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 77-year-old develops acute tubular necrosis (ATN) after contrast administration. Which urinalysis finding is most characteristic of ATN?
Answer: Muddy brown granular casts
Muddy brown granular casts are pathognomonic of acute tubular necrosis, representing sloughed tubular epithelial cells and debris from ischemic or nephrotoxic injury.
A geriatric ICU patient is on low-tidal-volume ventilation. PaO2/FiO2 ratio is 120 mmHg, bilateral infiltrates are present, and PAOP is normal. What ARDS severity category does this represent?
Answer: Moderate ARDS (PF ratio 100-200)
Per the Berlin Definition, a PaO2/FiO2 ratio of 100-200 mmHg with bilateral opacities and non-cardiogenic etiology constitutes moderate ARDS.
Which pain assessment tool is most appropriate for a non-verbal, mechanically ventilated adult patient in the ICU?
Answer: Critical Care Pain Observation Tool (CPOT)
CPOT uses behavioral indicators (facial expression, body movements, muscle tension, ventilator compliance) to assess pain in non-verbal ICU patients and is endorsed by SCCM guidelines.
A 72-year-old post-cardiac arrest patient achieves return of spontaneous circulation (ROSC) but remains comatose. Which intervention has the strongest evidence for improving neurological outcomes?
Answer: Targeted temperature management (TTM) at 33-36°C for 24 hours
Targeted temperature management between 33-36°C for 24 hours post-ROSC is recommended to prevent secondary neurological injury by reducing cerebral metabolic demand.
An older adult with acute STEMI is referred for primary PCI. What is the recommended door-to-balloon time?
Answer: 90 minutes
ACC/AHA guidelines recommend a door-to-balloon time of ≤90 minutes for primary PCI in STEMI, as every 30-minute delay increases 1-year mortality by approximately 7.5%.
When managing a patient with acute adrenal crisis (Addisonian crisis), which of the following is the correct immediate treatment?
Answer: IV hydrocortisone 100 mg bolus plus aggressive IV fluid resuscitation
Adrenal crisis is treated with immediate IV hydrocortisone 100 mg bolus (or 200-400 mg/day continuous infusion) plus aggressive normal saline resuscitation to correct volume depletion and hypotension.
Which drug class is contraindicated in the management of acute decompensated heart failure with cardiogenic shock?
Answer: Beta-blockers
Beta-blockers are contraindicated in acute cardiogenic shock because they reduce cardiac contractility and heart rate, further compromising already critically low cardiac output.