ATCN PRETEST EXAM SCRIPT 2026 TESTED
QUESTIONS AND ANSWERS 100% CORRECT
⩥ A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which
finding indicate that this intervention is having it's intended effect?
Answer: ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid resuscitation at
30 ml/kg to maintain a CVP of 8-12 or 12-15 if mechanically ventilated,
MAP greater than 65, ScvO2 greater than 70%, and urine output greater
than 0.5 kg/hr
⩥ 72 male patient in ICU for 6 days on the ventilator for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis and
subcutaneous Heparin since admission. Today his platelet count
decreased significantly to 43,000 and was found to have new DVT on
his right upper extremity. What do you suspect is the most likely cause
of these findings? Answer: HIT
The hallmark sign of HIT is a significant decrease in platelet count over
a 24 hours period (>50%) within 5-10 days of administering Heparin.
The other hallmark sign is a new development of DVT despite being on
VTE prophylaxis.
,⩥ TRALI: Answer: is a complication from a blood transfusion reaction,
which causes acute lung injury typically within 6 hours of a blood
transfusion.
⩥ 2 Hallmark signs of HIT: Answer: Decrease in platelet count over a 24
hr period.
New development of DVT despite being on VTE prophylaxis.
⩥ Values in Early compensated Hypovolemic shock? Answer: CO 4.0
L/min, HR 135, SV 65, SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted therefore preload
and contractility are decreased which leads to a decrease in SV and CO.
HR and SV increase as compensatory measure to preserve CO, MAP
and cerebral perfusion.
⩥ Post-renal failure values: Answer: Urine output < 200; urine sodium
30; BUN: Creatinine ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN & creatinine are
elevated. Urine sodium is typically 1-40 mEq/L.
⩥ What to do in the event of HIT: Answer: Stop Heparin and administer
an alternative direct thrombin inhibitor.
,⩥ Warfarin is contraindicated in HIT? T/F Answer: True - there is also
no evidence that shows protamine, corticosteroids, and benadryl are
effective treatments for HIT
⩥ Patients with right ventricular infarctions become preload dependent.
Meds that decrease preload should be avoided - which meds are these?
Answer: Morphine, Nitro, Beta blockers and diuretics.
⩥ Polymorphic ventricular tachycardia aka Torsades is treated by?
Answer: Magnesium
⩥ Myocardial contusions generally impact which parts of the heart? and
what would the values be? Answer: Atria & right ventricle because of
the position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
⩥ Neurogenic shock signs? Answer: CVP: 3, CI: 2.5, SVR: 650, SBP:
88
Neuro shock is associated with a loss of sympathetic tone causing
extensive peripheral vasodilation. Clinical signs and symptoms include
hypotension, a low SVR, low CVP and low normal CI
, ⩥ What causes a larger than normal A wave on a PAOP? Answer: Mitral
stenosis - causes increased left atrial pressure during atrial contraction.
⩥ Pulmonary HTN will result in what? Answer: Elevated PA pressures
but have no impact on PAOP.
⩥ Infective Endocarditis can cause what kind of impairment? Answer:
Neurologic impairment. One of the risks of infective endocarditis is the
bacterial strand breaking in the heart and throwing bacterial emboli
forward into the lungs from the right side of the heart or to the
brain/body from the left side of the heart.
⩥ Neurologic impairment could be a sign? Answer: Embolic ischemic
stroke.
⩥ Post bariatric surgery should avoid what kind of meds? Answer:
Extended release meds due to absorption concerns post-operatively
⩥ Chlorpropamide is a what? Answer: sulfonylurea drug that is used in
DI as an antidiuretic. It is primarily a glucose lowering agent.
(hypoglycemia)
⩥ Will a cardiac transplant patient respond to atropine? Answer: No -
pacing is the best instrument for symptomatic bradycardia.
QUESTIONS AND ANSWERS 100% CORRECT
⩥ A patient has sepsis, receives Lactated ringers 500ml IV bolus. Which
finding indicate that this intervention is having it's intended effect?
