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
An elderly patient in the ICU has serum sodium of 118 mEq/L with altered mental status. What is the maximum rate of correction to prevent osmotic demyelination syndrome?
Answer: 8-10 mEq/L in 24 hours
Sodium should be corrected no faster than 8-10 mEq/L per 24 hours to avoid osmotic demyelination syndrome (central pontine myelinolysis), which is irreversible.
A 70-year-old with acute kidney injury has a potassium of 6.8 mEq/L with peaked T-waves on EKG. What is the FIRST intervention?
Answer: IV calcium gluconate
IV calcium gluconate is administered first to stabilize the cardiac membrane, even though it does not lower potassium levels — this buys time for definitive treatment.
Which ventilator strategy has been shown to reduce mortality in ARDS patients?
Answer: Low tidal volume (6 mL/kg IBW) with plateau pressure ≤30 cmH2O
The ARDSNet protocol using low tidal volumes of 6 mL/kg IBW and limiting plateau pressures to ≤30 cmH2O has demonstrated a 22% reduction in mortality in ARDS.
A geriatric patient post-hip replacement develops sudden dyspnea, pleuritic chest pain, and oxygen saturation of 88%. Wells score is high. What is the next best step?
Answer: CT pulmonary angiography (CTPA)
CT pulmonary angiography is the gold-standard diagnostic test for pulmonary embolism, offering high sensitivity and specificity in hemodynamically stable patients.
Which laboratory finding is most consistent with disseminated intravascular coagulation (DIC)?
Answer: Low fibrinogen, elevated D-dimer, prolonged PT and aPTT
DIC is characterized by consumptive coagulopathy: low fibrinogen, elevated D-dimer (fibrin degradation products), prolonged PT/aPTT, and thrombocytopenia.
A 78-year-old patient in the ICU is assessed using the ABCDEF bundle. What does the 'A' component represent?
Answer: Assess, prevent, and manage pain
In the ABCDEF ICU Liberation Bundle, 'A' stands for 'Assess, Prevent, and Manage Pain,' emphasizing that pain should be addressed before sedation.
Which condition is the most common cause of acute liver failure in the United States?
Answer: Acetaminophen toxicity
Acetaminophen (Tylenol) overdose — both intentional and unintentional — accounts for approximately 50% of all acute liver failure cases in the United States.