ACCS Review UPDATED ACTUAL Exam
Questions and CORRECT Answers
Average urine output per hour is approximately? - CORRECT ANSWER - 40 mL
According to the Berlin Criteria, a patient is classified with severe ARDS when his Pao2/Fio2
ratio is? - CORRECT ANSWER - Less than 100
A patient is admitted to the ED with a possible CVA. Which diagnostic test is most appropriate
for identification of an acute cerebral infarction? - CORRECT ANSWER - CT Scan:
checks chest, abdomen and brain (2-3 dimensions)
Cerebral angiography - CORRECT ANSWER - measures abnormal cerebral circulation
PET scan - CORRECT ANSWER - checks for cancer, brain disorders and heart diseases
A patient has been intubated in the ED and has a 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 ANSWER - B. ET tube is in
the correct position
*etco2 will be > if in the esophagus
Post-operatively, Mr. Hart has a 2-3 mm ST segment elevation on his 12 lead electrocardiograph.
This is indicative of - CORRECT ANSWER - Myocardial injury
,Which of the following would most accurately provide necessary information regarding fluid
management in the care of a critically ill patient with pulmonary edema?
A. Bedside PFT
B. Intake and Output measurements
C. Daily weights
D. Pulmonary artery catheter - CORRECT ANSWER - D. Pulmonary artery catheter
A patient who was struck in the head with a blunt object is recovering in the ICU. He is angry,
combative, and irritable. He opens his eyes, grunts, and withdraws when the sole of his foot is
stimulated with a sharp object. What is his score on the Glasgow Coma scale? - CORRECT
ANSWER -8
Chest radiograph changes associated with congestive heart failure include:
1. Bilateral radiolucency
2. Increased pulmonary Vasculature
3. Cardiomegaly
A. 1 & 2 only
B. 2&3 only
C. 1& 3 only
D. All of the above - CORRECT ANSWER - B. 2 & 3
1 is normal
2 and 3 indicates CHF
A 57 year old male is admitted to the ICU with chest pain radiating down his left arm. Which of
the following lab tests would best confirm the diagnosis of myocardial infarction?
,A. PvO2
B. Phosphate
C. Troponin
D. Lactate - CORRECT ANSWER - C. Troponin
A 67 year old male with chest pain and shortness of breath is placed on a cardiac monitor in the
intensive care unit. The following rhythm is observed on the monitor - what is the correct
interpretation of a 3rd degree AV block? - CORRECT ANSWER - No PR interval
Describe a 2nd degree AV block - CORRECT ANSWER - P wave longer and skips a beat
Describe a Multifocal PVC - CORRECT ANSWER - it's unidentifiable = treat with O2
and amiodarone
Which of the following tests should the adult critical care specialist recommend in order to
confirm the diagnosis of pulmonary artery hypertension?
A. pulmonary functions tests
B. high resolution CT scan
C. Right heart catheterization
D. Six minute walk test - CORRECT ANSWER - C. Right heart catheterization
A 76 y.o. male presents to the ED with shortness of breath. Upon entering the room the adult
critical care specialist determines that the patient is alert and anxious on oxygen at 5L/min by
nasal cannula. He is seated in the tripod position and using accessory muscles to breathe. He has
audible crackles bilaterally, jugular venous distension, and +2 peripheral edema. The following
patient data is obtained:
HR 110/min
RR 31/min
, BP 154/92 mmHg
Spo2 90%
Which of the following tests should the specialist recommend to confirm a suspicion of
congestive heart failure?
A. troponin
B. brain natriuretic peptide
C. magnesium level
D. MB fraction of creatinine phosphokinase - CORRECT ANSWER - B. Brain natriuretic
peptide
The adult critical care specialist assigned to the cardiovascular intensive care unit hears an alarm
sound in Room 4. Upon entering the room, the specialist notes that the pulmonary artery pressure
tracing is dampened. The specialist should: - CORRECT ANSWER - flush the catheter
* dampening means it's wet and not reading
Mrs. Smith is in her third postoperative day following repair of fractured hip. A chest radiograph
obtained tis morning reveals a left lower lobe infiltrate. Patient assessment data includes:
Temp: 102*F (39*C)
HR 100, RR 24, Sat 92%, BP 90/70
RBC 4, Hb 11
Hct 39, WBC 20000, Platelets 250,000
What therapy should the specialist recommend?
