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Adult-Gerontology Acute Care Nurse Practitioner Flashcards

7 cards from real NP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Adult-Gerontology Acute Care Nurse Practitioner flashcards as text

  1. A 72-year-old patient on mechanical ventilation develops sudden hypotension, tachycardia, and decreased breath sounds on the left. What is the most likely diagnosis?

    Answer: Tension pneumothorax

    Tension pneumothorax presents with hypotension, tachycardia, tracheal deviation, and absent breath sounds on the affected side — a life-threatening emergency requiring immediate needle decompression.

  2. Which vasopressor is first-line for distributive shock in septic patients when mean arterial pressure (MAP) cannot be maintained above 65 mmHg with fluids?

    Answer: Norepinephrine

    Norepinephrine is the first-line vasopressor for septic shock per Surviving Sepsis Campaign guidelines due to its potent alpha-adrenergic activity and minimal chronotropic effects.

  3. An 80-year-old post-surgical patient develops acute confusion, agitation, and visual hallucinations on hospital day 2. Which intervention is most appropriate?

    Answer: Perform RASS and CAM-ICU assessment, then address modifiable causes

    Delirium management begins with systematic assessment using validated tools (CAM-ICU) and addressing reversible causes like pain, sleep disruption, and medications before pharmacological intervention.

  4. A 68-year-old with COPD exacerbation has a pH of 7.26, PaCO2 of 68 mmHg, and PaO2 of 52 mmHg. Which intervention should be initiated first?

    Answer: Non-invasive positive pressure ventilation (NIPPV)

    Non-invasive positive pressure ventilation (BiPAP) is the first-line intervention for acute hypercapnic respiratory failure in COPD, reducing mortality and intubation rates.

  5. Which scoring system is used to assess the severity of acute pancreatitis within the first 48 hours of admission?

    Answer: Ranson criteria

    Ranson criteria uses 11 parameters measured at admission and 48 hours to predict mortality risk in acute pancreatitis; scores ≥3 indicate severe disease.

  6. A 75-year-old presents with sudden-onset severe tearing chest pain radiating to the back. BP is 200/110 in the right arm and 160/90 in the left arm. What is the priority action?

    Answer: Obtain urgent CTA of the chest

    CTA of the chest is the diagnostic study of choice for suspected aortic dissection, and BP differential between arms is a classic finding; thrombolytics are contraindicated.

  7. When managing acute ischemic stroke, what is the maximum time window for IV alteplase administration from symptom onset in eligible patients?

    Answer: 4.5 hours

    IV alteplase can be administered up to 4.5 hours from symptom onset in carefully selected patients per AHA/ASA guidelines, though benefit is greatest when given earlier.