NR 574 / NR574 Acute Care Practicum I Final Exam
Actual 2026/2027 with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section 1: Acute Care Foundations & Clinical Decision-Making (Q1–Q14)
Q1: When applying the ABCDE approach to a critically ill patient, which intervention
should be performed first?
A. Establishing intravenous access
B. Administering supplemental oxygen and assessing airway patency [CORRECT]
C. Obtaining a 12-lead ECG
D. Drawing blood for laboratory analysis
Correct Answer: B
Rationale: The ABCDE approach prioritizes airway, breathing, and circulation before
disability and exposure; airway patency and adequate oxygenation are the immediate
priorities in any critically ill patient.
Q2: A patient presents with acute chest pain. Using clinical judgment, the nurse
practitioner prioritizes obtaining an ECG within 10 minutes because:
A. It definitively rules out all cardiac causes
B. It identifies ST-elevation myocardial infarction requiring immediate reperfusion
therapy [CORRECT]
C. It replaces the need for cardiac biomarkers
D. It is required before any analgesic administration
Correct Answer: B
Rationale: A 12-lead ECG obtained within 10 minutes of arrival is essential to identify
STEMI, which requires immediate activation of the cardiac catheterization lab for
primary PCI.
Q3: Evidence-based practice in acute care requires the nurse practitioner to:
A. Rely solely on clinical experience when making decisions
B. Integrate the best available research with clinical expertise and patient values
[CORRECT]
C. Follow institutional protocols without question
,D. Base all decisions on patient preferences alone
Correct Answer: B
Rationale: Evidence-based practice is a tripartite model that integrates the best
available research evidence, clinical expertise, and patient preferences and values to
optimize clinical outcomes.
Q4: Which laboratory value is most indicative of inadequate tissue perfusion in a
patient with suspected shock?
A. Elevated blood glucose
B. Elevated lactate level [CORRECT]
C. Elevated platelet count
D. Elevated hematocrit
Correct Answer: B
Rationale: Elevated serum lactate indicates anaerobic metabolism due to inadequate
tissue oxygen delivery and is a key marker of tissue hypoperfusion in shock states.
Q5: The primary purpose of the Glasgow Coma Scale (GCS) in acute care is to:
A. Determine the need for intubation
B. Assess the severity of altered consciousness and monitor neurologic trends
[CORRECT]
C. Diagnose the specific cause of coma
D. Predict long-term functional outcomes
Correct Answer: B
Rationale: The GCS provides a standardized, reproducible assessment of eye
opening, verbal response, and motor response to track changes in neurologic status
over time.
Q6: A patient with acute abdominal pain is triaged as ESI level 2. This indicates:
A. The patient can wait several hours for evaluation
B. The patient requires multiple resources and has a high-risk presentation
[CORRECT]
C. The patient has minor complaints requiring only one resource
D. The patient is already deceased
Correct Answer: B
Rationale: Emergency Severity Index (ESI) level 2 indicates a high-risk patient who is
not currently in extremis but has a potentially life-threatening condition requiring
prompt evaluation and multiple resources.
, Q7: When delegating tasks to unlicensed assistive personnel in an acute care
setting, the nurse practitioner must:
A. Delegate all tasks to maximize efficiency
B. Ensure the task is within the personnel's scope of practice and provide appropriate
supervision [CORRECT]
C. Delegate only tasks that the NP does not want to perform
D. Avoid delegation in all circumstances
Correct Answer: B
Rationale: Delegation requires matching the task to the individual's competency and
scope, providing clear instructions, and maintaining appropriate supervision to
ensure patient safety.
Q8: The most reliable indicator of fluid resuscitation adequacy in a patient with
septic shock is:
A. Central venous pressure of 12 mmHg
B. Achievement of mean arterial pressure ≥65 mmHg and normalization of lactate
[CORRECT]
C. Urine output of 0.3 mL/kg/hr
D. Heart rate below 100 bpm
Correct Answer: B
Rationale: While multiple parameters guide resuscitation, achieving a MAP ≥65
mmHg with lactate clearance is the most reliable indicator of restored tissue
perfusion in septic shock.
Q9: Which action demonstrates appropriate clinical prioritization using Maslow's
hierarchy of needs?
A. Addressing the patient's anxiety about hospitalization before managing hypoxia
B. Administering oxygen to a hypoxic patient before discussing discharge planning
[CORRECT]
C. Providing emotional support before obtaining vital signs
D. Arranging family visitation before securing IV access
Correct Answer: B
Rationale: Physiologic needs (oxygenation, circulation) take priority over safety,
belonging, and self-actualization needs according to Maslow's hierarchy.
