American Association of Critical- Care Nurses (AACN) Adult-
Gerontology Acute. Care Nurse Practitioner Certification
(ACNPC- AG) 2025 Actual Exam Questions and Answers
1. Postoperative assessment is performed on a
patient who underwent a lumbar 4/5 laminectomy
and discectomy 2 hours ago. Preoperatively, she
had pain in her right hip and leg with numbness of
her right foot, but no weakness. At the time of the
examination, her motor strength is 5/5 in all
extremities, and she has not voided
postoperatively. She is concerned that the
numbness in her foot has not resolved. Which of
the following is an ACNP's best action?
o A. Reassure her that numbness often persists
postoperatively.
o B. Scan her bladder to assess for cauda equina
syndrome.
o C. Obtain a CT scan of her lumbar spine to
evaluate for hematoma.
o D. Administer steroids for nerve root
radiculopathy.
o Correct answer= B.
o Rationale: Postoperative urinary retention can
lead to cauda equina syndrome, which is a
surgical emergency. The patient's persistent
numbness and lack of voiding necessitate ruling
out this potentially serious complication.
2. It is important to emphasize which of the following
when providing smoking cessation education to a
patient after coronary stent placement?
o A. Patients with atherosclerosis are more likely
to develop lung disease within 5 years.
, o B. Within 3 years of cessation, coronary artery
disease risk improves.
o C. Nicotine and clopidogrel (Plavix) may produce
adverse effects.
o D. Most patients find it easy to quit smoking
after stent placement.
o Correct answer= B.
o Rationale: Emphasizing the relatively short-
term benefits of smoking cessation on
cardiovascular risk is a powerful motivator for
patients after stent placement.
3. A patient has subcutaneous gas on CT scan in the
left foot with erythema extending up the lower
extremity. The vascular surgeon is requesting a CT
angiography of the lower extremity to assess
vascular status prior to operative intervention.
Which laboratory data is most concerning for
ordering this test?
o A. hemoglobin 7 g/dL
o B. lactate 2 mmol/L
o C. WBC 15/mm³
o D. creatinine 1.9 mg/dL
o Correct answer= D.
o Rationale: A creatinine level of 1.9 mg/dL
indicates potential renal impairment, which is a
relative contraindication for CT angiography due
to the nephrotoxic potential of the contrast dye.
4. A patient's laboratory results show a potassium
level of 8.0, and an ECG reveals peaked T waves. In
addition to 25 g dextrose 50%, which of the
following is the best emergency treatment?
o A. sodium polystyrene sulfonate resin
(Kayexalate) 25 g, regular insulin 20 units
, o B. calcium gluconate 10 mL, regular insulin 10
units
o C. calcium chloride 10 mL, regular insulin 20
units
o D. magnesium sulfate 1 g, regular insulin 10
units
o Correct answer= B.
o Rationale: Calcium gluconate is administered to
stabilize the cardiac membrane and prevent
arrhythmias associated with hyperkalemia.
Insulin and dextrose shift potassium
intracellularly. Kayexalate removes potassium
from the body, but works slowly.
5. A patient was in a 45 mph rollover MVC. His GCS
was 7, and he was intubated by EMS at the scene.
He presents to the emergency department with BP
76/54 and HR 90 after 2 L of normal saline. The
airway is maintained with an endotracheal tube.
Initially, there are bilateral breath sounds, pulses
1+ throughout, and his skin is cool. External
bleeding is controlled and the GCS is now 3T.
Secondary examination shows Grey Turner's sign
and a positive abdominal FAST examination. Which
of the following is the correct disposition for this
patient?
o A. Admit to the ICU.
o B. Stabilize in the emergency department.
o C. Transfer to the operating room.
o D. Send for a CT scan.
o Correct answer= C.
o Rationale: The patient's hemodynamic
instability, positive FAST exam, and Grey
Turner's sign suggest significant intra-abdominal
, bleeding, likely from a ruptured spleen or liver,
requiring immediate surgical intervention.
6. Which of the following abnormalities places a
patient at highest risk for embolic stroke?
o A. aortic stenosis
o B. patent ductus arteriosus
o C. pulmonary stenosis
o D. atrial septal defect
o Correct answer= D.
o Rationale: Atrial septal defects can lead to
paradoxical emboli, where clots from the venous
system cross into the arterial system through
the defect, increasing the risk of stroke.
7. A 45-year-old patient died following a prolonged
resuscitation attempt secondary to an MVC. The
patient's family has arrived to the hospital and
wants to be updated on the patient's condition. A
meeting is set up with the family. An important
initial step in this meeting includes
o A. understanding what the family knows about
the patient's situation.
o B. summarize events and establish plans for
subsequent patient care.
o C. conveying the news to appropriate individuals
using easily understood terms.
o D. empathizing with the individuals' emotions.
o Correct answer= A.
o Rationale: Before delivering difficult news, it's
crucial to understand the family's existing
knowledge and expectations to tailor the
conversation appropriately.
