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 critically ill patient is receiving propofol infusion for sedation at 70 mcg/kg/min for 48 hours. The nurse reports increasing lactic acidosis, new ECG changes, and lipemic plasma. The ACNP should suspect:
Answer: Propofol infusion syndrome
Propofol infusion syndrome (PRIS) presents with metabolic acidosis, rhabdomyolysis, cardiac dysfunction, and lipemia, especially with doses >4 mg/kg/hr for >48 hours.
A patient with severe traumatic brain injury has a Glasgow Coma Scale of 7 and ICP of 28 mmHg. After elevating the head of bed to 30° and ensuring normocapnia, the next intervention is:
Answer: Administer 23.4% hypertonic saline or mannitol
Hyperosmolar therapy with hypertonic saline or mannitol is the next step to reduce ICP after basic positioning and ventilation optimization.
Which glucose target is recommended by current evidence for critically ill adult patients in the ICU?
Answer: 140-180 mg/dL
The NICE-SUGAR trial showed that tight glycemic control (80-110) increased mortality; current guidelines target 140-180 mg/dL in most ICU patients.
A patient with end-stage renal disease on hemodialysis develops acute chest pain and shortness of breath. ECG shows diffuse ST elevation in all leads with PR depression. The ACNP's initial management should include:
Answer: NSAIDs and colchicine for pericarditis, with urgent dialysis to remove fluid
Diffuse ST elevation with PR depression in a dialysis patient indicates uremic pericarditis; NSAIDs, colchicine, and urgent dialysis are first-line treatment.
A 45-year-old woman is admitted with thyroid storm (Burch-Wartofsky score 65). Which medication must be given BEFORE radioactive iodine or inorganic iodide?
Answer: Propylthiouracil (PTU) or methimazole
Thionamides (PTU or methimazole) must be given before iodine to block new thyroid hormone synthesis and prevent iodine from being used as substrate.
A patient has a pulmonary artery catheter showing: CI 1.8 L/min/m², PCWP 8 mmHg, SVR 1800 dynes/sec/cm⁵. This pattern is most consistent with:
Answer: Hypovolemic shock
Hypovolemic shock presents with low cardiac index, low PCWP (low filling pressures), and elevated SVR as compensatory vasoconstriction occurs.
The ACNP is performing a capacity assessment for a patient who refuses a below-knee amputation for wet gangrene. Which element is NOT required for decision-making capacity?
Answer: Agreement with the recommended treatment plan
Capacity does not require agreement with the medical team; a competent patient has the right to refuse treatment as long as they understand and can reason about their decision.