CMN 574 EXAM 2 STUDY GUIDE
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the ICU develops sudden onset of tachypnea and tachycardia. Arterial blood
gas results show a pH of 7.48, PaCO2 of 30 mmHg, and PaO2 of 58 mmHg. Which of the
following diagnostic findings would most likely support a diagnosis of Acute Respiratory
Distress Syndrome (ARDS)?
A. Pulmonary Artery Occlusion Pressure (PAOP) of 22 mmHg
B. PaO2/FiO2 ratio of 180 mmHg
C. Reduced lung compliance with a PCWP of 25 mmHg
D. Unilateral lobar infiltrates on chest X-ray
Answer: B
Conceptual Explanation: ARDS is characterized by a PaO2/FiO2 ratio of less than 300
mmHg, bilateral infiltrates, and no evidence of left atrial hypertension (PAOP typically < 18
mmHg).
,2. A patient with a history of heart failure presents with nausea, vomiting, and blurred vision
with green-yellow halos. The EKG shows frequent PVCs and paroxysmal atrial tachycardia
with block. Which medication is the most likely cause?
A. Lisinopril
B. Furosemide
C. Metoprolol
D. Digoxin
Answer: D
Conceptual Explanation: These are classic signs of Digoxin toxicity, which can be
exacerbated by hypokalemia from diuretic use.
3. In the management of a patient with a hypertensive emergency and an aortic dissection,
what is the primary goal for systolic blood pressure (SBP) reduction within the first 20
minutes?
A. Reduce SBP to less than 160 mmHg
B. Reduce SBP by 25% of the baseline
C. Reduce SBP to 140-150 mmHg
D. Reduce SBP to 100-120 mmHg
Answer: D
, Conceptual Explanation: For aortic dissection, the goal is immediate reduction of SBP to
100-120 mmHg and heart rate below 60 bpm to reduce shear stress.
4. A patient presents with a serum sodium of 118 mEq/L and symptoms of confusion. You
initiate hypertonic saline (3%). What is the maximum recommended increase in serum
sodium in the first 24 hours to prevent osmotic demyelination syndrome?
A. 4-6 mEq/L
B. 12-14 mEq/L
C. 8-10 mEq/L
D. 15-20 mEq/L
Answer: C
Conceptual Explanation: Rapid correction of hyponatremia should not exceed 8-10
mEq/L in 24 hours to avoid Central Pontine Myelinolysis.
5. Which of the following hemodynamic profiles is most consistent with Septic Shock?
A. Low CVP, Low SVR, High CO
B. High CVP, High SVR, Low CO
C. High CVP, Low SVR, High CO
D. Low CVP, High SVR, Low CO
Answer: A
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the ICU develops sudden onset of tachypnea and tachycardia. Arterial blood
gas results show a pH of 7.48, PaCO2 of 30 mmHg, and PaO2 of 58 mmHg. Which of the
following diagnostic findings would most likely support a diagnosis of Acute Respiratory
Distress Syndrome (ARDS)?
A. Pulmonary Artery Occlusion Pressure (PAOP) of 22 mmHg
B. PaO2/FiO2 ratio of 180 mmHg
C. Reduced lung compliance with a PCWP of 25 mmHg
D. Unilateral lobar infiltrates on chest X-ray
Answer: B
Conceptual Explanation: ARDS is characterized by a PaO2/FiO2 ratio of less than 300
mmHg, bilateral infiltrates, and no evidence of left atrial hypertension (PAOP typically < 18
mmHg).
,2. A patient with a history of heart failure presents with nausea, vomiting, and blurred vision
with green-yellow halos. The EKG shows frequent PVCs and paroxysmal atrial tachycardia
with block. Which medication is the most likely cause?
A. Lisinopril
B. Furosemide
C. Metoprolol
D. Digoxin
Answer: D
Conceptual Explanation: These are classic signs of Digoxin toxicity, which can be
exacerbated by hypokalemia from diuretic use.
3. In the management of a patient with a hypertensive emergency and an aortic dissection,
what is the primary goal for systolic blood pressure (SBP) reduction within the first 20
minutes?
A. Reduce SBP to less than 160 mmHg
B. Reduce SBP by 25% of the baseline
C. Reduce SBP to 140-150 mmHg
D. Reduce SBP to 100-120 mmHg
Answer: D
, Conceptual Explanation: For aortic dissection, the goal is immediate reduction of SBP to
100-120 mmHg and heart rate below 60 bpm to reduce shear stress.
4. A patient presents with a serum sodium of 118 mEq/L and symptoms of confusion. You
initiate hypertonic saline (3%). What is the maximum recommended increase in serum
sodium in the first 24 hours to prevent osmotic demyelination syndrome?
A. 4-6 mEq/L
B. 12-14 mEq/L
C. 8-10 mEq/L
D. 15-20 mEq/L
Answer: C
Conceptual Explanation: Rapid correction of hyponatremia should not exceed 8-10
mEq/L in 24 hours to avoid Central Pontine Myelinolysis.
5. Which of the following hemodynamic profiles is most consistent with Septic Shock?
A. Low CVP, Low SVR, High CO
B. High CVP, High SVR, Low CO
C. High CVP, Low SVR, High CO
D. Low CVP, High SVR, Low CO
Answer: A
