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ACNPC Exam for American Association of Critical-Care Nurses (AACN) Certification Corporation verified answers
- Following a 10-foot fall, a young adult presents on a backboard with a c-collar on. The pt had an initial LOC at the scene and was lucid on arrival, but LOC is rapidly deteriorating. The right pupil is round and reactive, but the left is dilated and unresponsive to light. The ACNP should first suspect: a. a basilar skull fx b. a subdural hematoma c. an epidural hematoma d. a cerebellar herniation correct answer an epidural hematoma" "A pt is readmitted d/t suspected PE. Home meds include metformin (Glucophage). Which of the following available dx methods would be indicated? a. V/Q scan b. spiral CT c. pulmonary angiogram d. venous doppler study correct answer a. V/Q scan" "The ACNP should recognize that a toxic exposure to a. methanol is best tx with a sodium bicarb infusion b. salicylates is best tx with n-acetylcysteine (Mucomyst) c. benzos are best tx with hemodialysis d. carbon monoxide is best tx with hyperbaric oxygen correct answer d. carbon monoxide is best tx with hyperbaric oxygen" "When assessing the weaning ability of a 75 yo COPD pt who is being mechanically ventilated, it is important for the ACNP to consider that elderly pts a. have a greater respiratory reserve than younger pts b. have equivalent PaO2/FiO2 ratios compared to younger pts
c. tend to breath faster and shallower than younger pts d. tend to have a lower A-a gradient compared to younger pts correct answer c. tend to breath faster and shallower than younger pts" "While discharging a pt following knee replacement sx, the pt experiences a new onset episode of chest pain lasting 10 minutes. The cardiac biomarkers and 12-lead ECG are unremarkable. The pt is currently pain free and anxious to go home. The ACNP should a. dc the pt and have them f/u w/their PCP b. hold dc and repeat cardiac biomarkers in 8 hrs c. dc the pt and schedule an appt for a cardiology f/u d. hold dc and schedule an emergent cardiac catheterization correct answer b. hold dc and repeat cardiac biomarkers in 8 hrs" "Concerns are raised about a unit's increasing utilization of blood products. The ACNP is asked to participate on a newly formed inter-professional team. Upon agreeing to participate, the ACNP should first a. verify that the meeting schedule would align with the ACNPs schedule b. ensure that the ACNP's suggestions will be adopted c. find out who else will be participating d. identify the goals assigned to the team correct answer d. identify the goals assigned to the team" "Following cardiac sx, a pt in sinus rhythm suddenly converts to a fib. The pt is asymptomatic. Tx should include a. sedation and cardioversion b. diltiazem (Cardizem) infusion c. emergency defibrillation d. digoxin (Lanoxin) correct answer b. diltiazem (Cardizem) infusion" "
Nephron cannot conserve water. Commonly caused by damage to the pituitary gland or hypothalamus (surgery, tumor, meningitis, head injury). Can be nephrogenic where the kidney in unable to respond to ADH. Serum: Hypernatremia and hyperosmolarity. Urine: Hyponatremia and hypoosmolality. Replaced ADH and supportive fluid replacement." "Syndrome of Inapropriate Antidiuretic Hormone (SIADH)correct answer Excess ADH production. Nephron conserves excess water. Caused by head injury and lung cancers. Serum: Hyponatremia and hypoosmolality. Urine: Hypernatremia and hyperosmolarity. Fluid overload. Treat with: Free water restriction Loop diuretic and NS IN extremes 3% saline"
"Transudate pleural effusioncorrect answer CHF Constrictive pericarditis Cirrhosis SG <1. Protein <3 g/dl LDH < 200 Fluid-serum protein ratio <0. Fluid -serum LDH ratio <0.5" "Exudate pleural effusioncorrect answer Lung parenchymal infection Malignancy PE SG >1. Protein >3 g/dl LDH > Fluid-serum protein ratio >0. Fluid-serum LDH ratio >0.5" "Fibrinolysis Contraindicationscorrect answer Absolute Hx of cerebrovascular event (ICH, intracranial neoplasm, aneurysm, AVM) Non-hemorrhagic stroke or head trauma <3 months ago. Cranial or spinal trauma <2 months ago. Known bleeding disorder. Active internal bleeding.
