NURSING 7208
Adult Gerontology
Acute Care Nurse
Practitioner Practicum
Q & A w/ Rationales
2024
,1. When assessing a patient during the Adult-Gerontology
Acute Care Nurse Practitioner (AG-ACNP) practicum, the
presence of a widened mediastinum on chest X-ray is
suggestive of which condition?
a) Acute myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Pleural effusion
Correct answer: c) Aortic dissection
Rationale: A widened mediastinum on chest X-ray is often
seen in patients with aortic dissection, which is a life-
threatening condition. It is important for the AG-ACNP to
recognize this finding and initiate appropriate interventions
promptly.
2. During the AG-ACNP practicum, a patient presents with
sudden onset of severe chest pain, dyspnea, and tachypnea.
The nurse practitioner suspects a pulmonary embolism.
Which diagnostic test is considered the gold standard for
confirming this diagnosis?
a) Chest X-ray
b) Magnetic resonance imaging (MRI)
c) Spiral computed tomography (CT) scan
d) Pulmonary angiography
Correct answer: d) Pulmonary angiography
Rationale: Pulmonary angiography is considered the gold
standard diagnostic test for confirming a pulmonary
, embolism. It provides direct visualization of the pulmonary
arteries and can accurately identify the presence and
location of a clot.
3. As part of the AG-ACNP practicum, a patient with acute
respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. The nurse practitioner urgently
adjusts the ventilator settings after assessing:
a) Decreased tidal volume
b) Increased PaO2 level
c) Decreased heart rate
d) Increased blood pressure
Correct answer: a) Decreased tidal volume
Rationale: In ARDS patients on mechanical ventilation, a
decreased tidal volume may indicate worsening lung
compliance or airway obstruction. It is imperative for the
AG-ACNP to recognize this change and promptly optimize
ventilator settings to maintain adequate oxygenation and
ventilation.
4. During an AG-ACNP practicum, a patient with sepsis is
prescribed broad-spectrum antibiotics. The nurse
practitioner reviews the culture results and notes the
presence of a methicillin-resistant Staphylococcus aureus
(MRSA) infection. Which antibiotic would be most
appropriate to add or switch to in this situation?
a) Ciprofloxacin
b) Amoxicillin
c) Vancomycin
Adult Gerontology
Acute Care Nurse
Practitioner Practicum
Q & A w/ Rationales
2024
,1. When assessing a patient during the Adult-Gerontology
Acute Care Nurse Practitioner (AG-ACNP) practicum, the
presence of a widened mediastinum on chest X-ray is
suggestive of which condition?
a) Acute myocardial infarction
b) Pulmonary embolism
c) Aortic dissection
d) Pleural effusion
Correct answer: c) Aortic dissection
Rationale: A widened mediastinum on chest X-ray is often
seen in patients with aortic dissection, which is a life-
threatening condition. It is important for the AG-ACNP to
recognize this finding and initiate appropriate interventions
promptly.
2. During the AG-ACNP practicum, a patient presents with
sudden onset of severe chest pain, dyspnea, and tachypnea.
The nurse practitioner suspects a pulmonary embolism.
Which diagnostic test is considered the gold standard for
confirming this diagnosis?
a) Chest X-ray
b) Magnetic resonance imaging (MRI)
c) Spiral computed tomography (CT) scan
d) Pulmonary angiography
Correct answer: d) Pulmonary angiography
Rationale: Pulmonary angiography is considered the gold
standard diagnostic test for confirming a pulmonary
, embolism. It provides direct visualization of the pulmonary
arteries and can accurately identify the presence and
location of a clot.
3. As part of the AG-ACNP practicum, a patient with acute
respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. The nurse practitioner urgently
adjusts the ventilator settings after assessing:
a) Decreased tidal volume
b) Increased PaO2 level
c) Decreased heart rate
d) Increased blood pressure
Correct answer: a) Decreased tidal volume
Rationale: In ARDS patients on mechanical ventilation, a
decreased tidal volume may indicate worsening lung
compliance or airway obstruction. It is imperative for the
AG-ACNP to recognize this change and promptly optimize
ventilator settings to maintain adequate oxygenation and
ventilation.
4. During an AG-ACNP practicum, a patient with sepsis is
prescribed broad-spectrum antibiotics. The nurse
practitioner reviews the culture results and notes the
presence of a methicillin-resistant Staphylococcus aureus
(MRSA) infection. Which antibiotic would be most
appropriate to add or switch to in this situation?
a) Ciprofloxacin
b) Amoxicillin
c) Vancomycin
