Acute Care Nurse Practitioner Acute Care Nurse Practitioner MCQ 2

Question 1

A patient in the ICU develops sudden onset hypotension, tachycardia, and distended neck veins after central line insertion. What is the most likely diagnosis?

Accepted Answer

Tension pneumothorax

Answer

Tension pneumothorax after central line insertion presents with hypotension, tachycardia, distended neck veins, and tracheal deviation away from the affected side.

Question 2

Which ventilator setting should be prioritized when managing a patient with ARDS to reduce ventilator-induced lung injury?

Accepted Answer

Low tidal volume (6 mL/kg IBW) with permissive hypercapnia

Answer

Lung-protective ventilation using low tidal volumes of 6 mL/kg ideal body weight reduces ventilator-induced lung injury in ARDS.

Question 3

A patient presents with confusion, hyponatremia (Na 118 mEq/L), and is found to have SIADH. What is the safest initial treatment?

Accepted Answer

Fluid restriction to 500-1000 mL/day

Answer

Fluid restriction is the first-line treatment for SIADH; sodium correction should not exceed 8-10 mEq/L per 24 hours to prevent osmotic demyelination.

Question 4

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?

Accepted Answer

Send stool for Clostridioides difficile toxin PCR

Answer

C. difficile infection is the most likely diagnosis following antibiotic use, and stool PCR for C. difficile toxin is the appropriate diagnostic test.

Question 5

Which finding best differentiates cardiogenic shock from distributive (septic) shock?

Accepted Answer

Elevated pulmonary capillary wedge pressure (PCWP) with low cardiac output

Answer

Cardiogenic shock is characterized by elevated PCWP (≥18 mmHg) and low cardiac output, distinguishing it from septic shock which typically shows low SVR and high CO.

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Acute Care Nurse Practitioner MCQ 2