ACCS Prep (NBRC Practice Exam 1) |\ |\ |\ |\ |\ |\
questions with answers |\ |\
A 50 year old male present to the Ed with syncope and shock. He
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is admitted to the intensive care and pulmonary artery catheter
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is inserted. patient data is as follows:
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BP 70/40 MAP 50 CVP 20 RV 45/0 PAP 45/15 Mean PAP 25 PCWP
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7 |\
QT 2.5 SVR 18 (1440 dynes) PVR 8.4 (670 dynes)
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ABG (RA) pH:7.32,CO2 32,PaO2 59 SpO2, 89%.
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Mixed VBG: pH 7.28 CO2 38 PaO2 28 SpO2 49%
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Ca-vO2 difference is 8.0 vol%. |\ |\ |\ |\
The adult critical care specialist should recommend that the
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patient be treated quickly for: |\ |\ |\ |\
A. acute pulmonary embolism
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B. left heart failure
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C. right heart failure
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D. hypervolemia - CORRECT ANSWERS ✔✔A. acute pulmonary
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embolism (>PAP, >CVP) |\ |\
Normal:
, BP 120/80.....MAP 90......CVP 10.....RV 25/0.....PAP 25/8.....Mean
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PAP 14.....PCWP 8-10.......Qt 4-8.....
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SVR <20 or 1600dynes (Left heart system)
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PVR <2.5 or 200 dynes (Right heart - pulmonary sytem)
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-----
Left heart failure (>PCWP, <MAP, <QT)
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Right heart failure (>CVP, <PAP)
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Hypervolemia (all values are increased >) |\ |\ |\ |\ |\
cerebral angiography - CORRECT ANSWERS ✔✔exams head,
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brain, and neck blood vessels to identify abnormalities:
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aneurysms, strokes, blockages |\ |\
Positron Emission Tomography (PET) - CORRECT ANSWERS
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✔✔Narrow neck vessels |\ |\
checks (cancer, brain disorders, heart disease)
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A patient has been intubated in the ED and has an end-tidal CO2
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reading of 4%. The specialist should suspect that the:
|\ |\ |\ |\ |\ |\ |\ |\
A. patient has a pulmonary embolus
|\ |\ |\ |\ |\
B. ET tube is in the correct position
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C. ET tube is in the esophagus
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D. ET tube is in the right main stem bronchus - CORRECT
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ANSWERS ✔✔B. ET tube is in the correct position |\ |\ |\ |\ |\ |\ |\ |\
NOTE: ETCO2 will be > if in the esophagus
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questions with answers |\ |\
A 50 year old male present to the Ed with syncope and shock. He
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is admitted to the intensive care and pulmonary artery catheter
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is inserted. patient data is as follows:
|\ |\ |\ |\ |\ |\
BP 70/40 MAP 50 CVP 20 RV 45/0 PAP 45/15 Mean PAP 25 PCWP
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
7 |\
QT 2.5 SVR 18 (1440 dynes) PVR 8.4 (670 dynes)
|\ |\ |\ |\ |\ |\ |\ |\ |\
ABG (RA) pH:7.32,CO2 32,PaO2 59 SpO2, 89%.
|\ |\ |\ |\ |\ |\ |\
Mixed VBG: pH 7.28 CO2 38 PaO2 28 SpO2 49%
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Ca-vO2 difference is 8.0 vol%. |\ |\ |\ |\
The adult critical care specialist should recommend that the
|\ |\ |\ |\ |\ |\ |\ |\ |\
patient be treated quickly for: |\ |\ |\ |\
A. acute pulmonary embolism
|\ |\ |\
B. left heart failure
|\ |\ |\
C. right heart failure
|\ |\ |\
D. hypervolemia - CORRECT ANSWERS ✔✔A. acute pulmonary
|\ |\ |\ |\ |\ |\ |\ |\
embolism (>PAP, >CVP) |\ |\
Normal:
, BP 120/80.....MAP 90......CVP 10.....RV 25/0.....PAP 25/8.....Mean
|\ |\ |\ |\ |\ |\
PAP 14.....PCWP 8-10.......Qt 4-8.....
|\ |\ |\
SVR <20 or 1600dynes (Left heart system)
|\ |\ |\ |\ |\ |\
PVR <2.5 or 200 dynes (Right heart - pulmonary sytem)
|\ |\ |\ |\ |\ |\ |\ |\ |\
-----
Left heart failure (>PCWP, <MAP, <QT)
|\ |\ |\ |\ |\
Right heart failure (>CVP, <PAP)
|\ |\ |\ |\
Hypervolemia (all values are increased >) |\ |\ |\ |\ |\
cerebral angiography - CORRECT ANSWERS ✔✔exams head,
|\ |\ |\ |\ |\ |\ |\
brain, and neck blood vessels to identify abnormalities:
|\ |\ |\ |\ |\ |\ |\ |\
aneurysms, strokes, blockages |\ |\
Positron Emission Tomography (PET) - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Narrow neck vessels |\ |\
checks (cancer, brain disorders, heart disease)
|\ |\ |\ |\ |\
A patient has been intubated in the ED and has an end-tidal CO2
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
reading of 4%. The specialist should suspect that the:
|\ |\ |\ |\ |\ |\ |\ |\
A. patient has a pulmonary embolus
|\ |\ |\ |\ |\
B. ET tube is in the correct position
|\ |\ |\ |\ |\ |\ |\
C. ET tube is in the esophagus
|\ |\ |\ |\ |\ |\
D. ET tube is in the right main stem bronchus - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔B. ET tube is in the correct position |\ |\ |\ |\ |\ |\ |\ |\
NOTE: ETCO2 will be > if in the esophagus
|\ |\ |\ |\ |\ |\ |\ |\
