Finall Exam:l NRl 574/l NR574l (Latestl
2025/l 2026l Update)l Acutel Carel
Practicuml I
l Guide|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Chamberlain
Q:l EKGl changesl associatedl withl hyperkalemia
Answer:
Peaked/elevatedl Tl Waves,l widenedl ofl thel QRSl complex,l prolongedl PRI,l andl arrhythmias
Q:l Cushing'sl triad
Answer:
Signl ofl increasedl intracraniall pressure:l
•widenedl pulsel pressure
•bradycardia
•irregularl respirations:l Cheyne-Stokes
Q:l Riskl factorsl andl etiologiesl forl arteriall occlusivel mesentericl ischemia
Answer:
-embolil froml fragmentsl ofl proximall aorticl thrombus
-atheroscleroticl plaquel dislodgedl duringl surgeryl orl cardiacl catheterization
-leftl ventricularl dysfunctionl withl reducedl EF
-al fib
-Recentl MIl withl embolicl disease
-mitrall valvel disease
-endocarditis
Q:l Diagnosticl testingl forl mesentericl ischemia
Answer:
Labs:l CBCD,l CMP,l Coags,l lipase/amylase,l lactate,l cardiacl enzymes,l ABG
,Imaging:l CTl angiol ofl abdomenl isl goldl standardl imagingl forl dxl ofl AMIl andl preferredl
overl MRl angiol duel tol lowerl costl andl speed
*Orall contrastl shouldl bel avoidedl inl casesl ofl suspectedl AMI,l asl itl canl obscurel bowell
walll enhancementl andl mesentericl vessels
CTl abdl &l pelvisl w/l IV-l usuallyl usedl asl firstl imagingl tol evaluatel patientsl withl severel
acutel abdominall pain.l Mayl showl findingsl ofl al AMIl includingl SMVl orl SMAl
thrombosis,l portall venousl gas,l intestinall pneumatosis,l ischemial ofl otherl organs,l lackl ofl
bowell enhancement,l thickenedl bowell wall,l mesentericl fatl stranding,l orl
pneumoperitoneum.
Q:l Riskl factorsl forl intestinall obstruction
Answer:
-adhesionsl froml previousl abdl surgeries
-Internall orl externall hernias
-Foreignl bodies
-feces
-congenitall issuesl (atresia,l stenosis,l cystl formation,l intestinall duplication,l malrotation)
-traumal (hematomal formation)
-Inflammationl (IBD,l diverticulitis,l radiation,l TB)
-Volvulus
-ischemicl injury
-intussusception
-intraperitoneall abscess
-Endometriosis
-neoplasmsl (colon,l smalll bowel,l ovarian,l etc.)
Q:l Subjectivel findingsl inl intestinall obstruction
Answer:
-colickyl abdominall painl (crampy,l umbilicall painl initially;l laterl becomesl constantl andl
diffuse)
-Abdominall painl oftenl morel severel withl distantl obstruction
-vomitingl (morel significantl withl proximall obstruction)
-abdominall bloating
-obstipation
Q:l Objectivel findingsl inl acutel intestinall obstruction
Answer:
•l feverl (systemicl inflammationl orl strangulation)
,•l High-pitched,l tinklingl bowell soundsl (maybel hypol activel orl absentl withl completel
obstruction)
•l abdominall distentionl (morel significantl withl distall obstructionl duel tol greaterl volumel
ofl intraluminall fluidl accumulation)
•l Mildl abdominall tenderness,l butl nol peritoneall findings
•l tenderl abdominall orl groinl massesl (canl representl incarceratedl hernia)
•l signsl ofl shockl (tachycardia,l hypotension,l oliguria)
Q:l Significantl abdominall tendernessl withl palpationl shouldl increasel thel NPl suspicionl
for...
