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
A 65-year-old with heart failure presents with acute pulmonary edema. On exam: BP 160/100, HR 110, diffuse crackles, SpO2 84%. Which is the most appropriate initial pharmacological intervention?
Answer: IV furosemide and IV nitroglycerin
IV furosemide reduces preload through diuresis and venodilation, while IV nitroglycerin reduces preload and afterload, together providing rapid relief in hypertensive acute pulmonary edema.
An AG-ACNP is managing a patient with status epilepticus refractory to benzodiazepines. What is the next recommended pharmacological agent?
Answer: IV levetiracetam, fosphenytoin, or valproate
After benzodiazepine failure, second-line agents including IV levetiracetam, fosphenytoin, or valproate are recommended per Neurocritical Care Society guidelines for established status epilepticus.
Which clinical finding best differentiates cardiogenic shock from distributive (septic) shock?
Answer: Cool clammy skin with elevated SVR and low CO
Cardiogenic shock is characterized by cool, clammy skin with elevated systemic vascular resistance and low cardiac output, unlike septic shock which presents with warm skin and low SVR.
A 74-year-old patient on warfarin for atrial fibrillation presents with INR of 9.2 and active GI bleeding. What is the most appropriate reversal strategy?
Answer: 4-factor prothrombin complex concentrate (PCC) plus vitamin K
4-factor PCC combined with vitamin K provides the fastest, most complete reversal of warfarin in life-threatening bleeding, with PCC acting immediately and vitamin K maintaining reversal.
A post-operative 70-year-old develops fever, hypotension, and purulent drainage from a central line site on day 7. Blood cultures are drawn. What is the immediate next action?
Answer: Remove the central line and start empiric vancomycin
Suspected CLABSI requires immediate central line removal and initiation of empiric broad-spectrum antibiotics (vancomycin for gram-positives), not waiting for culture results in a hemodynamically unstable patient.
When assessing a geriatric patient for frailty in the acute care setting, which tool is most validated and widely used?
Answer: Clinical Frailty Scale (CFS)
The Clinical Frailty Scale is a 9-point scale validated for use in acute care settings to predict adverse outcomes including mortality, institutionalization, and prolonged hospital stay.
A 68-year-old with known liver cirrhosis presents with confusion, asterixis, and abdominal distension. Ammonia level is elevated. Which treatment is most effective?
Answer: Lactulose titrated to 2-3 soft bowel movements per day
Lactulose reduces ammonia absorption by acidifying the colon, promoting its conversion to ammonium ion and enhancing fecal elimination, targeting 2-3 soft stools per day.