AGACNP AACN Boards Questions and
Answers Updated 2026
3 steps of pain management - Answer1. aspirin, tylenol, NSAIDs
2. codeine, hydrocodone, oxycodone, tramadol (only with NSAIDS)
3. morphine, hydromorphone, methadone, fentanyl
Breakthrough cancer pain management - Answerfentanyl
Metastatic bone pain management - Answerbisphosphonates
Tension headache symptoms & management - Answersymptoms - tight, back of head/neck
management - OTC analgesics and rest
Migraine headache types and treatments - Answerclassic - WITH aura
common - WITHOUT aura
treatment - sumatriptan and analgesics
Cluster headache symptoms and management - Answersymptoms - occur at night, ipsilateral
congestion, rhinorrhea, and eye redness
Albumin levels <3.5 - Answerprotein malnutrition
Albumin <2.7 - AnswerEdema
Complications of enteral nutrition - Answeraspiration, refeeding, dehydration
Complications of parenteral nutrition - Answerpneumothorax, hemothorax
,Urine sodium >20 - Answerrenal salt wasting (kidney is the problem)
Urine sodium <10 - Answerkidney isn't the problem
isotonic hyponatremia serum osmolality and causes - Answerserum osmolality - 284-295
causes - extreme hyperlipidemia or nhyperproteinemia
hypotonic hyponatremia serum osmolality and types - Answerserum osmolality <280
hypovolemic w/ sodium <10
hypovolemic w/ sodium >20
hypervolemic
hypovolemic w/ urine sodium <10 causes - Answerdehydration, diuresis, vomiting
hypovolemic w/ urine sodium >20 - Answerdiuretics, ACE, mineralocorticoid deficiency
hypervolemic hypotonic hyponatremia - Answeredema, CHF, liver disease, renal failure
must restrict fluids
hypertonic hyponatremia serum osmolality and causes - Answerserum osmolality >290
causes - HHS
hypokalemia causes, signs/symptoms, treatment - Answercauses - diuretics, GI losses, renal loss,
alkalosis
signs/symptoms - weakness, fatigue, cramps, broad T waves, u waves
treatment - oral replacement if >2.5, 40mEq/L/hr IV if severe
hyperkalemia causes, signs/symptoms, treatment - Answercauses - renal failure, drugs,
hypoaldosteronism
signs/symptoms - weakness, flaccid paralysis, abdominal distension, diarrhea, peaked T waves
treatment - ion resin exchange (kayexalate), insulin, D5W
, hypocalcemia causes, signs/symptoms, treatment - Answercauses - pancreatitis, renal failure,
trauma, massive transfusions
symptoms - increased DTRs, cramps, convulsions, prolonged QT, Chvostek's and Trousseau's sign
treatment - check for alkalosis, IV calcium gluconate if acute, oral supplements if chronic
hypercalcemia causes, signs/symptoms, treatment - Answercauses - vitamin D intoxication,
immobilization, thiazide diuretics
symptoms - fatigue, muscle weakness, constipation, coma, death
treatment - calcitonin if renal/card involvement, NS, loop diuretics, dialysis if severe
respiratory acidosis causes, signs/symptoms, treatment - Answercauses - hypoventilation (pH<7.35,
pCO2>45)
symptoms - somnolence, confusion, coma, myoclonus with asterixis
treatment - narcan if unknown cause, increased ventilator rate
respiratory alkalosis causes, signs/symptoms, treatment - Answercauses - hyperventilation (pH>7.45,
pCO2<35)
symptoms - lightheadedness, tingling, tetany if severe
treatment - paper bag breathing, decreased ventilator rate
metabolic acidosis types, causes, treatment - Answertypes:
increased anion gap - DKA, alcoholic ketoacidosis, lactic acidosis
normal anion gap - diarrhea, ileostomy, renal tubular acidosis, DKA recovery
treat with fluids
metabolic alkalosis causes, signs/symptoms, treatment - Answercauses - saline responsive, NG
suction, vomiting, diuretics
treatment - d/c diuretics, give NaCl and KCl, H2 blockers if GI loss
Gram positive bacteria - Answerstreptococci, staphylococcus, enterococci, bacilli
Gram negative bacteria - AnswerE. coli, klebsiella, pseudomonas, acinetobacter, enterobacter
Answers Updated 2026
3 steps of pain management - Answer1. aspirin, tylenol, NSAIDs
2. codeine, hydrocodone, oxycodone, tramadol (only with NSAIDS)
3. morphine, hydromorphone, methadone, fentanyl
Breakthrough cancer pain management - Answerfentanyl
Metastatic bone pain management - Answerbisphosphonates
Tension headache symptoms & management - Answersymptoms - tight, back of head/neck
management - OTC analgesics and rest
Migraine headache types and treatments - Answerclassic - WITH aura
common - WITHOUT aura
treatment - sumatriptan and analgesics
Cluster headache symptoms and management - Answersymptoms - occur at night, ipsilateral
congestion, rhinorrhea, and eye redness
Albumin levels <3.5 - Answerprotein malnutrition
Albumin <2.7 - AnswerEdema
Complications of enteral nutrition - Answeraspiration, refeeding, dehydration
Complications of parenteral nutrition - Answerpneumothorax, hemothorax
,Urine sodium >20 - Answerrenal salt wasting (kidney is the problem)
Urine sodium <10 - Answerkidney isn't the problem
isotonic hyponatremia serum osmolality and causes - Answerserum osmolality - 284-295
causes - extreme hyperlipidemia or nhyperproteinemia
hypotonic hyponatremia serum osmolality and types - Answerserum osmolality <280
hypovolemic w/ sodium <10
hypovolemic w/ sodium >20
hypervolemic
hypovolemic w/ urine sodium <10 causes - Answerdehydration, diuresis, vomiting
hypovolemic w/ urine sodium >20 - Answerdiuretics, ACE, mineralocorticoid deficiency
hypervolemic hypotonic hyponatremia - Answeredema, CHF, liver disease, renal failure
must restrict fluids
hypertonic hyponatremia serum osmolality and causes - Answerserum osmolality >290
causes - HHS
hypokalemia causes, signs/symptoms, treatment - Answercauses - diuretics, GI losses, renal loss,
alkalosis
signs/symptoms - weakness, fatigue, cramps, broad T waves, u waves
treatment - oral replacement if >2.5, 40mEq/L/hr IV if severe
hyperkalemia causes, signs/symptoms, treatment - Answercauses - renal failure, drugs,
hypoaldosteronism
signs/symptoms - weakness, flaccid paralysis, abdominal distension, diarrhea, peaked T waves
treatment - ion resin exchange (kayexalate), insulin, D5W
, hypocalcemia causes, signs/symptoms, treatment - Answercauses - pancreatitis, renal failure,
trauma, massive transfusions
symptoms - increased DTRs, cramps, convulsions, prolonged QT, Chvostek's and Trousseau's sign
treatment - check for alkalosis, IV calcium gluconate if acute, oral supplements if chronic
hypercalcemia causes, signs/symptoms, treatment - Answercauses - vitamin D intoxication,
immobilization, thiazide diuretics
symptoms - fatigue, muscle weakness, constipation, coma, death
treatment - calcitonin if renal/card involvement, NS, loop diuretics, dialysis if severe
respiratory acidosis causes, signs/symptoms, treatment - Answercauses - hypoventilation (pH<7.35,
pCO2>45)
symptoms - somnolence, confusion, coma, myoclonus with asterixis
treatment - narcan if unknown cause, increased ventilator rate
respiratory alkalosis causes, signs/symptoms, treatment - Answercauses - hyperventilation (pH>7.45,
pCO2<35)
symptoms - lightheadedness, tingling, tetany if severe
treatment - paper bag breathing, decreased ventilator rate
metabolic acidosis types, causes, treatment - Answertypes:
increased anion gap - DKA, alcoholic ketoacidosis, lactic acidosis
normal anion gap - diarrhea, ileostomy, renal tubular acidosis, DKA recovery
treat with fluids
metabolic alkalosis causes, signs/symptoms, treatment - Answercauses - saline responsive, NG
suction, vomiting, diuretics
treatment - d/c diuretics, give NaCl and KCl, H2 blockers if GI loss
Gram positive bacteria - Answerstreptococci, staphylococcus, enterococci, bacilli
Gram negative bacteria - AnswerE. coli, klebsiella, pseudomonas, acinetobacter, enterobacter
