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 mechanically ventilated patient with ARDS has a PaO2/FiO2 ratio of 80 mmHg. Which ventilator strategy is most appropriate?

    Answer: Apply low tidal volume (6 mL/kg IBW) with PEEP titration

    Lung-protective ventilation with low tidal volume (6 mL/kg IBW) and optimized PEEP is the evidence-based standard for ARDS management.

  2. A critically ill patient on vasopressors develops acute mesenteric ischemia. Which finding is the earliest indicator?

    Answer: Metabolic acidosis with elevated lactate

    Elevated lactate from anaerobic metabolism is often the earliest sign of mesenteric ischemia before overt peritoneal signs develop.

  3. Which medication is first-line for managing refractory status epilepticus in an ICU patient who has failed benzodiazepines and a second-line AED?

    Answer: Midazolam continuous infusion

    Continuous midazolam infusion is a first-line anesthetic agent for refractory status epilepticus when second-line AEDs fail.

  4. An ICU patient has central DI following traumatic brain injury. Which lab pattern is expected?

    Answer: High serum sodium, low urine osmolality

    Central DI causes hypernatremia (high serum Na) with dilute urine (low urine osmolality) due to ADH deficiency.

  5. A post-cardiac surgery patient develops cardiac tamponade. Which hemodynamic finding is characteristic?

    Answer: Equalization of diastolic pressures across cardiac chambers

    Cardiac tamponade causes equalization of diastolic pressures (CVP ≈ PAOP ≈ PAD) due to external cardiac compression.

  6. A patient with septic shock has a ScvO2 of 58% despite adequate MAP. What is the most appropriate next step?

    Answer: Transfuse RBCs if Hgb < 10 g/dL or optimize cardiac output

    Low ScvO2 indicates inadequate oxygen delivery; optimizing cardiac output or correcting anemia improves oxygen delivery to tissues.

  7. Which intervention has the strongest evidence for reducing VAP (ventilator-associated pneumonia) incidence in the ICU?

    Answer: Oral chlorhexidine decontamination

    Oral chlorhexidine decontamination is part of VAP bundles and has strong evidence for reducing oropharyngeal colonization and VAP rates.