1
Chamberlain NR574 NR 574 Actual Exam
Questions and Answers with Rationales
2026/2027 | Acute Care Practicum I Final Exam |
ACNP Clinical Competency | Pass Guarantee
J
Q001: A 68-year-old intubated patient in the MICU develops sudden hypotension
(BP 70/40 mmHg) and a new wide-complex tachycardia at 160 bpm. The ventilator
alarms show falling EtCO₂. Which immediate intervention is most appropriate?
Options:
A. Administer amiodarone 150 mg IV push
B. Perform synchronized electrical cardioversion at 200 J
C. Give adenosine 6 mg rapid IV push
D. Order stat electrolytes and wait for results
ANSWER: B
Q002: A 55-year-old with acute pancreatitis has a Ca²⁺ of 6.8 mg/dL and perioral
numbness. Which is the correct initial ACNP action?
Options:
A. Start oral calcium carbonate 1 g TID
B. Give calcium gluconate 1 g IV over 10 min while on cardiac monitor
C. Order calcitriol 0.25 mcg PO daily
D. Administer magnesium sulfate 2 g IV first
ANSWER: B
Q003: A 72-year-old septic patient on norepinephrine has a ScvO₂ of 55 % and
Hgb 7.2 g/dL. Which intervention is most appropriate?
Options:
, 2
A. Increase norepinephrine to achieve MAP > 80 mmHg
B. Transfuse 1 unit PRBC and reassess
C. Start dobutamine 5 mcg/kg/min
D. Administer 1 L crystalloid bolus
ANSWER: B
Q004: A 40-year-old with acute asthma on BiPAP has PaCO₂ rising from 45 to 65
mmHg over 2 h. Which is the next best step?
Options:
A. Increase IPAP by 3 cmH₂O
B. Intubate and initiate mechanical ventilation
C. Give magnesium sulfate 2 g IV
D. Add heliox to BiPAP circuit
ANSWER: B
Q005: A 60-year-old post-PCI patient on ticagrelor develops epistaxis and Hgb
drop from 12 to 8 g/dL. BP 90/60 mmHg. Which is the priority action?
Options:
A. Hold ticagrelor and transfuse 2 units PRBC
B. Apply nasal packing and continue ticagrelor
C. Give protamine sulfate 10 mg IV
D. Start DDAVP 0.3 mcg/kg IV
ANSWER: A
Q006: A 50-year-old with acute PE on heparin has aPTT 95 sec (goal 46–70) and
no bleeding. What should the ACNP do?
Options:
A. Stop heparin and switch to argatroban
, 3
B. Decrease heparin rate by 50 % and recheck in 6 h
C. Continue current rate and recheck in 4 h
D. Give protamine sulfate 10 mg IV
ANSWER: B
Q007: A 35-year-old with DKA has K⁺ 2.9 mEq/L on admission. Before starting
insulin, which action is required?
Options:
A. Begin insulin 0.1 units/kg/h immediately
B. Give KCl 20 mEq IV over 1 h
C. Administer sodium bicarbonate 1 amp
D. Start 0.45 % saline at 250 mL/h
ANSWER: B
Q008: A 28-year-old post-tonsillectomy patient is drooling and has respiratory
distress. SpO₂ 88 % on room air. Which is the immediate priority?
Options:
A. Obtain lateral neck X-ray
B. Perform rapid-sequence intubation
C. Give dexamethasone 10 mg IV
D. Apply high-flow nasal cannula at 60 L/min
ANSWER: B
Q009: A 70-year-old with acute COPD exacerbation on HFNC has PaCO₂ 85
mmHg and pH 7.18 after 2 h. What is the next step?
Options:
A. Increase FiO₂ to 100 %
B. Intubate and initiate mechanical ventilation
Chamberlain NR574 NR 574 Actual Exam
Questions and Answers with Rationales
2026/2027 | Acute Care Practicum I Final Exam |
ACNP Clinical Competency | Pass Guarantee
J
Q001: A 68-year-old intubated patient in the MICU develops sudden hypotension
(BP 70/40 mmHg) and a new wide-complex tachycardia at 160 bpm. The ventilator
alarms show falling EtCO₂. Which immediate intervention is most appropriate?
Options:
A. Administer amiodarone 150 mg IV push
B. Perform synchronized electrical cardioversion at 200 J
C. Give adenosine 6 mg rapid IV push
D. Order stat electrolytes and wait for results
ANSWER: B
Q002: A 55-year-old with acute pancreatitis has a Ca²⁺ of 6.8 mg/dL and perioral
numbness. Which is the correct initial ACNP action?
Options:
A. Start oral calcium carbonate 1 g TID
B. Give calcium gluconate 1 g IV over 10 min while on cardiac monitor
C. Order calcitriol 0.25 mcg PO daily
D. Administer magnesium sulfate 2 g IV first
ANSWER: B
Q003: A 72-year-old septic patient on norepinephrine has a ScvO₂ of 55 % and
Hgb 7.2 g/dL. Which intervention is most appropriate?
Options:
, 2
A. Increase norepinephrine to achieve MAP > 80 mmHg
B. Transfuse 1 unit PRBC and reassess
C. Start dobutamine 5 mcg/kg/min
D. Administer 1 L crystalloid bolus
ANSWER: B
Q004: A 40-year-old with acute asthma on BiPAP has PaCO₂ rising from 45 to 65
mmHg over 2 h. Which is the next best step?
Options:
A. Increase IPAP by 3 cmH₂O
B. Intubate and initiate mechanical ventilation
C. Give magnesium sulfate 2 g IV
D. Add heliox to BiPAP circuit
ANSWER: B
Q005: A 60-year-old post-PCI patient on ticagrelor develops epistaxis and Hgb
drop from 12 to 8 g/dL. BP 90/60 mmHg. Which is the priority action?
Options:
A. Hold ticagrelor and transfuse 2 units PRBC
B. Apply nasal packing and continue ticagrelor
C. Give protamine sulfate 10 mg IV
D. Start DDAVP 0.3 mcg/kg IV
ANSWER: A
Q006: A 50-year-old with acute PE on heparin has aPTT 95 sec (goal 46–70) and
no bleeding. What should the ACNP do?
Options:
A. Stop heparin and switch to argatroban
, 3
B. Decrease heparin rate by 50 % and recheck in 6 h
C. Continue current rate and recheck in 4 h
D. Give protamine sulfate 10 mg IV
ANSWER: B
Q007: A 35-year-old with DKA has K⁺ 2.9 mEq/L on admission. Before starting
insulin, which action is required?
Options:
A. Begin insulin 0.1 units/kg/h immediately
B. Give KCl 20 mEq IV over 1 h
C. Administer sodium bicarbonate 1 amp
D. Start 0.45 % saline at 250 mL/h
ANSWER: B
Q008: A 28-year-old post-tonsillectomy patient is drooling and has respiratory
distress. SpO₂ 88 % on room air. Which is the immediate priority?
Options:
A. Obtain lateral neck X-ray
B. Perform rapid-sequence intubation
C. Give dexamethasone 10 mg IV
D. Apply high-flow nasal cannula at 60 L/min
ANSWER: B
Q009: A 70-year-old with acute COPD exacerbation on HFNC has PaCO₂ 85
mmHg and pH 7.18 after 2 h. What is the next step?
Options:
A. Increase FiO₂ to 100 %
B. Intubate and initiate mechanical ventilation
