie is a 26-year-old who presents to the emergency
department (ED) after just finishing a full marathon. She
complains of feeling lightheaded, nauseous, and has
vomited twice since completing the race. Her legs feel
tired, weak, and sore which she attributes to running 26.2
miles. She reports that she didn't stop to rehydrate as
much as she would have liked because she was intent on
finishing with her personal best time. She became very
concerned when she went to use the restroom and noticed
, 4|Page
that her urine was dark - almost like tea. The AGACNP
suspects rhabdomyolysis. Which test is needed to confirm
the diagnosis? - Answer-serum creatine kinase
Sylvie's EKG shows markedly elevated T waves and
prolongation of the PR and QRS intervals. The AGACNP
should anticipate which of the following results? - Answer-
hyperkalemia
Risk factors for acute intestinal obstruction? - Answer-
Adhesions from previous abdominal surgery Internal or
external hernias Foreign bodies Feces
Congenital issues (atresia, stenosis, cyst formation,
intestinal duplication, and mal- rotation) Trauma
(hematoma formation)Inflammation (inflammatory bowel
disease, diverticulitis, radiation, and tuberculosis)
Neoplasms including carcinomatosis, colon cancer,
primary small bowel cancer, and extraintestinal
malignancies such as ovarian cancer
Endometriosis Volvulus Ischemic injury Intussusception
Intraperitoneal abscess
Subjective findings of acute intestinal obstruction -
Answer-colicky abdominal pain (cramping periumbilical
