The AGACNP is caring for a patient for which they are concerned is developing delirium.  The AGACNP performs a bedside assessment using the Confusion Assessment Method for the ICU (CAM-ICU).  Which of the following findings must be present to diagnose delirium using the CAM-ICU tool?

EXTRA CREDIT = 1 POINT An AGACNP is reviewing antimicrobial selection in patients with sepsis, specifically related to which patients would require broad multidrug-resistant (MDR) pathogen coverage versus those who do not. According to the 2026 Surviving Sepsis Campaign guidelines, which patient is most likely to require empiric antimicrobial therapy that includes MDR gram-negative coverage?

A 62-year-old patient is admitted to the ICU following multiple abdominal surgeries for perforated diverticulitis. The patient has developed a high-output enterocutaneous fistula producing 1,800 mL/day of drainage. He is hemodynamically stable and not currently requiring pressor support. The patient is becoming progressively malnourished. Which nutrition strategy is most appropriate for this patient?

A patient with Guillain-Barré syndrome is experiencing severe burning neuropathic pain despite dilaudid therapy. Which additional medication would be most appropriate according to SCCM PADIS guidelines?

An AGACNP is obtaining informed consent for placement of a central venous catheter in a patient with septic shock. After explaining the procedure, the patient asks, “What exactly do I need to know before I decide?” Which response by the AGACNP best reflects the essential elements of informed consent?

A 68-year-old patient is receiving heated high flow nasal cannula therapy for severe pneumonia. During the night shift, the patient becomes acutely confused, inattentive, and restless. The CAM-ICU assessment is positive for delirium. Vital signs reveal a heart rate of 118 beats/min, respiratory rate of 24 breaths/min, blood pressure 132/89, and oxygen saturation of 90%. The patient was alert and oriented earlier in the day. The AGACNP suspects a reversible physiologic cause for the patient’s delirium. What is the most appropriate next step?

A 64-year-old male with acute respiratory distress syndrome (ARDS) is admitted to the ICU and intubated. He is hemodynamically stable and has a functioning gastrointestinal tract. The ICU team is considering early enteral nutrition.  Which of the following is true with respect to infectious risk and enteral feeding? Enteral feeding: 

An AGACNP is caring for a 68-year-old patient with severe COPD who is admitted to the ICU with acute respiratory failure. The patient requires noninvasive ventilation and is being asked to consider endotracheal intubation if his condition worsens. During the discussion, the patient clearly states that he does not want intubation. He accurately describes his diagnosis, repeats back the risks and benefits of intubation, acknowledges that refusing treatment could result in death, and states that maintaining independence is more important to him than prolonging life. The patient’s daughter disagrees with his decision and tells the AGACNP, “I don’t think he’s competent to make that choice. He’s obviously not getting enough oxygen.” Which response by the AGACNP is most appropriate?

A 72-year-old patient presents with sepsis secondary to suspected intra-abdominal infection from a perforated colonic viscus. An AGACNP is selecting empiric antimicrobial therapy while awaiting culture results.  According to the 2026 Surviving Sepsis Campaign recommendations, which principle should guide initial antibiotic selection for this patient?

An AGACNP is providing education to newly hired ICU nurses about medications commonly used for sedation of mechanically ventilated patients. Which complication should be monitored for in patients receiving prolonged or high-dose propofol infusions?