NR 571 Final Exam | Complex Diagnosis
& Management in Acute Care Review |
Chamberlain College | Latest 2024–2025
Update | 100 Questions
Instructions: This final exam for NR571: Complex Diagnosis & Management in Acute Care
contains 100 multiple-choice questions, designed to align with the course's focus on advanced
assessment, diagnosis, and management of acute conditions in adult and geriatric populations.
Each question provides four answer choices (A–D), the correct answer, and a concise rationale
explaining why the correct answer is right and why others are incorrect. Topics cover key acute
care areas: hepatobiliary disorders, shock, cardiovascular complications, sepsis, renal
dysfunction, endocrine emergencies, and acute pulmonary issues, per evidence-based
guidelines (e.g., SCCM, AHA, KDIGO). Each question is worth 1 point (total 100 points). Use this
for study and review. Good luck!
Question 1
What is the hallmark sign of acute cholecystitis?
A. Right upper quadrant pain with Murphy’s sign
B. Epigastric pain radiating to the chest
C. Left lower quadrant pain with rebound tenderness
D. Diffuse abdominal pain with rigidity
Correct Answer: A
Rationale: Acute cholecystitis presents with right upper quadrant pain and Murphy’s sign (pain
on palpation during inspiration), per surgical guidelines. Why correct: Specific to gallbladder
inflammation. Why others are incorrect: Epigastric pain (B) suggests pancreatitis or MI; left
lower pain (C) suggests diverticulitis; diffuse pain (D) suggests peritonitis.
Question 2
,What is the initial treatment for septic shock?
A. Fluid resuscitation with crystalloids
B. Vasopressor therapy alone
C. Broad-spectrum antibiotics alone
D. Mechanical ventilation
Correct Answer: A
Rationale: SCCM guidelines recommend 30 mL/kg crystalloid fluid bolus within 1 hour for septic
shock to restore perfusion. Why correct: Addresses hypovolemia. Why others are incorrect:
Vasopressors (B) are second-line; antibiotics (C) target infection; ventilation (D) is for respiratory
failure.
Question 3
A patient with acute myocardial infarction (MI) develops chest pain and ST elevation. What is the
priority intervention?
A. Percutaneous coronary intervention (PCI)
B. Administer morphine
C. Start heparin infusion
D. Order an echocardiogram
Correct Answer: A
Rationale: PCI within 90 minutes is the gold standard for STEMI to restore coronary flow, per
AHA guidelines. Why correct: Reperfusion saves myocardium. Why others are incorrect:
Morphine (B) relieves pain; heparin (C) prevents clots; echocardiogram (D) is diagnostic.
Question 4
What is the primary pathophysiological mechanism of hypovolemic shock?
A. Loss of circulating blood volume
B. Systemic vasodilation
C. Cardiac pump failure
D. Obstructed blood flow
Correct Answer: A
Rationale: Hypovolemic shock results from reduced blood volume (e.g., hemorrhage),
decreasing preload, per SCCM. Why correct: Core mechanism. Why others are incorrect:
Vasodilation (B) is septic; pump failure (C) is cardiogenic; obstruction (D) is obstructive shock.
Question 5
,A patient with diabetic ketoacidosis (DKA) presents with Kussmaul respirations. What is the
cause?
A. Compensation for metabolic acidosis
B. Hypoxemia from pulmonary edema
C. Hypercapnia from hypoventilation
D. Anxiety-induced hyperventilation
Correct Answer: A
Rationale: Kussmaul respirations compensate for metabolic acidosis in DKA by eliminating
CO2, per ADA guidelines. Why correct: Acid-base balance. Why others are incorrect: Edema
(B) is heart failure; hypercapnia (C) is respiratory failure; anxiety (D) is psychological.
Question 6
What is the diagnostic criterion for acute kidney injury (AKI)?
A. Increase in serum creatinine by 0.3 mg/dL within 48 hours
B. Decrease in urine output to 100 mL/day
C. Serum creatinine doubling in 24 hours
D. BUN elevation above 50 mg/dL
Correct Answer: A
Rationale: KDIGO defines AKI as a creatinine rise of ≥0.3 mg/dL in 48 hours or urine output
<0.5 mL/kg/h for 6 hours. Why correct: Standard criterion. Why others are incorrect: 100
mL/day (B) is too low; doubling (C) is chronic; BUN (D) is nonspecific.
