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 with diabetic ketoacidosis has a serum potassium of 3.2 mEq/L on presentation. What is the appropriate initial management?
Answer: Hold insulin and replace potassium until K+ is above 3.5 mEq/L
Insulin should be withheld until serum potassium is ≥3.5 mEq/L, as insulin drives potassium intracellularly and can cause life-threatening hypokalemia.
Which criterion is NOT part of the SOFA score used to define organ dysfunction in sepsis?
Answer: Serum albumin
The SOFA score assesses six organ systems using PaO2/FiO2, GCS, creatinine, bilirubin, MAP/vasopressors, and platelets — albumin is not included.
A patient with acute respiratory failure is being transitioned from assist-control ventilation to a spontaneous breathing trial. Which parameter is most predictive of successful extubation?
Answer: Rapid Shallow Breathing Index (RSBI) less than 105
An RSBI (respiratory rate/tidal volume in liters) of less than 105 breaths/min/L is the most validated predictor of successful extubation.
A 65-year-old patient develops oliguria, elevated creatinine, and muddy brown casts on urinalysis 48 hours after a CT with contrast. What best describes this condition?
Answer: Contrast-induced nephropathy (acute tubular necrosis)
Contrast-induced nephropathy presents as acute tubular necrosis 24-72 hours after contrast exposure, evidenced by muddy brown granular casts and rising creatinine.
An ICU patient on continuous renal replacement therapy (CRRT) develops bleeding from IV sites and has prolonged PT/PTT. What is the most likely cause related to CRRT?
Answer: Citrate accumulation causing hypocalcemia and coagulopathy
In citrate-anticoagulated CRRT, citrate accumulation (citrate lock syndrome) causes systemic hypocalcemia that impairs coagulation and can lead to bleeding.
Which finding on a 12-lead ECG is most specific for right ventricular strain in the setting of acute pulmonary embolism?
Answer: T-wave inversions in V1-V4
T-wave inversions in the right precordial leads (V1-V4) are the most common and specific ECG finding of RV strain due to massive pulmonary embolism.
A patient with severe pancreatitis has a Ranson's criteria score of 5 on admission. What does this predict?
Answer: High mortality risk requiring ICU-level care
A Ranson's score ≥3 indicates severe pancreatitis; a score of 5 is associated with approximately 40% mortality risk and necessitates ICU-level monitoring.