BKAT ICU Post-Test Exam ( Questions and Answers
2025 ) 100% Verified By Experts | Graded A+
Question:
A 65-year-old male patient admitted with severe community-acquired pneumonia is on
mechanical ventilation. His current ventilator settings include tidal volume 500 mL, respiratory
rate 14/min, FiO₂ 60%, and PEEP 8 cm H₂O. Over the last hour, his oxygen saturation has
dropped from 95% to 88%. Chest X-ray shows worsening bilateral infiltrates.
What ventilator adjustment would you recommend?
What are possible causes for his worsening oxygenation?
Answer:
Increase PEEP to improve alveolar recruitment and oxygenation, or consider increasing FiO₂
temporarily. Adjust tidal volume cautiously to avoid volutrauma.
Causes may include progression of ARDS, mucus plugging, pneumothorax, ventilator-
associated pneumonia, or worsening pulmonary edema. Clinical assessment and suctioning are
important.
Question:
A patient in the ICU develops sudden hypotension (BP 80/50 mmHg), tachycardia (HR 130
bpm), and cold, clammy skin. Central venous pressure is low.
What type of shock is most likely?
,What initial interventions should be started?
Answer:
Hypovolemic shock due to decreased preload and compensatory tachycardia.
Immediate fluid resuscitation with isotonic crystalloids, establish IV access, monitor vital signs,
and identify the bleeding source or fluid loss cause. Vasopressors only if fluid resuscitation is
insufficient.
Question:
A patient with chronic kidney disease stage 4 is admitted with confusion, nausea, and muscle
cramps. Labs reveal potassium 6.5 mEq/L and metabolic acidosis.
What ECG changes might you expect?
What is your immediate management of hyperkalemia?
Answer:
ECG may show peaked T waves, prolonged PR interval, and widened QRS complexes.
Immediate treatment includes IV calcium gluconate to stabilize cardiac membranes, IV insulin
with glucose to shift potassium intracellularly, and sodium bicarbonate if acidotic. Prepare for
dialysis if refractory.
Question:
During a cardiac arrest, after two minutes of CPR and one shock delivered for ventricular
fibrillation, the rhythm remains VFib. The airway is secured via endotracheal intubation.
What medication should be administered next?
,What is the recommended dose and frequency?
Answer:
Administer epinephrine to improve coronary and cerebral perfusion.
Dose is 1 mg IV/IO every 3–5 minutes during resuscitation. Amiodarone can be given after the
third shock if VF persists.
Question:
A patient with sepsis is being managed in the ICU. Despite adequate fluid resuscitation, the
MAP remains 55 mmHg. The patient is on norepinephrine infusion.
What is the target MAP for adequate tissue perfusion?
What other therapies can be considered if norepinephrine alone is insufficient?
Answer:
The target MAP is ≥ 65 mmHg to ensure adequate organ perfusion.
Consider adding vasopressin or epinephrine as adjunct vasopressors. Evaluate for adrenal
insufficiency and consider corticosteroids if indicated. Optimize oxygen delivery and monitor
lactate levels.
Question:
A 72-year-old female post-operative patient develops sudden shortness of breath, chest pain,
and tachycardia. Oxygen saturation drops to 85% on 4L nasal cannula.
What is the most likely diagnosis?
, What diagnostic tests would you order?
What is the immediate management?
Answer:
Pulmonary embolism (PE) is the most likely diagnosis given sudden respiratory distress, chest
pain, and hypoxia.
Diagnostic tests: CT pulmonary angiography (gold standard), D-dimer assay, ECG (may show
sinus tachycardia or S1Q3T3 pattern), and bedside ultrasound to assess right heart strain.
Immediate management includes oxygen supplementation, anticoagulation with low
molecular weight heparin or unfractionated heparin, and in severe cases, thrombolytic
therapy. Monitor hemodynamics closely.
Question:
A patient in ICU has a low urine output (<0.3 mL/kg/hr) and rising creatinine despite adequate
fluid resuscitation. Blood pressure is stable, but the patient is oliguric.
What type of acute kidney injury (AKI) is this likely to be?
What are key management strategies?
Answer:
Likely intrinsic AKI (acute tubular necrosis) since hypotension and hypovolemia have been
corrected and the patient remains oliguric.
Management includes avoiding nephrotoxic agents, optimizing fluid status, correcting
electrolyte imbalances, and considering renal replacement therapy if needed. Monitor urine
output and daily weights closely.
