AG-ACNP Boards Exam 2025
Questions and Answers
58 yo. M presents to ED with complaints of dry cough. CXR revealed generalized,
inflamed film throughout. What is the most likely diagnosis? - ANSWER✔✔-
Pneumonitis
What drug has been known to prevent nosocomial PNA? - ANSWER✔✔-Sulcarafate
(Carafate) - Mucosal Protective Agent
What is an initial finding associated with a pulmonary embolism? - ANSWER✔✔-
Respiratory Alkalosis - secondary to increased RR and blowing off CO2
What is diagnostic of pulmonary HTN? - ANSWER✔✔-2D echo
Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You notice
shunting. What should your next action be? - ANSWER✔✔-Increase PEEP from 5 to 10
to recruit alveoli and increase surface area to improve oxygenation
32 yo. M with PMH significant for mitral valve replacement now complains of
wheezing during physical activity 2-3 times/week. What should you do next? -
ANSWER✔✔-Send patient for pulmonary function testing.
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,What is the pathology of asthma? - ANSWER✔✔-Increased
responsiveness/hyperresponsiveness of the trachea and bronchi to a stimuli.
Acute inflammation
Narrowing of airways
Hypertrophy of smooth muscle
Mucosal plugging of airways
What are the hallmark signs and symptoms of asthma? - ANSWER✔✔-Respiratory
distress at rest
Difficulty speaking in sentences
RR > 28
Pulsus paradoxus > 12 mmHg
What PFT value is suggestive of an obstructive disease? - ANSWER✔✔-Decreased
FEV1
Which acid-base imbalance is associated with asthma? - ANSWER✔✔-Respiratory
Alkalosis with mild hypoxemia
What PFT values would indicate hospitalization of an asthmatic patient? -
ANSWER✔✔-Decreased FEV1 <30% predicted OR
does not increase to at least 40% predicted after 1 hr.
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, Peak flow is <60 L/min initially OR does not increase to >50% predicted after 1 hr tx
What are the ominous findings associated with an asthma exacerbation? -
ANSWER✔✔-Extreme fatigue
Lethargy
ABG - hypercapnea >pCO2 >45 mmHg = EMERGENCY
What is the outpatient daily management drug for asthma? - ANSWER✔✔-Inhaled
Corticosteroids - Budesonide (Pulmicort)
What side effect is associated with inhaled corticosteroids? - ANSWER✔✔-Candidal
infection of the oropharynx, dry mouth, and sore throat. Educate patient to rinse mouth.
What drug is indicated for breakthrough symptoms, rescue therapy and before exercise
in the asthma patient? - ANSWER✔✔-Short acting beta-2 adrenergic agonist - Albuterol
(Proventil)
If symptoms persist in the asthma patient, what pharmacological interventions are
indicated? - ANSWER✔✔-Increase inhaled corticosteroids or add long acting beta-2
adrenergic agonist - Salmeterol (Serevent)
What is the indications for ipratroprium bromide (Atrovent)? - ANSWER✔✔-Secretion
management. Inhaled anticholinergic
COPYRIGHT © 2025 ALL RIGHTS RESERVED
Questions and Answers
58 yo. M presents to ED with complaints of dry cough. CXR revealed generalized,
inflamed film throughout. What is the most likely diagnosis? - ANSWER✔✔-
Pneumonitis
What drug has been known to prevent nosocomial PNA? - ANSWER✔✔-Sulcarafate
(Carafate) - Mucosal Protective Agent
What is an initial finding associated with a pulmonary embolism? - ANSWER✔✔-
Respiratory Alkalosis - secondary to increased RR and blowing off CO2
What is diagnostic of pulmonary HTN? - ANSWER✔✔-2D echo
Your patient is intubated on the following settings: SIMV/FiO2 .6/PEEP 5. You notice
shunting. What should your next action be? - ANSWER✔✔-Increase PEEP from 5 to 10
to recruit alveoli and increase surface area to improve oxygenation
32 yo. M with PMH significant for mitral valve replacement now complains of
wheezing during physical activity 2-3 times/week. What should you do next? -
ANSWER✔✔-Send patient for pulmonary function testing.
COPYRIGHT © 2025 ALL RIGHTS RESERVED
,What is the pathology of asthma? - ANSWER✔✔-Increased
responsiveness/hyperresponsiveness of the trachea and bronchi to a stimuli.
Acute inflammation
Narrowing of airways
Hypertrophy of smooth muscle
Mucosal plugging of airways
What are the hallmark signs and symptoms of asthma? - ANSWER✔✔-Respiratory
distress at rest
Difficulty speaking in sentences
RR > 28
Pulsus paradoxus > 12 mmHg
What PFT value is suggestive of an obstructive disease? - ANSWER✔✔-Decreased
FEV1
Which acid-base imbalance is associated with asthma? - ANSWER✔✔-Respiratory
Alkalosis with mild hypoxemia
What PFT values would indicate hospitalization of an asthmatic patient? -
ANSWER✔✔-Decreased FEV1 <30% predicted OR
does not increase to at least 40% predicted after 1 hr.
COPYRIGHT © 2025 ALL RIGHTS RESERVED
, Peak flow is <60 L/min initially OR does not increase to >50% predicted after 1 hr tx
What are the ominous findings associated with an asthma exacerbation? -
ANSWER✔✔-Extreme fatigue
Lethargy
ABG - hypercapnea >pCO2 >45 mmHg = EMERGENCY
What is the outpatient daily management drug for asthma? - ANSWER✔✔-Inhaled
Corticosteroids - Budesonide (Pulmicort)
What side effect is associated with inhaled corticosteroids? - ANSWER✔✔-Candidal
infection of the oropharynx, dry mouth, and sore throat. Educate patient to rinse mouth.
What drug is indicated for breakthrough symptoms, rescue therapy and before exercise
in the asthma patient? - ANSWER✔✔-Short acting beta-2 adrenergic agonist - Albuterol
(Proventil)
If symptoms persist in the asthma patient, what pharmacological interventions are
indicated? - ANSWER✔✔-Increase inhaled corticosteroids or add long acting beta-2
adrenergic agonist - Salmeterol (Serevent)
What is the indications for ipratroprium bromide (Atrovent)? - ANSWER✔✔-Secretion
management. Inhaled anticholinergic
COPYRIGHT © 2025 ALL RIGHTS RESERVED
