ANCC Adult-Gerontology Acute Care Nursing 2

Question 1

A patient with ARDS is on mechanical ventilation. Which ventilator strategy reduces ventilator-induced lung injury?

Accepted Answer

Low tidal volume ventilation (6 mL/kg ideal body weight)

Answer

High tidal volumes to maximize oxygenation

Answer

High PEEP with unrestricted FiO2

Answer

Pressure-controlled ventilation with high inspiratory pressures

Question 2

When caring for a patient post-CABG, which finding requires immediate intervention?

Accepted Answer

Mediastinal chest tube output of 250 mL/hr for two consecutive hours

Answer

Serosanguinous drainage from chest tube totaling 50 mL in first hour

Answer

Urine output of 35 mL/hr

Answer

Temperature of 37.8 degrees C on postoperative day 1

Question 3

A patient with acute liver failure and hepatic encephalopathy needs management of cerebral edema. Which nursing intervention is the priority?

Accepted Answer

Elevate head of bed to 30 degrees and minimize stimulation

Answer

Administer lactulose and maintain head of bed flat

Answer

Encourage ambulation to reduce portal hypertension

Answer

Administer high-protein enteral nutrition to support liver regeneration

Question 4

According to the Surviving Sepsis Campaign, what is the recommended fluid resuscitation target within the first 3 hours of septic shock?

Accepted Answer

At least 30 mL/kg crystalloid

Answer

At least 20 mL/kg crystalloid

Answer

10 mL/kg colloid followed by reassessment

Answer

2 liters of normal saline regardless of weight

Question 5

Which intervention is most supported by evidence to prevent and treat ICU delirium?

Accepted Answer

Early mobilization, sleep protocol, and reorientation using the ABCDEF bundle

Answer

Routine physical restraints to prevent falls during confusion

Answer

Benzodiazepine administration to manage agitation

Answer

Continuous antipsychotic infusion as first-line treatment

Question 6

A patient with TBI has ICP of 28 mmHg and MAP of 85 mmHg. What is the CPP and is it within the recommended range?

Accepted Answer

CPP = 57 mmHg; below the recommended minimum of 60-70 mmHg

Answer

CPP = 57 mmHg; within acceptable range

Answer

CPP = 113 mmHg; dangerously high

Answer

CPP = 28 mmHg; critical ICP elevation only