Acute Care Nurse Practitioner Trivia 2

Question 1

Which lab value is the MOST sensitive early marker of acute kidney injury (AKI)?

Accepted Answer

Serum cystatin C

Answer

Cystatin C rises earlier than creatinine in AKI because it is freely filtered and not affected by muscle mass.

Question 2

A patient on mechanical ventilation has a plateau pressure of 34 cmH2O. What is the BEST next step?

Accepted Answer

Decrease tidal volume to 6 mL/kg IBW

Answer

Plateau pressures >30 cmH2O indicate over-distension; reducing tidal volume to 6 mL/kg IBW per ARDSNet protocol is the priority.

Question 3

Which rhythm is a contraindication to synchronized cardioversion?

Accepted Answer

Ventricular fibrillation

Answer

Ventricular fibrillation has no organized QRS complex to synchronize to, requiring unsynchronized defibrillation instead.

Question 4

What is the primary mechanism of injury in transfusion-related acute lung injury (TRALI)?

Accepted Answer

Donor antibodies activating recipient neutrophils

Answer

TRALI is most commonly caused by donor HLA or HNA antibodies that activate recipient neutrophils, leading to pulmonary capillary leak.

Question 5

A patient with septic shock receives adequate fluid resuscitation but MAP remains <65 mmHg. Which vasopressor is the FIRST-LINE agent?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor recommended by Surviving Sepsis Campaign guidelines for septic shock.

Acute Care Nurse Practitioner Practice Test