NR 574 Final Exam: (Latest 2026/2027 Update) Advanced Acute Care -
Rhabdo, GI, Hematology, Burns, Trauma, Neuro | Q&A | Grade A | 100%
Correct (Verified Answers) – Chamberlain University
Subject: Advanced Acute Care – Rhabdomyolysis, Intestinal Obstruction, Acute Mesenteric Ischemia,
Hepatorenal Syndrome, Hemophilia, HIT, DIC, Burns, Hypothermia, TBI, Spinal Cord Injury, Pelvic
Fractures, Compartment Syndrome
Source: NR 574 Final Exam / Chamberlain University / Clinical Practice Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What are common trauma-related risk factors for Rhabdomyolysis?
Correct Answer: Trauma, muscle compression, or ischemia. Examples: compartment syndrome, crush
injuries, lightning strike, near-drowning, significant burns, blunt force trauma, high-voltage electrical
injuries, prolonged immobilization following a fall.
1. Muscle injury releases intracellular contents into bloodstream.
2. Crush injuries cause massive muscle breakdown.
2. What is the most reliable lab test for rhabdomyolysis?
Correct Answer: Creatine kinase (CK). It will be markedly elevated >1000 IU/L (normal 45-260). CK
rises within 2-12 hours, peaks at 24-72 hours.
1. CK >5,000 results in acute kidney injury.
2. Serum CK >15,000 requires at least 6L of IV fluids.
3. What electrolyte abnormalities occur with rhabdomyolysis?
Correct Answer: Hyperkalemia (most concerning), hypocalcemia, hyperuricemia, hyperphosphatemia.
1. Hyperkalemia can cause cardiac dysrhythmias.
2. Treatment includes IV glucose, sodium bicarbonate, insulin, sodium polystyrene sulfonate, or
hemodialysis.
4. What are risk factors for acute intestinal obstruction?
Correct Answer: Adhesions from previous abdominal surgery, hernias, foreign bodies, feces,
congenital issues, trauma, inflammation (IBD, diverticulitis), neoplasms, endometriosis, volvulus,
ischemic injury, intussusception.
1. Adhesions are the most common cause of small bowel obstruction.
2. Hernias are the second most common cause.
, 5. What diagnostic imaging should be used for bowel obstruction?
Correct Answer: CT abdomen is useful for location of obstruction or identification of when surgery is
needed. Plain film x-ray shows dilated loops of bowel and air-fluid levels.
1. Barium is contraindicated in high-grade or complete obstruction.
2. Retained barium can cause concretions requiring surgical intervention.
6. Treatment of bowel obstruction includes?
Correct Answer: NG tube with intermittent suction for decompression, fluid resuscitation, electrolyte
management. Complete obstruction requires immediate surgical intervention.
1. NG decompression prevents emesis and aspiration.
2. Elevated serum lactate raises concern for strangulated obstruction.
7. Patients with severe acute abdominal pain that seems disproportional to physical exam findings
should be suspected as having?
Correct Answer: Acute Mesenteric Ischemia (AMI) - pain out of proportion to exam is classic.
1. Gold standard diagnostic imaging: CT angiography of the abdomen.
2. Oral contrast should be avoided as it can obscure bowel wall enhancement.
8. Treatment for acute mesenteric arterial embolism?
Correct Answer: Surgical laparotomy with embolectomy is preferred for solitary, proximal superior
mesenteric embolus.
1. Thrombolytics (urokinase, streptokinase, tPA) can be infused within 8 hours of symptom onset.
2. Vasopressors should be avoided as they can worsen ischemia.
9. Diagnostic criteria for Hepatorenal Syndrome include?
Correct Answer: Cirrhosis with ascites, absence of shock, no response to 2 days of diuretic withdrawal
and volume expansion with albumin, increase in serum creatinine ≥0.3 mg/dL within 48 hours or ≥50%
increase from baseline within 7 days.
1. Type 1: more serious, doubling of serum creatinine to >2.5 mg/dL in two weeks or less.
2. Type 2: less severe, diuretic-resistant ascites.
10. Treatment of Hepatorenal Syndrome includes?
Correct Answer: Definitive treatment is orthotopic liver transplantation. Bridge therapies include
terlipressin, norepinephrine, or octreotide/midodrine with IV albumin.
1. TIPS procedure can reduce portal pressure and improve renal perfusion.
2. CRRT can be used as bridge to transplant for non-candidates for TIPS.
11. What lab findings suggest hemophilia?
Correct Answer: Normal platelet count, prolonged aPTT, normal PT.
1. aPTT prolonged due to intrinsic pathway defect.
