AACN- CRITICAL CARE QUESTIONS AND ANSWERS
UPDATED 2026-2027
# Term Definition
1 Increased mortality due to bleeding (increased time to
Aortic occlusion for hemorrhagic shock control)
does what according to REBOA trial?
2 Cryoprecipitate
Treatment of cerebral hemorrhage
after tpa?
3 How does carbon monoxide cause
detriment? And SPo2 monitors Binds to mitochondria and impairs aerobic metabolism.
SPO2 normal because oximeters cannot differentiate
between oxyhemoglobin and carboxyhemoglobin, but
PO2 will be horrible
4
When to use hyperbaric in CO
Carboxyhemoglobin >25% or end organ ischemia
poisoning
5 Cyanide toxicity
stainless steel, plant sources, combustion of plastics.
Binds to mitochondria and impars mitochondria. Causes
hypotension, metabolic acidosis, significant lactaic
acidosis, and seizures. Sp02 is NORMAL because it
impairs oxygen use by tissues (bright red venous
blood). Treat with hydroxycobalamin, sodium nitrite,
sodium thiosulfate
6
Hemopericardium after stemi can
Type A aortic dissection, ventricular free wall rupture
happen 2 ways
7 Bi-level or biphasic vent mode
-Continuous positive airway pressure cycled between
high pressure and low pressure. -Breaths are pressure
limited and time cycled
-spontaneous breaths are permitted to occur
, 8 Airway pressure release ventilation
mode Long inspiratory time and brief expiratory time to low
set PEEP so breath can be released -Very high mean
airway pressure for recruitment
-driving pressure is very high -v. likely to autopeep
9 Left sided SVC
Enlarged coronary sinus should raise
suspicion for
# Term Definition
10 CCB Toxicity treatment
-Calcium -High dose insulin (increases calcium) plus
dextrose and K if needed -Lipid emulsion therapy. -
Atropine -VA ECMO
11
Vaccine induced thrombosis and -PF4 -Thrombosis typically occurs in cerebral or
thrombocytopenia, test splanchnic
12 How the heck do you use an
esophageal balloon? It measures the intrapleural pressure. Transpulmonary
pressure is = PEEP - Pesoph when youre at end
exhalation. If
transpulmonary pressure is negative at this time, need
to increase the PEEP to prevent atelectautrauma
13 AKIKI trial showed what
Stage 3 AKI in critically ill, randomized to early RRT vs.
delayed. In delayed strategy, 50% never even needed
RRT. Early initiation NOT related to increased survival or
decreased time on vent, but did increase CLABSI and
increased time for renal recovery
14 Toxic leukoencophalopathy, causes and
diagnosis Opiate fumes. Can cause psychomotor issues,
generalized motor impairment. Restricted diffusion in
cerebellum, bilaterall, periventricular.
15 Proning data for patients with PF <150
, 16 HLH primary and secondary
Primary is disorder of childhood, secondary is from
malignancy, immunodeficiency, EBV, adult onset stills,
lupus. -Presentation-rash, cyotpenia, splenomegaly,
coagulopathy, hyponatremia, elevated LDH, LOW CRP
17 Whats the stress index for this <1, need more PEEP
18 NUTREA 2 trial
RCT to compare holding feeds when residual
volume > 250 vs not measuring. No difference in
outcomes
# Term Definition
19 TACE Complications
Tumor lysis syndrome (hyperK, hyperphos, low
CAlcium), carcinoid crisis (flushing,
bronchospasm),
20
Need surgical evaluation of the bowel viability prior to
Treatment of mesenteric ischmeia
reperfusion
21 Hyperkalemia EKG
Peaked T waves, PR prolongation, QRS widening.
22 SBP Plus critically ill
Albumin to reduce AKI and mortality (SBP lowers
effective circulating volume). DONT use BB, which may
actually worsen mortality
23 What is severe MR Regurgitant volume >60, orifice >0.4cm
24 brucellosis, doxycycline and aminoglycoside
Fevers, night sweats, lung nodules,
noncaseating granulomas, with anemia
and luekopenia, exposure to dairy
UPDATED 2026-2027
# Term Definition
1 Increased mortality due to bleeding (increased time to
Aortic occlusion for hemorrhagic shock control)
does what according to REBOA trial?