Answer:
1-l ischemia
2-l peritonitis
3-l necrosis
Q:l Differentialsl forl intestinall perforation
Answer:
-IBD
-Ovarianl torsion
-rupturedl ovarianl cyst
-rupturedl tubol -l ovarianl cyst
-PID
-pancreatitis
-appendicitis
-cholecystitis
-PUD
Q:l Differentialsl forl acutel intestinall obstruction
Answer:
-functionall bowell obstructionl (adynamicl ileus,l colonicl pseudo-obstruction)
-mesentericl ischemia
-perforatedl viscus
-peritonitis
Q:l Differentialsl forl acutel mesentericl ischemia
Answer:
-peritonitis
, -volvulus
-Aorticl dissection
-appendicitis
-rupturedl ectopicl pregnancy
-Intestinall perforationl orl perforatedl viscusl
-Intestinall obstruction
-Ovarianl torsion
Q:l Alll patientsl withl acutel liverl failurel shouldl receivel _________________l regardlessl
ofl etiologyl uponl admissionl asl itl hasl shownl tol improvel
____________________________.
Answer:
N-acetylcysteinel (NAC)
Transplant-freel recovery
Q:l Parklandl formula
Answer:
Methodl ofl calculatingl fluidl repletionl inl burnl patients
TBSAl xl weightl (kg)l xl 4l =l amtl fluidsl needed
1/2l givenl inl 1stl 8l hrs
1/2l givenl overl nextl 16l hrs
Q:l Whol doesl thel Parklandl formulal applyl to?
Answer:
-Patientsl withl burnsl encompassingl >l 20%l TBSA
-Burnl thatl arel 2nd-degreel orl higher
Q:l Indicationsl tol transferl al burnl patientl tol al certifiedl burnl center
Answer:
-Burnsl >20%l TBSA
-Burnsl tol face/head/neck
-Burnsl tol genitals
-circumferentiall extremityl orl chestl burns
-Full-thicknessl burnsl >5%
-burnsl overl joints
-Burnsl withl inhalationl injury
-electricall burns
2025/l 2026l Update)l Acutel Carel
Practicuml I
l Guide|l Questionsl &l Answers|l Gradel A|l
100%l Correctl (Verifiedl Solutions)-l
Chamberlain
Q:l EKGl changesl associatedl withl hyperkalemia
Answer:
Peaked/elevatedl Tl Waves,l widenedl ofl thel QRSl complex,l prolongedl PRI,l andl arrhythmias
Q:l Cushing'sl triad
Answer:
Signl ofl increasedl intracraniall pressure:l
•widenedl pulsel pressure
•bradycardia
•irregularl respirations:l Cheyne-Stokes
Q:l Riskl factorsl andl etiologiesl forl arteriall occlusivel mesentericl ischemia
Answer:
-embolil froml fragmentsl ofl proximall aorticl thrombus
-atheroscleroticl plaquel dislodgedl duringl surgeryl orl cardiacl catheterization
-leftl ventricularl dysfunctionl withl reducedl EF
-al fib
-Recentl MIl withl embolicl disease
-mitrall valvel disease
-endocarditis
Q:l Diagnosticl testingl forl mesentericl ischemia
Answer:
Labs:l CBCD,l CMP,l Coags,l lipase/amylase,l lactate,l cardiacl enzymes,l ABG
,Imaging:l CTl angiol ofl abdomenl isl goldl standardl imagingl forl dxl ofl AMIl andl preferredl
overl MRl angiol duel tol lowerl costl andl speed
*Orall contrastl shouldl bel avoidedl inl casesl ofl suspectedl AMI,l asl itl canl obscurel bowell
walll enhancementl andl mesentericl vessels
CTl abdl &l pelvisl w/l IV-l usuallyl usedl asl firstl imagingl tol evaluatel patientsl withl severel
acutel abdominall pain.l Mayl showl findingsl ofl al AMIl includingl SMVl orl SMAl
thrombosis,l portall venousl gas,l intestinall pneumatosis,l ischemial ofl otherl organs,l lackl ofl
bowell enhancement,l thickenedl bowell wall,l mesentericl fatl stranding,l orl
pneumoperitoneum.