A. anti-infective agent
B. beta agonist aerosol
Questions and CORRECT Answers
Average urine output per hour is approximately? - CORRECT ANSWER - 40 mL
According to the Berlin Criteria, a patient is classified with severe ARDS when his Pao2/Fio2
ratio is? - CORRECT ANSWER - Less than 100
A patient is admitted to the ED with a possible CVA. Which diagnostic test is most appropriate
for identification of an acute cerebral infarction? - CORRECT ANSWER - CT Scan:
checks chest, abdomen and brain (2-3 dimensions)
Cerebral angiography - CORRECT ANSWER - measures abnormal cerebral circulation
PET scan - CORRECT ANSWER - checks for cancer, brain disorders and heart diseases
A patient has been intubated in the ED and has a 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 ANSWER - B. ET tube is in
the correct position
*etco2 will be > if in the esophagus
Post-operatively, Mr. Hart has a 2-3 mm ST segment elevation on his 12 lead electrocardiograph.
This is indicative of - CORRECT ANSWER - Myocardial injury
,Which of the following would most accurately provide necessary information regarding fluid
management in the care of a critically ill patient with pulmonary edema?
A. Bedside PFT
B. Intake and Output measurements
C. Daily weights
D. Pulmonary artery catheter - CORRECT ANSWER - D. Pulmonary artery catheter
A patient who was struck in the head with a blunt object is recovering in the ICU. He is angry,
combative, and irritable. He opens his eyes, grunts, and withdraws when the sole of his foot is
stimulated with a sharp object. What is his score on the Glasgow Coma scale? - CORRECT
ANSWER -8
Chest radiograph changes associated with congestive heart failure include:
1. Bilateral radiolucency
2. Increased pulmonary Vasculature
3. Cardiomegaly
A. 1 & 2 only
B. 2&3 only
C. 1& 3 only
D. All of the above - CORRECT ANSWER - B. 2 & 3
1 is normal
2 and 3 indicates CHF
A 57 year old male is admitted to the ICU with chest pain radiating down his left arm. Which of
the following lab tests would best confirm the diagnosis of myocardial infarction?
,A. PvO2
B. Phosphate
C. Troponin
D. Lactate - CORRECT ANSWER - C. Troponin
A 67 year old male with chest pain and shortness of breath is placed on a cardiac monitor in the
intensive care unit. The following rhythm is observed on the monitor - what is the correct
interpretation of a 3rd degree AV block? - CORRECT ANSWER - No PR interval
Describe a 2nd degree AV block - CORRECT ANSWER - P wave longer and skips a beat
Describe a Multifocal PVC - CORRECT ANSWER - it's unidentifiable = treat with O2
and amiodarone
Which of the following tests should the adult critical care specialist recommend in order to
confirm the diagnosis of pulmonary artery hypertension?
A. pulmonary functions tests
B. high resolution CT scan
C. Right heart catheterization
D. Six minute walk test - CORRECT ANSWER - C. Right heart catheterization
A 76 y.o. male presents to the ED with shortness of breath. Upon entering the room the adult
critical care specialist determines that the patient is alert and anxious on oxygen at 5L/min by
nasal cannula. He is seated in the tripod position and using accessory muscles to breathe. He has
audible crackles bilaterally, jugular venous distension, and +2 peripheral edema. The following
patient data is obtained:
HR 110/min
RR 31/min
, BP 154/92 mmHg
Spo2 90%
Which of the following tests should the specialist recommend to confirm a suspicion of
congestive heart failure?
A. troponin
B. brain natriuretic peptide
C. magnesium level
D. MB fraction of creatinine phosphokinase - CORRECT ANSWER - B. Brain natriuretic
peptide
The adult critical care specialist assigned to the cardiovascular intensive care unit hears an alarm
sound in Room 4. Upon entering the room, the specialist notes that the pulmonary artery pressure
tracing is dampened. The specialist should: - CORRECT ANSWER - flush the catheter
* dampening means it's wet and not reading
Mrs. Smith is in her third postoperative day following repair of fractured hip. A chest radiograph
obtained tis morning reveals a left lower lobe infiltrate. Patient assessment data includes:
Temp: 102*F (39*C)
HR 100, RR 24, Sat 92%, BP 90/70
RBC 4, Hb 11
Hct 39, WBC 20000, Platelets 250,000
What therapy should the specialist recommend?
A. anti-infective agent
B. beta agonist aerosol
