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ACNPC-AG
AACN Acute Care Nurse Practitioner (Adult-Gerontology)
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Question: 1027
A patient who has undergone a renal transplant is presenting with signs of acute rejection. Which of the following laboratory findings would be most indicative of a rejection episode?
1. Decreased serum creatinine
2. Elevated serum potassium
3. Decreased urine output
nation: An elevated serum creatinine level is a common indicator of acute rejection in transpl s, reflecting impaired renal function.
ion: 1028
ent undergoing immunotherapy for melanoma presents with new-onset cough, fever, and dys can reveals ground-glass opacities in the lungs. What should be the nurse practitioner�s pri
concern regarding this patient's condition?
mor progression ctrolyte imbalance umonitis
ocarditis er: C
nation: Pneumonitis is a common side effect of immune checkpoint inhibitors and presents w tory symptoms and characteristic imaging findings. Prompt recognition and management are to prevent severe complications.
ion: 1029
year-old man with diabetes and hypertension presents with sudden onset of right-sided weak cial droop. CT scan shows a left-sided hemorrhagic stroke. What is the most likely etiology
Elevated serum creatinine Answer: D
Expla ant
patient
Quest
A pati pnea.
A CT s mary
1. Tu
2. Ele
3. Pne
4. My
Answ
Expla ith
respira crucial
Quest
A 72- ness
and fa of his
stroke?
1. Hypertensive hemorrhage
2. Atrial fibrillation
3. Cerebral venous thrombosis
4. Ruptured aneurysm Answer: A
Explanation: Hypertensive hemorrhage is a common cause of intracerebral hemorrhage in patients with
long-standing hypertension, particularly in older individuals.
Question: 1030
A 65-year-old man with chronic heart failure presents with new-onset chest pain and dyspnea. His ECG shows ST segment depression. What is the most appropriate diagnostic test to further evaluate his condition?
1. Coronary angiography
2. Cardiac MRI
hocardiogram er: A
nation: In a patient with new-onset chest pain and ECG changes suggestive of ischemia, coro raphy is warranted to evaluate for significant coronary artery disease as the underlying caus
ion: 1031
ent with a solid tumor is being treated with a new monoclonal antibody that targets specific ns. Which of the following mechanisms of action is most characteristic of this treatment mo
uction of apoptosis through DNA damage hancing immune response against tumor cells cking angiogenesis by inhibiting VEGF
ect cytotoxicity to rapidly dividing cells er: B
nation: Monoclonal antibodies enhance the immune response against tumor cells by marking struction by immune effector cells.
ion: 1032
nurse is monitoring a patient receiving chemotherapy who develops a blistering rash on the trun
Chest X-ray
3. Ec
Answ
Expla nary
angiog e.
Quest
A pati tumor
antige dality?
1. Ind
2. En
3. Blo
4. Dir Answ
Expla them
for de
Quest
A k and
extremities. Considering the patient�s medication history, which of the following conditions should be suspected?
1. Stevens-Johnson Syndrome
2. Drug-induced hypersensitivity
3. Contact dermatitis
4. Psoriasis Answer: A
Explanation: The presentation of blistering rash in the context of chemotherapy suggests Stevens-Johnson Syndrome, particularly if there are mucosal surface involvements. Drug-induced hypersensitivity can cause similar rashes but is less specific.
Question: 1033
In managing a patient with distributive shock due to septicemia, which of the following is a key goal of fluid resuscitation?
1. Achieving a urine output of 30 ml/hour
ducing heart rate to below 100 bpm
reasing central venous pressure to over 10 mmHg er: A
nation: A urine output of 30 ml/hour is a common target in fluid resuscitation to ensure adeq erfusion and kidney function.
ion: 1034
ent with COPD exacerbation is receiving oxygen therapy via a nasal cannula. Which of the ing findings would indicate adequate oxygenation and ventilation during treatment?
ient tolerance of the oxygen device creased respiratory effort
Peak flow rate within normal limits
ygen saturation (SpO2) greater than 92% er: D
nation: An oxygen saturation greater than 92% indicates adequate oxygenation. Monitoring t al in managing patients with COPD exacerbations.
ion: 1035
Normalizing blood glucose levels
2. Re
3. Inc Answ
Expla uate
organ p
Quest
A pati follow
1. Pat
2. De C.
D. Ox
Answ
Expla his is
essenti
Quest
A 50-year-old man with a history of chronic alcohol use presents with acute abdominal pain and vomiting. His serum lipase is markedly elevated. Which of the following is the most likely underlying cause of his acute pancreatitis?
1. Gallstones
2. Hyperlipidemia
3. Alcohol consumption
4. Medication-induced Answer: C
Explanation: In this case, the patient's chronic alcohol use is the most likely cause of his acute pancreatitis, especially when presenting with elevated lipase levels.
Question: 1036
During a health fair, a nurse practitioner encounters a patient hesitant to participate in preventive screenings due to fear of potential findings. Which approach could best facilitate a productive conversation about the importance of screening?
phasizing the potential for early detection and treatment viding statistics on the low incidence of false positives assuring the patient that most findings are benign
er: B
nation: Emphasizing early detection and treatment can help alleviate fears and motivate patie pate in necessary screenings.
ion: 1037
ent with a accurate viral infection presents with chest pain and is diagnosed with myocarditis. ollowing treatments is contraindicated?
tivirals ticosteroids a-blockers uretics
er: B
nation: Corticosteroids are contraindicated in viral myocarditis as they can worsen the conditi have proven benefit.
ion: 1038
Highlighting the risks of not knowing one�s health status
Em
Pro
Re
Answ
Expla nts to
partici
Quest
A pati Which
of the f
1. An
2. Cor
3. Bet
4. Di
Answ
Expla on and
do not
Quest
A 65-year-old male with a history of congestive heart failure presents with edema, hyponatremia, and concentrated urine. What condition does this presentation most likely indicate?
