ACNPC-AG® Adult-Gerontology Acute Care
NP Exam 2 Questions and Answers Latest
Version A+
Question 1
Which laboratory value is most important to monitor in a patient receiving unfractionated
heparin?
A. INR
B. aPTT
C. Hemoglobin A1c
D. Serum calcium
Correct Answer: B. aPTT
Rationale: Unfractionated heparin therapy is monitored using activated partial thromboplastin
time (aPTT) or anti-Xa levels.
Question 2
An adult patient with acute respiratory failure has increasing work of breathing and declining
oxygen saturation despite supplemental oxygen. Which intervention is most appropriate?
A. Decrease oxygen therapy
B. Consider escalation to noninvasive or invasive ventilatory support
C. Encourage ambulation
D. Administer oral fluids only
Correct Answer: B. Consider escalation to noninvasive or invasive ventilatory support
Rationale: Worsening respiratory failure requires prompt evaluation and escalation of
respiratory support to prevent deterioration.
Question 3
,Which finding is most consistent with left-sided heart failure?
A. Peripheral edema only
B. Pulmonary crackles and orthopnea
C. Increased bowel sounds
D. Right upper quadrant tenderness only
Correct Answer: B. Pulmonary crackles and orthopnea
Rationale: Left ventricular dysfunction causes pulmonary congestion, resulting in dyspnea,
orthopnea, and crackles.
Question 4
A patient with atrial fibrillation has a rapid ventricular response. Which medication class is
commonly used for rate control?
A. Beta blockers
B. Antibiotics
C. Proton pump inhibitors
D. Antihistamines
Correct Answer: A. Beta blockers
Rationale: Beta blockers and calcium channel blockers are commonly used to control
ventricular rate in atrial fibrillation.
Question 5
A 68-year-old patient admitted with pneumonia becomes increasingly confused, hypotensive,
and tachycardic. The nurse practitioner suspects septic shock. Which intervention should occur
first?
A. Obtain a CT scan of the chest
B. Administer broad-spectrum antibiotics and initiate fluid resuscitation
C. Start oral antibiotics
D. Wait for culture results before treatment
Correct Answer: B. Administer broad-spectrum antibiotics and initiate fluid resuscitation
Rationale: Early sepsis management includes rapid antibiotic administration, obtaining cultures
when possible without delaying therapy, and restoring perfusion with IV fluids.
,Question 6
A patient develops sudden unilateral weakness and speech difficulty. What is the priority action?
A. Administer anticoagulants immediately
B. Activate stroke evaluation protocol and obtain emergent brain imaging
C. Delay assessment until symptoms resolve
D. Give oral medications
Correct Answer: B. Activate stroke evaluation protocol and obtain emergent brain imaging
Rationale: Acute stroke requires rapid evaluation to determine eligibility for reperfusion therapy
and exclude hemorrhage.
Question 7
Which ECG finding is associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT only
C. Sinus bradycardia only
D. ST elevation only
Correct Answer: A. Peaked T waves
Rationale: Hyperkalemia commonly causes tall peaked T waves, conduction abnormalities, and
potentially life-threatening arrhythmias.
Question 8
A patient with COPD exacerbation has increased dyspnea and wheezing. Which medication is
appropriate initially?
A. Short-acting bronchodilator therapy
B. Sedative medication only
C. Antibiotics for every patient
D. Fluid restriction only
Correct Answer: A. Short-acting bronchodilator therapy
Rationale: Bronchodilators improve airflow obstruction and are first-line therapy during COPD
exacerbations.
, Question 9
Which assessment finding suggests increased intracranial pressure?
A. Bradycardia with hypertension and irregular respirations
B. Increased appetite
C. Low blood glucose
D. Peripheral edema
Correct Answer: A. Bradycardia with hypertension and irregular respirations
Rationale: Cushing triad (hypertension, bradycardia, irregular respirations) indicates possible
increased intracranial pressure.
Question 10
A patient receiving opioids develops respiratory depression. Which medication reverses opioid
effects?
A. Naloxone
B. Flumazenil
C. Protamine
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
Question 11
Which marker is commonly used to evaluate myocardial injury?
