Preparing for the AGACNP (Adult-Gerontology Acute Care Nurse Practitioner) exam? Management is one of the areas our deck drills hardest: 440 of its 1020 flashcards focus on management, covering topics like RCA, Regional Citrate Anticoagulation. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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During CRRT utilizing Regional Citrate Anticoagulation (RCA), the NP notes the systemic ionized calcium (iCa) is 0.8 mmol/L and the post-filter iCa is 0.3 mmol/L. What is the most appropriate intervention?
Show answer →The NP should increase the systemic calcium gluconate/chloride infusion. The goal of RCA is to keep the post-filter iCa low (0.25–0.40 mmol/L) to prevent circuit clotting while maintaining the systemic iCa in a normal range (1.1–1.3 mmol/L). A systemic iCa of 0.8 indicates hypocalcemia (citrate toxicity risk or inadequate replacement). Rationale: Citrate chelates calcium in the circuit; most is removed by the filter, but some enters the patient, necessitating systemic replacement. Monitoring iCa is critical for safety.
A NP is considering Clevidipine for a patient in hypertensive emergency. What are two specific contraindications/limitations related to the formulation of this drug?
Show answer →1. Allergies to Soy or Eggs: Clevidipine is formulated in a lipid emulsion. 2. Impaired Lipid Metabolism: Use with caution in patients with acute pancreatitis or hypertriglyceridemia. Clinical Pearl: Clevidipine is a third-generation dihydropyridine CCB with an ultra-short half-life (approx. 1 minute), allowing for rapid titration. Remember that the caloric intake from the lipid emulsion (2 kcal/mL) must be accounted for in patients with strict nutritional requirements.
Why is Propofol often preferred over Midazolam for continuous sedation in the management of severe TBI in the ICU setting?
Show answer →Propofol is preferred due to its short half-life, allowing for rapid washout to perform serial neurological assessments. It also reduces the cerebral metabolic rate of oxygen (CMRO2) and can help lower ICP. Caution: High doses (>50 mcg/kg/min) for prolonged periods increase the risk of Propofol Infusion Syndrome (PRIS), characterized by metabolic acidosis, rhabdomyolysis, and cardiac failure.
A patient is admitted with acute pancreatitis. The team wants to order an abdominal CT with IV contrast to assess for necrosis. What is the optimal timing for this scan to ensure diagnostic accuracy?
Show answer →CT with IV contrast should ideally be delayed until 72–96 hours after symptom onset. Early CT (within 24 hours) often underestimates the extent of pancreatic necrosis as it takes time for perfusion deficits to become radiographically apparent. ANCC Tip: Use CT early only if the diagnosis is uncertain or to rule out other emergencies like perforation. For severity assessment, wait 3+ days to capture the full extent of tissue damage.
An ICU patient with suspected HIT has an AKI with a Creatinine of 3.2 mg/dL. Which non-heparin anticoagulant is the preferred first-line choice for this patient?
Show answer →Argatroban. It is hepatically metabolized, making it the preferred agent in renal failure or AKI. Bivalirudin is primarily cleared by the kidneys (and proteolysis) and requires significant dose reductions in renal impairment. Exam Strategy: Match the drug to organ function. Argatroban = Liver (Avoid in hepatic failure); Bivalirudin = Kidney (Avoid or dose-adjust in renal failure).
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1,020 AGACNP question-and-answer cards across 9 topics, written for this exam. Refund policy.
The full AGACNP deck contains 1020 flashcards, and 440 of them focus on management. This page shows 5 free samples.
Our AGACNP deck dedicates 440 of 1020 cards (43%) to management — always cross-check the official ANCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the AGACNP preview page has 30 more free cards. Full access to all 1020 cards is a one-time $7.
Assessment
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Basics
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Pathology
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Pharmacology
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Physiology
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