ACCS PMHNP Exam – Adult Critical Care Specialty Full
Practice Test Q&A | Latest Update 2026 | 100% Pass
Guarantee
1. A nursing student asks a nurse what the mechanism of action is for beta
blockers. The nurse responds by saying:
"They bind to receptors preventing the effects of angiotensin II which
prevents vasoconstriction"
"They inhibit the conversion of angiotensin I to angiotensin II which
leads to a decrease in vasoconstriction and blood pressure"
"They decrease excess intravascular fluid by promoting diuresis which
decreases blood pressure"
"They block the receptors that bind to epinephrine in the heart
which decreases blood pressure and heart rate"
2. In a patient with increased airway resistance, how would you expect dynamic
compliance to change, and what clinical implications might this have?
Dynamic compliance would fluctuate, reflecting varying oxygen
levels.
Dynamic compliance would decrease, indicating impaired lung
mechanics and potential respiratory distress.
Dynamic compliance would remain unchanged, indicating stable
respiratory status.
Dynamic compliance would increase, suggesting improved lung
function.
3. Describe how the appearance of infiltrates on a chest X-ray can indicate the
severity of pneumonia.
, Infiltrates on a chest X-ray are unrelated to pneumonia severity.
Infiltrates are always indicative of a viral infection.
Only localized infiltrates are significant for pneumonia.
The presence of diffuse or scattered infiltrates suggests lung
involvement and can indicate the severity of the infection.
4. If a patient does not exhibit chest movement during apnea testing, what
should be the next step in the evaluation for brain death?
Administer additional medications
Reconnect the patient to the ventilator
Obtain arterial blood gas after 8 minutes
Continue to observe for another 10 minutes
5. You are assisting in determination of brain death by performing an Apnea
Test. You have taken a baseline abg and the patient's PaCO2 is 41 mmHg. Six
minutes after removing your patient from the ventilator while giving them
oxygen, your patient's PaCO2 is 65 mmHg and you see no respiratory effort.
How would you interpret these results?
This supports the brain death diagnosis
This has nothing to do with brain death
This does not support the brain death diagnosis
This is inconclusive
6. Ventilator-associated pneumonia (VAP) is a major concern for ventilated
patients because it:
Causes 75% of nosocomial infections in vented patients
Occurs in 5% of ventilated patients
Develops within 24 hours of intubation
, Increases hospital stay length and mortality
7. Describe the role of a trigger variable in positive pressure ventilation.
A trigger variable is the rate at which breaths are delivered.
A trigger variable is the parameter that starts the inspiratory phase
of a positive pressure breath.
A trigger variable is the pressure maintained during the expiratory
phase.
A trigger variable is the amount of air delivered during expiration.
8. Describe how scoliosis can impact a patient's overall health and mobility.
Scoliosis can lead to pain, reduced lung capacity, and impaired
mobility.
Scoliosis has no significant impact on health.
Scoliosis improves overall posture and health.
Scoliosis only affects the lower back.
9. A patient in critical care presents with a peak inspiratory pressure of 55 cm
H2O and low oxygen saturation levels. How would the application of inverse
ratio ventilation benefit this patient?
By minimizing the use of sedatives during mechanical ventilation.
By decreasing the patient's respiratory rate to reduce fatigue.
By improving oxygenation and gas exchange despite high peak
inspiratory pressures.
By increasing the tidal volume to enhance ventilation.
10. In a patient exhibiting Cheyne-Stokes breathing, what clinical implications
should a nurse consider when planning care?
, No specific interventions are needed.
Stable respiratory function and minimal intervention required.
Potential for respiratory failure and the need for close monitoring.
Immediate intubation is necessary.
11. What is the primary reason for performing a BAL (broncho-alveolar lavage)?
to find out if there is bacteria or fungus growing in the lung to
target medications
to find out if the patient has COPD
to check for cancer/to stage cancer
to find out if the patient has ARDS
12. What does heart contractility refer to in terms of myocardial fibers?
The volume of blood the heart pumps per minute.
The resistance of blood flow in the arteries.
The ability of myocardial fibers to shorten during systole and the
ability for the heart to stretch.
The rate at which the heart beats during diastole.
13. Describe the role of Lidocaine in the preparation for a bronchoscopy.
Lidocaine is given to prevent infection.
Lidocaine is used to manage pain post-procedure.
Lidocaine is used as a topical anesthetic to numb the airway during
the procedure.
Lidocaine is administered to induce sedation.
