Adult Critical Care Specialty (ACCS) Exam Prep – 156 Most
Tested Questions & Verified Answers | Latest 2026
Update | Exam Prep PDF
1. In a patient with pulmonary hypertension, how might the administration of
Prostacyclin influence their condition?
It would enhance the production of surfactant.
It would lead to bronchoconstriction.
It would reduce pulmonary vascular resistance.
It would increase blood pressure in the pulmonary arteries.
2. Describe the difference between spontaneous respirations and apnea in
terms of breathing patterns.
Spontaneous respirations occur only during sleep, while apnea occurs
during wakefulness.
Spontaneous respirations are controlled by machines, while apnea is a
natural process.
Spontaneous respirations are the natural breathing process, while
apnea is a temporary cessation of breathing.
Spontaneous respirations involve rapid breathing, while apnea
involves slow breathing.
3. What is the first step in the Huff coughing technique for patients with COPD?
Sit upright and lean forward.
Inhale deeply through the mouth.
Hold breath for 2-3 seconds.
Forcefully exhale.
,4. 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
5. What condition does hyperventilation help to manage in the short term?
Asthma
Acute elevations of intracranial pressure
Pulmonary embolism
Chronic obstructive pulmonary disease
6. Describe the significance of deadspace ventilation in critical care nursing.
Deadspace ventilation is the measurement of lung compliance in
patients.
Deadspace ventilation is the amount of oxygen delivered to the
bloodstream during respiration.
Deadspace ventilation refers to the portion of each breath that does
not participate in gas exchange, which is crucial for assessing
respiratory efficiency in critically ill patients.
Deadspace ventilation is the total volume of air inhaled by a patient
during mechanical ventilation.
7. Which of the following statements is/are true concerning Inverse Ratio
Ventilation (IRV)?
I. Patients on IRV will most likely require sedation.
, II. IRV will decrease oxygenation, but increase ventilation.
III. A typical I:E Ratio in IRV would be 1:2.
IV. IRV will typically increase the mean airway pressure.
I and IV are correct.
Only 1 is correct.
II, III, and IV are correct.
II and III are correct.
8. In a patient with heart failure, how might changes in preload affect their
overall cardiac output?
Increased preload may lead to improved cardiac output initially, but
excessive preload can cause pulmonary congestion and decreased
output.
Changes in preload do not affect heart failure patients.
Preload has no effect on cardiac output in heart failure.
Decreased preload will always improve cardiac output in heart failure
patients.
9. In a critical care setting, if a patient is experiencing severe anxiety and
requires sedation for a procedure, how might Midazolam be utilized?
To stimulate appetite and digestion.
To enhance respiratory function and oxygenation.
To increase blood pressure and heart rate.
To provide sedation and reduce anxiety during the procedure.
, 10. In a patient diagnosed with disseminated intravascular coagulation (DIC),
which management strategy would be most critical to implement?
Performing surgical interventions to remove clots
Administering high doses of anticoagulants immediately
Increasing fluid intake to prevent dehydration
Monitoring and managing bleeding and clotting complications
11. In a patient suspected of having ventilator-associated pneumonia (VAP), how
would bronchoalveolar lavage (BAL) contribute to their treatment plan?
By delivering antibiotics directly to the alveoli.
By providing diagnostic samples to confirm the presence of
infection.
By improving oxygenation through lung expansion.
By monitoring the patient's vital signs during ventilation.
12. Two of the SIRS criteria plus a known or suspected infection is considered
which stage is the progression of sepsis?
Septic shock
Severe sepsis
Presepsis
Sepsis
13. What is the clinical significance of rhonchi in a patient assessment?
Fluid accumulation in the alveoli.
Obstruction of larger airways by secretions.
Tested Questions & Verified Answers | Latest 2026
Update | Exam Prep PDF
1. In a patient with pulmonary hypertension, how might the administration of
Prostacyclin influence their condition?
It would enhance the production of surfactant.
It would lead to bronchoconstriction.
It would reduce pulmonary vascular resistance.
It would increase blood pressure in the pulmonary arteries.
2. Describe the difference between spontaneous respirations and apnea in
terms of breathing patterns.
Spontaneous respirations occur only during sleep, while apnea occurs
during wakefulness.
Spontaneous respirations are controlled by machines, while apnea is a
natural process.
Spontaneous respirations are the natural breathing process, while
apnea is a temporary cessation of breathing.
Spontaneous respirations involve rapid breathing, while apnea
involves slow breathing.
3. What is the first step in the Huff coughing technique for patients with COPD?
Sit upright and lean forward.
Inhale deeply through the mouth.
Hold breath for 2-3 seconds.
Forcefully exhale.
,4. 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
5. What condition does hyperventilation help to manage in the short term?
Asthma
Acute elevations of intracranial pressure
Pulmonary embolism
Chronic obstructive pulmonary disease
6. Describe the significance of deadspace ventilation in critical care nursing.
Deadspace ventilation is the measurement of lung compliance in
patients.
Deadspace ventilation is the amount of oxygen delivered to the
bloodstream during respiration.
Deadspace ventilation refers to the portion of each breath that does
not participate in gas exchange, which is crucial for assessing
respiratory efficiency in critically ill patients.
Deadspace ventilation is the total volume of air inhaled by a patient
during mechanical ventilation.
7. Which of the following statements is/are true concerning Inverse Ratio
Ventilation (IRV)?
I. Patients on IRV will most likely require sedation.
, II. IRV will decrease oxygenation, but increase ventilation.
III. A typical I:E Ratio in IRV would be 1:2.
IV. IRV will typically increase the mean airway pressure.
I and IV are correct.
Only 1 is correct.
II, III, and IV are correct.
II and III are correct.
8. In a patient with heart failure, how might changes in preload affect their
overall cardiac output?
Increased preload may lead to improved cardiac output initially, but
excessive preload can cause pulmonary congestion and decreased
output.
Changes in preload do not affect heart failure patients.
Preload has no effect on cardiac output in heart failure.
Decreased preload will always improve cardiac output in heart failure
patients.
9. In a critical care setting, if a patient is experiencing severe anxiety and
requires sedation for a procedure, how might Midazolam be utilized?
To stimulate appetite and digestion.
To enhance respiratory function and oxygenation.
To increase blood pressure and heart rate.
To provide sedation and reduce anxiety during the procedure.
, 10. In a patient diagnosed with disseminated intravascular coagulation (DIC),
which management strategy would be most critical to implement?
Performing surgical interventions to remove clots
Administering high doses of anticoagulants immediately
Increasing fluid intake to prevent dehydration
Monitoring and managing bleeding and clotting complications
11. In a patient suspected of having ventilator-associated pneumonia (VAP), how
would bronchoalveolar lavage (BAL) contribute to their treatment plan?
By delivering antibiotics directly to the alveoli.
By providing diagnostic samples to confirm the presence of
infection.
By improving oxygenation through lung expansion.
By monitoring the patient's vital signs during ventilation.
12. Two of the SIRS criteria plus a known or suspected infection is considered
which stage is the progression of sepsis?
Septic shock
Severe sepsis
Presepsis
Sepsis
13. What is the clinical significance of rhonchi in a patient assessment?
Fluid accumulation in the alveoli.
Obstruction of larger airways by secretions.
