AACN AGACNP BOARDS MATERIALS|VERIFIED QUESTIONS AND
ANSWERS|GRADED A+ |LATEST 2026/2027
Pericarditis - ANSWER✔ Often present w/ friction rub, sharp CP w/ inspiration, low-grade fever,
muffled heart tones, hypotension. Tx w/ colchicine.
Pulmonary edema - ANSWER✔ Pink/frothy sputum. Tachypnea, dyspnea, b/l wheeze. CXR shows
alveolar infiltrates, kerley B lines, and pleural effusions.
Cardiac tamponade - ANSWER✔ Becks Triad= muffled tones, JVD, HoTN. Narrow pulse pressure. Low
C.O., low BP, tachy, high RR, JVD, pulsus paradoxus.
Diagnose w/ Echo
CPGs for hypertensive urgency BP reduction - ANSWER✔ 10-25% in the 1st hour, then 160/100
within 6h, then to normal over next 24h.
Septal MI - ANSWER✔ V1, V2
LAD
Anterior MI - ANSWER✔ V3, V4
LAD
Inferior/posterior MI - ANSWER✔ II, III, aVF
RCA
Lateral MI - ANSWER✔ I, aVL, V5, V6
Circumflex
Endocarditis - ANSWER✔ Echo shows vegetation, abscess, or valve dysfunction. Tx ABX
,Pulsus paradoxus - ANSWER✔ Fall in SBP >10 mmHg during inspiration
S4 gallop - ANSWER✔ Common in aortic stenosis
A-FIb ablation - ANSWER✔ >90% pulmonary veins. Anticoags for 2-3 months following.
NYHA HF Classification - ANSWER✔ Stages of HF:
Class I (mild): no sx, no limitations
Class II (mild): no sx @ rest, slight limitation, ordinary activity leads to sx
Class III (moderate): no sx @ rest, marked limitation w/ physical activity, less than ordinary activity
results in sx
Class IV (severe): sx @ rest, unable to do any physical activity w/o discomfort
Nitroglycerin - ANSWER✔ Vasodilator, causes hypotension, HA.
AHA guideline statin therapy - ANSWER✔ Age 40-75 w/ DM and LDL >/= 70 should get moderate to
high intensity statin therapy
Hyperkalemia ECG changes - ANSWER✔ • Tall/peaked T wave
• Prolonged PR
• ST depression
• Wide QRS
• Loss of P wave
• V-FIb
• Ventricular standstill
,Common complication of carotid endarterectomy - ANSWER✔ Hypoglossal nerve damage, tongue
deviation ipsilateral side of surgery.
Common rhythm w/ TOF - ANSWER✔ V-Tach
Statin side effect - ANSWER✔ Causes painful muscle spasms 2/2 skeletal muscle breakdown,
increased CK levels.
ACS medications - ANSWER✔ Aspirin 1st (antiplatelet), nitroglycerin for ischemia, beta blocker to
reduce cardiac workload by reducing HR.
Cardiac resynchronization therapy - ANSWER✔ Uses 3 leads (RA, RV, LV) to improve ventricular filling
and cardiac output.
Clopidogrel (Plavix) - ANSWER✔ Antiplatelet;
Loading dose 300 mg, then 75 mg daily
Digoxin toxicity - ANSWER✔ Brady, PVCs, LBBB.
*Diltiazem known to increase digoxin levels, worsening toxicity. Tx= digibind.
SVT - ANSWER✔ tachy 100-300 bpm, generally narrow QRS complexes, and P wave often buried in or
after the QRS complex.
Postural orthostatic tachycardia syndrome (POTS) - ANSWER✔ Usually triggered lying to standing.
Sx= lightheadedness, fainting, and rapid HR.
Tx= increase Na+ and fluids, add beta blocker.
Target Temp Management (TTM) - ANSWER✔ Reduce mortality and improve neurological outcomes
in unresponsive patients who achieve ROSC after cardiac arrest.
Contraindications; hemorrhagic stroke, GCS > 8, uncontrolled bleeding, uncontrolled hemodynamically
unstable rhythms, and cardiac arrest due to trauma.
, Pulmonary Embolism - ANSWER✔ CP, dyspnea, tachycardia, tachypnea, hemoptysis. Trop/BNP often
elevated 2/2 R heart strain. CTPA gold standard diagnostic. Tx w/ Hep gtt, unless thrombectomy or tPA.
Pulmonary HTN - ANSWER✔ Dyspnea, ECG= R axis deviation, RV hypertrophy, tricuspid regurg.
Diagnose w/ R heart cath.
Community acquired PNA (CAP) - ANSWER✔ Strept pneumoniae likely pathogen. Oral amoxicillin +
macrolide ie azithromycin.
Hospital acquired PNA (HAP) - ANSWER✔ 48 hrs after admission. Strept/Staph (MSSA/MRSA) and
pseudomonas pathogens. Sputum culture, broad spec- Zosyn & Vanc (MRSA coverage)
Ventilator acquired PNA (VAP) - ANSWER✔ 48 hrs after intubation.
Tx: Vanc/Zosyn + Linezolid
Acute asthma - ANSWER✔ Mag sulfate for severe acute exacc to improve airflow. Dehydration 2/2
high RR in status asthmaticus.
Vent wean criteria - ANSWER✔ FiO2 </=0.5
PEEP </ = 8
RR < 30
min vent < 10 L/min.
Empyema - ANSWER✔ Accumulation of purulent material in pleural space. CT = well defined fluid
accumulation often displacing lung parenchyma. Tx = cultures via blood/thoracent, drainage CT, ABX.
Airway obstruction - ANSWER✔ Stridor present, give nebulized racemic epi to reverse bronchospasm
and relax airway.
