ACCS Review Practice Exam
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Questions and Answers

What is the average urine output per hour?

40 mL

According to the Berlin Criteria, what is the Pao2/Fio2 ratio indicating severe ARDS?

Less than 100

Which diagnostic test is most appropriate to identify an acute cerebral infarction?

CT Scan: checks chest, abdomen and brain (2-3 dimensions)

What does cerebral angiography measure?

<p>Abnormal cerebral circulation</p> Signup and view all the answers

What does a PET scan check for?

<p>Cancer, brain disorders and heart diseases</p> Signup and view all the answers

What should the specialist suspect if a patient has an end tidal CO2 reading of 4% after being intubated?

<p>ET tube is in the correct position</p> Signup and view all the answers

What is indicated by a 2-3 mm ST segment elevation on a 12 lead ECG post-operatively?

<p>Myocardial injury</p> Signup and view all the answers

Which would most accurately provide necessary information regarding fluid management in a critically ill patient with pulmonary edema?

<p>Pulmonary artery catheter</p> Signup and view all the answers

What is the Glasgow Coma Scale score of a patient who opens his eyes, grunts, and withdraws when the foot sole is stimulated?

<p>8</p> Signup and view all the answers

Which chest radiograph changes are associated with congestive heart failure?

<p>2 &amp; 3 only</p> Signup and view all the answers

What lab test would best confirm the diagnosis of myocardial infarction for a patient with chest pain?

<p>Troponin</p> Signup and view all the answers

What is the correct interpretation of a 3rd degree AV block observed on a cardiac monitor?

<p>No PR interval</p> Signup and view all the answers

Describe a 2nd degree AV block.

<p>P wave longer and skips a beat</p> Signup and view all the answers

Describe a multifocal PVC.

<p>It's unidentifiable = treat with O2 and amiodarone</p> Signup and view all the answers

Which test should confirm the diagnosis of pulmonary artery hypertension?

<p>Right heart catheterization</p> Signup and view all the answers

Which test should be recommended to confirm suspicion of congestive heart failure for a patient with shortness of breath?

<p>Brain natriuretic peptide</p> Signup and view all the answers

What should the specialist do if the pulmonary artery pressure tracing is dampened?

<p>Flush the catheter</p> Signup and view all the answers

What therapy should be recommended for Mrs. Smith following a radiograph revealing a left lower lobe infiltrate?

<p>Anti-infective agent</p> Signup and view all the answers

For a mildly obese woman with a positive bubble study and estimated peak pulmonary arterial pressure of 59, what should be the initial therapy?

<p>Pulmonary arterial hypertension</p> Signup and view all the answers

What should be recommended for a patient with blunt chest trauma experiencing shortness of breath?

<p>Insertion of a left chest tube</p> Signup and view all the answers

What therapy should be initiated for a patient indicating congestive heart failure?

<p>Congestive heart failure</p> Signup and view all the answers

What should be recommended for Mr. Jones, who has a history of vomiting and abdominal pain with specific lab results?

<p>Insulin</p> Signup and view all the answers

Study Notes

Urine Output and ARDS Classification

  • Average urine output per hour is approximately 40 mL.
  • Severe ARDS is indicated when the Pao2/Fio2 ratio is less than 100 according to the Berlin Criteria.

Diagnostic Tests for CVA and Cerebral Conditions

  • CT Scan is the most appropriate test for identifying an acute cerebral infarction.
  • Cerebral angiography measures abnormal cerebral circulation.
  • PET scan checks for cancer, brain disorders, and heart diseases.

End-Tidal CO2 and Intubation

  • An end-tidal CO2 reading of 4% suggests the ET tube is correctly positioned, as higher levels indicate esophageal placement.

Cardiac Monitoring and Conditions

  • 2-3 mm ST segment elevation post-operatively indicates myocardial injury.
  • The most accurate test for fluid management in pulmonary edema is a pulmonary artery catheter.
  • A Glasgow Coma Scale score of 8 indicates severe impairment in a patient displaying aggression and withdrawal responses.

Congestive Heart Failure Indicators

  • Chest radiograph changes suggesting congestive heart failure include increased pulmonary vasculature and cardiomegaly.
  • Confirmatory test for congestive heart failure is a brain natriuretic peptide (BNP) assessment.

Cardiac Rhythm Interpretation

  • In 3rd degree AV block, there is no PR interval.
  • 2nd degree AV block is characterized by longer P waves that skip beats.
  • Multifocal PVC is unidentifiable and should be treated with oxygen and amiodarone.

Diagnosis of Pulmonary Artery Hypertension

  • Right heart catheterization is the recommended test to confirm pulmonary artery hypertension.

Postoperative Complications and Care

  • A left lower lobe infiltrate in a post-operative patient may require an anti-infective agent.
  • Symptoms of shortness of breath, crackles, and edema in a 66-year-old woman indicate the need for congestive heart failure treatment.

Management of Chest Trauma and Conditions

  • Increased aeration on a chest CT may necessitate insertion of a left chest tube.

Metabolic Imbalances and Initial Treatment

  • A patient with symptoms of vomiting and abdominal pain, along with lab results indicating hyperglycemia and acidosis, should initially receive insulin therapy.

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Test your knowledge with this ACCS Review Practice Exam covering key medical concepts such as average urine output, ARDS classification, and diagnostic tests for cerebral infarction. Ideal for those preparing for advanced clinical scenarios in healthcare.

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