Q10: A nurse practitioner is caring for a patient with acute kidney injury who
develops new-onset atrial fibrillation. The most appropriate initial action is to:
A. Start anticoagulation immediately
Actual 2026/2027 with Detailed Rationales | 100%
Verified | Pass Guaranteed – A+ Graded
Section 1: Acute Care Foundations & Clinical Decision-Making (Q1–Q14)
Q1: When applying the ABCDE approach to a critically ill patient, which intervention
should be performed first?
A. Establishing intravenous access
B. Administering supplemental oxygen and assessing airway patency [CORRECT]
C. Obtaining a 12-lead ECG
D. Drawing blood for laboratory analysis
Correct Answer: B
Rationale: The ABCDE approach prioritizes airway, breathing, and circulation before
disability and exposure; airway patency and adequate oxygenation are the immediate
priorities in any critically ill patient.
Q2: A patient presents with acute chest pain. Using clinical judgment, the nurse
practitioner prioritizes obtaining an ECG within 10 minutes because:
A. It definitively rules out all cardiac causes
B. It identifies ST-elevation myocardial infarction requiring immediate reperfusion
therapy [CORRECT]
C. It replaces the need for cardiac biomarkers
D. It is required before any analgesic administration
Correct Answer: B
Rationale: A 12-lead ECG obtained within 10 minutes of arrival is essential to identify
STEMI, which requires immediate activation of the cardiac catheterization lab for
primary PCI.
Q3: Evidence-based practice in acute care requires the nurse practitioner to:
A. Rely solely on clinical experience when making decisions
B. Integrate the best available research with clinical expertise and patient values
[CORRECT]
C. Follow institutional protocols without question
,D. Base all decisions on patient preferences alone
Correct Answer: B
Rationale: Evidence-based practice is a tripartite model that integrates the best
available research evidence, clinical expertise, and patient preferences and values to
optimize clinical outcomes.
Q4: Which laboratory value is most indicative of inadequate tissue perfusion in a
patient with suspected shock?
A. Elevated blood glucose
B. Elevated lactate level [CORRECT]
C. Elevated platelet count
D. Elevated hematocrit
Correct Answer: B
Rationale: Elevated serum lactate indicates anaerobic metabolism due to inadequate
tissue oxygen delivery and is a key marker of tissue hypoperfusion in shock states.
Q5: The primary purpose of the Glasgow Coma Scale (GCS) in acute care is to:
A. Determine the need for intubation
B. Assess the severity of altered consciousness and monitor neurologic trends
[CORRECT]
C. Diagnose the specific cause of coma
D. Predict long-term functional outcomes
Correct Answer: B
Rationale: The GCS provides a standardized, reproducible assessment of eye
opening, verbal response, and motor response to track changes in neurologic status
over time.
Q6: A patient with acute abdominal pain is triaged as ESI level 2. This indicates:
A. The patient can wait several hours for evaluation
B. The patient requires multiple resources and has a high-risk presentation
[CORRECT]
C. The patient has minor complaints requiring only one resource
D. The patient is already deceased
Correct Answer: B
Rationale: Emergency Severity Index (ESI) level 2 indicates a high-risk patient who is
not currently in extremis but has a potentially life-threatening condition requiring
prompt evaluation and multiple resources.
, Q7: When delegating tasks to unlicensed assistive personnel in an acute care
setting, the nurse practitioner must:
A. Delegate all tasks to maximize efficiency
B. Ensure the task is within the personnel's scope of practice and provide appropriate
supervision [CORRECT]
C. Delegate only tasks that the NP does not want to perform
D. Avoid delegation in all circumstances
Correct Answer: B
Rationale: Delegation requires matching the task to the individual's competency and
scope, providing clear instructions, and maintaining appropriate supervision to
ensure patient safety.
Q8: The most reliable indicator of fluid resuscitation adequacy in a patient with
septic shock is:
A. Central venous pressure of 12 mmHg
B. Achievement of mean arterial pressure ≥65 mmHg and normalization of lactate
[CORRECT]
C. Urine output of 0.3 mL/kg/hr
D. Heart rate below 100 bpm
Correct Answer: B
Rationale: While multiple parameters guide resuscitation, achieving a MAP ≥65
mmHg with lactate clearance is the most reliable indicator of restored tissue
perfusion in septic shock.
Q9: Which action demonstrates appropriate clinical prioritization using Maslow's
hierarchy of needs?
A. Addressing the patient's anxiety about hospitalization before managing hypoxia
B. Administering oxygen to a hypoxic patient before discussing discharge planning
[CORRECT]
C. Providing emotional support before obtaining vital signs
D. Arranging family visitation before securing IV access
Correct Answer: B
Rationale: Physiologic needs (oxygenation, circulation) take priority over safety,
belonging, and self-actualization needs according to Maslow's hierarchy.
Q10: A nurse practitioner is caring for a patient with acute kidney injury who
develops new-onset atrial fibrillation. The most appropriate initial action is to:
A. Start anticoagulation immediately
