Acute Care Nurse Practitioner Acute Care Nurse Practitioner MCQ 5

Question 1

A mechanically ventilated patient suddenly develops high peak airway pressures with stable plateau pressures. What is the most likely cause?

Accepted Answer

Mucus plugging or bronchospasm

Answer

A rise in peak pressure with normal plateau pressure indicates increased airway resistance, most commonly due to mucus plugging, bronchospasm, or ETT kinking — not decreased compliance.

Question 2

A patient is admitted with acute decompensated heart failure and a BNP of 1,800 pg/mL. Which intervention has the strongest evidence for improving dyspnea in the first 24 hours?

Accepted Answer

IV loop diuretics for decongestion

Answer

IV loop diuretics (furosemide) remain the cornerstone of acute decompensated heart failure treatment, rapidly reducing preload and relieving pulmonary congestion.

Question 3

A trauma patient arrives with BP 70/40, HR 130, and obvious penetrating abdominal injury. Which resuscitation strategy is most appropriate?

Accepted Answer

Permissive hypotension with 1:1:1 blood product ratio (PRBCs:FFP:platelets)

Answer

Damage control resuscitation using permissive hypotension (MAP 50 mmHg) and balanced blood product ratios (1:1:1) until surgical hemorrhage control is the standard of care in hemorrhagic shock.

Question 4

Which electrolyte abnormality is most associated with prolonged QT interval and risk of torsades de pointes in ICU patients?

Accepted Answer

Hypomagnesemia

Answer

Hypomagnesemia prolongs ventricular repolarization and QT interval, predisposing ICU patients to torsades de pointes, especially when combined with QT-prolonging medications.

Question 5

A patient with status epilepticus fails to respond after two doses of benzodiazepines. What is the next appropriate pharmacological intervention?

Accepted Answer

Levetiracetam, fosphenytoin, or valproate IV

Answer

Current guidelines recommend second-line agents — levetiracetam, fosphenytoin, or valproate — after benzodiazepine failure in status epilepticus; all three have similar efficacy per the ESETT trial.

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Practice Test

Acute Care Nurse Practitioner Acute Care Nurse Practitioner MCQ 5