Technological and Procedural Proficiency 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 Technological and Procedural Proficiency flashcards as text
A mechanically ventilated patient develops sudden hemodynamic collapse with absent breath sounds on the left and tracheal deviation to the right. The FIRST intervention should be:
Answer: Immediate needle decompression of the left chest
Tension pneumothorax is a clinical emergency requiring immediate needle decompression; delaying for imaging in an unstable patient is contraindicated.
The driving pressure (ΔP) in mechanical ventilation is calculated as:
Answer: Plateau pressure − PEEP
Driving pressure equals plateau pressure minus PEEP, representing the tidal stress applied to the respiratory system and correlating with ARDS mortality.
During insertion of a chest tube for hemothorax, initial drainage exceeds 1,500 mL. The MOST appropriate next step is:
Answer: Immediate surgical consultation for thoracotomy
Initial drainage >1,500 mL from a hemothorax meets criteria for massive hemothorax and mandates immediate surgical consultation for operative intervention.
In a patient receiving vasopressors via peripheral IV due to lack of central access, which site is PREFERRED to minimize tissue necrosis risk?
Answer: Forearm (proximal to antecubital)
Proximal forearm veins are preferred for peripheral vasopressor administration because they allow earlier detection of extravasation and have better flow rates than distal sites.
What is the primary purpose of performing an occlusion (wedge) pressure measurement with a pulmonary artery catheter?
Answer: Estimate left ventricular end-diastolic pressure
Pulmonary artery occlusion pressure (PAOP) reflects left atrial pressure and, by extension, left ventricular end-diastolic pressure, guiding volume status assessment.
Which ventilator mode is MOST appropriate for a patient with severe diaphragmatic fatigue who needs to gradually resume spontaneous breathing?
Answer: Pressure Support Ventilation (PSV)
PSV allows the patient to initiate each breath while the ventilator augments effort, enabling progressive weaning as diaphragmatic strength recovers.
During intra-aortic balloon pump (IABP) therapy, timing is set so that balloon inflation occurs at:
Answer: Dicrotic notch on arterial waveform
Correct IABP timing requires balloon inflation at the dicrotic notch, which marks aortic valve closure (end-systole), to maximize diastolic augmentation.