NR 574: Acute-Care Practicum I — Next-Generation NCLEX-
Style Comprehensive Practice Exam (2026 Edition) Advanced
Practice Nursing • Chamberlain College of Nursing Alignment
High-Fidelity Case Scenarios | NGN Question Formats | 100%
Verified & Updated
NR 574: Acute-Care Practicum I – Exam Overview
Feature Details
Course NR 574 – Acute-Care Practicum I
Institution Chamberlain College of Nursing
Synthesis of clinical management skills; analysis, application, and evaluation o
Focus
patient assessment and healthcare intervention in complex acute care setting
NR-581, NR-582, NR-583, NR-584, NR-585, NR-586, NR-507, NR-565, NR-567,
Prerequisites
509
Exam Next-Generation NCLEX (NGN)-style questions, including high-fidelity case
Format scenarios
Cardiovascular, Respiratory, Neurology, Trauma, Burns, Hematology, Renal, an
Key Topics
Endocrine
High-Yield NGN-Style Practice Questions
,SECTION 1: CARDIOVASCULAR & RESPIRATORY ACUTE CARE
Question 1
A 72-year-old male is admitted to the ICU with acute decompensated heart
failure. He has a history of hypertension and coronary artery disease. Vital signs:
BP 158/92 mmHg, HR 112 bpm, RR 28/min, SpO₂ 89% on 4L nasal cannula.
Crackles are audible to the mid-scapular region, and 3+ pitting edema is noted in
the lower extremities. BNP is 1,200 pg/mL.
Question 1a: Which of the following is the priority nursing intervention?
A. Administer IV furosemide
B. Place the patient in high-Fowler's position
C. Initiate BiPAP
D. Administer IV morphine
Correct Answer: B
Rationale: High-Fowler's position is the priority intervention for acute pulmonary
edema. It reduces venous return (preload), decreases cardiac workload, and
improves ventilation. IV furosemide and BiPAP are critical but should follow
positioning. Morphine is used for anxiety and preload reduction but is not the first
action.
Question 1b: The provider orders a 40 mg IV push of furosemide. Which finding
indicates the medication is effective?
A. Increased urine output and decreased crackles
B. Decreased heart rate and increased BP
C. Increased SpO₂ and decreased respiratory rate
D. Both A and C
Correct Answer: D
Rationale: Effective furosemide therapy results in diuresis (increased urine
output), which reduces fluid overload and pulmonary congestion. This leads to
, decreased crackles (improved lung sounds) and improved oxygenation (increased
SpO₂) with decreased work of breathing.
Question 2 (NGN Bow-Tie)
A 68-year-old female with a history of COPD presents with worsening shortness of
breath, productive cough with yellow sputum, and confusion. Vital signs: BP
142/88 mmHg, HR 108 bpm, RR 32/min, SpO₂ 87% on room air. ABG: pH 7.28,
PaCO₂ 58 mmHg, PaO₂ 55 mmHg, HCO₃ 26 mEq/L.
Complete the following bow-tie by selecting the appropriate options:
Condition Priority Action Complication to Monitor
A. Respiratory alkalosis A. Administer oxygen at 6L/min A. Pneumothorax
B. Respiratory acidosis B. Initiate BiPAP B. Oxygen toxicity
C. Metabolic acidosis C. Prepare for intubation C. Carbon dioxide narcosis
D. Metabolic alkalosis D. Administer bronchodilators D. Pulmonary embolism
Correct Answer:
• Condition: B. Respiratory acidosis
• Priority Action: B. Initiate BiPAP
• Complication to Monitor: C. Carbon dioxide narcosis
Rationale: The ABG shows respiratory acidosis (low pH, elevated PaCO₂). Non-
invasive positive pressure ventilation (BiPAP) is first-line for hypercapnic
respiratory failure in COPD. High-flow oxygen should be used cautiously as it can
eliminate the hypoxic drive and worsen CO₂ retention, leading to carbon dioxide
narcosis.