ANSWERS|GRADED A+ |LATEST 2026/2027
Pericarditis - ANSWER✔ Often present w/ friction rub, sharp CP w/ inspiration, low-grade fever,
muffled heart tones, hypotension. Tx w/ colchicine.
Pulmonary edema - ANSWER✔ Pink/frothy sputum. Tachypnea, dyspnea, b/l wheeze. CXR shows
alveolar infiltrates, kerley B lines, and pleural effusions.
Cardiac tamponade - ANSWER✔ Becks Triad= muffled tones, JVD, HoTN. Narrow pulse pressure. Low
C.O., low BP, tachy, high RR, JVD, pulsus paradoxus.
Diagnose w/ Echo
CPGs for hypertensive urgency BP reduction - ANSWER✔ 10-25% in the 1st hour, then 160/100
within 6h, then to normal over next 24h.
Septal MI - ANSWER✔ V1, V2
LAD
Anterior MI - ANSWER✔ V3, V4
LAD
Inferior/posterior MI - ANSWER✔ II, III, aVF
RCA
Lateral MI - ANSWER✔ I, aVL, V5, V6
Circumflex
Endocarditis - ANSWER✔ Echo shows vegetation, abscess, or valve dysfunction. Tx ABX
,Pulsus paradoxus - ANSWER✔ Fall in SBP >10 mmHg during inspiration
S4 gallop - ANSWER✔ Common in aortic stenosis
A-FIb ablation - ANSWER✔ >90% pulmonary veins. Anticoags for 2-3 months following.
NYHA HF Classification - ANSWER✔ Stages of HF:
Class I (mild): no sx, no limitations
Class II (mild): no sx @ rest, slight limitation, ordinary activity leads to sx
Class III (moderate): no sx @ rest, marked limitation w/ physical activity, less than ordinary activity
results in sx
Class IV (severe): sx @ rest, unable to do any physical activity w/o discomfort
Nitroglycerin - ANSWER✔ Vasodilator, causes hypotension, HA.
AHA guideline statin therapy - ANSWER✔ Age 40-75 w/ DM and LDL >/= 70 should get moderate to
high intensity statin therapy
Hyperkalemia ECG changes - ANSWER✔ • Tall/peaked T wave
• Prolonged PR
• ST depression
• Wide QRS
• Loss of P wave
• V-FIb
• Ventricular standstill
,Common complication of carotid endarterectomy - ANSWER✔ Hypoglossal nerve damage, tongue
deviation ipsilateral side of surgery.
Common rhythm w/ TOF - ANSWER✔ V-Tach
Statin side effect - ANSWER✔ Causes painful muscle spasms 2/2 skeletal muscle breakdown,
increased CK levels.
ACS medications - ANSWER✔ Aspirin 1st (antiplatelet), nitroglycerin for ischemia, beta blocker to
reduce cardiac workload by reducing HR.
Cardiac resynchronization therapy - ANSWER✔ Uses 3 leads (RA, RV, LV) to improve ventricular filling
and cardiac output.
Clopidogrel (Plavix) - ANSWER✔ Antiplatelet;
Loading dose 300 mg, then 75 mg daily
Digoxin toxicity - ANSWER✔ Brady, PVCs, LBBB.
*Diltiazem known to increase digoxin levels, worsening toxicity. Tx= digibind.
SVT - ANSWER✔ tachy 100-300 bpm, generally narrow QRS complexes, and P wave often buried in or
after the QRS complex.
Postural orthostatic tachycardia syndrome (POTS) - ANSWER✔ Usually triggered lying to standing.
Sx= lightheadedness, fainting, and rapid HR.
Tx= increase Na+ and fluids, add beta blocker.
Target Temp Management (TTM) - ANSWER✔ Reduce mortality and improve neurological outcomes
in unresponsive patients who achieve ROSC after cardiac arrest.
Contraindications; hemorrhagic stroke, GCS > 8, uncontrolled bleeding, uncontrolled hemodynamically
unstable rhythms, and cardiac arrest due to trauma.
, Pulmonary Embolism - ANSWER✔ CP, dyspnea, tachycardia, tachypnea, hemoptysis. Trop/BNP often
elevated 2/2 R heart strain. CTPA gold standard diagnostic. Tx w/ Hep gtt, unless thrombectomy or tPA.
Pulmonary HTN - ANSWER✔ Dyspnea, ECG= R axis deviation, RV hypertrophy, tricuspid regurg.
Diagnose w/ R heart cath.
Community acquired PNA (CAP) - ANSWER✔ Strept pneumoniae likely pathogen. Oral amoxicillin +
macrolide ie azithromycin.
Hospital acquired PNA (HAP) - ANSWER✔ 48 hrs after admission. Strept/Staph (MSSA/MRSA) and
pseudomonas pathogens. Sputum culture, broad spec- Zosyn & Vanc (MRSA coverage)
Ventilator acquired PNA (VAP) - ANSWER✔ 48 hrs after intubation.
Tx: Vanc/Zosyn + Linezolid
Acute asthma - ANSWER✔ Mag sulfate for severe acute exacc to improve airflow. Dehydration 2/2
high RR in status asthmaticus.
Vent wean criteria - ANSWER✔ FiO2 </=0.5
PEEP </ = 8
RR < 30
min vent < 10 L/min.
Empyema - ANSWER✔ Accumulation of purulent material in pleural space. CT = well defined fluid
accumulation often displacing lung parenchyma. Tx = cultures via blood/thoracent, drainage CT, ABX.
Airway obstruction - ANSWER✔ Stridor present, give nebulized racemic epi to reverse bronchospasm
and relax airway.
