Midterm Exam: NR574/ NR 574 (2026/2027 New Update) Acute Care Practicum Review | Week 1-4 | Verified Questions and Answers| 100% Correct- Chamberlain

Midterm Exam: NR574/ NR 574 (2026/2027 New Update) Acute Care Practicum Review | Week 1-4 | Verified Questions and Answers| 100% Correct- Chamberlain Q. What is the definition of ischemic stroke? ANSWER Loss of blood flow to brain tissue causing infarction. Q. What is the definition of hemorrhagic stroke? ANSWER Bleeding into brain tissue or surrounding spaces. Q. What is the most common type of stroke? ANSWER Ischemic stroke. Q. What is the most important initial test in suspected stroke? ANSWER Non-contrast CT of the head. Q. What is the purpose of non-contrast CT in acute stroke? ANSWER Rule out hemorrhage. Q. What is the most common cause of ischemic stroke? ANSWER Thromboembolism. Q. What is the classic presentation of ischemic stroke? ANSWER Sudden focal neurologic deficit. Q. What are examples of focal neurologic deficits? ANSWER Unilateral weakness, aphasia, facial droop. Q. What is the primary treatment goal in ischemic stroke? ANSWER Restore cerebral blood flow. Q. What is the time window for IV TPA administration? ANSWER Within 4.5 hours of symptom onset. Q. What is the blood pressure requirement before TPA? ANSWER Less than 185/110 mmHg. Q. What is an absolute contraindication to TPA? ANSWER Intracranial hemorrhage. Q. What are other contraindications to TPA? ANSWER Recent surgery, active bleeding, anticoagulation with high INR. Q. What is the primary complication of TPA? ANSWER Intracranial hemorrhage. Q. What should be done if a patient is not a TPA candidate? ANSWER Antiplatelet therapy. Q. What is the most common cause of intracerebral hemorrhage? ANSWER Hypertension. Q. What is the key management priority in hemorrhagic stroke? ANSWER Blood pressure control. Q. What should be done regarding anticoagulation in hemorrhagic stroke? ANSWER Immediately reversed. Q. What is the warfarin reversal agent? ANSWER Vitamin K and PCC. Q. What is the classic triad of meningitis? ANSWER Fever, neck stiffness, altered mental status. Q. What is the most common cause of bacterial meningitis in adults? ANSWER Streptococcus pneumoniae. Q. What are CSF findings in bacterial meningitis? ANSWER High WBC, low glucose, high protein. Q. What are CSF findings in viral meningitis? ANSWER Normal glucose, mild protein elevation. Q. What is an indication for lumbar puncture? ANSWER Suspected meningitis. Q. When is a CT scan required before lumbar puncture? ANSWER When signs of increased intracranial pressure are present. Q. What are signs of increased intracranial pressure? ANSWER Papilledema, focal neurologic deficits, altered mental status. Q. When should antibiotics be started in relation to lumbar puncture? ANSWER Before LP if LP is delayed. Q. What is the most common cause of viral encephalitis? ANSWER Herpes simplex virus. Q. What is a classic symptom of encephalitis? ANSWER Altered mental status. Q. What is the treatment for suspected HSV encephalitis? ANSWER IV acyclovir. Q. What is the definition of delirium? ANSWER Acute, fluctuating disturbance in attention and cognition. Q. What is the most common cause of delirium? ANSWER Underlying medical illness or infection. Q. What is the hallmark feature of delirium? ANSWER Fluctuating mental status. Q. What is the best initial management of delirium? ANSWER Treat underlying cause. Q. What is the recommendation regarding medication use in delirium? ANSWER Avoid unless patient is a danger. Q. What is the classic triad of increased intracranial pressure? ANSWER Cushing's triad. Q. What are the components of Cushing's triad? ANSWER Hypertension, bradycardia, irregular respirations. Q. What is the initial management of increased ICP? ANSWER Elevate head of bed. Q. What medication is used to reduce ICP? ANSWER Mannitol or hypertonic saline. Q. Is it true that CT head is done before TPA? ANSWER True. Q. Is it true that normal CT rules out ischemic stroke? ANSWER False. Is it true that TPA is given before CT? False. Is it true that antibiotics should not be delayed for LP? True. Is it true that delirium is a chronic condition? False. Is it true that HSV encephalitis requires immediate treatment? True. Primary function of platelets Form the initial hemostatic plug Primary function of coagulation factors Stabilize clot formation INR measures Extrinsic pathway aPTT measures Intrinsic pathway Definition of HIT Immune-mediated platelet activation causing thrombocytopenia and thrombosis Typical timing of HIT onset 5 to 10 days after heparin exposure Key clinical clue to HIT Falling platelet count with thrombosis Platelet count finding in HIT Drop of 50 percent or more from baseline Management of suspected HIT Stop all heparin immediately Anticoagulant used in HIT Direct thrombin inhibitor (argatroban) Platelet transfusion in HIT Contraindicated unless life-threatening bleeding Definition of DIC Systemic activation of coagulation leading to clotting and bleeding Common causes of DIC Sepsis, trauma, malignancy Platelet count in DIC Low PT and aPTT in DIC Prolonged Fibrinogen level in DIC Low D-dimer in DIC Elevated Primary treatment of DIC Treat underlying cause Definition of ITP Autoimmune destruction of platelets Platelet count in ITP Low with otherwise normal labs Bleeding pattern in ITP Mucocutaneous bleeding First-line treatment for ITP Corticosteroids IVIG is used in ITP when Severe bleeding or very low platelets Definition of hemophilia Inherited deficiency of clotting factors Most common type of hemophilia Hemophilia A (factor VIII deficiency) Classic presentation of hemophilia Hemarthrosis Lab finding in hemophilia Prolonged aPTT Treatment for hemophilia Factor replacement Medication that prolongs INR Warfarin Warfarin reversal for life-threatening bleeding Vitamin K and prothrombin complex concentrate Medication reversed by protamine sulfate Heparin Medication that does not require INR monitoring Direct oral anticoagulants DOAC reversal agent for dabigatran Idarucizumab Thrombocytopenia always causes bleeding False HIT causes bleeding rather than thrombosis False Platelets