A. Troponin
B. Albumin
C. Bilirubin
D. Amylase
Correct Answer: A. Troponin
NP Exam 2 Questions and Answers Latest
Version A+
Question 1
Which laboratory value is most important to monitor in a patient receiving unfractionated
heparin?
A. INR
B. aPTT
C. Hemoglobin A1c
D. Serum calcium
Correct Answer: B. aPTT
Rationale: Unfractionated heparin therapy is monitored using activated partial thromboplastin
time (aPTT) or anti-Xa levels.
Question 2
An adult patient with acute respiratory failure has increasing work of breathing and declining
oxygen saturation despite supplemental oxygen. Which intervention is most appropriate?
A. Decrease oxygen therapy
B. Consider escalation to noninvasive or invasive ventilatory support
C. Encourage ambulation
D. Administer oral fluids only
Correct Answer: B. Consider escalation to noninvasive or invasive ventilatory support
Rationale: Worsening respiratory failure requires prompt evaluation and escalation of
respiratory support to prevent deterioration.
Question 3
,Which finding is most consistent with left-sided heart failure?
A. Peripheral edema only
B. Pulmonary crackles and orthopnea
C. Increased bowel sounds
D. Right upper quadrant tenderness only
Correct Answer: B. Pulmonary crackles and orthopnea
Rationale: Left ventricular dysfunction causes pulmonary congestion, resulting in dyspnea,
orthopnea, and crackles.
Question 4
A patient with atrial fibrillation has a rapid ventricular response. Which medication class is
commonly used for rate control?
A. Beta blockers
B. Antibiotics
C. Proton pump inhibitors
D. Antihistamines
Correct Answer: A. Beta blockers
Rationale: Beta blockers and calcium channel blockers are commonly used to control
ventricular rate in atrial fibrillation.
Question 5
A 68-year-old patient admitted with pneumonia becomes increasingly confused, hypotensive,
and tachycardic. The nurse practitioner suspects septic shock. Which intervention should occur
first?
A. Obtain a CT scan of the chest
B. Administer broad-spectrum antibiotics and initiate fluid resuscitation
C. Start oral antibiotics
D. Wait for culture results before treatment
Correct Answer: B. Administer broad-spectrum antibiotics and initiate fluid resuscitation
Rationale: Early sepsis management includes rapid antibiotic administration, obtaining cultures
when possible without delaying therapy, and restoring perfusion with IV fluids.
,Question 6
A patient develops sudden unilateral weakness and speech difficulty. What is the priority action?
A. Administer anticoagulants immediately
B. Activate stroke evaluation protocol and obtain emergent brain imaging
C. Delay assessment until symptoms resolve
D. Give oral medications
Correct Answer: B. Activate stroke evaluation protocol and obtain emergent brain imaging
Rationale: Acute stroke requires rapid evaluation to determine eligibility for reperfusion therapy
and exclude hemorrhage.
Question 7
Which ECG finding is associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT only
C. Sinus bradycardia only
D. ST elevation only
Correct Answer: A. Peaked T waves
Rationale: Hyperkalemia commonly causes tall peaked T waves, conduction abnormalities, and
potentially life-threatening arrhythmias.
Question 8
A patient with COPD exacerbation has increased dyspnea and wheezing. Which medication is
appropriate initially?
A. Short-acting bronchodilator therapy
B. Sedative medication only
C. Antibiotics for every patient
D. Fluid restriction only
Correct Answer: A. Short-acting bronchodilator therapy
Rationale: Bronchodilators improve airflow obstruction and are first-line therapy during COPD
exacerbations.
, Question 9
Which assessment finding suggests increased intracranial pressure?
A. Bradycardia with hypertension and irregular respirations
B. Increased appetite
C. Low blood glucose
D. Peripheral edema
Correct Answer: A. Bradycardia with hypertension and irregular respirations
Rationale: Cushing triad (hypertension, bradycardia, irregular respirations) indicates possible
increased intracranial pressure.
Question 10
A patient receiving opioids develops respiratory depression. Which medication reverses opioid
effects?
A. Naloxone
B. Flumazenil
C. Protamine
D. Vitamin K
Correct Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
Question 11
Which marker is commonly used to evaluate myocardial injury?
A. Troponin
B. Albumin
C. Bilirubin
D. Amylase
Correct Answer: A. Troponin
