Final Exam: NR 574/ NR574 (Latest
2025/ 2026 Update) Acute Care
Practicum I Test Bank| 450 Questions
with Verified Answers| 100% Correct |
Grade A – Chamberlain.
Question:
Jerome has 75% TBSA 2nd and 3rd degree burn injuries. He weighs 80
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
kilograms (kg). Based on the Parkland formula how much fluid should
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Jerome receive in the first 8 hours??
i,- i,- i,- i,- i,- i,-
Answer:
12 L
i,- i,-
Parkland formula is TBSA x weight x 4ml. Half of this is given in the first 8
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
hours. 75 x 80 x 4= 24L/2= 12L.
i,- i,- i,- i,- i,- i,- i,-
Question:
Neal was involved in a house fire. He sustained burns to the head, neck,
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
face, chest, and bilateral upper extremities. Neal was intubated by EMS
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
before arrival. What are the AGACNP's priority diagnostic studies for
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Neal??
Answer:
Carboxyhemoglobin (CO) level & ABGs i,- i,- i,- i,-
,Question:
Harleen sustained a 50% TBSA burn injury. The time of injury was 6 hours
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
ago. The nurse reports that Harleen's urine output has decreased to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
10ml/hr for the last two hours. What is the most appropriate intervention
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
by the nurse practitioner??
i,- i,- i,-
Answer:
Provide 1L rapid bolus of lactated ringers (LR)
i,- i,- i,- i,- i,- i,- i,-
Rationale: Urine decrease in a burn injury in the first 24 hours is generally
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
going to be met with a fluid challenge. Burns require a large volume of
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
fluids; some require upwards of 30L of fluid in just the first24 hours.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Thermal injury causes an overwhelming fluid shift with most intravascular
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
fluid shifting into the tissues and the third space. That fluid has to be
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
replaced quickly. Urine output, lactic, CVP, acidosis are all signs of change
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
in fluid status in a burn client.
i,- i,- i,- i,- i,- i,-
Question:
Hepatorenal syndrome (HRS)? i,- i,-
Answer:
functional form of renal failure that occurs primarily in pt with cirrhosis
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
and ascites.
i,-
,Question:
Type 1 hepatorenal syndrome is characterized by...?
i,- i,- i,- i,- i,- i,-
Answer:
-rapidly progressive renal impairment-doubling of initial serum Cr to
i,- i,- i,- i,- i,- i,- i,- i,- i,-
greater than 2.5mg/dL over a period less than 2 weeks -without liver
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
transplant prognosis is very poor i,- i,- i,- i,-
Question:
Type 2 hepatorenal syndrome is characterized by...?
i,- i,- i,- i,- i,- i,-
Answer:
moderate form of renal failure-serum Cr levels between 1.5 to 2.5
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
mg/dLreduction in GFR with elevation in serum creatinine-associated with
i,- i,- i,- i,- i,- i,- i,- i,- i,-
a more indolent course and improved survival compared to type 1
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Question:
Risk Factors of hepatorenal syndrome?
i,- i,- i,- i,-
Answer:
Dilutional hyponatremia Previous episodes of ascites Presence of
i,- i,- i,- i,- i,- i,- i,- i,-
esophageal varices Poor nutritional statusInfections such as spontaneous
i,- i,- i,- i,- i,- i,- i,- i,-
bacterial peritonitisSevere urinary sodium retention (urine sodium < 5
i,- i,- i,- i,- i,- i,- i,- i,- i,-
milliequivalents/liter [mEq/L]) Large-volume paracentesis without albumin i,- i,- i,- i,- i,- i,-
replacementAcute alcoholic hepatitisLow mean arterial blood pressure i,- i,- i,- i,- i,- i,- i,-
(map <80 mm Hg)
i,- i,- i,-
, Question:
subjective clinical presentation of hepatorenal syndrome?
i,- i,- i,- i,- i,-
Answer:
Most clients with HRS have a known diagnosis of acute or chronic liver
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
disease and present with nonspecific symptoms including:-dysgeusia
i,- i,- i,- i,- i,- i,- i,-
(altered taste perception)-malaise
i,- i,-
-fatigue-decreased urine output. i,- i,-
Question:
objective clinical presentation of hepatorenal syndrome?
i,- i,- i,- i,- i,-
Answer:
HRS has no characteristic physical exam findings.It is important to assess
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
the client for stigmata of chronic liver disease including: -spider nevi-
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
scleral icterus-lower extremity edema asterixis-abdominal distention-fluid
i,- i,- i,- i,- i,- i,-
wave-paraumbilical hernia-bruits. i,-
Question:
Diagnostic criteria in hepatorenal syndrome? i,- i,- i,- i,-
Answer:
1.cirrhosis with ascites 2.increase in Cr >0.3 mg/dL within 48 hrs or >50%
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
increase from baseline within a7 day period 3.no response to a 2
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
2025/ 2026 Update) Acute Care
Practicum I Test Bank| 450 Questions
with Verified Answers| 100% Correct |
Grade A – Chamberlain.