Unilateral fixed pupil Nausea/vomiting Dizziness Treatment: BP Control Surgical intervention." "Subdural Hematomacorrect answer Damage to the bridging veins causing blood to accumulate under the dura mater. Can be acute or chronic. Headache Gradual LOC/change in mental status Seizures Treatment: Surgical intervention Watch and wait. Anti-seizure prophylaxis." "Kernig's Signcorrect answer Sign of meningitis; positive when the leg is fully bent at the hip and knee, and subsequent extension of the knee leads to pain." "Brudzinski's Signcorrect answer Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed." "Bacterial Meningitiscorrect answer Glucose <45 mg/dl
Protein >50 mg/dl Opening pressure is markedly high. Cell count 200-20,000 PMN/microliter." "Viral Meningitiscorrect answer Glucose Normal Protein >50 mg/dl and purulent. Opening pressure Normal/slightly elevated. Cell count 100-1000 lymphocytes/microliter" "Physiologic (AKA innocent/functional)correct answer Grade 1-3/6 early to midsystolic murmur. Heard best at LSB but usually audible over precordium No radiation. Softens or disappears with standing. Increases in intensity with activity, fever, anemia. S1 and S2 intact. PMI normal." "Aortic Stenosis Murmurcorrect answer Grade 1-4/6 harsh systolic murmur, usually crescendo- decrescendo pattern. Heard best at 2nd RICS, apex, and softens with standing. Radiates to carotids, may have diminished S2, slow filling carotid pulse, narrow pulse pressure, loud S4, heaving PMI. Great the degree of stenosis the later the peak of murmur. Younger adults due to bicuspid valve. Older adults due to calcific /rheumatic. Dizziness and syncope are an ominous sign pointing to severely decreased cardiac output."
Persistent ostium secundium in mid septum. Will resolve with ASD correction." "Pulmonary Hypertensioncorrect answer Narrow splitting S2, murmur of tricuspid regurgitation. SOB nearly universal. Seen RVH, RAH as identified on EKG/echo. Secondary PH may be a consequence of Redux "Phen/fen" use" "Mitral Regurgitationcorrect answer Grade 1-4/6 high pitched blowing systolic murmur, often extending beyond S2. Sounds like a long "haaaa, hooo". Heard best at RLSB. Radiates to axilla, often with laterally displaced PMI. Decreased with standing, Valsalva maneuver. Increased by squat, hand grip. Found in ischemic heart disease, endocarditis, RHD." "Mitral Valve Prolapsecorrect answer Grade 1-3/6 late systolic crescendo murmur with honking quality heard best at apex. Murmur follows midsystolic click. Valsalva or standing moves click forward into earlier systole, resulting in a longer sounding murmur. Hard grasp or squat click moves back resulting in a shorter murmur. Often seen with minor thoracic deformities such as pectus excavatum, straight back, and shallow AP diameter. There is sometimes chest pain." "McMurray Testcorrect answer Meniscal tear" "Talar Tilt Testcorrect answer Ankle Instability"
"Tinel's signcorrect answer carpal tunnel syndrome" "Lachman Testcorrect answer ACL tear" "Straight Leg Raise Testcorrect answer Lumbar nerve root compression" "Spurling Testcorrect answer Cervical nerve root compression" "Drop Arm Testcorrect answer Rotator cuff evaluation" "Finkelstein Testcorrect answer De Quervain's Tenosynovitis" "Osgood-Schlatter diseasecorrect answer inflammation or irritation of the tibia at its point of attachment with the patellar tendon" "Osteoarthritis (OA)correct answer Joint space narrowing" "Heberden's nodescorrect answer Closest to the tip of the finger." "Bouchard's nodescorrect answer Middle Joint of finger." "
