Chamberlain College of Nursing | NR 574 Acute Care Practicum I
NR 574 Acute Care Practicum I Final
Comprehensive Examination 2026/2027 |
Verified Questions
Chamberlain College of Nursing | NR 574 Acute Care Practicum I | University-Level Advanced Practice
Nursing Students
75 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
Chamberlain College of Nursing | NR 574 Acute Care Practicum I
Final Comprehensive Examination Actual Exam | Academic Year 2026/2027
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This Final Comprehensive Examination contains 75 verified questions designed for university-level
advanced nursing students enrolled in NR 574 Acute Care Practicum I at Chamberlain College of Nursing.
The questions are distributed across four core domains: Cardiovascular and Pulmonary Acute Care (19
questions), Neurological and Endocrine Acute Care (19 questions), Gastrointestinal, Renal, and
Hematologic Acute Care (19 questions), and Trauma, Sepsis, and Multisystem Organ Failure (18
questions). All content is original and constructed to reinforce the official NR 574 course objectives for
actual exam readiness and clinical proficiency, aligned to the 2026/2027 academic year. Each item
emphasizes acute assessment, hemodynamic management, and critical intervention strategies drawn
from foundational acute and critical care nursing methodology.
ACTUAL QUESTIONS
Domain 1: Cardiovascular and Pulmonary Acute Care
Question 1. A patient in the ICU has a central venous pressure (CVP) of 2 mm Hg and is
hypotensive. What does this finding most likely indicate?
A. Hypovolemia or decreased venous return
B. Fluid overload
C. Left ventricular failure
D. Increased afterload only
Correct Answer: A
Rationale: A low CVP reflects reduced right-sided preload and is consistent with hypovolemia or
decreased venous return. Volume resuscitation is typically indicated after confirming the clinical
context.
Question 2. Which hemodynamic profile is most consistent with cardiogenic shock?
A. High cardiac output, low systemic vascular resistance
B. High cardiac output, high systemic vascular resistance
C. Low cardiac output, high systemic vascular resistance, elevated pulmonary artery wedge pressure
D. Normal cardiac output with low wedge pressure
Correct Answer: C
Rationale: Cardiogenic shock is characterized by pump failure: reduced cardiac output, compensatory
vasoconstriction (high SVR), and elevated left-sided filling pressures (high PAWP).
Question 3. A patient with acute decompensated heart failure is receiving nitroprusside.
What is the primary therapeutic goal of this medication?
A. Increase preload
B. Reduce afterload through arterial vasodilation
C. Increase myocardial contractility directly
D. Provide rate control
Correct Answer: B
Rationale: Nitroprusside is a potent arterial (and venous) vasodilator used to reduce afterload, thereby
improving forward stroke volume in selected patients with acute heart failure and elevated systemic
vascular resistance.
Question 4. Which ventilator mode delivers a set tidal volume with each mandatory breath
and allows spontaneous breathing between mandatory breaths?
A. Pressure support ventilation only
B. Continuous positive airway pressure (CPAP) alone
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
, C. High-frequency oscillatory ventilation
D. Synchronized intermittent mandatory ventilation (SIMV)
Correct Answer: D
Rationale: SIMV delivers a clinician-set number of mandatory volume- or pressure-controlled breaths
synchronized with patient effort and permits spontaneous breathing between those breaths.
Question 5. A patient develops acute respiratory distress syndrome (ARDS). Which
ventilation strategy is evidence-based?
A. Low tidal volume ventilation (approximately 6 mL/kg predicted body weight) with plateau
pressure limitation
B. High tidal volumes of 12–15 mL/kg predicted body weight
C. Zero positive end-expiratory pressure (PEEP)
D. Unrestricted high plateau pressures
Correct Answer: A
Rationale: Lung-protective ventilation with low tidal volumes (~6 mL/kg PBW) and limitation of
plateau pressure reduces ventilator-induced lung injury and improves outcomes in ARDS.
Question 6. What is the most appropriate initial management of a patient with suspected
tension pneumothorax?
A. Immediate chest radiograph before any intervention
B. Needle decompression followed by tube thoracostomy
C. Observation with serial examinations only
D. Positive-pressure ventilation without decompression
Correct Answer: B
Rationale: Tension pneumothorax is a clinical diagnosis. Immediate needle decompression to relieve
pressure, followed by definitive tube thoracostomy, is required.
Question 7. A patient with ST-elevation myocardial infarction is candidates for
reperfusion. What is the preferred time goal for primary percutaneous coronary
intervention (PCI)?
A. Within 24 hours
B. Within 7 days
C. Door-to-balloon time of 90 minutes or less
D. Only after full anticoagulation for 48 hours
Correct Answer: C
Rationale: Guidelines emphasize timely primary PCI with a door-to-balloon (or first-medical-contact-
to-device) goal of 90 minutes or less to maximize myocardial salvage.
Question 8. Which finding on a pulmonary artery catheter is most consistent with
hypovolemic shock?
A. Low cardiac output, low PAWP, and low CVP
B. Elevated cardiac output and elevated PAWP
C. High SVR with high cardiac output
D. Normal filling pressures with high mixed venous oxygen saturation
Correct Answer: A
Rationale: Hypovolemic shock produces reduced preload (low CVP and PAWP), reduced cardiac output,
and compensatory elevation of SVR.