2025 ) 100% Verified By Experts | Graded A+
Question:
A 65-year-old male patient admitted with severe community-acquired pneumonia is on
mechanical ventilation. His current ventilator settings include tidal volume 500 mL, respiratory
rate 14/min, FiO₂ 60%, and PEEP 8 cm H₂O. Over the last hour, his oxygen saturation has
dropped from 95% to 88%. Chest X-ray shows worsening bilateral infiltrates.
What ventilator adjustment would you recommend?
What are possible causes for his worsening oxygenation?
Answer:
Increase PEEP to improve alveolar recruitment and oxygenation, or consider increasing FiO₂
temporarily. Adjust tidal volume cautiously to avoid volutrauma.
Causes may include progression of ARDS, mucus plugging, pneumothorax, ventilator-
associated pneumonia, or worsening pulmonary edema. Clinical assessment and suctioning are
important.
Question:
A patient in the ICU develops sudden hypotension (BP 80/50 mmHg), tachycardia (HR 130
bpm), and cold, clammy skin. Central venous pressure is low.
What type of shock is most likely?
,What initial interventions should be started?
Answer:
Hypovolemic shock due to decreased preload and compensatory tachycardia.
Immediate fluid resuscitation with isotonic crystalloids, establish IV access, monitor vital signs,
and identify the bleeding source or fluid loss cause. Vasopressors only if fluid resuscitation is
insufficient.
Question:
A patient with chronic kidney disease stage 4 is admitted with confusion, nausea, and muscle
cramps. Labs reveal potassium 6.5 mEq/L and metabolic acidosis.
What ECG changes might you expect?
What is your immediate management of hyperkalemia?
Answer:
ECG may show peaked T waves, prolonged PR interval, and widened QRS complexes.
Immediate treatment includes IV calcium gluconate to stabilize cardiac membranes, IV insulin
with glucose to shift potassium intracellularly, and sodium bicarbonate if acidotic. Prepare for
dialysis if refractory.
Question:
During a cardiac arrest, after two minutes of CPR and one shock delivered for ventricular
fibrillation, the rhythm remains VFib. The airway is secured via endotracheal intubation.
What medication should be administered next?
,What is the recommended dose and frequency?
Answer:
Administer epinephrine to improve coronary and cerebral perfusion.
Dose is 1 mg IV/IO every 3–5 minutes during resuscitation. Amiodarone can be given after the
third shock if VF persists.
Question:
A patient with sepsis is being managed in the ICU. Despite adequate fluid resuscitation, the
MAP remains 55 mmHg. The patient is on norepinephrine infusion.
What is the target MAP for adequate tissue perfusion?
What other therapies can be considered if norepinephrine alone is insufficient?
Answer:
The target MAP is ≥ 65 mmHg to ensure adequate organ perfusion.
Consider adding vasopressin or epinephrine as adjunct vasopressors. Evaluate for adrenal
insufficiency and consider corticosteroids if indicated. Optimize oxygen delivery and monitor
lactate levels.
Question:
A 72-year-old female post-operative patient develops sudden shortness of breath, chest pain,
and tachycardia. Oxygen saturation drops to 85% on 4L nasal cannula.
What is the most likely diagnosis?
, What diagnostic tests would you order?
What is the immediate management?
Answer:
Pulmonary embolism (PE) is the most likely diagnosis given sudden respiratory distress, chest
pain, and hypoxia.
Diagnostic tests: CT pulmonary angiography (gold standard), D-dimer assay, ECG (may show
sinus tachycardia or S1Q3T3 pattern), and bedside ultrasound to assess right heart strain.
Immediate management includes oxygen supplementation, anticoagulation with low
molecular weight heparin or unfractionated heparin, and in severe cases, thrombolytic
therapy. Monitor hemodynamics closely.
Question:
A patient in ICU has a low urine output (<0.3 mL/kg/hr) and rising creatinine despite adequate
fluid resuscitation. Blood pressure is stable, but the patient is oliguric.
What type of acute kidney injury (AKI) is this likely to be?
What are key management strategies?
Answer:
Likely intrinsic AKI (acute tubular necrosis) since hypotension and hypovolemia have been
corrected and the patient remains oliguric.
Management includes avoiding nephrotoxic agents, optimizing fluid status, correcting
electrolyte imbalances, and considering renal replacement therapy if needed. Monitor urine
output and daily weights closely.
