Mixed Deck — All Acute Care Nurse Practitioner Topics Flashcards
100 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 20 Mixed Deck — All Acute Care Nurse Practitioner Topics flashcards as text
Which ventilator mode allows the patient to trigger breaths but guarantees a set tidal volume with each breath?
Answer: Assist-control volume control (AC-VC)
AC-VC delivers a set tidal volume with each breath (patient-triggered or machine-triggered), ensuring consistent volume delivery.
Which acid-base disturbance is an expected finding in a patient with permissive hypercapnia during ARDS management?
Answer: Respiratory acidosis with partial metabolic compensation
Permissive hypercapnia intentionally allows PaCO₂ to rise; the kidneys partially compensate with bicarbonate retention, producing respiratory acidosis.
Please indicate which of the following is not an illustration of a task that a nurse practitioner may delegate to a nursing assistant.
Answer: Assessing a patient's signs and symptoms
Assessing a patient's signs and symptoms requires clinical judgment, critical thinking, and a comprehensive understanding of pathophysiology, which are skills within the scope of a licensed nurse (NP or RN). Nursing assistants (NAs) are trained for basic care tasks and cannot perform assessments or provide initial patient education that demands professional nursing judgment. Therefore, assessing a patient's condition is not an appropriate task for delegation to an NA.
When interpreting a bronchoalveolar lavage (BAL) result showing >15% hemosiderin-laden macrophages, the ACNP should suspect:
Answer: Diffuse alveolar hemorrhage
Hemosiderin-laden macrophages in BAL indicate prior alveolar bleeding, consistent with diffuse alveolar hemorrhage.
Which parameter is used to decide between synchronized cardioversion and defibrillation?
Answer: Presence of organized QRS complexes
Synchronized cardioversion is used when organized QRS complexes are present (AF, flutter, SVT, VT with pulse); defibrillation is for VF/pulseless VT.
Which of the following statements regarding ACE inhibitors, the angiotensin-converting enzyme, is true?
Answer: The patient can make up for a skipped dose by taking one as soon as he/she remembers
For most medications, including ACE inhibitors, if a dose is missed, the general advice is to take it as soon as remembered, unless it's almost time for the next scheduled dose. Doubling the next dose is generally discouraged due to the risk of overdose and increased side effects. Patients on ACE inhibitors should also be cautious with activity levels due to potential orthostatic hypotension.
Which arrhythmia is the MOST common cause of sudden cardiac arrest in adults?
Answer: Ventricular fibrillation
Ventricular fibrillation is the most common initial arrhythmia in sudden cardiac arrest, requiring immediate defibrillation.
Which anticoagulation strategy is recommended for acute massive pulmonary embolism (PE) with hemodynamic instability?
Answer: Systemic thrombolysis with alteplase + unfractionated heparin
Systemic thrombolysis (alteplase 100 mg IV) plus unfractionated heparin is indicated for massive PE with hemodynamic instability.
In DKA management, insulin infusion should NOT be started until which lab value is corrected?
Answer: Potassium ≥3.5 mEq/L
Insulin drives potassium intracellularly; starting insulin with hypokalemia risks life-threatening arrhythmias from further potassium drop.
Which electrolyte abnormality is MOST commonly associated with seizures in critically ill patients?
Answer: Hyponatremia
Hyponatremia causes cerebral edema and lowers seizure threshold; acute, severe hyponatremia is a common reversible cause of seizures in the ICU.
Which echocardiographic finding indicates right ventricular strain in pulmonary embolism?
Answer: RV dilation with septal flattening (D-sign) and McConnell's sign
RV dilation, D-shaped septum (septal flattening), and McConnell's sign (RV free wall akinesis with preserved apex) indicate acute RV strain from PE.
Which intervention is MOST appropriate for acutely managing elevated ICP (>22 mmHg) in a TBI patient?
Answer: Elevate head of bed to 30° and administer hypertonic saline or mannitol
HOB 30° elevation and osmotic therapy (hypertonic saline or mannitol) are first-line interventions for elevated ICP management.
According to the Sepsis-3 consensus definition (2016), sepsis is best defined as:
Answer: Life-threatening organ dysfunction caused by a dysregulated host response to infection
Sepsis-3 (2016) redefined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, replacing the older SIRS-based criteria.
Which drugs are most likely to be prescribed to a patient who is having a hypertensive crisis?
Answer: IV Nitroprusside (Nitropress)
Both IV Nitroprusside (Nitropress) and IV Nitroglycerin are potent vasodilators commonly used in the acute management of hypertensive crises. Nitroprusside is a very rapid-acting agent often used for severe cases, while Nitroglycerin is also effective, particularly when there's associated myocardial ischemia or heart failure. Torsemide is a loop diuretic, which is not a primary agent for immediate reduction of blood pressure in a crisis.
Which electrolyte abnormality is most associated with prolonged QT interval and risk of torsades de pointes in ICU patients?
Answer: Hypomagnesemia
Hypomagnesemia prolongs ventricular repolarization and QT interval, predisposing ICU patients to torsades de pointes, especially when combined with QT-prolonging medications.
What is the target glucose range recommended by most critical care guidelines for ICU patients?
Answer: 140-180 mg/dL
Tight glycemic control (80-110) increased mortality per the NICE-SUGAR trial; current guidelines target 140-180 mg/dL to balance glycemic control and hypoglycemia risk.
A post-op cardiac surgery patient develops Beck's triad. Which condition does this suggest?
Answer: Cardiac tamponade
Beck's triad (hypotension, muffled heart sounds, JVD) is the classic presentation of cardiac tamponade from pericardial fluid compressing the heart.
A patient with acute decompensated HF refractory to diuretics has worsening dyspnea and oliguria. Which intervention should be considered next?
Answer: Initiate ultrafiltration or aquapheresis
Ultrafiltration (aquapheresis) mechanically removes excess fluid in diuretic-resistant heart failure, providing reliable decongestion.
The quick SOFA (qSOFA) score is a bedside screening tool for sepsis risk. Which three parameters comprise the qSOFA score?
Answer: Altered mental status, respiratory rate ≥ 22 breaths/min, systolic BP ≤ 100 mmHg
qSOFA uses three bedside variables: altered mentation, RR ≥22/min, and SBP ≤100 mmHg; a score ≥2 identifies patients at high risk for poor outcomes outside the ICU.
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.