Acute Care Nurse Practitioner Flashcards
7 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Acute Care Nurse Practitioner flashcards as text
A patient in the ICU has a serum sodium of 118 mEq/L and is symptomatic with seizures. The ACNP should correct sodium at a rate no faster than:
Answer: 1-2 mEq/L per hour until seizures stop, then 6-8 mEq/L per day total
Rapid correction beyond 10-12 mEq/L in 24 hours risks osmotic demyelination syndrome, even when initial correction for seizures is done faster.
Which finding is most consistent with hepatorenal syndrome type 1?
Answer: Serum creatinine doubling to >2.5 mg/dL within 2 weeks in a patient with cirrhosis
Hepatorenal syndrome type 1 is defined by a rapid doubling of creatinine to >2.5 mg/dL within 2 weeks in a patient with end-stage liver disease.
A patient with suspected pulmonary embolism has a Wells score of 6 and a positive D-dimer. The most appropriate next step is:
Answer: CT pulmonary angiography (CTPA)
A high pre-test probability score with elevated D-dimer warrants definitive imaging with CTPA to confirm PE before or concurrent with anticoagulation decisions.
The ACNP orders continuous renal replacement therapy (CRRT) for a critically ill patient. Which electrolyte requires close monitoring and frequent supplementation during CRRT?
Answer: Phosphorus
Phosphorus is significantly cleared by CRRT filters and requires frequent monitoring and replacement to prevent hypophosphatemia.
A mechanically ventilated patient's peak airway pressure suddenly increases from 25 to 45 cmH2O, but plateau pressure remains unchanged. The most likely cause is:
Answer: Endotracheal tube obstruction or bronchospasm
Increased peak pressure with unchanged plateau pressure indicates increased airway resistance (not compliance), pointing to ETT secretion plugging or bronchospasm.
A patient with ST-elevation MI undergoes primary PCI and is now on dual antiplatelet therapy. On day 2, the patient develops melena and hemoglobin drops from 12 to 9 g/dL. The ACNP should:
Answer: Consult cardiology before discontinuing any antiplatelet agent and proceed with endoscopy
The risk of stent thrombosis if antiplatelet therapy is discontinued in the early post-PCI period is high, so cardiology must be involved before altering therapy.
Which finding on a 12-lead ECG is most specific for right ventricular strain in massive pulmonary embolism?
Answer: S1Q3T3 pattern
The S1Q3T3 pattern (S wave in lead I, Q wave and inverted T wave in lead III) is the classic ECG finding of acute right heart strain from PE.