ANCC ACUTE CARE NURSE PRACTITIONER (ACNP) 2026 BOARD EXAM
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A patient, who has been in the intensive care unit for 17 days, develops
hypernatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated,
and is receiving mechanical ventilation. The serum osmolality is 320 mOsm/L kg
H2O. Clinical signs include tachycardia and hypotension. An acute care nurse
practitioner's initial treatment is to:
reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride
solution.
reduce serum sodium concentration by infusing a 0.45% sodium c - Correct
Answer-replenish volume by infusing a 0.9% sodium chloride solution.
priority is to replenish the volume and the fix the osmolality
A 78-year-old male patient with heart failure develops a bacterial urinary tract
infection secondary to an indwelling Foley catheter. The patient has a known
history of allergy to penicillin and sulfonamides. The appropriate choice for
antimicrobial therapy is:
cephalexin (Keflex).
ciprofloxacin (Cipro).
doxycycline (Vibramycin).
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, ANCC Acute Care Nurse Practitioner (ACNP) 2026 BOARD EXAM
tetracycline (Sumycin). - Correct Answer-ciprofloxacin (Cipro)
Cephalosporin (ceph) are "cousins" with penicillin (cross-allergy).
Tetracyclines can cause severe side effects and are not recommended for elderly.
An acute care nurse practitioner is evaluating a 78-year-old patient for an aortic
valve replacement. Laboratory results indicate a low serum albumin level. The
nurse practitioner prescribes a high-protein diet and evaluates the patient's
response by:
assessing the total serum protein level.
calculating the body fat percentage.
obtaining a complete blood count.
obtaining a serum prealbumin level. - Correct Answer-obtaining a serum
prealbumin level.
Albumin is relatively insensitive to change of nutritional status. Our body has a
large pool of albumin and it could take up to 14 days for albumin to come back to
normal once the pool is depleted. Albumin level could also be affected by one's
renal function and hydration state.
Prealbumin is one of the earliest indicator for nutritional status now.
Normal level 16-35 mg/dL
A 42-year-old patient with metastatic lung cancer is admitted with severe
intractable pain related to a pathologic fracture of the left femur. The plan is to
stabilize the fracture surgically, and begin local radiation therapy to the site. For
this patient, the most appropriate analgesic regimen is:
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