NR574 Midterm Exam Acute Care Practicum
Review | Week 1-4 | Chamberlain | 2026/2027
Updated | 300+ Questions & Verified Answers |
100% Correct
Foundations of Acute Care Management & Clinical Reasoning | Focus: Assessment,
Diagnostics, & Initial Management of Common Acute Conditions
Chamberlain University | NR 574 AGACNP Practicum | Weeks 1-4 Cumulative Review
PART 1 – WEEKS 1-4 ACUTE CARE FOUNDATIONS SYNTHESIS (2026-2027)
I. Advanced Assessment & Diagnostics in Acute Care
• Triage HPI: OPQRST-AAA (Onset, Provocation, Quality, Region, Severity, Timing,
Associated sx, Alleviating/Aggravating, pt Attribution).
• Focused cardiac exam: JVP, PMI, S3/S4, new murmur, MR gallop.
• Lung exam: bronchial vs vesicular, asymmetric expansion, fremitus, egophony.
• EKG rapid screen (2026 AHA): rate → rhythm → axis → intervals → STEMI/NSTEMI
signs.
• CXR 2026 interpretation system: ABCDE—A (Airway), B (Bones), C (Cardiac), D
(Diaphragm), E (Everything else).
, • ABG quick acid-base: pH 7.35–7.45; PaCO₂ 35–45; HCO₃ 22–26; expected PaCO₂ =
(1.5 × HCO₃) + 8 ± 2 for metabolic acidosis.
II. Hemodynamic Principles
• MAP = DBP + 1/3 (SBP – DBP); keep ≥ 65 mmHg in shock.
• Preload ↑: hypervolemia, ↑ venous tone; ↓: hemorrhage, venodilators.
• Afterload ↑: HTN, vasopressors; ↓: sepsis, ACEI, spinal shock.
• Swan numbers 2026: PCWP 8–12 mmHg, CI 2.5–4 L/min/m², SVR 800–1200
dyn·s·cm⁻⁵.
III. ACS & Acute Heart Failure
• STEMI: ST ↑ ≥ 1 mm in ≥ 2 contiguous leads or new LBBB with concordant STE;
door-to-device ≤ 90 min (2026 AHA).
• NSTEMI: ↑ troponin; TIMI score guides urgency; ESC 0/1h rule-out/rule-in with hs-cTn.
• Initial meds: ASA 325 chewed, P2Y12 load (ticagrelor 180 mg), heparin 70 U/kg bolus,
± morphine if chest pain refractory.
• ADHF 2026 ESC: SBP > 100 → IV diuretic (furosemide 1–2× home dose); SBP < 90 →
inotrope (dobutamine) ± vasopressor.
IV. Pulmonary Emergencies
• COPD exacerbation 2026 GOLD: give SABA + SAMA, PO steroids 40 mg × 5 d,
antibiotics if ≥ 2 Anthonisen criteria.
• Status asthmaticus: MDI + spacer equivalent to neb; IV Mg 2 g if FEV₁ < 40%; NIV if pH
7.25–7.30.
Review | Week 1-4 | Chamberlain | 2026/2027
Updated | 300+ Questions & Verified Answers |
100% Correct
Foundations of Acute Care Management & Clinical Reasoning | Focus: Assessment,
Diagnostics, & Initial Management of Common Acute Conditions
Chamberlain University | NR 574 AGACNP Practicum | Weeks 1-4 Cumulative Review
PART 1 – WEEKS 1-4 ACUTE CARE FOUNDATIONS SYNTHESIS (2026-2027)
I. Advanced Assessment & Diagnostics in Acute Care
• Triage HPI: OPQRST-AAA (Onset, Provocation, Quality, Region, Severity, Timing,
Associated sx, Alleviating/Aggravating, pt Attribution).
• Focused cardiac exam: JVP, PMI, S3/S4, new murmur, MR gallop.
• Lung exam: bronchial vs vesicular, asymmetric expansion, fremitus, egophony.
• EKG rapid screen (2026 AHA): rate → rhythm → axis → intervals → STEMI/NSTEMI
signs.
• CXR 2026 interpretation system: ABCDE—A (Airway), B (Bones), C (Cardiac), D
(Diaphragm), E (Everything else).
, • ABG quick acid-base: pH 7.35–7.45; PaCO₂ 35–45; HCO₃ 22–26; expected PaCO₂ =
(1.5 × HCO₃) + 8 ± 2 for metabolic acidosis.
II. Hemodynamic Principles
• MAP = DBP + 1/3 (SBP – DBP); keep ≥ 65 mmHg in shock.
• Preload ↑: hypervolemia, ↑ venous tone; ↓: hemorrhage, venodilators.
• Afterload ↑: HTN, vasopressors; ↓: sepsis, ACEI, spinal shock.
• Swan numbers 2026: PCWP 8–12 mmHg, CI 2.5–4 L/min/m², SVR 800–1200
dyn·s·cm⁻⁵.
III. ACS & Acute Heart Failure
• STEMI: ST ↑ ≥ 1 mm in ≥ 2 contiguous leads or new LBBB with concordant STE;
door-to-device ≤ 90 min (2026 AHA).
• NSTEMI: ↑ troponin; TIMI score guides urgency; ESC 0/1h rule-out/rule-in with hs-cTn.
• Initial meds: ASA 325 chewed, P2Y12 load (ticagrelor 180 mg), heparin 70 U/kg bolus,
± morphine if chest pain refractory.
• ADHF 2026 ESC: SBP > 100 → IV diuretic (furosemide 1–2× home dose); SBP < 90 →
inotrope (dobutamine) ± vasopressor.
IV. Pulmonary Emergencies
• COPD exacerbation 2026 GOLD: give SABA + SAMA, PO steroids 40 mg × 5 d,
antibiotics if ≥ 2 Anthonisen criteria.
• Status asthmaticus: MDI + spacer equivalent to neb; IV Mg 2 g if FEV₁ < 40%; NIV if pH
7.25–7.30.