2. Factor VIII assay low in hemophilia A; Factor IX low in hemophilia B.
Rhabdo, GI, Hematology, Burns, Trauma, Neuro | Q&A | Grade A | 100%
Correct (Verified Answers) – Chamberlain University
Subject: Advanced Acute Care – Rhabdomyolysis, Intestinal Obstruction, Acute Mesenteric Ischemia,
Hepatorenal Syndrome, Hemophilia, HIT, DIC, Burns, Hypothermia, TBI, Spinal Cord Injury, Pelvic
Fractures, Compartment Syndrome
Source: NR 574 Final Exam / Chamberlain University / Clinical Practice Guidelines (2026/2027 Update)
Format: Q&A Guide with Clinical Rationales | Grade A Guaranteed
1. What are common trauma-related risk factors for Rhabdomyolysis?
Correct Answer: Trauma, muscle compression, or ischemia. Examples: compartment syndrome, crush
injuries, lightning strike, near-drowning, significant burns, blunt force trauma, high-voltage electrical
injuries, prolonged immobilization following a fall.
1. Muscle injury releases intracellular contents into bloodstream.
2. Crush injuries cause massive muscle breakdown.
2. What is the most reliable lab test for rhabdomyolysis?
Correct Answer: Creatine kinase (CK). It will be markedly elevated >1000 IU/L (normal 45-260). CK
rises within 2-12 hours, peaks at 24-72 hours.
1. CK >5,000 results in acute kidney injury.
2. Serum CK >15,000 requires at least 6L of IV fluids.
3. What electrolyte abnormalities occur with rhabdomyolysis?
Correct Answer: Hyperkalemia (most concerning), hypocalcemia, hyperuricemia, hyperphosphatemia.
1. Hyperkalemia can cause cardiac dysrhythmias.
2. Treatment includes IV glucose, sodium bicarbonate, insulin, sodium polystyrene sulfonate, or
hemodialysis.
4. What are risk factors for acute intestinal obstruction?
Correct Answer: Adhesions from previous abdominal surgery, hernias, foreign bodies, feces,
congenital issues, trauma, inflammation (IBD, diverticulitis), neoplasms, endometriosis, volvulus,
ischemic injury, intussusception.
1. Adhesions are the most common cause of small bowel obstruction.
2. Hernias are the second most common cause.
, 5. What diagnostic imaging should be used for bowel obstruction?
Correct Answer: CT abdomen is useful for location of obstruction or identification of when surgery is
needed. Plain film x-ray shows dilated loops of bowel and air-fluid levels.
1. Barium is contraindicated in high-grade or complete obstruction.
2. Retained barium can cause concretions requiring surgical intervention.
6. Treatment of bowel obstruction includes?
Correct Answer: NG tube with intermittent suction for decompression, fluid resuscitation, electrolyte
management. Complete obstruction requires immediate surgical intervention.
1. NG decompression prevents emesis and aspiration.
2. Elevated serum lactate raises concern for strangulated obstruction.
7. Patients with severe acute abdominal pain that seems disproportional to physical exam findings
should be suspected as having?
Correct Answer: Acute Mesenteric Ischemia (AMI) - pain out of proportion to exam is classic.
1. Gold standard diagnostic imaging: CT angiography of the abdomen.
2. Oral contrast should be avoided as it can obscure bowel wall enhancement.
8. Treatment for acute mesenteric arterial embolism?
Correct Answer: Surgical laparotomy with embolectomy is preferred for solitary, proximal superior
mesenteric embolus.
1. Thrombolytics (urokinase, streptokinase, tPA) can be infused within 8 hours of symptom onset.
2. Vasopressors should be avoided as they can worsen ischemia.
9. Diagnostic criteria for Hepatorenal Syndrome include?
Correct Answer: Cirrhosis with ascites, absence of shock, no response to 2 days of diuretic withdrawal
and volume expansion with albumin, increase in serum creatinine ≥0.3 mg/dL within 48 hours or ≥50%
increase from baseline within 7 days.
1. Type 1: more serious, doubling of serum creatinine to >2.5 mg/dL in two weeks or less.
2. Type 2: less severe, diuretic-resistant ascites.
10. Treatment of Hepatorenal Syndrome includes?
Correct Answer: Definitive treatment is orthotopic liver transplantation. Bridge therapies include
terlipressin, norepinephrine, or octreotide/midodrine with IV albumin.
1. TIPS procedure can reduce portal pressure and improve renal perfusion.
2. CRRT can be used as bridge to transplant for non-candidates for TIPS.
11. What lab findings suggest hemophilia?
Correct Answer: Normal platelet count, prolonged aPTT, normal PT.
1. aPTT prolonged due to intrinsic pathway defect.
2. Factor VIII assay low in hemophilia A; Factor IX low in hemophilia B.
