Free ACCNS-AG exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the ACCNS-AG exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An adult recovering from acute coronary syndrome has no high bleeding risk. The CNS reviews the discharge antiplatelet plan. What is the minimum duration of aspirin plus an oral P2Y12 inhibitor in the guideline's default strategy?

   1. A. At least 1 month
   2. B. At least 3 months
   3. C. At least 6 months
   4. D. At least 12 months

   Answer: D

   Explanation: The AHA states, "Dual antiplatelet therapy with aspirin and an oral P2Y12 inhibitor is indicated for at least 12 months as the default strategy in patients with ACS who are not at high bleeding risk." This patient meets that condition, so the minimum default duration is 12 months.

   Reference: Top Things to Know: 2025 Guideline for Acute Coronary Syndromes — Top Things to Know, paragraph 2

2. 2An older adult has heard the benefits and harms of two medically reasonable treatments but remains undecided. The CNS wants to learn how the patient weighs the tradeoff. Which question most directly elicits that information?

   1. A. Which benefit would make a treatment worthwhile despite its burdens?
   2. B. Which treatment name is easiest for you to remember?
   3. C. Which part of the treatment explanation remains unclear?
   4. D. Which family member would you like to join the discussion?

   Answer: A

   Explanation: AHRQ describes shared decision making as exploring options and "what matters most to them." Asking how a benefit compares with its burdens elicits the patient's priorities. The other questions address recall, comprehension, or who participates, all useful in other parts of a decision conversation but not the patient's weighting of outcomes.

   Reference: The SHARE Approach — The SHARE Approach

3. 3A patient is hospitalized after acute coronary syndrome and can tolerate statins. Which initial lipid-lowering regimen most directly follows the 2025 ACS guideline?

   1. A. High-intensity statin, with ezetimibe considered
   2. B. Moderate-intensity statin, with ezetimibe considered
   3. C. Low-intensity statin, with ezetimibe considered
   4. D. Ezetimibe alone, with a statin deferred

   Answer: A

   Explanation: The AHA states, "High-intensity statin therapy is recommended for all ACS patients with the option to initiate concurrent ezetimibe." A high-intensity statin is therefore the core initial regimen; ezetimibe can be added concurrently.

   Reference: Top Things to Know: 2025 Guideline for Acute Coronary Syndromes — Top Things to Know, paragraph 3

4. 4Nurses disagree about goals of care for a frail older patient and report moral distress. As the CNS plans an institutional response, which resource specifically lets the disciplines examine their divergent care goals together?

   1. A. An interdisciplinary forum for open discussion of patient goals
   2. B. A critical stress debriefing for clinicians after the event
   3. C. Individual crisis counseling for clinicians requesting support
   4. D. An employee assistance referral for clinicians under stress

   Answer: A

   Explanation: AACN recommends that institutions "Create interdisciplinary forums to discuss patient goals of care and divergent opinions regarding those goals of care in an open, respectful environment." The forum addresses the team's competing goals together. Debriefing, counseling, and employee assistance are real support resources, but their stated functions do not provide that joint discussion.

   Reference: ACCNS-AG Exam Handbook — Test Plan p.8, Advocacy/Moral Agency

5. 5An adult with acute coronary syndrome develops cardiogenic shock. Angiography identifies one acute culprit occlusion and several chronic coronary lesions. Which vessel should receive emergency revascularization according to the ACS guideline?

   1. A. The acute culprit vessel causing the infarction
   2. B. The chronic lesion with the greatest diameter stenosis
   3. C. The previously stented vessel with the oldest implant
   4. D. The nonculprit vessel supplying the largest territory

   Answer: A

   Explanation: The AHA states, "In patients with ACS and cardiogenic shock, emergency revascularization of the culprit vessel is indicated; however, routine PCI of non-infarct-related arteries at the time of PCI is not recommended." The acute infarct-related culprit vessel is the emergency target, not a chronic or nonculprit lesion.

   Reference: Top Things to Know: 2025 Guideline for Acute Coronary Syndromes — Top Things to Know, paragraph 6

6. 6A hospital ethics committee is revising how it makes crisis-care decisions. Which professional group does AACN's moral-distress position statement say must be included as decision makers on every institutional ethics committee?

   1. A. Nurses providing patient care
   2. B. Respiratory therapists providing patient care
   3. C. Hospital pharmacists providing patient care
   4. D. Hospital chaplains providing patient care

   Answer: A

   Explanation: AACN calls on institutions to "Guarantee that nurses are included as decision makers on all institutional ethics committees." The other disciplines may contribute to ethics work, but the cited AACN directive specifically guarantees nurses a decision-making role.

   Reference: AACN Position Statement: Moral Distress in Times of Crisis — Recommended Actions for Healthcare Institutions

7. 7A patient with established heart failure had a left ventricular ejection fraction of 35% last year and 45% at the current visit after treatment. Which guideline category describes this trajectory?

   1. A. Heart failure with reduced ejection fraction
   2. B. Heart failure with improved ejection fraction
   3. C. Heart failure with mildly reduced ejection fraction
   4. D. Heart failure with preserved ejection fraction

   Answer: B

   Explanation: Table 4 defines HFimpEF by "Previous LVEF ≤40% and a follow-up measurement of LVEF >40%." The prior 35% and current 45% meet that trajectory; the current value alone does not determine the category.

   Reference: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure — Table 4, Classification of HF by LVEF, p.22

8. 8An older adult with moderate Alzheimer disease struggles to answer an open-ended question about a drink. Which replacement question follows the Alzheimer's Association's communication guidance for this stage?

   1. A. Would you like some water?
   2. B. Would you prefer water or juice?
   3. C. What would you like to drink?
   4. D. Tell me what you usually drink.

   Answer: A

   Explanation: The Alzheimer's Association advises, "Ask yes or no questions." A single yes-or-no offer follows that guidance; the other forms ask the person to choose between alternatives or generate an open response.

   Reference: Communication — Communication in the middle stage

9. 9A CNS is reviewing which patient with heart failure and congestion is a candidate for adding a thiazide to diuretic therapy. Which prior treatment course meets the guideline's reserve condition?

   1. A. Persistent congestion despite a moderate- or high-dose loop diuretic
   2. B. Persistent congestion despite an initial low-dose loop diuretic
   3. C. Persistent congestion despite a moderate-dose mineralocorticoid antagonist
   4. D. Persistent congestion despite a high-dose thiazide diuretic

   Answer: A

   Explanation: The heart-failure guideline says thiazide addition "should be reserved for patients who do not respond to moderate- or high-dose loop diuretics to minimize electrolyte abnormalities." Only the moderate- or high-dose loop nonresponse in A meets that reserve condition.

   Reference: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure — Diuretics and Decongestion Strategies in Patients With HF, recommendation 2, p.68

10. 10After documenting a difficult conversation with a frail older patient, a nurse joins the CNS's reflective-practice project. Whose feedback does the ACCNS-AG caring-practice competency specifically call for the nurse to invite?

    1. A. Feedback from nursing peers
    2. B. Feedback from unit supervisors
    3. C. Feedback from the patient's family
    4. D. Feedback from external reviewers

    Answer: A

    Explanation: The ACCNS-AG competency directs the CNS to engage nurses in activities that "promote self-awareness and invite peer feedback to improve the practice of nursing". A reflective account followed by nursing-peer feedback matches the specified mechanism; the other feedback sources may be useful in other settings but are not the peer feedback named here.

    Reference: ACCNS-AG Exam Handbook — Test Plan p.8, Caring Practices