TEXAS PERFUSIONIST CLINICAL EXAM –
PRACTICE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
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1. The primary purpose of hemodilution during
cardiopulmonary bypass (CPB) is to:
A. Reduce coagulation factors
B. Increase blood viscosity
C. Improve microcirculatory flow
D. Increase systemic vascular resistance
Rationale: Hemodilution decreases blood viscosity, improving
microvascular perfusion during CPB.
2. The most accurate indicator of adequate tissue perfusion
during CPB is:
A. Heart rate
B. CVP
,C. Mixed venous oxygen saturation (SvO₂)
D. Hematocrit
Rationale: SvO₂ reflects whole-body oxygen balance and is the
best global perfusion indicator.
3. During CPB, the normal target hematocrit for adults is:
A. 15–20%
B. 20–24%
C. 24–28%
D. 30–35%
Rationale: Maintaining Hct 24–28% preserves oxygen-carrying
capacity without excessive viscosity.
4. A sudden decrease in arterial line pressure during CPB most
likely indicates:
A. Oxygenator failure
B. Excessive blood viscosity
C. Arterial line disconnection or leak
D. Venous line obstruction
Rationale: A drop in arterial pressure typically suggests loss of
resistance caused by a leak or disconnection.
,5. A perfusionist notes high negative pressure on the venous
line. The first action is to:
A. Reduce pump RPMs
B. Check for venous line obstruction
C. Increase vacuum assist
D. Add extra volume to reservoir
Rationale: High negative pressure usually comes from
restricted venous return, so the line is checked first.
6. The primary reason for using arterial filters is to:
A. Add oxygen
B. Reduce microemboli
C. Adjust temperature
D. Improve hematocrit
Rationale: Arterial filters trap air and particulates, preventing
embolization.
7. Which of the following best describes pulsatile flow on CPB?
A. Provides no clinical benefit
B. More physiologic and may improve end-organ perfusion
C. Always mandatory
D. Reduces coronary perfusion
, Rationale: Pulsatile flow better mimics natural physiology and
improves microcirculatory perfusion.
8. Protamine is used to:
A. Increase ACT
B. Improve oxygenation
C. Reverse heparin
D. Reduce afterload
Rationale: Protamine binds heparin and reverses
anticoagulation post-CPB.
9. A low oxygenator gas flow with normal FiO₂ will cause:
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Insufficient sweep gas reduces CO₂ removal, leading
to respiratory acidosis.
10. The primary determinant of oxygen delivery (DO₂) on
bypass is:
PRACTICE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
1. The primary purpose of hemodilution during
cardiopulmonary bypass (CPB) is to:
A. Reduce coagulation factors
B. Increase blood viscosity
C. Improve microcirculatory flow
D. Increase systemic vascular resistance
Rationale: Hemodilution decreases blood viscosity, improving
microvascular perfusion during CPB.
2. The most accurate indicator of adequate tissue perfusion
during CPB is:
A. Heart rate
B. CVP
,C. Mixed venous oxygen saturation (SvO₂)
D. Hematocrit
Rationale: SvO₂ reflects whole-body oxygen balance and is the
best global perfusion indicator.
3. During CPB, the normal target hematocrit for adults is:
A. 15–20%
B. 20–24%
C. 24–28%
D. 30–35%
Rationale: Maintaining Hct 24–28% preserves oxygen-carrying
capacity without excessive viscosity.
4. A sudden decrease in arterial line pressure during CPB most
likely indicates:
A. Oxygenator failure
B. Excessive blood viscosity
C. Arterial line disconnection or leak
D. Venous line obstruction
Rationale: A drop in arterial pressure typically suggests loss of
resistance caused by a leak or disconnection.
,5. A perfusionist notes high negative pressure on the venous
line. The first action is to:
A. Reduce pump RPMs
B. Check for venous line obstruction
C. Increase vacuum assist
D. Add extra volume to reservoir
Rationale: High negative pressure usually comes from
restricted venous return, so the line is checked first.
6. The primary reason for using arterial filters is to:
A. Add oxygen
B. Reduce microemboli
C. Adjust temperature
D. Improve hematocrit
Rationale: Arterial filters trap air and particulates, preventing
embolization.
7. Which of the following best describes pulsatile flow on CPB?
A. Provides no clinical benefit
B. More physiologic and may improve end-organ perfusion
C. Always mandatory
D. Reduces coronary perfusion
, Rationale: Pulsatile flow better mimics natural physiology and
improves microcirculatory perfusion.
8. Protamine is used to:
A. Increase ACT
B. Improve oxygenation
C. Reverse heparin
D. Reduce afterload
Rationale: Protamine binds heparin and reverses
anticoagulation post-CPB.
9. A low oxygenator gas flow with normal FiO₂ will cause:
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Rationale: Insufficient sweep gas reduces CO₂ removal, leading
to respiratory acidosis.
10. The primary determinant of oxygen delivery (DO₂) on
bypass is:
