1|Page
Latest PNCB Acute Care Certification Practice Test
With 150 questions and Correct Answers with
Rationales/ PNCB Acute Care Practice Exam (New)
Hyperthyroidism/Grave's Disease/Thyrotoxicosis/"Thyroid
Storm" (pg.111) - ...ANSWER...✓✓ Patient presents with
weight loss, palpitations, nervousness, heat intolerance
Exophthalmos (AKA proptosis) 'bulging of the eye'
AVOID Aspirin (ASA) - Prevents binding of thyroglobulin,
making the situation worse
Treatment: IV Fluids 1st, Beta Blockers (Propanolol),
Steroids (Dexamethasone), and Tylenol for fever.
Septic Shock (pg.113) - ...ANSWER...✓✓ Someone who is
in shock second degree to sepsis (infection in the
bloodstream)
Hypotensive with normal HR
,2|Page
Hypotensive while being refractory to fluids
Patient needs IV fluid therapy and vasopressors
Levophed (Norepinephrine) is vasopressor of choice in
profound hypotension
Do not use Etomidate in RSI (due to its adrenal
suppression) *Also do not use Etomidate in Addison's
Disease also due to the adrenal suppression
Pancreatitis (pg.113) - ...ANSWER...✓✓ Pain that is usually
centered in the upper middle or upper left abdomen. Often
radiates from the front of the abdomen through to the
back, begins or worsens after eating, lasts a few days,
and may feel worse when a person lies flat on their back.
The digestive enzymes in the pancreas are destroying the
pancreas.
Increased lipase levels (usually >3x normal)
*Amylase may also be increased but Faudree did not
preface this in his study guide notes.
,3|Page
Demerol for pain (b/c Morphine has the ability to cause
spasms of the Sphincter of Oddi)
Typically requires surgical intervention.
Grey Turner's Sign (pg.113) - ...ANSWER...✓✓ Flank
ecchymosis caused by hemorrhagic pancreatitis.
Cullen's Sign (pg. 113) - ...ANSWER...✓✓ Periumbilical
ecchymosis caused by hemorrhagic pancreatitis.
Hypothyroidism/Myxedema Coma (pg. 112) -
...ANSWER...✓✓ Patient presents with fatigue, cold
intolerance, weight gain, puffy eyelids, sparse hair,
possibly goiter.
Primarily occurs in women.
>90% cases in winter (b/c the patient has cold intolerance
and is not suffering from hypothermia)
, 4|Page
Officially Myxedema Coma upon changes in LOC.
Treatment: Levothyroxine (Synthroid) (T4) or Triostat (T3)
IV
Cushing's Syndrome (pg.112) - ...ANSWER...✓✓ Buffalo
hump, moon face, thin arms and legs, purple striae on
abdomen.
Causes: Excessive use of corticosteroids (Iatrogenic,
from corticosteroid treatment(s)) or Tumor
Treatment: Usually resolves when corticosteroids are
stopped or tumor is removed.
Adrenal Insufficiency/Adrenal Crisis (pg. 112) -
...ANSWER...✓✓ Also known as (AKA): Addison's Disease
Patient presents with depression, malaise, salt craving,
and bronze colored skin like JFK.
Treatment: Oral steroids (Prednisone)
Latest PNCB Acute Care Certification Practice Test
With 150 questions and Correct Answers with
Rationales/ PNCB Acute Care Practice Exam (New)
Hyperthyroidism/Grave's Disease/Thyrotoxicosis/"Thyroid
Storm" (pg.111) - ...ANSWER...✓✓ Patient presents with
weight loss, palpitations, nervousness, heat intolerance
Exophthalmos (AKA proptosis) 'bulging of the eye'
AVOID Aspirin (ASA) - Prevents binding of thyroglobulin,
making the situation worse
Treatment: IV Fluids 1st, Beta Blockers (Propanolol),
Steroids (Dexamethasone), and Tylenol for fever.
Septic Shock (pg.113) - ...ANSWER...✓✓ Someone who is
in shock second degree to sepsis (infection in the
bloodstream)
Hypotensive with normal HR
,2|Page
Hypotensive while being refractory to fluids
Patient needs IV fluid therapy and vasopressors
Levophed (Norepinephrine) is vasopressor of choice in
profound hypotension
Do not use Etomidate in RSI (due to its adrenal
suppression) *Also do not use Etomidate in Addison's
Disease also due to the adrenal suppression
Pancreatitis (pg.113) - ...ANSWER...✓✓ Pain that is usually
centered in the upper middle or upper left abdomen. Often
radiates from the front of the abdomen through to the
back, begins or worsens after eating, lasts a few days,
and may feel worse when a person lies flat on their back.
The digestive enzymes in the pancreas are destroying the
pancreas.
Increased lipase levels (usually >3x normal)
*Amylase may also be increased but Faudree did not
preface this in his study guide notes.
,3|Page
Demerol for pain (b/c Morphine has the ability to cause
spasms of the Sphincter of Oddi)
Typically requires surgical intervention.
Grey Turner's Sign (pg.113) - ...ANSWER...✓✓ Flank
ecchymosis caused by hemorrhagic pancreatitis.
Cullen's Sign (pg. 113) - ...ANSWER...✓✓ Periumbilical
ecchymosis caused by hemorrhagic pancreatitis.
Hypothyroidism/Myxedema Coma (pg. 112) -
...ANSWER...✓✓ Patient presents with fatigue, cold
intolerance, weight gain, puffy eyelids, sparse hair,
possibly goiter.
Primarily occurs in women.
>90% cases in winter (b/c the patient has cold intolerance
and is not suffering from hypothermia)
, 4|Page
Officially Myxedema Coma upon changes in LOC.
Treatment: Levothyroxine (Synthroid) (T4) or Triostat (T3)
IV
Cushing's Syndrome (pg.112) - ...ANSWER...✓✓ Buffalo
hump, moon face, thin arms and legs, purple striae on
abdomen.
Causes: Excessive use of corticosteroids (Iatrogenic,
from corticosteroid treatment(s)) or Tumor
Treatment: Usually resolves when corticosteroids are
stopped or tumor is removed.
Adrenal Insufficiency/Adrenal Crisis (pg. 112) -
...ANSWER...✓✓ Also known as (AKA): Addison's Disease
Patient presents with depression, malaise, salt craving,
and bronze colored skin like JFK.
Treatment: Oral steroids (Prednisone)