14. What is the typical progression of septic shock from an initial infection?
Practice Test Q&A | Latest Update 2026 | 100% Pass
Guarantee
1. A nursing student asks a nurse what the mechanism of action is for beta
blockers. The nurse responds by saying:
"They bind to receptors preventing the effects of angiotensin II which
prevents vasoconstriction"
"They inhibit the conversion of angiotensin I to angiotensin II which
leads to a decrease in vasoconstriction and blood pressure"
"They decrease excess intravascular fluid by promoting diuresis which
decreases blood pressure"
"They block the receptors that bind to epinephrine in the heart
which decreases blood pressure and heart rate"
2. In a patient with increased airway resistance, how would you expect dynamic
compliance to change, and what clinical implications might this have?
Dynamic compliance would fluctuate, reflecting varying oxygen
levels.
Dynamic compliance would decrease, indicating impaired lung
mechanics and potential respiratory distress.
Dynamic compliance would remain unchanged, indicating stable
respiratory status.
Dynamic compliance would increase, suggesting improved lung
function.
3. Describe how the appearance of infiltrates on a chest X-ray can indicate the
severity of pneumonia.
, Infiltrates on a chest X-ray are unrelated to pneumonia severity.
Infiltrates are always indicative of a viral infection.
Only localized infiltrates are significant for pneumonia.
The presence of diffuse or scattered infiltrates suggests lung
involvement and can indicate the severity of the infection.
4. If a patient does not exhibit chest movement during apnea testing, what
should be the next step in the evaluation for brain death?
Administer additional medications
Reconnect the patient to the ventilator
Obtain arterial blood gas after 8 minutes
Continue to observe for another 10 minutes
5. You are assisting in determination of brain death by performing an Apnea
Test. You have taken a baseline abg and the patient's PaCO2 is 41 mmHg. Six
minutes after removing your patient from the ventilator while giving them
oxygen, your patient's PaCO2 is 65 mmHg and you see no respiratory effort.
How would you interpret these results?
This supports the brain death diagnosis
This has nothing to do with brain death
This does not support the brain death diagnosis
This is inconclusive
6. Ventilator-associated pneumonia (VAP) is a major concern for ventilated
patients because it:
Causes 75% of nosocomial infections in vented patients
Occurs in 5% of ventilated patients
Develops within 24 hours of intubation
, Increases hospital stay length and mortality
7. Describe the role of a trigger variable in positive pressure ventilation.
A trigger variable is the rate at which breaths are delivered.
A trigger variable is the parameter that starts the inspiratory phase
of a positive pressure breath.
A trigger variable is the pressure maintained during the expiratory
phase.
A trigger variable is the amount of air delivered during expiration.
8. Describe how scoliosis can impact a patient's overall health and mobility.
Scoliosis can lead to pain, reduced lung capacity, and impaired
mobility.
Scoliosis has no significant impact on health.
Scoliosis improves overall posture and health.
Scoliosis only affects the lower back.
9. A patient in critical care presents with a peak inspiratory pressure of 55 cm
H2O and low oxygen saturation levels. How would the application of inverse
ratio ventilation benefit this patient?
By minimizing the use of sedatives during mechanical ventilation.
By decreasing the patient's respiratory rate to reduce fatigue.
By improving oxygenation and gas exchange despite high peak
inspiratory pressures.
By increasing the tidal volume to enhance ventilation.
10. In a patient exhibiting Cheyne-Stokes breathing, what clinical implications
should a nurse consider when planning care?
, No specific interventions are needed.
Stable respiratory function and minimal intervention required.
Potential for respiratory failure and the need for close monitoring.
Immediate intubation is necessary.
11. What is the primary reason for performing a BAL (broncho-alveolar lavage)?
to find out if there is bacteria or fungus growing in the lung to
target medications
to find out if the patient has COPD
to check for cancer/to stage cancer
to find out if the patient has ARDS
12. What does heart contractility refer to in terms of myocardial fibers?
The volume of blood the heart pumps per minute.
The resistance of blood flow in the arteries.
The ability of myocardial fibers to shorten during systole and the
ability for the heart to stretch.
The rate at which the heart beats during diastole.
13. Describe the role of Lidocaine in the preparation for a bronchoscopy.
Lidocaine is given to prevent infection.
Lidocaine is used to manage pain post-procedure.
Lidocaine is used as a topical anesthetic to numb the airway during
the procedure.
Lidocaine is administered to induce sedation.
14. What is the typical progression of septic shock from an initial infection?
