March 10, 2015

Acute Care Nurse Practitioner Practice Exam Questions

The Acute Care Nurse Practitioner Exam is a comprehensive and challenging examination for men and women who want to enter this exciting and essential field of health care. The exam is administered by computer in testing locations around the country. In order to qualify for the exam, test takers must hold either a valid RN license or a master’s or other postgraduate degree from an accredited acute-care nurse practitioner program, with advanced coursework in health assessment, pharmacology, and pathophysiology.

The Acute Care Nurse Practitioner Exam covers five domains of practice: the relationship between nurse practitioner and patient (21 questions, 14.3 percent of the exam); assessment and diagnosis (36 questions, 23.6 percent); clinical management (51 questions, 33.9 percent); healthcare delivery (21 questions, 14.1 percent); and professional responsibility (21 questions, 14.1 percent).

The exam material can also be broken down by type of health problem, with questions related to conditions in nine different body systems:

Cardiovascular system issues covered include acute coronary syndromes, coronary artery disease, hypertension, heart failure, valvular disease, peripheral vascular disease, pericarditis, cardiomyopathy, aneurysm, and endocarditis.

Pulmonary system disorder information addresses conditions such as emphysema, asthma, bronchitis, tuberculosis, and pleural effusion.

Questions on the endocrine system cover topics that include diabetes mellitus, thyroid disease, Addison’s disease, Cushing’s disease, and diabetes insipidus.

Neurologic conditions on the Acute Care Nurse Practitioner exam include cerebrovascular disease, neurologic inflammatory or degenerative processes, head and spinal cord trauma, meningitis, herniated disk, and headache.

There are questions regarding disorders of the renal, genitourinary, and gynecologic systems, including infection, renal disease, benign prostate hypertrophy, renal artery stenosis, and renal calculi.

Gastrointestinal system conditions on the exam include peptic ulcer disease, hepatitis, pancreatitis, peritonitis, appendicitis, bowel obstruction, and cirrhosis, among others.

Hematology and oncology questions address anemias, cancers, sickle cell disease, and coagulopathies.

Questions related to the immune system cover acquired immunodeficiency (AIDS) syndrome and human immunodeficiency virus (HIV) infection, rheumatoid arthritis, acute allergic reactions, and immunosuppression.

Trauma and degenerative joint diseases of the musculoskeletal system are also addressed.

In addition, the Acute Care Nurse Practitioner Exam covers some of the psychosocial health issues that are pertinent to the life of an acute-care nurse practitioner and includes violence, depression, substance abuse, anxiety, grief, sexuality, powerlessness, and altered mental states. The exam also addresses common problems in acute care, such as fever, shock, nutritional imbalances, poisoning, wound management, infections, transplantation, and pain.

Acute Care Nurse Practitioner Study Guide

Start learning how to be successful on your Acute Care Nurse Practitioner exam. Our Acute Care Nurse Practitioner study guide is guaranteed to help you get the results you deserve on your Acute Care Nurse Practitioner test. Some test takers prefer to study using flashcards and so we have created the best Acute Care Nurse Practitioner flashcards that cover everything you need to know for the Acute Care Nurse Practitioner exam. Note that using multiple study aids will help you maximize the benefit from your study time.

Acute Care Nurse Practitioner Study Guide
Acute Care Nurse Practitioner Flashcards

Acute Care Nurse Practitioner Practice Test

1. A 40-year-old female hospitalized for severe exacerbation of asthma has been treated for 6 days with albuterol by small volume nebulizer, oral theophylline, and IV methylprednisolone. The patient’s blood gases have stabilized. When discontinuing the IV steroid in preparation for discharge, the acute care nurse practitioner should order:

a. Inhaled steroid, such as Azmacort, only
b. Oral prednisone 20 mg daily for one week and then Azmacort
c Oral prednisone in decreasing doses
d. Oral prednisone in decreasing doses and inhaled steroid, such as Azmacort

2. A patient states, “This treatment is too much trouble.” Which of the following is the best example of therapeutic communication?

a. “I agree with you.”
b. “You think the treatment isn’t helping you?”
c. “You should trust the doctor.”
d. “Don’t worry. Everything will be fine.”

3. A patient who receives multiple transfusions with citrated blood products must be monitored closely for:

a. Hyponatremia
b. Hypomagnesemia
c. Hypokalemia
d. Hypocalcemia

4. Which of the following arterial blood gas (ABG) findings is consistent with metabolic acidosis in an adult?

a. HCO3 <22 mEq/L and pH <7.35
b. HCO3 >26 mEq/L and pH >7.45
c. PaCO2 35–45 mm Hg and PaO2>80 mg Hg
d. PaCO2 >55 mm Hg and PaO2 <60

5. When irrigating a wound, what wound irrigation pressure is needed to effectively cleanse the wound while avoiding trauma?

a. <4 psi
b. 20–30 psi
c. 10–15 psi
d. >15 psi

1. D: Patients receiving oral or intravenous steroids should be prescribed oral prednisone in decreasing doses while initiating inhaled steroids. Severe episodes of asthma may occur with withdrawal of oral or IV steroids when switching to inhaled aerosol, so combining inhaled treatment with decreasing doses can help prevent adrenal suppression, which results in acute exacerbation of symptoms. Patients should use a metered-dose inhaler (MDI) with a reservoir device or a formulation with a spacing tube (such as Azmacort) and rinse the mouth thoroughly after inhaling to prevent thrush.

2. B: “You think the treatment isn’t helping you?” is a verbal expression of an implied message. The topic should be explored while allowing the patient to terminate the discussion without probing: “I’d like to hear how you feel about that.” Agreeing with rather than accepting and responding to the patient’s statements can make it difficult for the patient to change his/her statement or opinion later. The nurse should avoid giving advice with “should” statements. Meaningless clichés, such as “Don’t worry,” can block effective communication.

3. D: Patients who receive multiple transfusions with citrated blood products must be carefully monitored for hypocalcemia. Calcium is important for transmitting nerve impulses and regulating muscle contraction and relaxation, including the myocardium. Calcium activates enzymes that stimulate chemical reactions and has a role in coagulation of blood. Values include:
Normal values: 8.2 to 10.2 mg/dL.
Hypocalcemia: <8.2 mg/dL. Critical value: <7 mg/dL.
Hypercalcemia: >10.2 mg/dL. Critical value: >12 mg/dL.
Symptoms include tetany, tingling, seizures, altered mental status, and ventricular tachycardia. Treatment is calcium replacement and vitamin D.

4. A: HCO3 <22 mEq/L and pH <7.35 are consistent with metabolic acidosis, which may result from severe diarrhea, starvation, DKA, kidney failure, and aspirin toxicity. Symptoms may include headache, altered consciousness, agitation, lethargy, and coma. Cardiac dysrhythmias and Kussmaul respiration are common. Other readings:
HCO3 >26 mEq/L and pH >7.45 are consistent with metabolic alkalosis.
PaCO2 35–45 mm Hg and PaO2 >80 mg Hg are normal adult readings.
D. PaCO2 >55 mm Hg and PaO2 <60 are consistent with acute respiratory failure in a previously healthy adult.

5. C: Wounds should be irrigated with pressures of 10 to 15 psi. An irrigation pressure of <4 psi does not adequately cleanse a wound, and pressures >15 psi can result in trauma to the wound, interfering with healing. A mechanical irrigation device is more effective for irrigation than a bulb syringe, which delivers about <2 psi. A 250 mL squeeze bottle supplies about 4.5 psi, adequate for low-pressure cleaning. A 35-mL syringe with a 19-gauge needle provides about 8 psi.

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