1. SIADH
2. Heart failure exacerbation
3. Diabetes insipidus
4. Cushing's syndrome Answer: A
Explanation: The presence of edema, hyponatremia, and concentrated urine suggests SIADH, where excess water retention leads to dilutional hyponatremia.
Question: 1039
Which of the following patients is at the highest risk for developing contrast-associated nephropathy (CAN) after receiving intravenous contrast for imaging studies?
1. A 50-year-old with well-controlled hypertension
5-year-old with type 2 diabetes and a GFR of 50 mL/min 0-year-old healthy individual with no comorbidities
er: C
nation: Patients with diabetes and reduced renal function (GFR < 60 mL/min) are at significa risk for CAN due to their compromised renal perfusion and function, making them suscepti otoxic effects of contrast agents.
ion: 1040
nurse is caring for a patient with a deep venous thrombosis who has developed a painful, swolle red, warm area at the site. Which of the following complications should the nurse be most v
pticemia
monary embolism mphedema
ronic venous insufficiency er: B
nation: Pulmonary embolism is a serious complication of deep venous thrombosis, where a cl ges and travels to the lungs, potentially leading to severe respiratory distress or death.
A 30-year-old with a history of asthma
2. A 6
3. A 4
Answ
Expla ntly
higher ble to
nephr
Quest
A n leg
with a igilant
about?
1. Se
2. Pul
3. Ly
4. Ch
Answ
Expla ot
dislod
Question: 1041
A patient with severe aortic stenosis is being considered for surgical intervention. Which of the following findings on echocardiogram would indicate the need for urgent surgical management?
1. Left ventricular hypertrophy
2. Asymptomatic status with normal exercise tolerance
3. Moderate mitral regurgitation
4. Severe systolic dysfunction with an ejection fraction <50%
Explanation: Severe systolic dysfunction with reduced ejection fraction (<50%) is a critical indication for surgical intervention in aortic stenosis, regardless of symptoms.
Question: 1042
A patient with interstitial lung disease presents with progressive dyspnea on exertion and a dry cough. Which of the following findings on physical examination would be most consistent with this diagnosis?
lness to percussion eezing
dor er: A
nation: Fine inspiratory crackles are characteristic of interstitial lung disease and indicate the ce of abnormal lung parenchyma.
ion: 1043
year-old woman with a history of chronic headache and dizziness undergoes a brain MRI tha a mass in the posterior fossa. Which of the following conditions is most likely indicated by g?
oustic neuroma ningioma tastatic tumor ebellar infarct
er: A
nation: An acoustic neuroma, a benign tumor on the vestibulocochlear nerve, is commonly lo osterior fossa and can present with headaches and dizziness.
Fine inspiratory crackles
Dul
Wh
Stri Answ
Expla presen
Quest
A 68- t
shows this
findin
1. Ac
2. Me
3. Me
4. Cer Answ
Expla cated
in the p
Question: 1044
A patient with a history of heart failure presents with acute cardiogenic shock. Which of the following findings would most likely be present on physical examination?
1. Warm and dry skin
2. Normal heart sounds
3. Decreased pulmonary capillary wedge pressure
4. Jugular venous distension
Explanation: Jugular venous distension is indicative of fluid overload and right-sided heart failure commonly seen in cardiogenic shock.
Question: 1045
In a patient with a solid tumor undergoing chemotherapy, what is the most appropriate strategy to manage potential medication-induced myelosuppression?
prophylactic anticoagulation rease oral fluid intake
nitor complete blood counts frequently er: D
nation: Frequent monitoring of complete blood counts is crucial for early detection and ement of myelosuppression during chemotherapy.
ion: 1046
of the following statements regarding hepatitis B virus (HBV) infection is true, particularly of acute liver failure?
infection with hepatitis D virus worsens the prognosis of HBV. ute liver failure is common in chronic HBV infection.
ute HBV infection is usually asymptomatic. sence of HBsAg indicates cleared infection.
er: A
nation: Co-infection with hepatitis D virus can lead to more severe liver disease and worsen osis in patients with HBV.
ion: 1047
Administer antiemetics preemptively
Use
Inc
Mo
Answ Expla
manag
Quest
Which in the
context
1. Co-
2. Ac
3. Ac
4. Pre Answ
Expla the
progn
Quest
An 80-year-old woman with a history of hypertension and diabetes presents with a sudden onset of severe headache, confusion, and left-sided weakness. A CT scan reveals a subarachnoid hemorrhage. Which of the following complications should be monitored closely in this patient?
1. Cerebral vasospasm
2. Hydrocephalus
3. All of the above
4. Seizures
Explanation: Patients with subarachnoid hemorrhage are at risk for multiple complications, including cerebral vasospasm, hydrocephalus due to blood obstructing CSF flow, and seizures.
Question: 1048
A patient post-abdominal aortic aneurysm repair develops a fever and leukocytosis. Which of the following complications should be most immediately considered?
monary embolism
-abdominal abscess nal failure
er: C
nation: Fever and leukocytosis post-operatively raise suspicion for an intra-abdominal absces ial complication of surgical repair.
Aortic rupture
Pul
Intra
Re
Answ
Expla s, a
potent

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