NR 571 – Complex Diagnosis and Management in Acute Care | Midterm Exam Questions & Answers | Cha
OBJECTIVE ASSESSMENT - EXAM
NR 571 – Complex Diagnosis and
Management in Acute Care |
Midterm Exam Questions &
Answers | Chamberlain University
| 2026/2027 Edition
A+ Verified 2026/2027 Edition Passing Score: 80%
Verification Status Academic Year Required to Pass
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Cardiovascular Emergencies (Questions 1–10)
Section 2: Pulmonary and Respiratory Emergencies (Questions 11–20)
Section 3: Neurological and Neurosurgical Emergencies (Questions 21–30)
Section 4: Gastrointestinal, Genitourinary, and Endocrine Emergencies (Questions 31–40)
Section 5: Sepsis, Shock, and Multi-System Failure (Questions 41–50)
This examination assesses graduate-level knowledge in complex diagnosis and management of acute care
conditions. Each question presents a realistic clinical scenario requiring analysis, synthesis, and evaluation of
advanced acute care management strategies. Select the single best answer for each question.
Section 1: Cardiovascular Emergencies
Q1A 68-year-old male presents to the emergency department with crushing substernal chest pain
Q1.
radiating to his left jaw and arm, onset 45 minutes ago. He is diaphoretic, blood pressure is 88/52
mmHg, heart rate 112 bpm, and oxygen saturation 91% on room air. A 12-lead ECG reveals
ST-segment elevation in leads V1-V4. Which is the most appropriate immediate management priority?
A. Administer sublingual nitroglycerin 0.4 mg every 5 minutes
B. Initiate primary percutaneous coronary intervention within 90 minutes
C. Begin thrombolytic therapy with tenecteplase immediately
D. Start intravenous beta-blockade with metoprolol 5 mg
Correct Answer: B
This patient has an anterior STEMI with cardiogenic shock (hypotension, tachycardia, diaphoresis). Primary PCI is the
preferred reperfusion strategy when it can be performed within 90 minutes of first medical contact. Thrombolytics are
contraindicated in cardiogenic shock due to poor efficacy. Nitroglycerin would worsen hypotension, and beta-blockers are
contraindicated in acute decompensated heart failure.
, NR 571 – Complex Diagnosis and Management in Acute Care | Midterm Exam Questions & Answers
NR 571
| Chamberlain
Midterm Exam
University | 2026
Q2A 54-year-old female with a history of hypertension presents with sudden-onset severe tearing
Q2.
chest pain radiating to her back. Her blood pressure is 186/110 mmHg in the right arm and 142/88
mmHg in the left arm. A chest CT angiogram reveals a Stanford Type A aortic dissection extending
from the ascending aorta. What is the definitive management?
A. Endovascular stent graft placement in the interventional suite
B. Immediate surgical repair with ascending aortic replacement
C. Aggressive blood pressure control with intravenous labetalol only
D. Anticoagulation with intravenous heparin and watchful waiting
Correct Answer: B
Stanford Type A aortic dissections involve the ascending aorta and require emergent surgical repair to prevent rupture,
cardiac tamponade, and coronary artery compromise. Endovascular repair is reserved for Type B dissections. Medical
management alone is insufficient for Type A, and anticoagulation would increase hemorrhage risk.
Q3A 72-year-old male with atrial fibrillation on warfarin presents with acute-onset left-sided
Q3.
hemiparesis, facial droop, and dysarthria. His last known well time was 2.5 hours ago. CT head
shows no hemorrhage. INR is 2.8. Blood pressure is 175/95 mmHg. Which intervention is most
appropriate?
A. Administer intravenous alteplase 0.9 mg/kg immediately
B. Begin mechanical thrombectomy without thrombolysis
C. Reverse warfarin with 4-factor prothrombin complex concentrate and defer thrombolysis
D. Start aspirin 325 mg orally and admit for observation
Correct Answer: C
The patient's INR of 2.8 exceeds the threshold of 1.7 for IV thrombolysis eligibility. Warfarin must be reversed with
4-factor PCC before considering any reperfusion therapy. Mechanical thrombectomy may be considered if a large vessel
occlusion is confirmed, but thrombolysis is contraindicated with elevated INR. Aspirin alone is insufficient for acute
ischemic stroke.
