Barkley Emergency/Critical
Care PRACTICE QUESTIONS
|ORIGINAL QUESTIONS &
ANSWERS |DETAILED
RATIONALES |HINTED
COMPLETE EXAM PREP
GRADED A+*INSTANT
DOWNLOAD PDF
Section I — Initial Emergency Assessment & Resuscitation
1.
A patient arrives in the emergency department after a motor-vehicle
collision. He is unresponsive and has noisy respirations. What is the
priority intervention?
A. Obtain a chest x-ray
B. Establish two large-bore IVs
C. Open and maintain the airway while protecting the cervical spine
D. Administer IV analgesia
,The primary survey begins with airway assessment. In trauma, the
cervical spine should be protected while the airway is opened and
maintained.
2.
Which finding most strongly suggests impending respiratory failure?
A. Respiratory rate of 20/min
B. Oxygen saturation of 95%
C. Mild tachycardia
D. Increasing somnolence with shallow respirations
Altered mental status and inadequate ventilatory effort are late and
concerning signs of respiratory failure.
3.
A critically ill patient has a blood pressure of 78/42 mmHg, cool
extremities, and altered mental status. What is the most appropriate
initial priority?
A. Obtain a CT scan
B. Assess and support circulation while identifying the cause of
shock
C. Administer oral fluids
D. Perform a detailed neurological examination
Hypotension with poor perfusion indicates shock. Immediate
stabilization and identification of the underlying cause take priority.
4.
Which finding is most consistent with compensated shock?
A. Severe hypotension
B. Cardiac arrest
C. Tachycardia with preserved blood pressure
D. Pulselessness
,Early shock may be compensated by sympathetic activation,
producing tachycardia and vasoconstriction before hypotension
develops.
5.
Which oxygen-delivery device can provide the highest oxygen
concentration among standard noninvasive devices?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
A properly fitted nonrebreather mask can deliver a high inspired
oxygen concentration when supplied with adequate flow.
6.
A patient with severe asthma becomes increasingly drowsy and
develops a markedly decreased respiratory rate. What does this
finding indicate?
A. Clinical improvement
B. Anxiety resolution
C. Impending respiratory failure
D. Mild bronchospasm
Decreasing respiratory effort in severe asthma is ominous and may
indicate respiratory muscle fatigue and impending respiratory arrest.
7.
A patient with an acute emergency has a Glasgow Coma Scale score
of 7. Which intervention should be anticipated?
A. Oral fluids
B. Ambulation
C. Definitive airway management
D. Discharge with observation
, A markedly depressed level of consciousness increases the risk of loss
of airway protection and aspiration; definitive airway management
should be considered.
8.
Which finding is most concerning in a patient with possible sepsis?
A. Temperature of 37.1°C
B. Heart rate of 88/min
C. New altered mental status with hypotension
D. Respiratory rate of 14/min
Altered mentation and hypotension suggest organ dysfunction and
impaired perfusion.
9.
A patient presents after a significant hemorrhage. Which laboratory
finding may occur early?
A. Elevated hemoglobin
B. Normal initial hemoglobin despite major blood loss
C. Severe hypercalcemia
D. Increased platelet count
Hemoglobin may initially remain relatively normal after acute blood
loss because plasma and red cells are lost proportionally.
10.
Which clinical finding is most indicative of poor peripheral perfusion?
A. Warm hands
B. Capillary refill of 1 second
C. Mottled, cool skin with delayed capillary refill
D. Bounding peripheral pulses
Cool, mottled skin and delayed capillary refill reflect peripheral
vasoconstriction and impaired tissue perfusion.
Care PRACTICE QUESTIONS
|ORIGINAL QUESTIONS &
ANSWERS |DETAILED
RATIONALES |HINTED
COMPLETE EXAM PREP
GRADED A+*INSTANT
DOWNLOAD PDF
Section I — Initial Emergency Assessment & Resuscitation
1.
A patient arrives in the emergency department after a motor-vehicle
collision. He is unresponsive and has noisy respirations. What is the
priority intervention?
A. Obtain a chest x-ray
B. Establish two large-bore IVs
C. Open and maintain the airway while protecting the cervical spine
D. Administer IV analgesia
,The primary survey begins with airway assessment. In trauma, the
cervical spine should be protected while the airway is opened and
maintained.
2.
Which finding most strongly suggests impending respiratory failure?
A. Respiratory rate of 20/min
B. Oxygen saturation of 95%
C. Mild tachycardia
D. Increasing somnolence with shallow respirations
Altered mental status and inadequate ventilatory effort are late and
concerning signs of respiratory failure.
3.
A critically ill patient has a blood pressure of 78/42 mmHg, cool
extremities, and altered mental status. What is the most appropriate
initial priority?
A. Obtain a CT scan
B. Assess and support circulation while identifying the cause of
shock
C. Administer oral fluids
D. Perform a detailed neurological examination
Hypotension with poor perfusion indicates shock. Immediate
stabilization and identification of the underlying cause take priority.
4.
Which finding is most consistent with compensated shock?
A. Severe hypotension
B. Cardiac arrest
C. Tachycardia with preserved blood pressure
D. Pulselessness
,Early shock may be compensated by sympathetic activation,
producing tachycardia and vasoconstriction before hypotension
develops.
5.
Which oxygen-delivery device can provide the highest oxygen
concentration among standard noninvasive devices?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Nonrebreather mask
A properly fitted nonrebreather mask can deliver a high inspired
oxygen concentration when supplied with adequate flow.
6.
A patient with severe asthma becomes increasingly drowsy and
develops a markedly decreased respiratory rate. What does this
finding indicate?
A. Clinical improvement
B. Anxiety resolution
C. Impending respiratory failure
D. Mild bronchospasm
Decreasing respiratory effort in severe asthma is ominous and may
indicate respiratory muscle fatigue and impending respiratory arrest.
7.
A patient with an acute emergency has a Glasgow Coma Scale score
of 7. Which intervention should be anticipated?
A. Oral fluids
B. Ambulation
C. Definitive airway management
D. Discharge with observation
, A markedly depressed level of consciousness increases the risk of loss
of airway protection and aspiration; definitive airway management
should be considered.
8.
Which finding is most concerning in a patient with possible sepsis?
A. Temperature of 37.1°C
B. Heart rate of 88/min
C. New altered mental status with hypotension
D. Respiratory rate of 14/min
Altered mentation and hypotension suggest organ dysfunction and
impaired perfusion.
9.
A patient presents after a significant hemorrhage. Which laboratory
finding may occur early?
A. Elevated hemoglobin
B. Normal initial hemoglobin despite major blood loss
C. Severe hypercalcemia
D. Increased platelet count
Hemoglobin may initially remain relatively normal after acute blood
loss because plasma and red cells are lost proportionally.
10.
Which clinical finding is most indicative of poor peripheral perfusion?
A. Warm hands
B. Capillary refill of 1 second
C. Mottled, cool skin with delayed capillary refill
D. Bounding peripheral pulses
Cool, mottled skin and delayed capillary refill reflect peripheral
vasoconstriction and impaired tissue perfusion.