Style Comprehensive Practice Exam (2026 Edition) Advanced
Practice Nursing • Chamberlain College of Nursing Alignment
High-Fidelity Case Scenarios | NGN Question Formats | 100%
Verified & Updated
NR 574: Acute-Care Practicum I – Exam Overview
Feature Details
Course NR 574 – Acute-Care Practicum I
Institution Chamberlain College of Nursing
Synthesis of clinical management skills; analysis, application, and evaluation o
Focus
patient assessment and healthcare intervention in complex acute care setting
NR-581, NR-582, NR-583, NR-584, NR-585, NR-586, NR-507, NR-565, NR-567,
Prerequisites
509
Exam Next-Generation NCLEX (NGN)-style questions, including high-fidelity case
Format scenarios
Cardiovascular, Respiratory, Neurology, Trauma, Burns, Hematology, Renal, an
Key Topics
Endocrine
High-Yield NGN-Style Practice Questions
,SECTION 1: CARDIOVASCULAR & RESPIRATORY ACUTE CARE
Question 1
A 72-year-old male is admitted to the ICU with acute decompensated heart
failure. He has a history of hypertension and coronary artery disease. Vital signs:
BP 158/92 mmHg, HR 112 bpm, RR 28/min, SpO₂ 89% on 4L nasal cannula.
Crackles are audible to the mid-scapular region, and 3+ pitting edema is noted in
the lower extremities. BNP is 1,200 pg/mL.
Question 1a: Which of the following is the priority nursing intervention?
A. Administer IV furosemide
B. Place the patient in high-Fowler's position
C. Initiate BiPAP
D. Administer IV morphine
Correct Answer: B
Rationale: High-Fowler's position is the priority intervention for acute pulmonary
edema. It reduces venous return (preload), decreases cardiac workload, and
improves ventilation. IV furosemide and BiPAP are critical but should follow
positioning. Morphine is used for anxiety and preload reduction but is not the first
action.
Question 1b: The provider orders a 40 mg IV push of furosemide. Which finding
indicates the medication is effective?
A. Increased urine output and decreased crackles
B. Decreased heart rate and increased BP
C. Increased SpO₂ and decreased respiratory rate
D. Both A and C
Correct Answer: D
Rationale: Effective furosemide therapy results in diuresis (increased urine
output), which reduces fluid overload and pulmonary congestion. This leads to
, decreased crackles (improved lung sounds) and improved oxygenation (increased
SpO₂) with decreased work of breathing.
Question 2 (NGN Bow-Tie)
A 68-year-old female with a history of COPD presents with worsening shortness of
breath, productive cough with yellow sputum, and confusion. Vital signs: BP
142/88 mmHg, HR 108 bpm, RR 32/min, SpO₂ 87% on room air. ABG: pH 7.28,
PaCO₂ 58 mmHg, PaO₂ 55 mmHg, HCO₃ 26 mEq/L.
Complete the following bow-tie by selecting the appropriate options:
Condition Priority Action Complication to Monitor
A. Respiratory alkalosis A. Administer oxygen at 6L/min A. Pneumothorax
B. Respiratory acidosis B. Initiate BiPAP B. Oxygen toxicity
C. Metabolic acidosis C. Prepare for intubation C. Carbon dioxide narcosis
D. Metabolic alkalosis D. Administer bronchodilators D. Pulmonary embolism
Correct Answer:
• Condition: B. Respiratory acidosis
• Priority Action: B. Initiate BiPAP
• Complication to Monitor: C. Carbon dioxide narcosis
Rationale: The ABG shows respiratory acidosis (low pH, elevated PaCO₂). Non-
invasive positive pressure ventilation (BiPAP) is first-line for hypercapnic
respiratory failure in COPD. High-flow oxygen should be used cautiously as it can
eliminate the hypoxic drive and worsen CO₂ retention, leading to carbon dioxide
narcosis.