Question 7
A patient with acute pulmonary edema requires immediate intervention. What is the first-line
treatment?
A. Furosemide IV
B. Supplemental oxygen
C. Nitroglycerin sublingual
D. Intubation
Correct Answer: B
Rationale: Oxygen improves hypoxemia in pulmonary edema, per ACC guidelines, before
diuretics or vasodilators. Why correct: Addresses hypoxia. Why others are incorrect:
Furosemide (A) reduces fluid; nitroglycerin (C) reduces preload; intubation (D) is for severe
cases.
, Question 8
What is the primary cause of acute liver failure in the US?
A. Acetaminophen overdose
B. Hepatitis B infection
C. Alcoholic hepatitis
D. Autoimmune hepatitis
Correct Answer: A
Rationale: Acetaminophen overdose is the leading cause of acute liver failure, causing
hepatotoxicity, per AASLD. Why correct: Most common etiology. Why others are incorrect:
Hepatitis B (B) is viral; alcoholic (C) is chronic; autoimmune (D) is rare.
Question 9
A patient in cardiogenic shock has a low cardiac output. What is the initial pharmacological
intervention?
A. Dobutamine
B. Norepinephrine
C. Dopamine
D. Epinephrine
Correct Answer: A
Rationale: Dobutamine, an inotrope, improves cardiac contractility in cardiogenic shock, per
AHA. Why correct: Enhances pump function. Why others are incorrect: Norepinephrine (B) is
for vasogenic shock; dopamine (C) is less specific; epinephrine (D) is for anaphylaxis.
Question 10
What is the hallmark laboratory finding in disseminated intravascular coagulation (DIC)?
A. Prolonged prothrombin time (PT)
B. Elevated hemoglobin
C. Normal platelet count
D. Decreased D-dimer
Correct Answer: A
Rationale: DIC causes coagulopathy, prolonging PT due to factor consumption, per ISTH
guidelines. Why correct: Reflects clotting dysfunction. Why others are incorrect: Hemoglobin
(B) decreases; platelets (C) drop; D-dimer (D) is elevated.
& Management in Acute Care Review |
Chamberlain College | Latest 2024–2025
Update | 100 Questions
Instructions: This final exam for NR571: Complex Diagnosis & Management in Acute Care
contains 100 multiple-choice questions, designed to align with the course's focus on advanced
assessment, diagnosis, and management of acute conditions in adult and geriatric populations.
Each question provides four answer choices (A–D), the correct answer, and a concise rationale
explaining why the correct answer is right and why others are incorrect. Topics cover key acute
care areas: hepatobiliary disorders, shock, cardiovascular complications, sepsis, renal
dysfunction, endocrine emergencies, and acute pulmonary issues, per evidence-based
guidelines (e.g., SCCM, AHA, KDIGO). Each question is worth 1 point (total 100 points). Use this
for study and review. Good luck!
Question 1
What is the hallmark sign of acute cholecystitis?
A. Right upper quadrant pain with Murphy’s sign
B. Epigastric pain radiating to the chest
C. Left lower quadrant pain with rebound tenderness
D. Diffuse abdominal pain with rigidity
Correct Answer: A
Rationale: Acute cholecystitis presents with right upper quadrant pain and Murphy’s sign (pain
on palpation during inspiration), per surgical guidelines. Why correct: Specific to gallbladder
inflammation. Why others are incorrect: Epigastric pain (B) suggests pancreatitis or MI; left
lower pain (C) suggests diverticulitis; diffuse pain (D) suggests peritonitis.
Question 2
,What is the initial treatment for septic shock?
A. Fluid resuscitation with crystalloids
B. Vasopressor therapy alone
C. Broad-spectrum antibiotics alone
D. Mechanical ventilation
Correct Answer: A
Rationale: SCCM guidelines recommend 30 mL/kg crystalloid fluid bolus within 1 hour for septic
shock to restore perfusion. Why correct: Addresses hypovolemia. Why others are incorrect:
Vasopressors (B) are second-line; antibiotics (C) target infection; ventilation (D) is for respiratory
failure.
Question 3
A patient with acute myocardial infarction (MI) develops chest pain and ST elevation. What is the
priority intervention?
