ACNPC-AG® Adult-Gerontology Acute Care
NP Exam Questions and Answers Latest
Version Top Rated
A 72-year-old patient presents with acute dyspnea, orthopnea, bilateral crackles, and an oxygen
saturation of 86% on room air. The patient has a history of heart failure with reduced ejection
fraction. Which intervention should the AG-ACNP initiate FIRST?
A. Administer IV furosemide
B. Obtain a lipid panel
C. Encourage oral fluids
D. Begin ambulation therapy
Correct Answer:
A. Administer IV furosemide
Rationale:
The patient has signs of acute decompensated heart failure with pulmonary congestion. IV loop
diuretics rapidly reduce volume overload and improve symptoms. Stabilization of the acute
condition takes priority over routine testing or rehabilitation.
Question 2
A patient with suspected sepsis has a blood pressure of 82/46 mmHg, elevated lactate, and
altered mental status. What is the priority intervention?
A. Initiate rapid IV fluid resuscitation
B. Administer oral antibiotics
C. Restrict fluids
D. Delay treatment until cultures return
Correct Answer:
A. Initiate rapid IV fluid resuscitation
Rationale:
Septic shock requires immediate stabilization. Early IV crystalloid administration improves
tissue perfusion. Antibiotics and cultures are important but should not delay urgent resuscitation.
Question 3
,A patient receiving heparin therapy develops a platelet count decrease of 60% from baseline.
What complication should the AG-ACNP suspect?
A. Heparin-induced thrombocytopenia (HIT)
B. Iron deficiency anemia
C. Disseminated lupus
D. Vitamin B12 deficiency
Correct Answer:
A. Heparin-induced thrombocytopenia (HIT)
Rationale:
A significant platelet drop after heparin exposure suggests HIT, a prothrombotic immune
reaction requiring immediate discontinuation of heparin and alternative anticoagulation.
Question 4
A patient presents with crushing chest pain, ST-segment elevation on ECG, and elevated
troponin levels. The most appropriate diagnosis is:
A. STEMI
B. Stable angina
C. Pericarditis
D. Pulmonary hypertension
Correct Answer:
A. STEMI
Rationale:
ST elevation with ischemic symptoms and elevated cardiac biomarkers indicates ST-elevation
myocardial infarction requiring urgent reperfusion therapy.
Question 5
A patient with COPD exacerbation has increased work of breathing and chronic CO₂ retention.
Which oxygen saturation target is generally appropriate?
A. 88–92%
B. 100%
C. 95–100%
D. Below 80%
,Correct Answer:
A. 88–92%
Rationale:
Patients with chronic hypercapnic respiratory disease may develop worsening CO₂ retention with
excessive oxygen administration. Controlled oxygen therapy is preferred.
Question 6
A mechanically ventilated patient suddenly develops hypotension, absent breath sounds on one
side, and tracheal deviation. What is the most likely diagnosis?
A. Tension pneumothorax
B. Pulmonary edema
C. Pleural effusion
D. Atelectasis
Correct Answer:
A. Tension pneumothorax
Rationale:
The combination of acute hypotension, unilateral absent breath sounds, and tracheal deviation
indicates obstructive shock from tension pneumothorax requiring immediate decompression.
Question 7
A patient with atrial fibrillation has a rapid ventricular response and stable blood pressure.
Which medication is commonly used for rate control?
A. Metoprolol
B. Epinephrine
C. Adenosine
D. Atropine
Correct Answer:
A. Metoprolol
Rationale:
Beta-blockers such as metoprolol slow AV nodal conduction and are commonly used for
ventricular rate control in stable atrial fibrillation.
, Question 8
A patient receiving vancomycin requires monitoring of:
A. Drug levels and renal function
B. Thyroid hormones only
C. Blood glucose only
D. Liver enzymes only
Correct Answer:
A. Drug levels and renal function
Rationale:
Vancomycin can cause nephrotoxicity and requires therapeutic drug monitoring to optimize
effectiveness and reduce toxicity.
Question 9
A patient presents with diabetic ketoacidosis (DKA). The initial priority is:
A. IV fluid replacement
B. Long-acting insulin administration
C. Oral glucose
D. Sodium restriction
Correct Answer:
A. IV fluid replacement
Rationale:
Patients with DKA are significantly dehydrated. Initial treatment focuses on restoring circulating
volume before insulin therapy.
Question 10
A patient with acute ischemic stroke arrives within the treatment window. Which action is
priority?