Question:
Jerome has 75% TBSA 2nd and 3rd degree burn injuries. He weighs 80
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
kilograms (kg). Based on the Parkland formula how much fluid should
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Jerome receive in the first 8 hours??
i,- i,- i,- i,- i,- i,-
Answer:
12 L
i,- i,-
Parkland formula is TBSA x weight x 4ml. Half of this is given in the first 8
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
hours. 75 x 80 x 4= 24L/2= 12L.
i,- i,- i,- i,- i,- i,- i,-
Question:
Neal was involved in a house fire. He sustained burns to the head, neck,
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
face, chest, and bilateral upper extremities. Neal was intubated by EMS
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
before arrival. What are the AGACNP's priority diagnostic studies for
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Neal??
Answer:
Carboxyhemoglobin (CO) level & ABGs i,- i,- i,- i,-
,Question:
Harleen sustained a 50% TBSA burn injury. The time of injury was 6 hours
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
ago. The nurse reports that Harleen's urine output has decreased to
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
10ml/hr for the last two hours. What is the most appropriate intervention
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
by the nurse practitioner??
i,- i,- i,-
Answer:
Provide 1L rapid bolus of lactated ringers (LR)
i,- i,- i,- i,- i,- i,- i,-
Rationale: Urine decrease in a burn injury in the first 24 hours is generally
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
going to be met with a fluid challenge. Burns require a large volume of
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
fluids; some require upwards of 30L of fluid in just the first24 hours.
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Thermal injury causes an overwhelming fluid shift with most intravascular
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
fluid shifting into the tissues and the third space. That fluid has to be
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
replaced quickly. Urine output, lactic, CVP, acidosis are all signs of change
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
in fluid status in a burn client.
i,- i,- i,- i,- i,- i,-
Question:
Hepatorenal syndrome (HRS)? i,- i,-
Answer:
functional form of renal failure that occurs primarily in pt with cirrhosis
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
and ascites.
i,-
,Question:
Type 1 hepatorenal syndrome is characterized by...?
i,- i,- i,- i,- i,- i,-
Answer:
-rapidly progressive renal impairment-doubling of initial serum Cr to
i,- i,- i,- i,- i,- i,- i,- i,- i,-
greater than 2.5mg/dL over a period less than 2 weeks -without liver
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
transplant prognosis is very poor i,- i,- i,- i,-
Question:
Type 2 hepatorenal syndrome is characterized by...?
i,- i,- i,- i,- i,- i,-
Answer:
moderate form of renal failure-serum Cr levels between 1.5 to 2.5
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
mg/dLreduction in GFR with elevation in serum creatinine-associated with
i,- i,- i,- i,- i,- i,- i,- i,- i,-
a more indolent course and improved survival compared to type 1
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
Question:
Risk Factors of hepatorenal syndrome?
i,- i,- i,- i,-
Answer:
Dilutional hyponatremia Previous episodes of ascites Presence of
i,- i,- i,- i,- i,- i,- i,- i,-
esophageal varices Poor nutritional statusInfections such as spontaneous
i,- i,- i,- i,- i,- i,- i,- i,-
bacterial peritonitisSevere urinary sodium retention (urine sodium < 5
i,- i,- i,- i,- i,- i,- i,- i,- i,-
milliequivalents/liter [mEq/L]) Large-volume paracentesis without albumin i,- i,- i,- i,- i,- i,-
replacementAcute alcoholic hepatitisLow mean arterial blood pressure i,- i,- i,- i,- i,- i,- i,-
(map <80 mm Hg)
i,- i,- i,-
, Question:
subjective clinical presentation of hepatorenal syndrome?
i,- i,- i,- i,- i,-
Answer:
Most clients with HRS have a known diagnosis of acute or chronic liver
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
disease and present with nonspecific symptoms including:-dysgeusia
i,- i,- i,- i,- i,- i,- i,-
(altered taste perception)-malaise
i,- i,-
-fatigue-decreased urine output. i,- i,-
Question:
objective clinical presentation of hepatorenal syndrome?
i,- i,- i,- i,- i,-
Answer:
HRS has no characteristic physical exam findings.It is important to assess
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
the client for stigmata of chronic liver disease including: -spider nevi-
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
scleral icterus-lower extremity edema asterixis-abdominal distention-fluid
i,- i,- i,- i,- i,- i,-
wave-paraumbilical hernia-bruits. i,-
Question:
Diagnostic criteria in hepatorenal syndrome? i,- i,- i,- i,-
Answer:
1.cirrhosis with ascites 2.increase in Cr >0.3 mg/dL within 48 hrs or >50%
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
increase from baseline within a7 day period 3.no response to a 2
i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,- i,-
