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 admitted for septic shock is on norepinephrine 0.3 mcg/kg/min and vasopressin 0.03 units/min. Despite adequate fluid resuscitation (CVP 12, ScvO2 68%), MAP remains 58 mmHg. The next pharmacological intervention should be:
Answer: Add low-dose corticosteroids (hydrocortisone 200 mg/day)
Refractory septic shock despite two vasopressors warrants evaluation for relative adrenal insufficiency and empiric corticosteroid therapy per Surviving Sepsis guidelines.
A patient with a known history of heparin-induced thrombocytopenia (HIT) requires anticoagulation for a new DVT. The preferred agent is:
Answer: Argatroban
Argatroban is a direct thrombin inhibitor that does not cross-react with HIT antibodies and is the preferred anticoagulant for patients with confirmed HIT.
A patient with acute liver failure has an INR of 4.2. The ACNP orders fresh frozen plasma (FFP) before a central line placement. What is the primary concern with this approach?
Answer: FFP does not reliably correct the bleeding risk in acute liver failure and exposes the patient to volume overload
INR in liver failure reflects both pro- and anti-coagulant factor deficits and does not accurately predict bleeding risk; FFP provides marginal, transient correction with volume and transfusion risks.
Which intervention has been shown to reduce 90-day mortality in patients with moderate-to-severe ARDS?
Answer: Prone positioning for ≥16 hours per day
The PROSEVA trial demonstrated a 28% absolute reduction in 90-day mortality with prone positioning for ≥16 hours/day in moderate-to-severe ARDS.
A patient on warfarin for atrial fibrillation has an INR of 9.2 and active intracranial hemorrhage on CT. The ACNP should immediately administer:
Answer: 4-factor prothrombin complex concentrate (4F-PCC) plus vitamin K
4F-PCC provides rapid, complete INR reversal for life-threatening warfarin-associated bleeding; vitamin K is added for sustained reversal.
A 72-year-old post-cardiac surgery patient develops atrial fibrillation with rapid ventricular response (HR 145) and hemodynamic instability (BP 80/50 mmHg). The immediate treatment is:
Answer: Synchronized cardioversion
Hemodynamically unstable atrial fibrillation requires immediate synchronized cardioversion per ACLS guidelines.
A patient with acute pancreatitis has worsening respiratory status. CT shows bilateral infiltrates and a PaO2/FiO2 ratio of 180 mmHg. This is consistent with:
Answer: Moderate ARDS per Berlin criteria
The Berlin definition classifies ARDS as moderate when PaO2/FiO2 is 100-200 mmHg with bilateral opacities on imaging.