NURSING · OBJECTIVE ASSESSMENT
A+ VERIFIED
Final Exam: NR 574 Acute Care Practicum I
Guide — Complete
Official Exam
50 Questions Full Rationales Verified Answers
50 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Advanced Health Assessment & Diagnostic Reasoning
02 Management of Acute & Chronic Conditions
03 Pharmacologic & Non-Pharmacologic Interventions
04 Interprofessional Collaboration & Care Coordination
05 Ethical, Legal & Professional Issues in Acute Care
ABOUT THIS ASSESSMENT
Build mastery in acute care practicum — from advanced health assessment and diagnostic reasoning to management of acute and
chronic conditions, pharmacologic and non-pharmacologic interventions, interprofessional collaboration, and ethical, legal, and
professional issues. This original study bank targets application and analysis skills for NR 574 Acute Care Practicum I, with full
rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Graduate) Application / Analysis
STUVIA ACTUAL EXAM Page 1
,SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING
Q1. A 72-year-old client is admitted with progressive dyspnea and orthopnea. On examination the AGACNP
notes elevated jugular venous pressure, an S3 gallop, and bilateral crackles. Chest radiograph shows
pulmonary vascular congestion. The most appropriate next diagnostic step to differentiate heart-failure
phenotypes is:
A. Immediate coronary angiography without non-invasive imaging.
B. Transthoracic echocardiography to assess ejection fraction, wall motion, and valvular function.
C. Pulmonary function testing as the sole diagnostic study.
D. Observation without further imaging because the diagnosis is already clear.
Correct Answer: B
Rationale:
Echocardiography is the cornerstone for classifying heart failure (HFrEF vs HFpEF), evaluating valves, and guiding therapy. Angiography is
reserved for suspected acute coronary syndromes; PFTs do not differentiate HF phenotypes.
Q2. A postoperative client develops sudden-onset hypoxia, tachycardia, and unilateral diminished breath
sounds. Tracheal deviation is noted away from the affected side. The AGACNP recognizes the physical findings
and prioritizes which confirmatory action?
A. Administer nebulized bronchodilators as the first intervention.
B. Encourage incentive spirometry and observe for two hours.
C. Immediate bedside ultrasound or chest radiograph while preparing for possible needle decompression or chest-tube insertion.
D. Order a complete metabolic panel before any imaging.
Correct Answer: C
Rationale:
Tracheal deviation away from the silent hemithorax suggests tension pneumothorax. Rapid imaging (or clinical diagnosis in extremis) and
preparation for decompression are required; delay for routine labs is unsafe.
Q3. An older adult presents with acute confusion, fever, and right-lower-lobe crackles. The AGACNP must
distinguish delirium from dementia while evaluating for pneumonia. The most useful bedside approach is:
A. Rely solely on the Mini-Mental State Examination without assessing attention.
B. Sedate the client before any cognitive assessment.
C. Apply a validated delirium instrument (e.g., CAM-ICU) and obtain collateral history regarding baseline cognition and acuity of
change.
D. Assume chronic dementia and defer infectious work-up.
Correct Answer: C
Rationale:
Delirium is characterized by acute onset and inattention; CAM-ICU and collateral history reliably identify it. Dementia is chronic and does not
preclude concurrent infection evaluation.
STUVIA ACTUAL EXAM · Page 2
, SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING
Q4. A client with cirrhosis develops new ascites and abdominal pain. The AGACNP performs diagnostic
paracentesis. Which ascitic-fluid result most strongly supports spontaneous bacterial peritonitis?
A. Amylase level three times the serum value.
B. Absolute neutrophil count ≥250 cells/µL with a positive culture or clinical suspicion.
C. Serum-ascites albumin gradient <1.1 g/dL alone.
D. Triglyceride level >200 mg/dL.
Correct Answer: B
Rationale:
SBP is diagnosed by an ascitic fluid neutrophil count ≥250 cells/µL. SAAG indicates portal hypertension; triglycerides suggest chylous
ascites; amylase suggests pancreatic source.
Q5. A client with known coronary disease reports crescendo angina at rest. The 12-lead ECG shows new 2-mm
ST depression in leads V4–V6. Troponin is mildly elevated. The AGACNP classifies the presentation and selects
the initial risk-stratification pathway.
A. Demand ischemia from anemia that needs no anti-ischemic therapy.
B. Pericarditis requiring only NSAIDs.
C. Non–ST-elevation acute coronary syndrome; initiate dual antiplatelet therapy, anticoagulation, and early invasive strategy based
on risk score.
D. Stable angina manageable with outpatient stress testing only.
Correct Answer: C
Rationale:
Rest angina with dynamic ST depression and troponin rise defines NSTE-ACS. Guideline-directed medical therapy and timely angiography
are indicated.
Q6. A septic client has a lactate of 4.8 mmol/L after initial fluid resuscitation. Mean arterial pressure remains 58
mm Hg. The AGACNP interprets the lactate trend and next management priority as:
A. Normal perfusion; no further hemodynamic support is needed.
B. Indication for immediate corticosteroids without source control.
C. Persistent hypoperfusion; continue volume repletion if fluid-responsive and initiate vasopressors to restore MAP ≥65 mm Hg
while treating the source.
D. Isolated laboratory error; repeat lactate only after 24 hours.
Correct Answer: C
Rationale:
Elevated lactate after resuscitation signals ongoing hypoperfusion. Sepsis bundles emphasize source control, fluids, and vasopressors to
achieve MAP targets.
