Acute Care Nurse Practitioner MCQ 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 MCQ flashcards as text
A patient presents with acute MI and develops new holosystolic murmur with hemodynamic compromise 3 days post-infarction. What complication is most likely?
Answer: Ventricular septal rupture
Ventricular septal rupture typically occurs 3-5 days after MI (especially inferior MI), presenting with a new harsh holosystolic murmur and rapid hemodynamic deterioration.
Which parameter most accurately reflects tissue oxygen delivery and is used to guide resuscitation in septic shock?
Answer: Serum lactate clearance
Serum lactate clearance of ≥10% over 2 hours is a validated endpoint for resuscitation in septic shock, reflecting improved tissue oxygenation.
A patient with known COPD is intubated and placed on mechanical ventilation. ABG shows pH 7.22, PaCO2 88, PaO2 78. What adjustment addresses auto-PEEP?
Answer: Decrease respiratory rate and increase expiratory time
In COPD patients, auto-PEEP results from air trapping; decreasing the respiratory rate and prolonging expiratory time allows complete exhalation and reduces dynamic hyperinflation.
A post-cardiac surgery patient has a MAP of 55 mmHg, CVP of 18 mmHg, and mixed venous O2 saturation of 45%. Which diagnosis is most consistent?
Answer: Cardiogenic shock
Cardiogenic shock presents with low MAP, elevated CVP (high filling pressure), and low mixed venous O2 saturation due to increased oxygen extraction from poor cardiac output.
Which intervention is most effective in preventing stress ulcers in mechanically ventilated ICU patients?
Answer: Early enteral nutrition
Early enteral nutrition is the most effective intervention for stress ulcer prophylaxis as it maintains mucosal integrity and reduces gastric pH through physiological mechanisms.
A patient on vasopressors develops cold, mottled extremities with a rising creatinine. Which medication should be considered to improve renal perfusion?
Answer: Low-dose vasopressin as an adjunct
Low-dose vasopressin (0.03-0.04 units/min) as an adjunct to norepinephrine may reduce catecholamine requirements and has favorable renal effects in vasodilatory shock.
A patient develops sudden dyspnea, pleuritic chest pain, and right heart strain on ECG after prolonged immobilization. D-dimer is elevated. What is the next diagnostic step?
Answer: CT pulmonary angiography (CTPA)
CT pulmonary angiography is the gold standard diagnostic test for pulmonary embolism when clinical suspicion is high and renal function allows contrast use.