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
NR 574 Acute Care Practicum I Final
Comprehensive Examination 2026/2027 |
Verified Questions
Chamberlain College of Nursing | NR 574 Acute Care Practicum I | University-Level Advanced Practice
Nursing Students
75 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
Chamberlain College of Nursing | NR 574 Acute Care Practicum I
Final Comprehensive Examination Actual Exam | Academic Year 2026/2027
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This Final Comprehensive Examination contains 75 verified questions designed for university-level
advanced nursing students enrolled in NR 574 Acute Care Practicum I at Chamberlain College of Nursing.
The questions are distributed across four core domains: Cardiovascular and Pulmonary Acute Care (19
questions), Neurological and Endocrine Acute Care (19 questions), Gastrointestinal, Renal, and
Hematologic Acute Care (19 questions), and Trauma, Sepsis, and Multisystem Organ Failure (18
questions). All content is original and constructed to reinforce the official NR 574 course objectives for
actual exam readiness and clinical proficiency, aligned to the 2026/2027 academic year. Each item
emphasizes acute assessment, hemodynamic management, and critical intervention strategies drawn
from foundational acute and critical care nursing methodology.
ACTUAL QUESTIONS
Domain 1: Cardiovascular and Pulmonary Acute Care
Question 1. A patient in the ICU has a central venous pressure (CVP) of 2 mm Hg and is
hypotensive. What does this finding most likely indicate?
A. Hypovolemia or decreased venous return
B. Fluid overload
C. Left ventricular failure
D. Increased afterload only
Correct Answer: A
Rationale: A low CVP reflects reduced right-sided preload and is consistent with hypovolemia or
decreased venous return. Volume resuscitation is typically indicated after confirming the clinical
context.
Question 2. Which hemodynamic profile is most consistent with cardiogenic shock?
A. High cardiac output, low systemic vascular resistance
B. High cardiac output, high systemic vascular resistance
C. Low cardiac output, high systemic vascular resistance, elevated pulmonary artery wedge pressure
D. Normal cardiac output with low wedge pressure
Correct Answer: C
Rationale: Cardiogenic shock is characterized by pump failure: reduced cardiac output, compensatory
vasoconstriction (high SVR), and elevated left-sided filling pressures (high PAWP).
Question 3. A patient with acute decompensated heart failure is receiving nitroprusside.
What is the primary therapeutic goal of this medication?
A. Increase preload
B. Reduce afterload through arterial vasodilation
C. Increase myocardial contractility directly
D. Provide rate control
Correct Answer: B
Rationale: Nitroprusside is a potent arterial (and venous) vasodilator used to reduce afterload, thereby
improving forward stroke volume in selected patients with acute heart failure and elevated systemic
vascular resistance.
Question 4. Which ventilator mode delivers a set tidal volume with each mandatory breath
and allows spontaneous breathing between mandatory breaths?
A. Pressure support ventilation only
B. Continuous positive airway pressure (CPAP) alone
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
, C. High-frequency oscillatory ventilation
D. Synchronized intermittent mandatory ventilation (SIMV)
Correct Answer: D
Rationale: SIMV delivers a clinician-set number of mandatory volume- or pressure-controlled breaths
synchronized with patient effort and permits spontaneous breathing between those breaths.
Question 5. A patient develops acute respiratory distress syndrome (ARDS). Which
ventilation strategy is evidence-based?
A. Low tidal volume ventilation (approximately 6 mL/kg predicted body weight) with plateau
pressure limitation
B. High tidal volumes of 12–15 mL/kg predicted body weight
C. Zero positive end-expiratory pressure (PEEP)
D. Unrestricted high plateau pressures
Correct Answer: A
Rationale: Lung-protective ventilation with low tidal volumes (~6 mL/kg PBW) and limitation of
plateau pressure reduces ventilator-induced lung injury and improves outcomes in ARDS.
Question 6. What is the most appropriate initial management of a patient with suspected
tension pneumothorax?
A. Immediate chest radiograph before any intervention
B. Needle decompression followed by tube thoracostomy
C. Observation with serial examinations only
D. Positive-pressure ventilation without decompression
Correct Answer: B
Rationale: Tension pneumothorax is a clinical diagnosis. Immediate needle decompression to relieve
pressure, followed by definitive tube thoracostomy, is required.
Question 7. A patient with ST-elevation myocardial infarction is candidates for
reperfusion. What is the preferred time goal for primary percutaneous coronary
intervention (PCI)?
A. Within 24 hours
B. Within 7 days
C. Door-to-balloon time of 90 minutes or less
D. Only after full anticoagulation for 48 hours
Correct Answer: C
Rationale: Guidelines emphasize timely primary PCI with a door-to-balloon (or first-medical-contact-
to-device) goal of 90 minutes or less to maximize myocardial salvage.
Question 8. Which finding on a pulmonary artery catheter is most consistent with
hypovolemic shock?
A. Low cardiac output, low PAWP, and low CVP
B. Elevated cardiac output and elevated PAWP
C. High SVR with high cardiac output
D. Normal filling pressures with high mixed venous oxygen saturation
Correct Answer: A
Rationale: Hypovolemic shock produces reduced preload (low CVP and PAWP), reduced cardiac output,
and compensatory elevation of SVR.
NR 574 Acute Care Practicum I Final Comprehensive Examination 2026/2027 | Verified Questions
