AACN ACNPC-AG CERTIFICATION PSI PROCTORED ACTUAL EXAM – QUESTIONS AND ANSWERS
| VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A 72-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
increased dyspnea, productive cough, and oxygen saturation of 86% on room air. Which initial
intervention is most appropriate for the Adult-Gerontology Clinical Nurse Specialist (ACNPC-
AG) to recommend?
A. Initiate high-flow oxygen therapy to maintain oxygen saturation above 98%
B. Administer controlled oxygen therapy targeting an oxygen saturation of 88% to 92%
C. Restrict oxygen administration to prevent worsening respiratory failure
D. Immediately prepare the patient for mechanical ventilation
════════════════════
Correct Answer: B. Administer controlled oxygen therapy targeting an oxygen saturation of
88% to 92%
Rationale:
Controlled oxygen therapy is appropriate for many patients with COPD because excessive
oxygen administration can worsen carbon dioxide retention in susceptible individuals. A
target saturation of 88% to 92% balances oxygenation needs while reducing the risk of
hypercapnia. High-flow oxygen, oxygen restriction, and immediate ventilation are not
appropriate initial actions without further assessment.
════════════════════
2. A hospitalized older adult develops acute confusion, inattention, and fluctuating levels of
consciousness after undergoing surgery. Which condition should the ACNPC-AG identify as the
most likely diagnosis?
A. Major neurocognitive disorder
B. Depression
C. Delirium
D. Normal aging-related cognitive decline
════════════════════
Correct Answer: C. Delirium
, Rationale:
Delirium is characterized by an acute onset of altered attention, cognition, and awareness
with fluctuating symptoms. Major neurocognitive disorders develop gradually, depression
does not typically cause fluctuating consciousness, and normal aging does not produce acute
cognitive changes.
════════════════════
3. A patient receiving warfarin therapy has an international normalized ratio (INR) of 6.2
without evidence of active bleeding. Which action is most appropriate?
A. Hold warfarin and evaluate bleeding risk
B. Administer intravenous vitamin K immediately
C. Increase the warfarin dose to stabilize therapy
D. Discontinue all anticoagulation permanently
════════════════════
Correct Answer: A. Hold warfarin and evaluate bleeding risk
Rationale:
An elevated INR without bleeding generally requires holding warfarin and reassessing
therapy. Vitamin K may be considered for significantly elevated INR levels or bleeding
situations. Increasing the dose or permanently discontinuing anticoagulation is inappropriate.
════════════════════
4. The ACNPC-AG is reviewing quality improvement data showing increased catheter-
associated urinary tract infections (CAUTIs) on a hospital unit. Which intervention
demonstrates the highest level of evidence-based practice?
A. Increase documentation requirements for catheter use
B. Educate staff regarding catheter insertion and maintenance bundles
C. Replace all urinary catheters every 48 hours
D. Require physician approval for every catheter removal
════════════════════
Correct Answer: B. Educate staff regarding catheter insertion and maintenance bundles
Rationale:
,Evidence-based CAUTI prevention focuses on appropriate catheter use, aseptic insertion,
maintenance practices, and timely removal. Increasing documentation alone does not prevent
infection, routine catheter replacement increases risk, and removal approval requirements
may delay appropriate discontinuation.
════════════════════
5. A patient with heart failure reports increasing fatigue, orthopnea, and a 5-pound weight
gain over three days. Which finding requires the most immediate intervention?
A. Mild bilateral ankle edema
B. Increased appetite
C. New oxygen saturation of 84% on room air
D. Reports of occasional nocturia
════════════════════
Correct Answer: C. New oxygen saturation of 84% on room air
Rationale:
Severe hypoxemia indicates possible acute decompensated heart failure with pulmonary
congestion and requires immediate assessment and intervention. Mild edema, appetite
changes, and nocturia are less urgent findings.
════════════════════
6. An ACNPC-AG is developing a clinical practice guideline for early mobility in critically ill
adults. Which component is essential for successful implementation?
A. Eliminating interdisciplinary involvement
B. Using current evidence and measurable outcomes
C. Applying the guideline without evaluating results
D. Limiting participation to nursing staff only
════════════════════
Correct Answer: B. Using current evidence and measurable outcomes
Rationale:
, Successful practice guideline development requires evidence review, stakeholder involvement,
implementation planning, and outcome measurement. Ignoring evaluation or
interdisciplinary collaboration reduces effectiveness.
════════════════════
7. A patient receiving opioid therapy becomes difficult to arouse with a respiratory rate of 6
breaths/minute. Which medication should the ACNPC-AG anticipate administering?
A. Flumazenil
B. Naloxone
C. Epinephrine
D. Atropine
════════════════════
Correct Answer: B. Naloxone
Rationale:
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
Flumazenil reverses benzodiazepines, epinephrine treats anaphylaxis or cardiac arrest, and
atropine treats certain bradyarrhythmias.
════════════════════
8. A patient with diabetes mellitus has a hemoglobin A1c of 9.5%. Which interpretation is
most accurate?
