LATEST VERSIONS (EXAM 1 & 2) WITH COMPLETE 1300
ACTUAL EXAM QUESTIONS AND CORRECT DETAILED
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Question 1
A 65-year-old man is brought to the ICU after a Whipple
procedure. His urine output is 15 mL/hr over the past 2 hours.
Blood pressure is 90/60 mmHg, heart rate 110 bpm, central
venous pressure (CVP) is 4 mmHg. What is the most appropriate
next step?
A. Administer furosemide 40 mg IV
B. Start norepinephrine infusion
C. Administer 500 mL bolus of isotonic crystalloid
D. Obtain a stat echocardiogram
E. Start dopamine infusion
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,Answer: C
Rationale: Low CVP with hypotension and oliguria indicates
hypovolemia. Fluid resuscitation is first-line. Furosemide would
worsen hypovolemia. Vasopressors are not first-line without
adequate preload.
Question 2
Which of the following is the most reliable indicator of adequate
resuscitation in a patient with septic shock?
A. Normalization of serum lactate
B. Central venous pressure of 8-12 mmHg
C. Mean arterial pressure >65 mmHg
D. Urine output >0.5 mL/kg/hr
E. ScvO2 >70%
Answer: A
Rationale: Lactate normalization indicates resolution of tissue
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,hypoperfusion. While all are goals of EGDT, lactate clearance is
the strongest prognostic indicator.
Question 3
A patient with blunt abdominal trauma undergoes FAST exam
which is positive. The patient is hypotensive with a heart rate of
130 bpm. What is the next step?
A. CT abdomen with IV contrast
B. Diagnostic peritoneal lavage
C. Laparotomy
D. Serial abdominal exams
E. Observe in ICU
Answer: C
Rationale: Positive FAST in an unstable patient after blunt trauma
indicates hemoperitoneum requiring emergent laparotomy. CT is
contraindicated in unstable patients.
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, Question 4
A 72-year-old man with a history of CHF presents with dyspnea.
He is intubated for respiratory failure. Ventilator settings: TV
450 mL, rate 16, PEEP 5, FiO2 0.6. ABG: pH 7.25, PaCO2 55,
PaO2 70, HCO3 24. What is the most appropriate change?
A. Increase rate to 20
B. Increase tidal volume to 550 mL
C. Increase PEEP to 10
D. Decrease FiO2 to 0.5
E. Add inspiratory hold
Answer: A
Rationale: The patient has acute hypercapnic respiratory failure (pH
<7.30 with elevated PaCO2). Increasing respiratory rate will
decrease PaCO2. Increasing TV risks barotrauma.
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