STUVIA ACTUAL EXAM · Page 3
A+ VERIFIED
Final Exam: NR 574 Acute Care Practicum I
Guide — Complete
Official Exam
50 Questions Full Rationales Verified Answers
50 5 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Advanced Health Assessment & Diagnostic Reasoning
02 Management of Acute & Chronic Conditions
03 Pharmacologic & Non-Pharmacologic Interventions
04 Interprofessional Collaboration & Care Coordination
05 Ethical, Legal & Professional Issues in Acute Care
ABOUT THIS ASSESSMENT
Build mastery in acute care practicum — from advanced health assessment and diagnostic reasoning to management of acute and
chronic conditions, pharmacologic and non-pharmacologic interventions, interprofessional collaboration, and ethical, legal, and
professional issues. This original study bank targets application and analysis skills for NR 574 Acute Care Practicum I, with full
rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
80% Advanced (Graduate) Application / Analysis
STUVIA ACTUAL EXAM Page 1
,SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING
Q1. A 72-year-old client is admitted with progressive dyspnea and orthopnea. On examination the AGACNP
notes elevated jugular venous pressure, an S3 gallop, and bilateral crackles. Chest radiograph shows
pulmonary vascular congestion. The most appropriate next diagnostic step to differentiate heart-failure
phenotypes is:
A. Immediate coronary angiography without non-invasive imaging.
B. Transthoracic echocardiography to assess ejection fraction, wall motion, and valvular function.
C. Pulmonary function testing as the sole diagnostic study.
D. Observation without further imaging because the diagnosis is already clear.
Correct Answer: B
Rationale:
Echocardiography is the cornerstone for classifying heart failure (HFrEF vs HFpEF), evaluating valves, and guiding therapy. Angiography is
reserved for suspected acute coronary syndromes; PFTs do not differentiate HF phenotypes.
Q2. A postoperative client develops sudden-onset hypoxia, tachycardia, and unilateral diminished breath
sounds. Tracheal deviation is noted away from the affected side. The AGACNP recognizes the physical findings
and prioritizes which confirmatory action?
A. Administer nebulized bronchodilators as the first intervention.
B. Encourage incentive spirometry and observe for two hours.
C. Immediate bedside ultrasound or chest radiograph while preparing for possible needle decompression or chest-tube insertion.
D. Order a complete metabolic panel before any imaging.
Correct Answer: C
Rationale:
Tracheal deviation away from the silent hemithorax suggests tension pneumothorax. Rapid imaging (or clinical diagnosis in extremis) and
preparation for decompression are required; delay for routine labs is unsafe.
Q3. An older adult presents with acute confusion, fever, and right-lower-lobe crackles. The AGACNP must
distinguish delirium from dementia while evaluating for pneumonia. The most useful bedside approach is:
A. Rely solely on the Mini-Mental State Examination without assessing attention.
B. Sedate the client before any cognitive assessment.
C. Apply a validated delirium instrument (e.g., CAM-ICU) and obtain collateral history regarding baseline cognition and acuity of
change.
D. Assume chronic dementia and defer infectious work-up.
Correct Answer: C
Rationale:
Delirium is characterized by acute onset and inattention; CAM-ICU and collateral history reliably identify it. Dementia is chronic and does not
preclude concurrent infection evaluation.
STUVIA ACTUAL EXAM · Page 2
, SECTION 1: ADVANCED HEALTH ASSESSMENT & DIAGNOSTIC REASONING
Q4. A client with cirrhosis develops new ascites and abdominal pain. The AGACNP performs diagnostic
paracentesis. Which ascitic-fluid result most strongly supports spontaneous bacterial peritonitis?
A. Amylase level three times the serum value.
B. Absolute neutrophil count ≥250 cells/µL with a positive culture or clinical suspicion.
C. Serum-ascites albumin gradient <1.1 g/dL alone.
D. Triglyceride level >200 mg/dL.
Correct Answer: B
Rationale:
SBP is diagnosed by an ascitic fluid neutrophil count ≥250 cells/µL. SAAG indicates portal hypertension; triglycerides suggest chylous
ascites; amylase suggests pancreatic source.
Q5. A client with known coronary disease reports crescendo angina at rest. The 12-lead ECG shows new 2-mm
ST depression in leads V4–V6. Troponin is mildly elevated. The AGACNP classifies the presentation and selects
the initial risk-stratification pathway.
A. Demand ischemia from anemia that needs no anti-ischemic therapy.
B. Pericarditis requiring only NSAIDs.
C. Non–ST-elevation acute coronary syndrome; initiate dual antiplatelet therapy, anticoagulation, and early invasive strategy based
on risk score.
D. Stable angina manageable with outpatient stress testing only.
Correct Answer: C
Rationale:
Rest angina with dynamic ST depression and troponin rise defines NSTE-ACS. Guideline-directed medical therapy and timely angiography
are indicated.
Q6. A septic client has a lactate of 4.8 mmol/L after initial fluid resuscitation. Mean arterial pressure remains 58
mm Hg. The AGACNP interprets the lactate trend and next management priority as:
A. Normal perfusion; no further hemodynamic support is needed.
B. Indication for immediate corticosteroids without source control.
C. Persistent hypoperfusion; continue volume repletion if fluid-responsive and initiate vasopressors to restore MAP ≥65 mm Hg
while treating the source.
D. Isolated laboratory error; repeat lactate only after 24 hours.
Correct Answer: C
Rationale:
Elevated lactate after resuscitation signals ongoing hypoperfusion. Sepsis bundles emphasize source control, fluids, and vasopressors to
achieve MAP targets.
STUVIA ACTUAL EXAM · Page 3
