Acute Care Nurse Practitioner Cheat Sheet 2026

The 30 highest-yield Acute Care Nurse Practitioner facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which is the MOST common cause of hospital-acquired pneumonia in mechanically ventilated patients? → Pseudomonas aeruginosa
2. A patient with diabetic ketoacidosis has a serum potassium of 3.2 mEq/L on presentation. What is the appropriate initial management? → Hold insulin and replace potassium until K+ is above 3.5 mEq/L
3. Which of the following patients would most likely benefit from exposure therapy guided by the therapist? → A patient with a specific phobia
4. A patient in the ICU develops sudden onset hypotension, tachycardia, and distended neck veins after central line insertion. What is the most likely diagnosis? → Tension pneumothorax
5. The quick SOFA (qSOFA) score is a bedside screening tool for sepsis risk. Which three parameters comprise the qSOFA score? → Altered mental status, respiratory rate ≥ 22 breaths/min, systolic BP ≤ 100 mmHg
6. A 72-year-old post-operative patient develops fever, leukocytosis, and watery diarrhea 5 days after broad-spectrum antibiotics. What is the next best step? → Send stool for Clostridioides difficile toxin PCR
7. Which ventilator mode delivers a set tidal volume regardless of patient effort or airway resistance? → Volume control ventilation (VCV)
8. Please indicate which of the following is not an illustration of a task that a nurse practitioner may delegate to a nursing assistant. → Assessing a patient's signs and symptoms
9. Which formula correctly calculates systemic vascular resistance (SVR)? → (MAP - CVP) / CO × 80
10. Status epilepticus (SE) is defined as continuous seizure activity lasting longer than how many minutes? → 5 minutes
11. A patient in the ICU has a serum sodium of 118 mEq/L and is symptomatic with seizures. The ACNP should correct sodium at a rate no faster than: → 1-2 mEq/L per hour until seizures stop, then 6-8 mEq/L per day total
12. Which condition is MOST likely to cause a false elevation in serum creatinine without true reduction in GFR? → Trimethoprim use
13. Which urinalysis finding MOST suggests intrinsic renal AKI (acute tubular necrosis)? → Muddy brown granular casts
14. Rhabdomyolysis-induced AKI is BEST prevented by which intervention? → Aggressive IV fluid resuscitation with normal saline
15. A patient presents with acute MI and develops new holosystolic murmur with hemodynamic compromise 3 days post-infarction. What complication is most likely? → Ventricular septal rupture
16. Which intervention is indicated for a patient in third-degree (complete) AV block with a ventricular rate of 28 bpm and hypotension? → Administer atropine 0.5 mg IV and prepare for transvenous pacing
17. A patient with chronic liver disease presents with asterixis, confusion, and elevated ammonia. Which dietary intervention is most appropriate? → Adequate protein intake (1.2-1.5 g/kg/day) with branched-chain amino acids
18. A patient on warfarin for atrial fibrillation has an INR of 9.2 and active intracranial hemorrhage on CT. The ACNP should immediately administer: → 4-factor prothrombin complex concentrate (4F-PCC) plus vitamin K
19. A mechanically ventilated patient suddenly develops high peak airway pressures with stable plateau pressures. What is the most likely cause? → Mucus plugging or bronchospasm
20. A patient presents with confusion, hyponatremia (Na 118 mEq/L), and is found to have SIADH. What is the safest initial treatment? → Fluid restriction to 500-1000 mL/day
21. What tidal volume is recommended for lung-protective ventilation in ARDS per the ARDSNet protocol? → 6–8 mL/kg predicted body weight
22. Which of the following statements regarding ACE inhibitors, the angiotensin-converting enzyme, is true? → The patient can make up for a skipped dose by taking one as soon as he/she remembers
23. A patient with status epilepticus fails lorazepam and fosphenytoin. What is the NEXT step in management? → Initiate propofol or midazolam infusion for refractory status
24. A patient on vasopressors has digital ischemia developing in multiple extremities. Which intervention is MOST appropriate? → Wean vasopressors to the lowest effective dose and consider phentolamine
25. The Cerebral Spinal Fluid's (CSF) major purpose is to... → providing mechanical protection to the brain and the spinal cord.
26. The patient has diabetic ketoacidosis (DKA). Please specify the right course of action in this situation. → The patient receives an insulin dose
27. A patient with status epilepticus fails to respond after two doses of benzodiazepines. What is the next appropriate pharmacological intervention? → Levetiracetam, fosphenytoin, or valproate IV
28. A patient has a pulmonary artery catheter showing: CI 1.8 L/min/m², PCWP 8 mmHg, SVR 1800 dynes/sec/cm⁵. This pattern is most consistent with: → Hypovolemic shock
29. According to KDIGO criteria, which finding defines Stage 1 AKI? → Creatinine increase ≥0.3 mg/dL within 48 hours
30. Which finding on CT scan of the head indicates a subdural hematoma rather than an epidural hematoma? → Crescent-shaped hyperdense collection crossing suture lines