Practice Test Geeks(ACCS) Adult Critical Care Specialty Practice Test
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Patient Management and Care Flashcards

7 cards from real ACCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Patient Management and Care flashcards as text

  1. A patient develops heparin-induced thrombocytopenia (HIT) confirmed by positive PF4 antibody. What is the appropriate management?

    Answer: Discontinue heparin and start argatroban or bivalirudin

    HIT requires immediate heparin cessation and initiation of a direct thrombin inhibitor (argatroban or bivalirudin) due to thrombotic risk.

  2. A critically ill patient on mechanical ventilation has peak airway pressure of 42 cmH2O and plateau pressure of 28 cmH2O. What does this suggest?

    Answer: Increased airway resistance

    A high gradient between peak and plateau pressure with normal plateau indicates elevated airway resistance (e.g., bronchospasm, secretions), not reduced compliance.

  3. Which nutritional approach is recommended for critically ill patients who cannot tolerate enteral feeding within 72 hours of ICU admission?

    Answer: Permit permissive underfeeding until day 7-10 before starting PN

    Current guidelines support delaying parenteral nutrition until day 7-10 in low-nutritional-risk patients if enteral feeding is not tolerated, as early PN worsens outcomes.

  4. An ICU patient develops acute adrenal insufficiency. Which steroid regimen is preferred in septic shock not responding to vasopressors?

    Answer: Hydrocortisone 200–300 mg/day in divided doses or continuous infusion

    Low-dose hydrocortisone (200–300 mg/day) is recommended for vasopressor-refractory septic shock to provide both glucocorticoid and mineralocorticoid effects.

  5. A ventilated ARDS patient is placed in prone position. After 16 hours, SpO2 improves from 88% to 96%. When should prone positioning be discontinued?

    Answer: When PaO2/FiO2 ratio exceeds 150 mmHg on PEEP ≤10 for two consecutive supine assessments

    Prone positioning is discontinued when the patient sustains PaO2/FiO2 >150 on PEEP ≤10 cmH2O during supine trials, indicating respiratory improvement.

  6. A patient in the ICU develops new-onset atrial fibrillation with rapid ventricular response and hemodynamic compromise. What is the immediate treatment?

    Answer: Synchronized cardioversion

    Hemodynamic instability from AF with rapid ventricular response requires immediate synchronized cardioversion.

  7. Which scoring tool is most widely used in the ICU to assess delirium in mechanically ventilated patients?

    Answer: Confusion Assessment Method for the ICU (CAM-ICU)

    The CAM-ICU is the validated standard tool for delirium detection in mechanically ventilated ICU patients.