8. A staff nurse mentions to an ACNP that she read an
article on vitamin D deficiency and its relationship
to heart failure. The staff nurse thought that the
Gerontology Acute. Care Nurse Practitioner Certification
(ACNPC- AG) 2025 Actual Exam Questions and Answers
1. Postoperative assessment is performed on a
patient who underwent a lumbar 4/5 laminectomy
and discectomy 2 hours ago. Preoperatively, she
had pain in her right hip and leg with numbness of
her right foot, but no weakness. At the time of the
examination, her motor strength is 5/5 in all
extremities, and she has not voided
postoperatively. She is concerned that the
numbness in her foot has not resolved. Which of
the following is an ACNP's best action?
o A. Reassure her that numbness often persists
postoperatively.
o B. Scan her bladder to assess for cauda equina
syndrome.
o C. Obtain a CT scan of her lumbar spine to
evaluate for hematoma.
o D. Administer steroids for nerve root
radiculopathy.
o Correct answer= B.
o Rationale: Postoperative urinary retention can
lead to cauda equina syndrome, which is a
surgical emergency. The patient's persistent
numbness and lack of voiding necessitate ruling
out this potentially serious complication.
2. It is important to emphasize which of the following
when providing smoking cessation education to a
patient after coronary stent placement?
o A. Patients with atherosclerosis are more likely
to develop lung disease within 5 years.
, o B. Within 3 years of cessation, coronary artery
disease risk improves.
o C. Nicotine and clopidogrel (Plavix) may produce
adverse effects.
o D. Most patients find it easy to quit smoking
after stent placement.
o Correct answer= B.
o Rationale: Emphasizing the relatively short-
term benefits of smoking cessation on
cardiovascular risk is a powerful motivator for
patients after stent placement.
3. A patient has subcutaneous gas on CT scan in the
left foot with erythema extending up the lower
extremity. The vascular surgeon is requesting a CT
angiography of the lower extremity to assess
vascular status prior to operative intervention.
Which laboratory data is most concerning for
ordering this test?
o A. hemoglobin 7 g/dL
o B. lactate 2 mmol/L
o C. WBC 15/mm³
o D. creatinine 1.9 mg/dL
o Correct answer= D.
o Rationale: A creatinine level of 1.9 mg/dL
indicates potential renal impairment, which is a
relative contraindication for CT angiography due
to the nephrotoxic potential of the contrast dye.
4. A patient's laboratory results show a potassium
level of 8.0, and an ECG reveals peaked T waves. In
addition to 25 g dextrose 50%, which of the
following is the best emergency treatment?
o A. sodium polystyrene sulfonate resin
(Kayexalate) 25 g, regular insulin 20 units
, o B. calcium gluconate 10 mL, regular insulin 10
units
o C. calcium chloride 10 mL, regular insulin 20
units
o D. magnesium sulfate 1 g, regular insulin 10
units
o Correct answer= B.
o Rationale: Calcium gluconate is administered to
stabilize the cardiac membrane and prevent
arrhythmias associated with hyperkalemia.
Insulin and dextrose shift potassium
intracellularly. Kayexalate removes potassium
from the body, but works slowly.
5. A patient was in a 45 mph rollover MVC. His GCS
was 7, and he was intubated by EMS at the scene.
He presents to the emergency department with BP
76/54 and HR 90 after 2 L of normal saline. The
airway is maintained with an endotracheal tube.
Initially, there are bilateral breath sounds, pulses
1+ throughout, and his skin is cool. External
bleeding is controlled and the GCS is now 3T.
Secondary examination shows Grey Turner's sign
and a positive abdominal FAST examination. Which
of the following is the correct disposition for this
patient?
o A. Admit to the ICU.
o B. Stabilize in the emergency department.
o C. Transfer to the operating room.
o D. Send for a CT scan.
o Correct answer= C.
o Rationale: The patient's hemodynamic
instability, positive FAST exam, and Grey
Turner's sign suggest significant intra-abdominal
, bleeding, likely from a ruptured spleen or liver,
requiring immediate surgical intervention.
6. Which of the following abnormalities places a
patient at highest risk for embolic stroke?
o A. aortic stenosis
o B. patent ductus arteriosus
o C. pulmonary stenosis
o D. atrial septal defect
o Correct answer= D.
o Rationale: Atrial septal defects can lead to
paradoxical emboli, where clots from the venous
system cross into the arterial system through
the defect, increasing the risk of stroke.
7. A 45-year-old patient died following a prolonged
resuscitation attempt secondary to an MVC. The
patient's family has arrived to the hospital and
wants to be updated on the patient's condition. A
meeting is set up with the family. An important
initial step in this meeting includes
o A. understanding what the family knows about
the patient's situation.
o B. summarize events and establish plans for
subsequent patient care.
o C. conveying the news to appropriate individuals
using easily understood terms.
o D. empathizing with the individuals' emotions.
o Correct answer= A.
o Rationale: Before delivering difficult news, it's
crucial to understand the family's existing
knowledge and expectations to tailor the
conversation appropriately.
8. A staff nurse mentions to an ACNP that she read an
article on vitamin D deficiency and its relationship
to heart failure. The staff nurse thought that the
