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Acute Care Nurse Practitioner (Adult-Gerontology) Practice Test

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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?
A. Decreased serum creatinine
B. Elevated serum potassium
C. Decreased urine output
D. Elevated serum creatinine
Answer: D
Explanation: An elevated serum creatinine level is a common indicator of acute rejection in transplant
patients, reflecting impaired renal function.
Question: 1028
A patient undergoing immunotherapy for melanoma presents with new-onset cough, fever, and dyspnea.
A CT scan reveals ground-glass opacities in the lungs. What should be the nurse practitioner�s primary
concern regarding this patient's condition?
A. Tumor progression
B. Electrolyte imbalance
C. Pneumonitis
D. Myocarditis
Answer: C
Explanation: Pneumonitis is a common side effect of immune checkpoint inhibitors and presents with
respiratory symptoms and characteristic imaging findings. Prompt recognition and management are
crucial to prevent severe complications.
Question: 1029
A 72-year-old man with diabetes and hypertension presents with sudden onset of right-sided weakness
and facial droop. CT scan shows a left-sided hemorrhagic stroke. What is the most likely etiology of his
stroke?
A. Hypertensive hemorrhage
B. Atrial fibrillation
C. Cerebral venous thrombosis
D. 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?
A. Coronary angiography
B. Cardiac MRI
C. Chest X-ray
D. Echocardiogram
Answer: A
Explanation: In a patient with new-onset chest pain and ECG changes suggestive of ischemia, coronary
angiography is warranted to evaluate for significant coronary artery disease as the underlying cause.
Question: 1031
A patient with a solid tumor is being treated with a new monoclonal antibody that targets specific tumor
antigens. Which of the following mechanisms of action is most characteristic of this treatment modality?
A. Induction of apoptosis through DNA damage
B. Enhancing immune response against tumor cells
C. Blocking angiogenesis by inhibiting VEGF
D. Direct cytotoxicity to rapidly dividing cells
Answer: B
Explanation: Monoclonal antibodies enhance the immune response against tumor cells by marking them
for destruction by immune effector cells.
Question: 1032
A nurse is monitoring a patient receiving chemotherapy who develops a blistering rash on the trunk and
extremities. Considering the patient�s medication history, which of the following conditions should be
suspected?
A. Stevens-Johnson Syndrome
B. Drug-induced hypersensitivity
C. Contact dermatitis
D. 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?
A. Achieving a urine output of 30 ml/hour
B. Normalizing blood glucose levels
C. Reducing heart rate to below 100 bpm
D. Increasing central venous pressure to over 10 mmHg
Answer: A
Explanation: A urine output of 30 ml/hour is a common target in fluid resuscitation to ensure adequate
organ perfusion and kidney function.
Question: 1034
A patient with COPD exacerbation is receiving oxygen therapy via a nasal cannula. Which of the
following findings would indicate adequate oxygenation and ventilation during treatment?
A. Patient tolerance of the oxygen device
B. Decreased respiratory effort
C. Peak flow rate within normal limits
D. Oxygen saturation (SpO2) greater than 92%
Answer: D
Explanation: An oxygen saturation greater than 92% indicates adequate oxygenation. Monitoring this is
essential in managing patients with COPD exacerbations.
Question: 1035
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?
A. Gallstones
B. Hyperlipidemia
C. Alcohol consumption
D. 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?
A. Highlighting the risks of not knowing one�s health status
B. Emphasizing the potential for early detection and treatment
C. Providing statistics on the low incidence of false positives
D. Reassuring the patient that most findings are benign
Answer: B
Explanation: Emphasizing early detection and treatment can help alleviate fears and motivate patients to
participate in necessary screenings.
Question: 1037
A patient with a exact viral infection presents with chest pain and is diagnosed with myocarditis. Which
of the following treatments is contraindicated?
A. Antivirals
B. Corticosteroids
C. Beta-blockers
D. Diuretics
Answer: B
Explanation: Corticosteroids are contraindicated in viral myocarditis as they can worsen the condition and
do not have proven benefit.
Question: 1038
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?
A. SIADH
B. Heart failure exacerbation
C. Diabetes insipidus
D. 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?
A. A 50-year-old with well-controlled hypertension
B. A 30-year-old with a history of asthma
C. A 65-year-old with type 2 diabetes and a GFR of 50 mL/min
D. A 40-year-old healthy individual with no comorbidities
Answer: C
Explanation: Patients with diabetes and reduced renal function (GFR < 60 mL/min) are at significantly
higher risk for CAN due to their compromised renal perfusion and function, making them susceptible to
nephrotoxic effects of contrast agents.
Question: 1040
A nurse is caring for a patient with a deep venous thrombosis who has developed a painful, swollen leg
with a red, warm area at the site. Which of the following complications should the nurse be most vigilant
about?
A. Septicemia
B. Pulmonary embolism
C. Lymphedema
D. Chronic venous insufficiency
Answer: B
Explanation: Pulmonary embolism is a serious complication of deep venous thrombosis, where a clot
dislodges and travels to the lungs, potentially leading to severe respiratory distress or death.
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?
A. Left ventricular hypertrophy
B. Asymptomatic status with normal exercise tolerance
C. Moderate mitral regurgitation
D. Severe systolic dysfunction with an ejection fraction <50%
Answer: D
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?
A. Fine inspiratory crackles
B. Dullness to percussion
C. Wheezing
D. Stridor
Answer: A
Explanation: Fine inspiratory crackles are characteristic of interstitial lung disease and indicate the
presence of abnormal lung parenchyma.
Question: 1043
A 68-year-old woman with a history of chronic headache and dizziness undergoes a brain MRI that
shows a mass in the posterior fossa. Which of the following conditions is most likely indicated by this
finding?
A. Acoustic neuroma
B. Meningioma
C. Metastatic tumor
D. Cerebellar infarct
Answer: A
Explanation: An acoustic neuroma, a benign tumor on the vestibulocochlear nerve, is commonly located
in the posterior fossa and can present with headaches and dizziness.
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?
A. Warm and dry skin
B. Normal heart sounds
C. Decreased pulmonary capillary wedge pressure
D. Jugular venous distension
Answer: D
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?
A. Administer antiemetics preemptively
B. Use prophylactic anticoagulation
C. Increase oral fluid intake
D. Monitor complete blood counts frequently
Answer: D
Explanation: Frequent monitoring of complete blood counts is crucial for early detection and
management of myelosuppression during chemotherapy.
Question: 1046
Which of the following statements regarding hepatitis B virus (HBV) infection is true, particularly in the
context of acute liver failure?
A. Co-infection with hepatitis D virus worsens the prognosis of HBV.
B. Acute liver failure is common in chronic HBV infection.
C. Acute HBV infection is usually asymptomatic.
D. Presence of HBsAg indicates cleared infection.
Answer: A
Explanation: Co-infection with hepatitis D virus can lead to more severe liver disease and worsen the
prognosis in patients with HBV.
Question: 1047
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?
A. Cerebral vasospasm
B. Hydrocephalus
C. All of the above
D. Seizures
Answer: C
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?
A. Aortic rupture
B. Pulmonary embolism
C. Intra-abdominal abscess
D. Renal failure
Answer: C
Explanation: Fever and leukocytosis post-operatively raise suspicion for an intra-abdominal abscess, a
potential complication of surgical repair.
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