A. Obtain rapid brain imaging
B. Give aspirin immediately before imaging
C. Lower blood pressure aggressively
D. Begin anticoagulation
NP Exam Questions and Answers Latest
Version Top Rated
A 72-year-old patient presents with acute dyspnea, orthopnea, bilateral crackles, and an oxygen
saturation of 86% on room air. The patient has a history of heart failure with reduced ejection
fraction. Which intervention should the AG-ACNP initiate FIRST?
A. Administer IV furosemide
B. Obtain a lipid panel
C. Encourage oral fluids
D. Begin ambulation therapy
Correct Answer:
A. Administer IV furosemide
Rationale:
The patient has signs of acute decompensated heart failure with pulmonary congestion. IV loop
diuretics rapidly reduce volume overload and improve symptoms. Stabilization of the acute
condition takes priority over routine testing or rehabilitation.
Question 2
A patient with suspected sepsis has a blood pressure of 82/46 mmHg, elevated lactate, and
altered mental status. What is the priority intervention?
A. Initiate rapid IV fluid resuscitation
B. Administer oral antibiotics
C. Restrict fluids
D. Delay treatment until cultures return
Correct Answer:
A. Initiate rapid IV fluid resuscitation
Rationale:
Septic shock requires immediate stabilization. Early IV crystalloid administration improves
tissue perfusion. Antibiotics and cultures are important but should not delay urgent resuscitation.
Question 3
,A patient receiving heparin therapy develops a platelet count decrease of 60% from baseline.
What complication should the AG-ACNP suspect?
A. Heparin-induced thrombocytopenia (HIT)
B. Iron deficiency anemia
C. Disseminated lupus
D. Vitamin B12 deficiency
Correct Answer:
A. Heparin-induced thrombocytopenia (HIT)
Rationale:
A significant platelet drop after heparin exposure suggests HIT, a prothrombotic immune
reaction requiring immediate discontinuation of heparin and alternative anticoagulation.
Question 4
A patient presents with crushing chest pain, ST-segment elevation on ECG, and elevated
troponin levels. The most appropriate diagnosis is:
A. STEMI
B. Stable angina
C. Pericarditis
D. Pulmonary hypertension
Correct Answer:
A. STEMI
Rationale:
ST elevation with ischemic symptoms and elevated cardiac biomarkers indicates ST-elevation
myocardial infarction requiring urgent reperfusion therapy.
Question 5
A patient with COPD exacerbation has increased work of breathing and chronic CO₂ retention.
Which oxygen saturation target is generally appropriate?
A. 88–92%
B. 100%
C. 95–100%
D. Below 80%
,Correct Answer:
A. 88–92%
Rationale:
Patients with chronic hypercapnic respiratory disease may develop worsening CO₂ retention with
excessive oxygen administration. Controlled oxygen therapy is preferred.
Question 6
A mechanically ventilated patient suddenly develops hypotension, absent breath sounds on one
side, and tracheal deviation. What is the most likely diagnosis?
A. Tension pneumothorax
B. Pulmonary edema
C. Pleural effusion
D. Atelectasis
Correct Answer:
A. Tension pneumothorax
Rationale:
The combination of acute hypotension, unilateral absent breath sounds, and tracheal deviation
indicates obstructive shock from tension pneumothorax requiring immediate decompression.
Question 7
A patient with atrial fibrillation has a rapid ventricular response and stable blood pressure.
Which medication is commonly used for rate control?
A. Metoprolol
B. Epinephrine
C. Adenosine
D. Atropine
Correct Answer:
A. Metoprolol
Rationale:
Beta-blockers such as metoprolol slow AV nodal conduction and are commonly used for
ventricular rate control in stable atrial fibrillation.
, Question 8
A patient receiving vancomycin requires monitoring of:
A. Drug levels and renal function
B. Thyroid hormones only
C. Blood glucose only
D. Liver enzymes only
Correct Answer:
A. Drug levels and renal function
Rationale:
Vancomycin can cause nephrotoxicity and requires therapeutic drug monitoring to optimize
effectiveness and reduce toxicity.
Question 9
A patient presents with diabetic ketoacidosis (DKA). The initial priority is:
A. IV fluid replacement
B. Long-acting insulin administration
C. Oral glucose
D. Sodium restriction
Correct Answer:
A. IV fluid replacement
Rationale:
Patients with DKA are significantly dehydrated. Initial treatment focuses on restoring circulating
volume before insulin therapy.
Question 10
A patient with acute ischemic stroke arrives within the treatment window. Which action is
priority?
A. Obtain rapid brain imaging
B. Give aspirin immediately before imaging
C. Lower blood pressure aggressively
D. Begin anticoagulation
