NR 571 Complex Diagnosis & Management
in Acute Care Midterm Exam Review |
Chamberlain College | Latest 2024–2025
Update | Questions and Verified Answers |
100% Correct | Grade A
This midterm exam for NR571 Complex Diagnosis & Management in Acute Care at Chamberlain
University contains 50 multiple-choice questions, reflecting the standard structure of the
2024/2025 exam. Questions cover complex acute care scenarios, differential diagnosis,
evidence-based management, and advanced practice nursing interventions for critically ill
patients, aligned with Advanced Practice Nursing in Acute Care (2nd Edition, Klein) and AACN
Essentials of Progressive Care Nursing (5th Edition, Burns). Each question includes the full
question text, four options (A, B, C, D), the correct answer, and a short rationale.
Question 1
A 65-year-old male with a history of COPD presents to the ED with acute shortness of breath,
respiratory rate of 32/min, and SpO2 88% on room air. What is the most appropriate initial
intervention?
A) Administer nebulized albuterol and ipratropium
B) Start high-flow oxygen at 100%
C) Order a chest X-ray immediately
D) Administer IV antibiotics
Correct Answer: A
Rationale : Nebulized bronchodilators (albuterol and ipratropium) are first-line for acute COPD
exacerbation to relieve bronchospasm (Klein, 2nd Ed., Ch. 8). Option B is incorrect because
high-flow oxygen can cause CO2 retention in COPD. Option C is incorrect because imaging is
secondary. Option D is incorrect because antibiotics require infection evidence (Burns, 5th Ed.,
Ch. 12).
Question 2
A 50-year-old female post-appendectomy develops fever, tachycardia, and hypotension on
,postoperative day 2. What is the most likely diagnosis?
A) Pulmonary embolism
B) Wound infection
C) Urinary tract infection
D) Myocardial infarction
Correct Answer: B
Rationale : Fever, tachycardia, and hypotension post-appendectomy suggest surgical site
infection (Klein, 2nd Ed., Ch. 10). Option A is incorrect because PE typically presents with
dyspnea. Option C is incorrect because UTI lacks systemic signs. Option D is incorrect
because MI involves chest pain (Burns, 5th Ed., Ch. 15).
Question 3
A 70-year-old male with atrial fibrillation presents with sudden weakness in the right arm and
slurred speech. What is the priority intervention?
A) Administer tPA if within 4.5 hours
B) Order head CT
C) Start heparin infusion
D) Perform lumbar puncture
Correct Answer: A
Rationale : Acute stroke symptoms with atrial fibrillation suggest ischemic stroke; tPA is priority if
within time window (Klein, 2nd Ed., Ch. 5). Option B is incorrect because CT confirms bleed but
delays tPA. Option C is incorrect because heparin is secondary. Option D is incorrect because
LP is for hemorrhage (Burns, 5th Ed., Ch. 3).
Question 4
A 45-year-old male in the ICU has a central line and develops fever. What is the first step?
A) Administer broad-spectrum antibiotics
B) Remove the central line
C) Order blood cultures
D) Increase fluids
Correct Answer: C
Rationale : Blood cultures are first to identify the source of fever in line-associated infection
(Klein, 2nd Ed., Ch. 11). Option A is incorrect because antibiotics require culture results. Option
B is incorrect because removal follows confirmation. Option D is incorrect because fluids are for
shock (Burns, 5th Ed., Ch. 16).
, Question 5
A 60-year-old female with sepsis has lactate of 4 mmol/L and hypotension despite fluids. What is
the next intervention?
A) Continue fluid bolus
B) Start norepinephrine
C) Order echocardiography
D) Administer hydrocortisone
Correct Answer: B
Rationale : Norepinephrine is first-line vasopressor for septic shock with persistent hypotension
(Klein, 2nd Ed., Ch. 13). Option A is incorrect because fluids are inadequate. Option C is
incorrect because echo is diagnostic. Option D is incorrect because hydrocortisone is adjunctive
(Burns, 5th Ed., Ch. 20).
Question 6
A 55-year-old male post-MI has ventricular tachycardia. What is the immediate treatment?
A) Amiodarone infusion
B) Synchronized cardioversion
C) Lidocaine bolus
D) Beta-blocker
Correct Answer: B
Rationale : Synchronized cardioversion is immediate for stable VT post-MI (Klein, 2nd Ed., Ch.
6). Option A is incorrect because amiodarone is for refractory VT. Option C is incorrect because
lidocaine is second-line. Option D is incorrect because beta-blockers are preventive (Burns, 5th
Ed., Ch. 4).
Question 7
A 75-year-old female with pneumonia has confusion and urinary incontinence. What is the most
likely complication?
