2026 AGACNP/RN Acute Care
Practice Exam 60 Original Multiple-Choice
Questions
1. A patient with crushing chest pain has ST elevation in leads II, III,
and aVF with hypotension and clear lungs. Which intervention
should the AGACNP prioritize?
A. Start nitroglycerin infusion
B. Give IV furosemide
C. Administer IV fluids and activate the cath lab
D. Begin high-dose beta-blocker therapy
2. A patient with septic shock remains hypotensive after 30 mL/kg
crystalloid bolus. Which vasopressor is first-line?
A. Dopamine
B. Phenylephrine
C. Epinephrine
D. Norepinephrine
,3. A patient with atrial fibrillation with rapid ventricular response is
hypotensive, confused, and diaphoretic. What is the best immediate
treatment?
A. IV metoprolol
B. IV amiodarone
C. Oral diltiazem
D. Synchronized cardioversion
4. A patient with DKA has a potassium level of 2.9 mEq/L. What
should be done first?
A. Start insulin infusion immediately
B. Give sodium bicarbonate
C. Hold insulin and replace potassium
D. Administer IV calcium gluconate
5. A patient with renal failure has peaked T waves and a potassium
of 6.9 mEq/L. What is the priority medication?
A. Sodium polystyrene sulfonate
B. Insulin with dextrose
C. Albuterol nebulizer
D. IV calcium gluconate
6. A patient presents with acute ischemic stroke symptoms 2 hours
after onset. Before IV thrombolytic therapy, blood pressure must
generally be below:
,A. 160/90 mmHg
B. 170/100 mmHg
C. 185/110 mmHg
D. 220/120 mmHg
7. Which intervention is appropriate for increased intracranial
pressure?
A. Keep head of bed flat
B. Avoid sedation entirely
C. Elevate head of bed to about 30 degrees
D. Encourage frequent suctioning every 15 minutes
8. A COPD patient with acute exacerbation is receiving oxygen.
What oxygen saturation target is generally appropriate?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
9. A ventilated patient with ARDS should receive which lung-
protective strategy?
A. High tidal volume ventilation
B. Zero PEEP
C. Low tidal volume ventilation, about 6 mL/kg ideal body weight
D. Routine hyperventilation to PaCO₂ below 25
, 10. A patient with pulmonary embolism is hypotensive with signs of
shock. No contraindications are present. Which therapy should be
considered?
A. Oral apixaban only
B. Aspirin only
C. Systemic thrombolytic therapy
D. Observation
11. Which bundle intervention helps prevent ventilator-associated
pneumonia?
A. Supine positioning
B. Routine ventilator circuit changes every shift
C. Head-of-bed elevation 30–45 degrees
D. Avoid oral care
12. A patient develops profuse diarrhea after antibiotics and tests
positive for C. difficile. Which oral medication is commonly
recommended as initial therapy?
A. Ciprofloxacin
B. IV vancomycin only
C. Fidaxomicin or oral vancomycin
D. Metronidazole gel
Practice Exam 60 Original Multiple-Choice
Questions
1. A patient with crushing chest pain has ST elevation in leads II, III,
and aVF with hypotension and clear lungs. Which intervention
should the AGACNP prioritize?
A. Start nitroglycerin infusion
B. Give IV furosemide
C. Administer IV fluids and activate the cath lab
D. Begin high-dose beta-blocker therapy
2. A patient with septic shock remains hypotensive after 30 mL/kg
crystalloid bolus. Which vasopressor is first-line?
A. Dopamine
B. Phenylephrine
C. Epinephrine
D. Norepinephrine
,3. A patient with atrial fibrillation with rapid ventricular response is
hypotensive, confused, and diaphoretic. What is the best immediate
treatment?
A. IV metoprolol
B. IV amiodarone
C. Oral diltiazem
D. Synchronized cardioversion
4. A patient with DKA has a potassium level of 2.9 mEq/L. What
should be done first?
A. Start insulin infusion immediately
B. Give sodium bicarbonate
C. Hold insulin and replace potassium
D. Administer IV calcium gluconate
5. A patient with renal failure has peaked T waves and a potassium
of 6.9 mEq/L. What is the priority medication?
A. Sodium polystyrene sulfonate
B. Insulin with dextrose
C. Albuterol nebulizer
D. IV calcium gluconate
6. A patient presents with acute ischemic stroke symptoms 2 hours
after onset. Before IV thrombolytic therapy, blood pressure must
generally be below:
,A. 160/90 mmHg
B. 170/100 mmHg
C. 185/110 mmHg
D. 220/120 mmHg
7. Which intervention is appropriate for increased intracranial
pressure?
A. Keep head of bed flat
B. Avoid sedation entirely
C. Elevate head of bed to about 30 degrees
D. Encourage frequent suctioning every 15 minutes
8. A COPD patient with acute exacerbation is receiving oxygen.
What oxygen saturation target is generally appropriate?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
9. A ventilated patient with ARDS should receive which lung-
protective strategy?
A. High tidal volume ventilation
B. Zero PEEP
C. Low tidal volume ventilation, about 6 mL/kg ideal body weight
D. Routine hyperventilation to PaCO₂ below 25
, 10. A patient with pulmonary embolism is hypotensive with signs of
shock. No contraindications are present. Which therapy should be
considered?
A. Oral apixaban only
B. Aspirin only
C. Systemic thrombolytic therapy
D. Observation
11. Which bundle intervention helps prevent ventilator-associated
pneumonia?
A. Supine positioning
B. Routine ventilator circuit changes every shift
C. Head-of-bed elevation 30–45 degrees
D. Avoid oral care
12. A patient develops profuse diarrhea after antibiotics and tests
positive for C. difficile. Which oral medication is commonly
recommended as initial therapy?
A. Ciprofloxacin
B. IV vancomycin only
C. Fidaxomicin or oral vancomycin
D. Metronidazole gel
