NR570 / NR 570 FINAL EXAM 2026/2027
– COMMON DIAGNOSIS &
MANAGEMENT IN ACUTE CARE
PRACTICUM | REAL EXAM QUESTIONS &
VERIFIED ANSWERS | 100% CORRECT |
CHAMBERLAIN COLLEGE PACK for Adult-
Gerontology Acute Care Nurse
Practitioner (AGACNP) students
EXAM OVERVIEW
NR570: Common Diagnosis and Management in Acute Care Practicum is a
graduate-level course at Chamberlain University for Adult-Gerontology Acute Care
Nurse Practitioner (AGACNP) students. The course expands knowledge in the care
of acutely ill adult and geriatric patients across diverse acute care settings. The
final exam covers high-yield topics including cardiovascular emergencies,
respiratory disorders, sepsis and shock, acute renal failure, gastrointestinal
emergencies, endocrine crises, neurologic emergencies, fluid and electrolyte
imbalances, and evidence-based management protocols.
,SECTION 1: CARDIOVASCULAR EMERGENCIES
Question 1
A 68-year-old male presents with substernal chest pressure radiating to the jaw,
diaphoresis, and nausea for 2 hours. ECG shows ST-segment elevation in leads V2-
V4. BP is 90/60 mmHg. What is the most appropriate next intervention?
A. Administer sublingual nitroglycerin and wait 30 minutes
B. Activate the cardiac catheterization lab for primary PCI
C. Administer tenecteplase (TNK) immediately
D. Admit to telemetry for observation
Correct Answer: B
Rationale: Anterior STEMI (ST elevation in V2-V4) with hypotension requires
emergent reperfusion. Primary percutaneous coronary intervention (PCI) within 90
minutes of arrival is the standard of care. Fibrinolytics are used only if PCI is
unavailable within 120 minutes. Beta-blockers and nitrates are contraindicated in
the setting of potential cardiogenic shock.
Question 2
A 55-year-old with acute decompensated heart failure has crackles to the mid-
lungs, S3 gallop, and oxygen saturation of 90% on room air. BP is 145/90 mmHg,
HR 110 bpm. What is the priority intervention?
,A. IV furosemide 40 mg
B. IV metoprolol 5 mg
C. Oral digoxin loading
D. IV normal saline bolus
Correct Answer: A
Rationale: IV loop diuretics (furosemide) are first-line for acute heart failure with
volume overload and pulmonary congestion. Beta-blockers are not given during
acute decompensation as they can worsen hemodynamics. IV fluids would
exacerbate pulmonary edema.
Question 3
A patient with atrial fibrillation with rapid ventricular response (HR 150 bpm) is
hemodynamically stable. Which medication is most appropriate for rate control?
A. IV amiodarone
B. IV diltiazem or IV metoprolol
C. IV digoxin as monotherapy
D. Direct current cardioversion
Correct Answer: B
Rationale: For hemodynamically stable atrial fibrillation with rapid ventricular
response, IV diltiazem (calcium channel blocker) or IV metoprolol (beta-blocker)
are first-line for rate control. Digoxin is slower-acting and is not first-line
monotherapy. Cardioversion is indicated for unstable patients.
, Question 4
A 65-year-old patient presents with acute respiratory distress, crackles in bilateral
lung bases, and an S3 gallop. The BNP is 1200 pg/mL. Which initial medication is
most appropriate?
A. Oral metoprolol
B. Intravenous furosemide
C. Intravenous normal saline
D. Oral lisinopril
Correct Answer: B
Rationale: Acute decompensated heart failure is characterized by fluid overload
and elevated BNP levels. Intravenous loop diuretics like furosemide are the first-
line treatment to reduce preload and alleviate pulmonary congestion. Initial
management focuses on stabilizing hemodynamics and oxygenation before starting
long-term oral therapies.
Question 5
A patient with acute pericarditis would most likely present with which
characteristic finding?
A. ST-segment elevation in all leads with reciprocal depression
B. Diffuse ST-segment elevation with PR-segment depression
C. Deep Q waves in inferior leads
D. T-wave inversion in lateral leads
Correct Answer: B
Rationale: Acute pericarditis classically presents with diffuse ST-segment
elevation (concave upward) and PR-segment depression across multiple leads.