A) Sepsis
B) Acute kidney injury
C) Delirium
D) Heart failure
Correct Answer: C
Rationale : Confusion and incontinence in elderly pneumonia patients suggest delirium (Klein,
2nd Ed., Ch. 9). Option A is incorrect because sepsis lacks incontinence. Option B is incorrect
because AKI causes oliguria. Option D is incorrect because heart failure causes dyspnea
(Burns, 5th Ed., Ch. 11).
in Acute Care Midterm Exam Review |
Chamberlain College | Latest 2024–2025
Update | Questions and Verified Answers |
100% Correct | Grade A
This midterm exam for NR571 Complex Diagnosis & Management in Acute Care at Chamberlain
University contains 50 multiple-choice questions, reflecting the standard structure of the
2024/2025 exam. Questions cover complex acute care scenarios, differential diagnosis,
evidence-based management, and advanced practice nursing interventions for critically ill
patients, aligned with Advanced Practice Nursing in Acute Care (2nd Edition, Klein) and AACN
Essentials of Progressive Care Nursing (5th Edition, Burns). Each question includes the full
question text, four options (A, B, C, D), the correct answer, and a short rationale.
Question 1
A 65-year-old male with a history of COPD presents to the ED with acute shortness of breath,
respiratory rate of 32/min, and SpO2 88% on room air. What is the most appropriate initial
intervention?
A) Administer nebulized albuterol and ipratropium
B) Start high-flow oxygen at 100%
C) Order a chest X-ray immediately
D) Administer IV antibiotics
Correct Answer: A
Rationale : Nebulized bronchodilators (albuterol and ipratropium) are first-line for acute COPD
exacerbation to relieve bronchospasm (Klein, 2nd Ed., Ch. 8). Option B is incorrect because
high-flow oxygen can cause CO2 retention in COPD. Option C is incorrect because imaging is
secondary. Option D is incorrect because antibiotics require infection evidence (Burns, 5th Ed.,
Ch. 12).
Question 2
A 50-year-old female post-appendectomy develops fever, tachycardia, and hypotension on
,postoperative day 2. What is the most likely diagnosis?
A) Pulmonary embolism
B) Wound infection
C) Urinary tract infection
D) Myocardial infarction
Correct Answer: B
Rationale : Fever, tachycardia, and hypotension post-appendectomy suggest surgical site
infection (Klein, 2nd Ed., Ch. 10). Option A is incorrect because PE typically presents with
dyspnea. Option C is incorrect because UTI lacks systemic signs. Option D is incorrect
because MI involves chest pain (Burns, 5th Ed., Ch. 15).
Question 3
A 70-year-old male with atrial fibrillation presents with sudden weakness in the right arm and
slurred speech. What is the priority intervention?
A) Administer tPA if within 4.5 hours
B) Order head CT
C) Start heparin infusion
D) Perform lumbar puncture
Correct Answer: A
Rationale : Acute stroke symptoms with atrial fibrillation suggest ischemic stroke; tPA is priority if
within time window (Klein, 2nd Ed., Ch. 5). Option B is incorrect because CT confirms bleed but
delays tPA. Option C is incorrect because heparin is secondary. Option D is incorrect because
LP is for hemorrhage (Burns, 5th Ed., Ch. 3).
Question 4
A 45-year-old male in the ICU has a central line and develops fever. What is the first step?
A) Administer broad-spectrum antibiotics
B) Remove the central line
C) Order blood cultures
D) Increase fluids
Correct Answer: C
Rationale : Blood cultures are first to identify the source of fever in line-associated infection
(Klein, 2nd Ed., Ch. 11). Option A is incorrect because antibiotics require culture results. Option
B is incorrect because removal follows confirmation. Option D is incorrect because fluids are for
shock (Burns, 5th Ed., Ch. 16).
, Question 5
A 60-year-old female with sepsis has lactate of 4 mmol/L and hypotension despite fluids. What is
the next intervention?
A) Continue fluid bolus
B) Start norepinephrine
C) Order echocardiography
D) Administer hydrocortisone
Correct Answer: B
Rationale : Norepinephrine is first-line vasopressor for septic shock with persistent hypotension
(Klein, 2nd Ed., Ch. 13). Option A is incorrect because fluids are inadequate. Option C is
incorrect because echo is diagnostic. Option D is incorrect because hydrocortisone is adjunctive
(Burns, 5th Ed., Ch. 20).
Question 6
A 55-year-old male post-MI has ventricular tachycardia. What is the immediate treatment?
A) Amiodarone infusion
B) Synchronized cardioversion
C) Lidocaine bolus
D) Beta-blocker
Correct Answer: B
Rationale : Synchronized cardioversion is immediate for stable VT post-MI (Klein, 2nd Ed., Ch.
6). Option A is incorrect because amiodarone is for refractory VT. Option C is incorrect because
lidocaine is second-line. Option D is incorrect because beta-blockers are preventive (Burns, 5th
Ed., Ch. 4).
Question 7
A 75-year-old female with pneumonia has confusion and urinary incontinence. What is the most
likely complication?
A) Sepsis
B) Acute kidney injury
C) Delirium
D) Heart failure
Correct Answer: C
Rationale : Confusion and incontinence in elderly pneumonia patients suggest delirium (Klein,
2nd Ed., Ch. 9). Option A is incorrect because sepsis lacks incontinence. Option B is incorrect
because AKI causes oliguria. Option D is incorrect because heart failure causes dyspnea
(Burns, 5th Ed., Ch. 11).
