Chamberlain University
Complex Diagnosis & Management in Acute Care
Practicum
NR571 Midterm Mock Exam: Complex Acute Care Manage-
ment Exam Question and Answers
Pages Total Marks Section Questions
22
Section 1 Multiple Choice
Name Student ID
Date Signature
How to use this exam
1 Set a timer. Practice under real exam conditions! No notes, no AI assistance.
2 When finished, scan the QR code on the last page to submit and see the correct answers
with detailed explanations.
3 Review your mistakes carefully and note down areas that need improvement. Use Studocu
AI to create targeted study materials like quizzes, summaries, and study guides.
,Section 100 total marks
Multiple Choice
Select the single best answer for each clinical scenario or conceptual question.
Question 1 2 total marks
A 62-year-old male with a history of Type 2 Diabetes Mellitus is brought to the emergency department
by his family. They report he has been increasingly confused and lethargic over the past 48 hours.
He recently had a viral upper respiratory infection. On physical examination, he appears severely
dehydrated with dry mucous membranes and poor skin turgor. His vital signs are: blood pressure 92/58
mmHg, heart rate 118 bpm, and temperature 99.1°F. Laboratory results show a blood glucose of 842
mg/dL, serum sodium 148 mEq/L, serum potassium 4.1 mEq/L, BUN 44 mg/dL, and creatinine 1.8 mg/dL.
An arterial blood gas (ABG) shows a pH of 7.32 and bicarbonate of 21 mEq/L. Serum ketones are trace.
Calculated serum osmolality is 345 mOsm/kg.
A Based on the patient's laboratory findings and clinical presentation, which diagnosis is most
likely?
A Starvation Ketoacidosis
B Euglycemic DKA
C Hyperosmolar Hyperglycemic State (HHS)
D Diabetic Ketoacidosis (DKA)
Question 2 2 total marks
A 34-year-old female with a known history of Graves' disease is admitted for an emergency appen-
dectomy. Post-operatively, she develops a fever of 104.5°F, heart rate of 162 bpm (atrial fibrillation),
profound agitation, and jaundice. Her skin is warm and moist.
A What is the most immediate pharmacological priority in managing this patient's suspected
thyroid storm to prevent cardiovascular collapse?
A Radioactive Iodine Ablation
B Intravenous Levothyroxine
C Oral Methimazole alone
D Intravenous Propropanol
, Question 3 2 total marks
A 45-year-old patient presents with severe epigastric pain that radiates to the back, associated with
nausea and vomiting. The patient admits to heavy alcohol use. Labs reveal a Serum Lipase level of 1,200
U/L (normal range 0-160 U/L) and a Serum Amylase of 450 U/L.
A According to the Atlanta classification, which finding would be most definitive for a diagnosis of
acute pancreatitis in this patient?
A The radiation of pain to the back
B The presence of nausea and vomiting
C The history of heavy alcohol consumption
D Serum lipase level greater than three times the upper limit of normal
Question 4 2 total marks
A patient with a history of chronic heart failure presents with decreased urine output and an increase
in Serum Creatinine from 1.0 mg/dL to 2.2 mg/dL within 24 hours. Laboratory analysis of the urine
reveals a Fractional Excretion of Sodium ( ) of < 1% and a BUN/Creatinine ratio of 25:1.
A Which type of acute kidney injury (AKI) is most consistent with these findings?
A Pre-renal AKI
B Intrinsic AKI (Acute Tubular Necrosis)
C Post-renal AKI (Obstructive)
D Chronic Kidney Disease Stage 3
Question 5 2 total marks
An 88-year-old female with mild cognitive impairment is hospitalized for a hip fracture. On post-op-
erative day 2, she becomes acutely combative, disoriented to time and place, and begins hallucinating
about 'bugs on the wall.' Her symptoms fluctuate throughout the day.
A What is the most likely diagnosis for this patient's acute change in mental status, and what is the
primary ethical responsibility of the provider?
