ACNP BOARD REVIEW Exam Reviewed
Questions and Answers Latest 2025/2026
GRADED A
A 21-year-old patient is admitted to the intensive care unit with a severe closed head
injury. The patient's family is becoming louder and more insistent about seeing the
patient. To establish a therapeutic relationship with the family, an acute care nurse
practitioner's initial action is to:
-acknowledge the family's anxiety.
-arrange for a meeting with a social worker.
-escort the family to a conference room.
-gently direct the family to maintain composure. - CORRECT ANSWER-acknowledge
the family's anxiety.
A 24-year-old male patient with a closed head injury has been intubated for 12 days.
The patient's parents have repeatedly refused consent for a tracheostomy and long-
term care placement. On multiple occasions, the surgeon has discussed the risks and
benefits of the surgery with them. Addressing the parents, the acute care nurse
practitioner states:
"I understand you have reservations about the placement of a tracheostomy."
"Please know that not many patients die while undergoing a tracheostomy."
"Without a tracheostomy, we can't transfer your son to another facility."
"You know, your son will die if a tracheostomy is not placed." - CORRECT ANSWER-"I
understand you have reservations about the placement of a tracheostomy."
, A 42-year-old patient with metastatic lung cancer is admitted with severe intractable
pain related to a pathologic fracture of the left femur. The plan is to stabilize the
fracture surgically, and begin local radiation therapy to the site. For this patient, the
most appropriate analgesic regimen is:
-fentanyl (Duragesic) transdermal system applied every 72 hours.
-meperidine (Demerol) 50 mg intramuscularly every three hours around the clock.
-morphine sulfate (Avinza) IV via a patient-controlled analgesia pump with a basal
rate.
-oxycodone/acetaminophen (Percocet) orally every six hours around the clock. -
CORRECT ANSWER-morphine sulfate (Avinza) IV via a patient-controlled analgesia
pump with a basal rate.
A 45-year-old patient, who is on mechanical ventilatory support in the intensive care
unit, is receiving a neuromuscular blockade for respiratory control related to acute
respiratory failure. To prevent keratoconjunctivitis sicca, the acute care nurse
practitioner prescribes:
artificial tears preparations.
IV antibiotic administration.
local sulfonamide therapy.
topical steroid administration. - CORRECT ANSWER-artificial tears preparations
A 57-year-old male patient arrives at the emergency department with substernal
chest pain. An electrocardiogram reveals ST segment depression in leads V3 and V4.
Before administering nitrates, an acute care nurse practitioner assesses the patient's
use of:
angiotensin-converting enzyme inhibitors.
aspirin.
beta-blockers.
Questions and Answers Latest 2025/2026
GRADED A
A 21-year-old patient is admitted to the intensive care unit with a severe closed head
injury. The patient's family is becoming louder and more insistent about seeing the
patient. To establish a therapeutic relationship with the family, an acute care nurse
practitioner's initial action is to:
-acknowledge the family's anxiety.
-arrange for a meeting with a social worker.
-escort the family to a conference room.
-gently direct the family to maintain composure. - CORRECT ANSWER-acknowledge
the family's anxiety.
A 24-year-old male patient with a closed head injury has been intubated for 12 days.
The patient's parents have repeatedly refused consent for a tracheostomy and long-
term care placement. On multiple occasions, the surgeon has discussed the risks and
benefits of the surgery with them. Addressing the parents, the acute care nurse
practitioner states:
"I understand you have reservations about the placement of a tracheostomy."
"Please know that not many patients die while undergoing a tracheostomy."
"Without a tracheostomy, we can't transfer your son to another facility."
"You know, your son will die if a tracheostomy is not placed." - CORRECT ANSWER-"I
understand you have reservations about the placement of a tracheostomy."
, A 42-year-old patient with metastatic lung cancer is admitted with severe intractable
pain related to a pathologic fracture of the left femur. The plan is to stabilize the
fracture surgically, and begin local radiation therapy to the site. For this patient, the
most appropriate analgesic regimen is:
-fentanyl (Duragesic) transdermal system applied every 72 hours.
-meperidine (Demerol) 50 mg intramuscularly every three hours around the clock.
-morphine sulfate (Avinza) IV via a patient-controlled analgesia pump with a basal
rate.
-oxycodone/acetaminophen (Percocet) orally every six hours around the clock. -
CORRECT ANSWER-morphine sulfate (Avinza) IV via a patient-controlled analgesia
pump with a basal rate.
A 45-year-old patient, who is on mechanical ventilatory support in the intensive care
unit, is receiving a neuromuscular blockade for respiratory control related to acute
respiratory failure. To prevent keratoconjunctivitis sicca, the acute care nurse
practitioner prescribes:
artificial tears preparations.
IV antibiotic administration.
local sulfonamide therapy.
topical steroid administration. - CORRECT ANSWER-artificial tears preparations
A 57-year-old male patient arrives at the emergency department with substernal
chest pain. An electrocardiogram reveals ST segment depression in leads V3 and V4.
Before administering nitrates, an acute care nurse practitioner assesses the patient's
use of:
angiotensin-converting enzyme inhibitors.
aspirin.
beta-blockers.