should be transfused in HIT False Treating underlying cause is key in DIC True Hemophilia affects the intrinsic pathway True Definition of upper GI bleed Bleeding proximal to the ligament of Treitz Definition of lower GI bleed Bleeding distal to the ligament of Treitz Most common cause of upper GI bleed Peptic ulcer disease Most common cause of lower GI bleed Diverticulosis Classic sign of upper GI bleed Melena Classic sign of brisk upper GI bleed Hematochezia Classic sign of lower GI bleed Bright red blood per rectum First step in management of GI bleed Assess hemodynamic stability and resuscitate Initial intervention for unstable GI bleed IV fluids and blood transfusion Target hemoglobin in active GI bleeding 7 to 8 g/dL Medication used acutely in upper GI bleed IV proton pump inhibitor Medication used for suspected variceal bleed Octreotide Diagnostic test of choice for upper GI bleed Endoscopy Diagnostic test of choice for lower GI bleed Colonoscopy after stabilization Most common causes of acute pancreatitis Gallstones and alcohol Classic presentation of pancreatitis Epigastric pain radiating to the back Key lab test for pancreatitis Lipase Preferred imaging in pancreatitis CT abdomen with contrast Primary management of acute pancreatitis IV fluids and bowel rest Antibiotics in acute pancreatitis Not routinely indicated Definition of acute hepatitis Inflammation of the liver Most common cause of viral hepatitis Hepatitis B and C Characteristic lab finding in acute hepatitis Markedly elevated AST and ALT AST to ALT ratio greater than 2 suggests Alcoholic liver disease Most common cause of chronic hepatitis Hepatitis C Classic symptom of appendicitis Periumbilical pain migrating to right lower quadrant Classic physical exam finding in appendicitis McBurney point tenderness Associated symptoms of appendicitis Anorexia, nausea, low-grade fever Diagnostic test of choice for appendicitis in adults CT abdomen with contrast Management of appendicitis Surgical consultation for appendectomy Most common causes of peptic ulcer disease NSAIDs and Helicobacter pylori Classic symptom of gastric ulcer Epigastric pain worsened with eating Classic symptom of duodenal ulcer Epigastric pain relieved with eating Diagnostic test for H. pylori infection Urea breath test or stool antigen test Treatment for H. pylori Combination antibiotic therapy with PPI Hemodynamic stability determines GI bleed management True Endoscopy is performed before resuscitation False Lipase is more specific than amylase for pancreatitis True Antibiotics are first-line in pancreatitis False Appendicitis pain starts in the right lower quadrant False AST greater than ALT suggests viral hepatitis False What are the four core principles of medical ethics? Autonomy, beneficence, nonmaleficence, justice What does autonomy mean in medical ethics? Respecting a patient's right to make decisions What is the definition of beneficence? Acting in the patient's best interest What does nonmaleficence refer to? Do no harm What is the principle of justice in medical ethics? Fair and equitable distribution of care What is required for decision-making capacity? Ability to understand, appreciate, reason, and communicate a choice Who determines a patient's capacity? The treating clinician Who determines a patient's competence? The court What is needed when a patient lacks capacity? A surrogate decision maker When is emergency treatment without consent allowed? When delay would result in serious harm or death What is the purpose of an advance directive? Communicate patient wishes when they cannot speak for themselves What does a living will address? Specific medical treatments a patient wants or refuses What does a healthcare power of attorney designate? A surrogate decision maker What does a DNR order indicate? No cardiopulmonary resuscitation When should restraints be used? Only as a last resort What is the least restrictive intervention principle? Use the minimal level of restraint necessary What is an indication for using restraints? Patient is an immediate danger to self or others What is required for the use of restraints? Frequent reassessment and documentation What are chemical restraints? Sedatives and antipsychotics used for behavior control What are the types of elder abuse? Physical, emotional, sexual, financial, neglect What is the most common form of elder abuse? Neglect What is the healthcare provider's responsibility in suspected elder abuse? Mandatory reporting What is required when there is suspicion of elder abuse? Reporting even without proof What are some health disparities faced by LGBTQ+ populations? Higher rates of mental health disorders and substance use What is the best practice when caring for LGBTQ+ patients? Use inclusive and affirming language How do adolescent consent laws vary? They vary by state What confidential services may be available for adolescents? STI testing and contraception What characterizes delirium? Acute onset and fluctuating course What is the best initial management of delirium? Identify and treat underlying cause When should pharmacologic treatment of delirium be avoided? Unless the patient is a danger What is the purpose of medical documentation? Communicate care and support billing What are the components of a SOAP note? Subjective, objective, assessment, plan What are pertinent positives? Findings that support diagnosis What are pertinent negatives? Findings that help rule out diagnoses What is E/M coding based on? Medical decision-making, not time alone What is required for higher E/M levels? Greater complexity and risk What do ICD-10 codes describe? Diagnosis What do CPT codes describe? Procedures and services What does USPSTF grade A or B recommend? Should be offered routinely What does a USPSTF grade C recommendation indicate? Individualized decision What is the purpose of preventive screening? Detect disease early in asymptomatic patients Is capacity the same as competence? False Can restraints be used for convenience? False Do advance directives override family wishes? True Does suspicion of abuse require reporting? True Is E/M coding based solely on time? False