Answer: ScvO2 of 72%
Early goal directed therapy for sepsis includes early fluid resuscitation at
30 ml/kg to maintain a CVP of 8-12 or 12-15 if mechanically ventilated,
MAP greater than 65, ScvO2 greater than 70%, and urine output greater
than 0.5 kg/hr
⩥ 72 male patient in ICU for 6 days on the ventilator for treatment of a
COPD exacerbation. He has been receiving VTE prophylaxis and
subcutaneous Heparin since admission. Today his platelet count
decreased significantly to 43,000 and was found to have new DVT on
his right upper extremity. What do you suspect is the most likely cause
of these findings? Answer: HIT
The hallmark sign of HIT is a significant decrease in platelet count over
a 24 hours period (>50%) within 5-10 days of administering Heparin.
The other hallmark sign is a new development of DVT despite being on
VTE prophylaxis.
,⩥ TRALI: Answer: is a complication from a blood transfusion reaction,
which causes acute lung injury typically within 6 hours of a blood
transfusion.
⩥ 2 Hallmark signs of HIT: Answer: Decrease in platelet count over a 24
hr period.
New development of DVT despite being on VTE prophylaxis.
⩥ Values in Early compensated Hypovolemic shock? Answer: CO 4.0
L/min, HR 135, SV 65, SVR 1700, MAP 65
In hypovolemic states, circulating volume is depleted therefore preload
and contractility are decreased which leads to a decrease in SV and CO.
HR and SV increase as compensatory measure to preserve CO, MAP
and cerebral perfusion.
⩥ Post-renal failure values: Answer: Urine output < 200; urine sodium
30; BUN: Creatinine ratio 15:1; urine specific gravity 1.010
BUN: Creatinine ratio is 15:1, but both the BUN & creatinine are
elevated. Urine sodium is typically 1-40 mEq/L.
⩥ What to do in the event of HIT: Answer: Stop Heparin and administer
an alternative direct thrombin inhibitor.
,⩥ Warfarin is contraindicated in HIT? T/F Answer: True - there is also
no evidence that shows protamine, corticosteroids, and benadryl are
effective treatments for HIT
⩥ Patients with right ventricular infarctions become preload dependent.
Meds that decrease preload should be avoided - which meds are these?
Answer: Morphine, Nitro, Beta blockers and diuretics.
⩥ Polymorphic ventricular tachycardia aka Torsades is treated by?
Answer: Magnesium
⩥ Myocardial contusions generally impact which parts of the heart? and
what would the values be? Answer: Atria & right ventricle because of
the position of the heart in the chest.
PAOP 6, PA Pressure 40/24, RA Pressure 16
⩥ Neurogenic shock signs? Answer: CVP: 3, CI: 2.5, SVR: 650, SBP:
88
Neuro shock is associated with a loss of sympathetic tone causing
extensive peripheral vasodilation. Clinical signs and symptoms include
hypotension, a low SVR, low CVP and low normal CI
, ⩥ What causes a larger than normal A wave on a PAOP? Answer: Mitral
stenosis - causes increased left atrial pressure during atrial contraction.
⩥ Pulmonary HTN will result in what? Answer: Elevated PA pressures
but have no impact on PAOP.
⩥ Infective Endocarditis can cause what kind of impairment? Answer:
Neurologic impairment. One of the risks of infective endocarditis is the
bacterial strand breaking in the heart and throwing bacterial emboli
forward into the lungs from the right side of the heart or to the
brain/body from the left side of the heart.
⩥ Neurologic impairment could be a sign? Answer: Embolic ischemic
stroke.
⩥ Post bariatric surgery should avoid what kind of meds? Answer:
Extended release meds due to absorption concerns post-operatively
⩥ Chlorpropamide is a what? Answer: sulfonylurea drug that is used in
DI as an antidiuretic. It is primarily a glucose lowering agent.
(hypoglycemia)
⩥ Will a cardiac transplant patient respond to atropine? Answer: No -
pacing is the best instrument for symptomatic bradycardia.
