NR 574 Acute Care Practicum
Final Review 2026/2027 –
Questions & Answers with
Detailed Rationales Guaranteed
Pass (GRADED A+)
Question 1
A patient with acute hypoxemic respiratory failure has an
oxygen saturation of 84% on room air. Which intervention
should the nurse initiate first?
A. Obtain a sputum culture
B. Encourage oral fluids
C. Apply supplemental oxygen
D. Administer an antitussive
Answer: C. Apply supplemental oxygen
Rationale: Correcting hypoxemia is an immediate priority.
Supplemental oxygen should be initiated while the underlying
cause is evaluated and treated.
Question 2
,A patient with suspected sepsis has a blood pressure of 82/48
mmHg and a heart rate of 124/min. Which intervention is most
appropriate initially?
A. Restrict fluids
B. Initiate prescribed IV crystalloid therapy
C. Administer a sedative
D. Place the patient on bed rest without treatment
Answer: B. Initiate prescribed IV crystalloid therapy
Rationale: Hypotension in suspected sepsis may indicate
inadequate tissue perfusion. IV crystalloid resuscitation is a key
early intervention when clinically appropriate.
Question 3
Which finding is most concerning in a patient with acute chest
pain?
A. Pain rated 2/10 after eating
B. Chest discomfort accompanied by diaphoresis and dyspnea
C. Mild tenderness over the shoulder
D. Pain that occurs only with arm movement
Answer: B. Chest discomfort accompanied by diaphoresis and
dyspnea
Rationale: Chest pain associated with diaphoresis and dyspnea
can indicate acute coronary syndrome and requires immediate
assessment and intervention.
,Question 4
A patient develops sudden unilateral weakness and difficulty
speaking. What is the nurse's priority action?
A. Give the patient oral fluids
B. Determine the time the patient was last known well
C. Place the patient in a dark room
D. Encourage ambulation
Answer: B. Determine the time the patient was last known well
Rationale: The onset or last-known-well time is critical when
evaluating suspected acute ischemic stroke because treatment
eligibility can depend on the time window.
Question 5
Which laboratory value is most important to monitor in a patient
receiving unfractionated heparin?
A. INR only
B. aPTT or institution-specific heparin monitoring assay
C. Serum sodium
D. Hemoglobin A1c
Answer: B. aPTT or institution-specific heparin monitoring
assay
, Rationale: Unfractionated heparin requires laboratory
monitoring to assess its anticoagulant effect and reduce the risk
of excessive anticoagulation.
Question 6
A patient with acute kidney injury has a potassium level of 6.7
mEq/L and peaked T waves on ECG. Which problem requires
immediate attention?
A. Mild anemia
B. Hyperkalemia with cardiac manifestations
C. Elevated blood urea nitrogen
D. Mild peripheral edema
Answer: B. Hyperkalemia with cardiac manifestations
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias. ECG changes indicate an urgent need for
treatment.
Question 7
A patient with COPD exacerbation is receiving oxygen therapy.
Which approach is generally appropriate?
A. Withhold oxygen completely
B. Titrate oxygen to the prescribed target saturation
C. Give the highest possible oxygen concentration indefinitely
D. Replace oxygen with oral fluids
Final Review 2026/2027 –
Questions & Answers with
Detailed Rationales Guaranteed
Pass (GRADED A+)
Question 1
A patient with acute hypoxemic respiratory failure has an
oxygen saturation of 84% on room air. Which intervention
should the nurse initiate first?
A. Obtain a sputum culture
B. Encourage oral fluids
C. Apply supplemental oxygen
D. Administer an antitussive
Answer: C. Apply supplemental oxygen
Rationale: Correcting hypoxemia is an immediate priority.
Supplemental oxygen should be initiated while the underlying
cause is evaluated and treated.
Question 2
,A patient with suspected sepsis has a blood pressure of 82/48
mmHg and a heart rate of 124/min. Which intervention is most
appropriate initially?
A. Restrict fluids
B. Initiate prescribed IV crystalloid therapy
C. Administer a sedative
D. Place the patient on bed rest without treatment
Answer: B. Initiate prescribed IV crystalloid therapy
Rationale: Hypotension in suspected sepsis may indicate
inadequate tissue perfusion. IV crystalloid resuscitation is a key
early intervention when clinically appropriate.
Question 3
Which finding is most concerning in a patient with acute chest
pain?
A. Pain rated 2/10 after eating
B. Chest discomfort accompanied by diaphoresis and dyspnea
C. Mild tenderness over the shoulder
D. Pain that occurs only with arm movement
Answer: B. Chest discomfort accompanied by diaphoresis and
dyspnea
Rationale: Chest pain associated with diaphoresis and dyspnea
can indicate acute coronary syndrome and requires immediate
assessment and intervention.
,Question 4
A patient develops sudden unilateral weakness and difficulty
speaking. What is the nurse's priority action?
A. Give the patient oral fluids
B. Determine the time the patient was last known well
C. Place the patient in a dark room
D. Encourage ambulation
Answer: B. Determine the time the patient was last known well
Rationale: The onset or last-known-well time is critical when
evaluating suspected acute ischemic stroke because treatment
eligibility can depend on the time window.
Question 5
Which laboratory value is most important to monitor in a patient
receiving unfractionated heparin?
A. INR only
B. aPTT or institution-specific heparin monitoring assay
C. Serum sodium
D. Hemoglobin A1c
Answer: B. aPTT or institution-specific heparin monitoring
assay
, Rationale: Unfractionated heparin requires laboratory
monitoring to assess its anticoagulant effect and reduce the risk
of excessive anticoagulation.
Question 6
A patient with acute kidney injury has a potassium level of 6.7
mEq/L and peaked T waves on ECG. Which problem requires
immediate attention?
A. Mild anemia
B. Hyperkalemia with cardiac manifestations
C. Elevated blood urea nitrogen
D. Mild peripheral edema
Answer: B. Hyperkalemia with cardiac manifestations
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias. ECG changes indicate an urgent need for
treatment.
Question 7
A patient with COPD exacerbation is receiving oxygen therapy.
Which approach is generally appropriate?
A. Withhold oxygen completely
B. Titrate oxygen to the prescribed target saturation
C. Give the highest possible oxygen concentration indefinitely
D. Replace oxygen with oral fluids
