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?

The AGACNP is reviewing and considering sleep disruption in critically ill patients and the possible clinical consequences. Which of the following statements is most accurate regarding sleep disturbance and deprivation in the ICU? 

A 58-year-old male is post-operative day 4 following coronary artery bypass graft (CABG) surgery. He develops a temperature of 38.5°C (101.3°F) and mild tachycardia but his vital signs are otherwise stable. The AGACNP presents to the bedside to evaluate him.  His surgical site is clean, and there are no signs of erythema or drainage. His white blood cell count on morning labs is 11,000 uL.  He has no indwelling catheters or lines as they have all been previously discontinued.  He has no new infiltrates on CXR or other signs of infection.  He has been progressing well overall postoperatively but has not been ambulating as recommended because he feels tired.   At this stage in the patient’s post operative course and with the given information, the AGACNP should most consider which of the following sources of fever? 

Calculate the following liquid diet intake for lunch in mL. 8 oz coffee 4 oz jello 4 oz pudding Total intake in mL: [BLANK-1] mL

Calculate the following dosage. Order: Metoprolol 12.5 mg po daily Available: 25 mg tablets How many tables will the client receive in one dose? [BLANK-1]

Finely is described by coworkers as highly organized and meticulous. Finely has a strong sense of self-discipline. According to the Big Five Factors of Personality, Finely is most likely to score high on