2 Cryoprecipitate
Treatment of cerebral hemorrhage
after tpa?
3 How does carbon monoxide cause
detriment? And SPo2 monitors Binds to mitochondria and impairs aerobic metabolism.
SPO2 normal because oximeters cannot differentiate
between oxyhemoglobin and carboxyhemoglobin, but
PO2 will be horrible
4
When to use hyperbaric in CO
Carboxyhemoglobin >25% or end organ ischemia
poisoning
5 Cyanide toxicity
stainless steel, plant sources, combustion of plastics.
Binds to mitochondria and impars mitochondria. Causes
hypotension, metabolic acidosis, significant lactaic
acidosis, and seizures. Sp02 is NORMAL because it
impairs oxygen use by tissues (bright red venous
blood). Treat with hydroxycobalamin, sodium nitrite,
sodium thiosulfate
6
Hemopericardium after stemi can
Type A aortic dissection, ventricular free wall rupture
happen 2 ways
7 Bi-level or biphasic vent mode
-Continuous positive airway pressure cycled between
high pressure and low pressure. -Breaths are pressure
limited and time cycled
-spontaneous breaths are permitted to occur
, 8 Airway pressure release ventilation
mode Long inspiratory time and brief expiratory time to low
set PEEP so breath can be released -Very high mean
airway pressure for recruitment
-driving pressure is very high -v. likely to autopeep
9 Left sided SVC
Enlarged coronary sinus should raise
suspicion for
# Term Definition
10 CCB Toxicity treatment
-Calcium -High dose insulin (increases calcium) plus
dextrose and K if needed -Lipid emulsion therapy. -
Atropine -VA ECMO
11
Vaccine induced thrombosis and -PF4 -Thrombosis typically occurs in cerebral or
thrombocytopenia, test splanchnic
12 How the heck do you use an
esophageal balloon? It measures the intrapleural pressure. Transpulmonary
pressure is = PEEP - Pesoph when youre at end
exhalation. If
transpulmonary pressure is negative at this time, need
to increase the PEEP to prevent atelectautrauma
13 AKIKI trial showed what
Stage 3 AKI in critically ill, randomized to early RRT vs.
delayed. In delayed strategy, 50% never even needed
RRT. Early initiation NOT related to increased survival or
decreased time on vent, but did increase CLABSI and
increased time for renal recovery
14 Toxic leukoencophalopathy, causes and
diagnosis Opiate fumes. Can cause psychomotor issues,
generalized motor impairment. Restricted diffusion in
cerebellum, bilaterall, periventricular.
15 Proning data for patients with PF <150
, 16 HLH primary and secondary
Primary is disorder of childhood, secondary is from
malignancy, immunodeficiency, EBV, adult onset stills,
lupus. -Presentation-rash, cyotpenia, splenomegaly,
coagulopathy, hyponatremia, elevated LDH, LOW CRP
17 Whats the stress index for this <1, need more PEEP
18 NUTREA 2 trial
RCT to compare holding feeds when residual
volume > 250 vs not measuring. No difference in
outcomes
# Term Definition
19 TACE Complications
Tumor lysis syndrome (hyperK, hyperphos, low
CAlcium), carcinoid crisis (flushing,
bronchospasm),
20
Need surgical evaluation of the bowel viability prior to
Treatment of mesenteric ischmeia
reperfusion
21 Hyperkalemia EKG
Peaked T waves, PR prolongation, QRS widening.
22 SBP Plus critically ill
Albumin to reduce AKI and mortality (SBP lowers
effective circulating volume). DONT use BB, which may
actually worsen mortality
23 What is severe MR Regurgitant volume >60, orifice >0.4cm
24 brucellosis, doxycycline and aminoglycoside
Fevers, night sweats, lung nodules,
noncaseating granulomas, with anemia
and luekopenia, exposure to dairy