A. Percutaneous coronary intervention (PCI)
B. Administer morphine
C. Start heparin infusion
D. Order an echocardiogram
Correct Answer: A
Rationale: PCI within 90 minutes is the gold standard for STEMI to restore coronary flow, per
AHA guidelines. Why correct: Reperfusion saves myocardium. Why others are incorrect:
Morphine (B) relieves pain; heparin (C) prevents clots; echocardiogram (D) is diagnostic.
Question 4
What is the primary pathophysiological mechanism of hypovolemic shock?
A. Loss of circulating blood volume
B. Systemic vasodilation
C. Cardiac pump failure
D. Obstructed blood flow
Correct Answer: A
Rationale: Hypovolemic shock results from reduced blood volume (e.g., hemorrhage),
decreasing preload, per SCCM. Why correct: Core mechanism. Why others are incorrect:
Vasodilation (B) is septic; pump failure (C) is cardiogenic; obstruction (D) is obstructive shock.
Question 5
,A patient with diabetic ketoacidosis (DKA) presents with Kussmaul respirations. What is the
cause?
A. Compensation for metabolic acidosis
B. Hypoxemia from pulmonary edema
C. Hypercapnia from hypoventilation
D. Anxiety-induced hyperventilation
Correct Answer: A
Rationale: Kussmaul respirations compensate for metabolic acidosis in DKA by eliminating
CO2, per ADA guidelines. Why correct: Acid-base balance. Why others are incorrect: Edema
(B) is heart failure; hypercapnia (C) is respiratory failure; anxiety (D) is psychological.
Question 6
What is the diagnostic criterion for acute kidney injury (AKI)?
A. Increase in serum creatinine by 0.3 mg/dL within 48 hours
B. Decrease in urine output to 100 mL/day
C. Serum creatinine doubling in 24 hours
D. BUN elevation above 50 mg/dL
Correct Answer: A
Rationale: KDIGO defines AKI as a creatinine rise of ≥0.3 mg/dL in 48 hours or urine output
<0.5 mL/kg/h for 6 hours. Why correct: Standard criterion. Why others are incorrect: 100
mL/day (B) is too low; doubling (C) is chronic; BUN (D) is nonspecific.
Question 7
A patient with acute pulmonary edema requires immediate intervention. What is the first-line
treatment?
A. Furosemide IV
B. Supplemental oxygen
C. Nitroglycerin sublingual
D. Intubation
Correct Answer: B
Rationale: Oxygen improves hypoxemia in pulmonary edema, per ACC guidelines, before
diuretics or vasodilators. Why correct: Addresses hypoxia. Why others are incorrect:
Furosemide (A) reduces fluid; nitroglycerin (C) reduces preload; intubation (D) is for severe
cases.
, Question 8
What is the primary cause of acute liver failure in the US?
A. Acetaminophen overdose
B. Hepatitis B infection
C. Alcoholic hepatitis
D. Autoimmune hepatitis
Correct Answer: A
Rationale: Acetaminophen overdose is the leading cause of acute liver failure, causing
hepatotoxicity, per AASLD. Why correct: Most common etiology. Why others are incorrect:
Hepatitis B (B) is viral; alcoholic (C) is chronic; autoimmune (D) is rare.
Question 9
A patient in cardiogenic shock has a low cardiac output. What is the initial pharmacological
intervention?
A. Dobutamine
B. Norepinephrine
C. Dopamine
D. Epinephrine
Correct Answer: A
Rationale: Dobutamine, an inotrope, improves cardiac contractility in cardiogenic shock, per
AHA. Why correct: Enhances pump function. Why others are incorrect: Norepinephrine (B) is
for vasogenic shock; dopamine (C) is less specific; epinephrine (D) is for anaphylaxis.
Question 10
What is the hallmark laboratory finding in disseminated intravascular coagulation (DIC)?
A. Prolonged prothrombin time (PT)
B. Elevated hemoglobin
C. Normal platelet count
D. Decreased D-dimer
Correct Answer: A
Rationale: DIC causes coagulopathy, prolonging PT due to factor consumption, per ISTH
guidelines. Why correct: Reflects clotting dysfunction. Why others are incorrect: Hemoglobin
(B) decreases; platelets (C) drop; D-dimer (D) is elevated.