– COMMON DIAGNOSIS &
MANAGEMENT IN ACUTE CARE
PRACTICUM | REAL EXAM QUESTIONS &
VERIFIED ANSWERS | 100% CORRECT |
CHAMBERLAIN COLLEGE PACK for Adult-
Gerontology Acute Care Nurse
Practitioner (AGACNP) students
EXAM OVERVIEW
NR570: Common Diagnosis and Management in Acute Care Practicum is a
graduate-level course at Chamberlain University for Adult-Gerontology Acute Care
Nurse Practitioner (AGACNP) students. The course expands knowledge in the care
of acutely ill adult and geriatric patients across diverse acute care settings. The
final exam covers high-yield topics including cardiovascular emergencies,
respiratory disorders, sepsis and shock, acute renal failure, gastrointestinal
emergencies, endocrine crises, neurologic emergencies, fluid and electrolyte
imbalances, and evidence-based management protocols.
,SECTION 1: CARDIOVASCULAR EMERGENCIES
Question 1
A 68-year-old male presents with substernal chest pressure radiating to the jaw,
diaphoresis, and nausea for 2 hours. ECG shows ST-segment elevation in leads V2-
V4. BP is 90/60 mmHg. What is the most appropriate next intervention?
A. Administer sublingual nitroglycerin and wait 30 minutes
B. Activate the cardiac catheterization lab for primary PCI
C. Administer tenecteplase (TNK) immediately
D. Admit to telemetry for observation
Correct Answer: B
Rationale: Anterior STEMI (ST elevation in V2-V4) with hypotension requires
emergent reperfusion. Primary percutaneous coronary intervention (PCI) within 90
minutes of arrival is the standard of care. Fibrinolytics are used only if PCI is
unavailable within 120 minutes. Beta-blockers and nitrates are contraindicated in
the setting of potential cardiogenic shock.
Question 2
A 55-year-old with acute decompensated heart failure has crackles to the mid-
lungs, S3 gallop, and oxygen saturation of 90% on room air. BP is 145/90 mmHg,
HR 110 bpm. What is the priority intervention?
,A. IV furosemide 40 mg
B. IV metoprolol 5 mg
C. Oral digoxin loading
D. IV normal saline bolus
Correct Answer: A
Rationale: IV loop diuretics (furosemide) are first-line for acute heart failure with
volume overload and pulmonary congestion. Beta-blockers are not given during
acute decompensation as they can worsen hemodynamics. IV fluids would
exacerbate pulmonary edema.
Question 3
A patient with atrial fibrillation with rapid ventricular response (HR 150 bpm) is
hemodynamically stable. Which medication is most appropriate for rate control?
A. IV amiodarone
B. IV diltiazem or IV metoprolol
C. IV digoxin as monotherapy
D. Direct current cardioversion
Correct Answer: B
Rationale: For hemodynamically stable atrial fibrillation with rapid ventricular
response, IV diltiazem (calcium channel blocker) or IV metoprolol (beta-blocker)
are first-line for rate control. Digoxin is slower-acting and is not first-line
monotherapy. Cardioversion is indicated for unstable patients.
, Question 4
A 65-year-old patient presents with acute respiratory distress, crackles in bilateral
lung bases, and an S3 gallop. The BNP is 1200 pg/mL. Which initial medication is
most appropriate?
A. Oral metoprolol
B. Intravenous furosemide
C. Intravenous normal saline
D. Oral lisinopril
Correct Answer: B
Rationale: Acute decompensated heart failure is characterized by fluid overload
and elevated BNP levels. Intravenous loop diuretics like furosemide are the first-
line treatment to reduce preload and alleviate pulmonary congestion. Initial
management focuses on stabilizing hemodynamics and oxygenation before starting
long-term oral therapies.
Question 5
A patient with acute pericarditis would most likely present with which
characteristic finding?
A. ST-segment elevation in all leads with reciprocal depression
B. Diffuse ST-segment elevation with PR-segment depression
C. Deep Q waves in inferior leads
D. T-wave inversion in lateral leads
Correct Answer: B
Rationale: Acute pericarditis classically presents with diffuse ST-segment
elevation (concave upward) and PR-segment depression across multiple leads.