A Depression; start SSRI therapy and assess for suicide risk
B Schizophrenia; consult psychiatry for antipsychotic initiation
C Dementia; initiate long-term memory testing
D Delirium; identify and treat the underlying cause while ensuring safety
Downloaded by Wambo Jeni ()
Complex Diagnosis & Management in Acute Care
Practicum
NR571 Midterm Mock Exam: Complex Acute Care Manage-
ment Exam Question and Answers
Pages Total Marks Section Questions
22
Section 1 Multiple Choice
Name Student ID
Date Signature
How to use this exam
1 Set a timer. Practice under real exam conditions! No notes, no AI assistance.
2 When finished, scan the QR code on the last page to submit and see the correct answers
with detailed explanations.
3 Review your mistakes carefully and note down areas that need improvement. Use Studocu
AI to create targeted study materials like quizzes, summaries, and study guides.
,Section 100 total marks
Multiple Choice
Select the single best answer for each clinical scenario or conceptual question.
Question 1 2 total marks
A 62-year-old male with a history of Type 2 Diabetes Mellitus is brought to the emergency department
by his family. They report he has been increasingly confused and lethargic over the past 48 hours.
He recently had a viral upper respiratory infection. On physical examination, he appears severely
dehydrated with dry mucous membranes and poor skin turgor. His vital signs are: blood pressure 92/58
mmHg, heart rate 118 bpm, and temperature 99.1°F. Laboratory results show a blood glucose of 842
mg/dL, serum sodium 148 mEq/L, serum potassium 4.1 mEq/L, BUN 44 mg/dL, and creatinine 1.8 mg/dL.
An arterial blood gas (ABG) shows a pH of 7.32 and bicarbonate of 21 mEq/L. Serum ketones are trace.
Calculated serum osmolality is 345 mOsm/kg.
A Based on the patient's laboratory findings and clinical presentation, which diagnosis is most
likely?
A Starvation Ketoacidosis
B Euglycemic DKA
C Hyperosmolar Hyperglycemic State (HHS)
D Diabetic Ketoacidosis (DKA)
Question 2 2 total marks
A 34-year-old female with a known history of Graves' disease is admitted for an emergency appen-
dectomy. Post-operatively, she develops a fever of 104.5°F, heart rate of 162 bpm (atrial fibrillation),
profound agitation, and jaundice. Her skin is warm and moist.
A What is the most immediate pharmacological priority in managing this patient's suspected
thyroid storm to prevent cardiovascular collapse?
A Radioactive Iodine Ablation
B Intravenous Levothyroxine
C Oral Methimazole alone
D Intravenous Propropanol
, Question 3 2 total marks
A 45-year-old patient presents with severe epigastric pain that radiates to the back, associated with
nausea and vomiting. The patient admits to heavy alcohol use. Labs reveal a Serum Lipase level of 1,200
U/L (normal range 0-160 U/L) and a Serum Amylase of 450 U/L.
A According to the Atlanta classification, which finding would be most definitive for a diagnosis of
acute pancreatitis in this patient?
A The radiation of pain to the back
B The presence of nausea and vomiting
C The history of heavy alcohol consumption
D Serum lipase level greater than three times the upper limit of normal
Question 4 2 total marks
A patient with a history of chronic heart failure presents with decreased urine output and an increase
in Serum Creatinine from 1.0 mg/dL to 2.2 mg/dL within 24 hours. Laboratory analysis of the urine
reveals a Fractional Excretion of Sodium ( ) of < 1% and a BUN/Creatinine ratio of 25:1.
A Which type of acute kidney injury (AKI) is most consistent with these findings?
A Pre-renal AKI
B Intrinsic AKI (Acute Tubular Necrosis)
C Post-renal AKI (Obstructive)
D Chronic Kidney Disease Stage 3
Question 5 2 total marks
An 88-year-old female with mild cognitive impairment is hospitalized for a hip fracture. On post-op-
erative day 2, she becomes acutely combative, disoriented to time and place, and begins hallucinating
about 'bugs on the wall.' Her symptoms fluctuate throughout the day.
A What is the most likely diagnosis for this patient's acute change in mental status, and what is the
primary ethical responsibility of the provider?
A Depression; start SSRI therapy and assess for suicide risk
B Schizophrenia; consult psychiatry for antipsychotic initiation
C Dementia; initiate long-term memory testing
D Delirium; identify and treat the underlying cause while ensuring safety
Downloaded by Wambo Jeni ()