OBJECTIVE ASSESSMENT - EXAM
NR 571 – Complex Diagnosis and
Management in Acute Care |
Midterm Exam Questions &
Answers | Chamberlain University
| 2026/2027 Edition
A+ Verified 2026/2027 Edition Passing Score: 80%
Verification Status Academic Year Required to Pass
COVER PAGE - 1
,SECTIONS COVERED
Section 1: Cardiovascular Emergencies (Questions 1–10)
Section 2: Pulmonary and Respiratory Emergencies (Questions 11–20)
Section 3: Neurological and Neurosurgical Emergencies (Questions 21–30)
Section 4: Gastrointestinal, Genitourinary, and Endocrine Emergencies (Questions 31–40)
Section 5: Sepsis, Shock, and Multi-System Failure (Questions 41–50)
This examination assesses graduate-level knowledge in complex diagnosis and management of acute care
conditions. Each question presents a realistic clinical scenario requiring analysis, synthesis, and evaluation of
advanced acute care management strategies. Select the single best answer for each question.
Section 1: Cardiovascular Emergencies
Q1A 68-year-old male presents to the emergency department with crushing substernal chest pain
Q1.
radiating to his left jaw and arm, onset 45 minutes ago. He is diaphoretic, blood pressure is 88/52
mmHg, heart rate 112 bpm, and oxygen saturation 91% on room air. A 12-lead ECG reveals
ST-segment elevation in leads V1-V4. Which is the most appropriate immediate management priority?
A. Administer sublingual nitroglycerin 0.4 mg every 5 minutes
B. Initiate primary percutaneous coronary intervention within 90 minutes
C. Begin thrombolytic therapy with tenecteplase immediately
D. Start intravenous beta-blockade with metoprolol 5 mg
Correct Answer: B
This patient has an anterior STEMI with cardiogenic shock (hypotension, tachycardia, diaphoresis). Primary PCI is the
preferred reperfusion strategy when it can be performed within 90 minutes of first medical contact. Thrombolytics are
contraindicated in cardiogenic shock due to poor efficacy. Nitroglycerin would worsen hypotension, and beta-blockers are
contraindicated in acute decompensated heart failure.
, NR 571 – Complex Diagnosis and Management in Acute Care | Midterm Exam Questions & Answers
NR 571
| Chamberlain
Midterm Exam
University | 2026
Q2A 54-year-old female with a history of hypertension presents with sudden-onset severe tearing
Q2.
chest pain radiating to her back. Her blood pressure is 186/110 mmHg in the right arm and 142/88
mmHg in the left arm. A chest CT angiogram reveals a Stanford Type A aortic dissection extending
from the ascending aorta. What is the definitive management?
A. Endovascular stent graft placement in the interventional suite
B. Immediate surgical repair with ascending aortic replacement
C. Aggressive blood pressure control with intravenous labetalol only
D. Anticoagulation with intravenous heparin and watchful waiting
Correct Answer: B
Stanford Type A aortic dissections involve the ascending aorta and require emergent surgical repair to prevent rupture,
cardiac tamponade, and coronary artery compromise. Endovascular repair is reserved for Type B dissections. Medical
management alone is insufficient for Type A, and anticoagulation would increase hemorrhage risk.
Q3A 72-year-old male with atrial fibrillation on warfarin presents with acute-onset left-sided
Q3.
hemiparesis, facial droop, and dysarthria. His last known well time was 2.5 hours ago. CT head
shows no hemorrhage. INR is 2.8. Blood pressure is 175/95 mmHg. Which intervention is most
appropriate?
A. Administer intravenous alteplase 0.9 mg/kg immediately
B. Begin mechanical thrombectomy without thrombolysis
C. Reverse warfarin with 4-factor prothrombin complex concentrate and defer thrombolysis
D. Start aspirin 325 mg orally and admit for observation
Correct Answer: C
The patient's INR of 2.8 exceeds the threshold of 1.7 for IV thrombolysis eligibility. Warfarin must be reversed with
4-factor PCC before considering any reperfusion therapy. Mechanical thrombectomy may be considered if a large vessel
occlusion is confirmed, but thrombolysis is contraindicated with elevated INR. Aspirin alone is insufficient for acute
ischemic stroke.