A. The patient has excellent glucose control
B. The patient has significant hyperglycemia over approximately three months
C. The patient is experiencing acute hypoglycemia
D. The value confirms diabetic ketoacidosis
════════════════════
Correct Answer: B. The patient has significant hyperglycemia over approximately three
months
Rationale:
| VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A 72-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
increased dyspnea, productive cough, and oxygen saturation of 86% on room air. Which initial
intervention is most appropriate for the Adult-Gerontology Clinical Nurse Specialist (ACNPC-
AG) to recommend?
A. Initiate high-flow oxygen therapy to maintain oxygen saturation above 98%
B. Administer controlled oxygen therapy targeting an oxygen saturation of 88% to 92%
C. Restrict oxygen administration to prevent worsening respiratory failure
D. Immediately prepare the patient for mechanical ventilation
════════════════════
Correct Answer: B. Administer controlled oxygen therapy targeting an oxygen saturation of
88% to 92%
Rationale:
Controlled oxygen therapy is appropriate for many patients with COPD because excessive
oxygen administration can worsen carbon dioxide retention in susceptible individuals. A
target saturation of 88% to 92% balances oxygenation needs while reducing the risk of
hypercapnia. High-flow oxygen, oxygen restriction, and immediate ventilation are not
appropriate initial actions without further assessment.
════════════════════
2. A hospitalized older adult develops acute confusion, inattention, and fluctuating levels of
consciousness after undergoing surgery. Which condition should the ACNPC-AG identify as the
most likely diagnosis?
A. Major neurocognitive disorder
B. Depression
C. Delirium
D. Normal aging-related cognitive decline
════════════════════
Correct Answer: C. Delirium
, Rationale:
Delirium is characterized by an acute onset of altered attention, cognition, and awareness
with fluctuating symptoms. Major neurocognitive disorders develop gradually, depression
does not typically cause fluctuating consciousness, and normal aging does not produce acute
cognitive changes.
════════════════════
3. A patient receiving warfarin therapy has an international normalized ratio (INR) of 6.2
without evidence of active bleeding. Which action is most appropriate?
A. Hold warfarin and evaluate bleeding risk
B. Administer intravenous vitamin K immediately
C. Increase the warfarin dose to stabilize therapy
D. Discontinue all anticoagulation permanently
════════════════════
Correct Answer: A. Hold warfarin and evaluate bleeding risk
Rationale:
An elevated INR without bleeding generally requires holding warfarin and reassessing
therapy. Vitamin K may be considered for significantly elevated INR levels or bleeding
situations. Increasing the dose or permanently discontinuing anticoagulation is inappropriate.
════════════════════
4. The ACNPC-AG is reviewing quality improvement data showing increased catheter-
associated urinary tract infections (CAUTIs) on a hospital unit. Which intervention
demonstrates the highest level of evidence-based practice?
A. Increase documentation requirements for catheter use
B. Educate staff regarding catheter insertion and maintenance bundles
C. Replace all urinary catheters every 48 hours
D. Require physician approval for every catheter removal
════════════════════
Correct Answer: B. Educate staff regarding catheter insertion and maintenance bundles
Rationale:
,Evidence-based CAUTI prevention focuses on appropriate catheter use, aseptic insertion,
maintenance practices, and timely removal. Increasing documentation alone does not prevent
infection, routine catheter replacement increases risk, and removal approval requirements
may delay appropriate discontinuation.
════════════════════
5. A patient with heart failure reports increasing fatigue, orthopnea, and a 5-pound weight
gain over three days. Which finding requires the most immediate intervention?
A. Mild bilateral ankle edema
B. Increased appetite
C. New oxygen saturation of 84% on room air
D. Reports of occasional nocturia
════════════════════
Correct Answer: C. New oxygen saturation of 84% on room air
Rationale:
Severe hypoxemia indicates possible acute decompensated heart failure with pulmonary
congestion and requires immediate assessment and intervention. Mild edema, appetite
changes, and nocturia are less urgent findings.
════════════════════
6. An ACNPC-AG is developing a clinical practice guideline for early mobility in critically ill
adults. Which component is essential for successful implementation?
A. Eliminating interdisciplinary involvement
B. Using current evidence and measurable outcomes
C. Applying the guideline without evaluating results
D. Limiting participation to nursing staff only
════════════════════
Correct Answer: B. Using current evidence and measurable outcomes
Rationale:
, Successful practice guideline development requires evidence review, stakeholder involvement,
implementation planning, and outcome measurement. Ignoring evaluation or
interdisciplinary collaboration reduces effectiveness.
════════════════════
7. A patient receiving opioid therapy becomes difficult to arouse with a respiratory rate of 6
breaths/minute. Which medication should the ACNPC-AG anticipate administering?
A. Flumazenil
B. Naloxone
C. Epinephrine
D. Atropine
════════════════════
Correct Answer: B. Naloxone
Rationale:
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
Flumazenil reverses benzodiazepines, epinephrine treats anaphylaxis or cardiac arrest, and
atropine treats certain bradyarrhythmias.
════════════════════
8. A patient with diabetes mellitus has a hemoglobin A1c of 9.5%. Which interpretation is
most accurate?
A. The patient has excellent glucose control
B. The patient has significant hyperglycemia over approximately three months
C. The patient is experiencing acute hypoglycemia
D. The value confirms diabetic ketoacidosis
════════════════════
Correct Answer: B. The patient has significant hyperglycemia over approximately three
months
Rationale:
