ANCC Adult-Gerontology Acute Care Nurse Practitioner Certification Examination Practice Test
Adult-gerontology acute care practice focuses on managing adults with serious, unstable, or complex health problems. Questions in this bank sample clinical decisions involving acute kidney injury, electrolyte emergencies, respiratory failure, sepsis, stroke, seizures, endocrine crises, and altered mental status.
Exam overview
About the ANCC Adult-Gerontology Acute Care Nurse Practitioner Certification… Exam
Acute-care decisions require interpreting trends and findings together: electrocardiographic changes with potassium levels, blood gases with mental status, and infection signs with possible obstruction. Practice also involves prioritizing immediate stabilization, selecting diagnostic steps, and recognizing when a condition calls for urgent intervention or source-control evaluation. Medication safety is central when acute illness changes renal function, oral intake, or hemodynamic status. Other scenarios test recognition and initial management of hepatic encephalopathy, hypoglycemia, adrenal crisis, prolonged seizures, and suspected ischemic stroke. For each case, identify the immediate threat, distinguish stabilization from definitive treatment, and consider which additional assessment or diagnostic information would change the next decision.
Sample Practice Questions
Review a selection from this exam's published US Practice Tests practice bank.
A patient with acute kidney injury has a serum potassium of 6.8 mEq/L and peaked T waves on electrocardiogram. Which intervention should be given first to reduce immediate cardiac risk?
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Correct answer: AIntravenous calcium stabilizes the cardiac membrane and is the immediate priority when severe hyperkalemia is accompanied by electrocardiographic changes. Additional measures are then needed to shift potassium into cells and remove potassium from the body.
A patient with fever, hypotension, and flank pain has urinalysis findings consistent with infection. Which additional finding most strongly suggests an infected obstructed urinary system requiring urgent source-control evaluation?
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Correct answer: AHydronephrosis in a patient with systemic infection raises concern for urinary obstruction with infection. This combination can require urgent urologic assessment and drainage in addition to antimicrobial therapy.
A patient with cirrhosis and ascites becomes confused and has asterixis. Which initial intervention is most appropriate for suspected hepatic encephalopathy while evaluating for precipitating causes?
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Correct answer: ALactulose is used to reduce intestinal ammonia absorption and promote its elimination. Evaluation and treatment of precipitating factors, including infection, bleeding, constipation, and medication effects, are also essential.
A patient with an indwelling urinary catheter develops fever and suprapubic discomfort. The catheter is no longer needed for care. Which action best supports infection prevention and management?
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Correct answer: ARemoving an unnecessary indwelling catheter reduces ongoing device-associated infection risk. The patient should be assessed for infection and treated according to clinical findings and appropriate testing.
A patient with chronic obstructive pulmonary disease becomes somnolent while receiving supplemental oxygen. Arterial blood gas shows pH 7.28 and PaCO2 68 mm Hg. Which interpretation is most accurate?
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Correct answer: BThe low pH indicates acidemia, and the elevated PaCO2 identifies a respiratory cause, consistent with acute respiratory acidosis. Somnolence may reflect worsening hypercapnia and requires prompt assessment of ventilation and respiratory support needs.
A patient with a suspected acute ischemic stroke arrives within the first hour after symptom onset. What is the immediate imaging study used to identify intracranial hemorrhage before considering reperfusion treatment?
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Correct answer: AA noncontrast head CT is commonly obtained urgently to distinguish intracranial hemorrhage from ischemia before thrombolytic treatment is considered. Further imaging and treatment decisions depend on the clinical presentation and local stroke protocol.
A patient with a history of adrenal insufficiency presents with vomiting, profound weakness, and hypotension during an acute illness. Which treatment should be anticipated promptly?
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Correct answer: AAcute illness can precipitate adrenal crisis in a patient with adrenal insufficiency. Prompt parenteral stress-dose glucocorticoid treatment and supportive management are essential.
How to use this practice test
Access is free. Each practice session draws up to 20 random questions from the 50-question bank and displays results when the session ends. Use the results to identify clinical decisions that need further review, such as emergency prioritization, medication precautions, or interpretation of acute findings.
Preparation tips
- For hyperkalemia cases, connect serum potassium and ECG changes to immediate cardiac stabilization and subsequent potassium-lowering measures.
- Practice reading arterial blood gases alongside respiratory status to distinguish acute ventilatory failure from other causes of altered consciousness.
- For suspected stroke scenarios, sequence emergency brain imaging to exclude hemorrhage before considering reperfusion options.
- Compare acute illness medication risks in renal impairment, including metformin accumulation concerns during dehydration and acute kidney injury.
- Review first-response priorities for adrenal crisis, severe hypoglycemia, hepatic encephalopathy, and prolonged convulsive seizures.