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

Low tidal volume ventilation (6 mL/kg ideal body weight) is the evidence-based lung-protective strategy for ARDS. The ARDSNet trial demonstrated significant mortality reduction compared to 12 mL/kg tidal volumes.

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

Chest tube output greater than 200 mL/hr for 2 consecutive hours post-CABG indicates excessive bleeding requiring immediate surgical re-exploration.

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

Elevating the head of bed to 30 degrees promotes venous drainage and reduces intracranial pressure. Minimizing stimulation reduces ICP spikes.

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

The Surviving Sepsis Campaign recommends at least 30 mL/kg intravenous crystalloid fluid within the first 3 hours of sepsis-induced hypoperfusion or septic shock.

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

The ABCDEF bundle (Assess, Both SAT/SBT, Choice of analgesia/sedation, Delirium assessment, Early mobility, Family engagement) is the evidence-based framework for preventing and treating ICU delirium.

ANCC - American Nurses Credentialing Center Practice Test

ANCC - American Nurses Credentialing Center Practice Test

ANCC Adult-Gerontology Acute Care Nursing 2