Q:l Riskl factorsl forl intestinall obstruction
Answer:
-adhesionsl froml previousl abdl surgeries
-Internall orl externall hernias
-Foreignl bodies
-feces
-congenitall issuesl (atresia,l stenosis,l cystl formation,l intestinall duplication,l malrotation)
-traumal (hematomal formation)
-Inflammationl (IBD,l diverticulitis,l radiation,l TB)
-Volvulus
-ischemicl injury
-intussusception
-intraperitoneall abscess
-Endometriosis
-neoplasmsl (colon,l smalll bowel,l ovarian,l etc.)
Q:l Subjectivel findingsl inl intestinall obstruction
Answer:
-colickyl abdominall painl (crampy,l umbilicall painl initially;l laterl becomesl constantl andl
diffuse)
-Abdominall painl oftenl morel severel withl distantl obstruction
-vomitingl (morel significantl withl proximall obstruction)
-abdominall bloating
-obstipation
Q:l Objectivel findingsl inl acutel intestinall obstruction
Answer:
•l feverl (systemicl inflammationl orl strangulation)
,•l High-pitched,l tinklingl bowell soundsl (maybel hypol activel orl absentl withl completel
obstruction)
•l abdominall distentionl (morel significantl withl distall obstructionl duel tol greaterl volumel
ofl intraluminall fluidl accumulation)
•l Mildl abdominall tenderness,l butl nol peritoneall findings
•l tenderl abdominall orl groinl massesl (canl representl incarceratedl hernia)
•l signsl ofl shockl (tachycardia,l hypotension,l oliguria)
Q:l Significantl abdominall tendernessl withl palpationl shouldl increasel thel NPl suspicionl
for...
Answer:
1-l ischemia
2-l peritonitis
3-l necrosis
Q:l Differentialsl forl intestinall perforation
Answer:
-IBD
-Ovarianl torsion
-rupturedl ovarianl cyst
-rupturedl tubol -l ovarianl cyst
-PID
-pancreatitis
-appendicitis
-cholecystitis
-PUD
Q:l Differentialsl forl acutel intestinall obstruction
Answer:
-functionall bowell obstructionl (adynamicl ileus,l colonicl pseudo-obstruction)
-mesentericl ischemia
-perforatedl viscus
-peritonitis
Q:l Differentialsl forl acutel mesentericl ischemia
Answer:
-peritonitis
, -volvulus
-Aorticl dissection
-appendicitis
-rupturedl ectopicl pregnancy
-Intestinall perforationl orl perforatedl viscusl
-Intestinall obstruction
-Ovarianl torsion
Q:l Alll patientsl withl acutel liverl failurel shouldl receivel _________________l regardlessl
ofl etiologyl uponl admissionl asl itl hasl shownl tol improvel
____________________________.
Answer:
N-acetylcysteinel (NAC)
Transplant-freel recovery
Q:l Parklandl formula
Answer:
Methodl ofl calculatingl fluidl repletionl inl burnl patients
TBSAl xl weightl (kg)l xl 4l =l amtl fluidsl needed
1/2l givenl inl 1stl 8l hrs
1/2l givenl overl nextl 16l hrs
Q:l Whol doesl thel Parklandl formulal applyl to?
Answer:
-Patientsl withl burnsl encompassingl >l 20%l TBSA
-Burnl thatl arel 2nd-degreel orl higher
Q:l Indicationsl tol transferl al burnl patientl tol al certifiedl burnl center
Answer:
-Burnsl >20%l TBSA
-Burnsl tol face/head/neck
-Burnsl tol genitals
-circumferentiall extremityl orl chestl burns
-Full-thicknessl burnsl >5%
-burnsl overl joints
-Burnsl withl inhalationl injury
-electricall burns
