Air Methods Critical Care Exam
(Actual 2025/2026) – 200
Questions and Verified Answers
1. What is the most reliable method of confirming and monitoring correct
placement of an endotracheal tube?
Continuous waveform capnography
2. In a patient with severe traumatic brain injury, what is the target PaCO₂
range during the first 24 hours to prevent secondary injury?
35-45 mmHg (normocapnia); avoid hyperventilation unless signs of
herniation
3. What is the first-line vasopressor for septic shock after adequate fluid
resuscitation?
Norepinephrine
4. A patient on pressure control ventilation has a tidal volume of 350 mL with
a set pressure of 20 cmH₂O. Lung compliance suddenly decreases to 15
mL/cmH₂O. What change in tidal volume would be expected?
Tidal volume will decrease significantly because pressure-controlled
breaths are not volume-guaranteed
5. What is the most common arrhythmia immediately following a blunt cardiac
injury?
Sinus tachycardia
6. In a patient with undifferentiated shock and a narrow QRS, what is the initial
vasoactive agent of choice?
Norepinephrine
7. What is the normal range for central venous pressure (CVP)?
2-6 mmHg (or 4-8 cmH₂O)
,8. What is the diagnostic finding of cardiac tamponade on echocardiography?
Diastolic collapse of the right ventricle and/or right atrium with a
circumferential pericardial effusion
9. What is the most common cause of non-traumatic hemorrhagic shock in a
young adult?
Ruptured ectopic pregnancy (in females) or ruptured esophageal
varices (in both sexes)
10.What is the preferred method of intraosseous access in a critically ill adult
during cardiac arrest?
Proximal tibia or humeral head using a semiautomatic drill device
11.What is the initial fluid of choice for resuscitation in a patient with diabetic
ketoacidosis?
0.9% normal saline
12.What is the target mean arterial pressure (MAP) for a patient with septic
shock after initial fluid resuscitation?
≥65 mmHg
13.What is the most sensitive and specific test for acute mesenteric ischemia?
CT angiography of the abdomen
14.In a patient with status epilepticus refractory to benzodiazepines, what is the
next first-line anticonvulsant?
Fosphenytoin (or levetiracetam if fosphenytoin unavailable)
15.What is the primary determinant of coronary artery perfusion pressure?
Aortic diastolic pressure minus left ventricular end-diastolic pressure
16.What is the preferred method of advanced airway management in a patient
with suspected cervical spine injury?
Video laryngoscopy with manual in-line stabilization
17.What is the most common acid-base disturbance seen in a patient with
salicylate overdose?
Mixed high-anion-gap metabolic acidosis and respiratory alkalosis
18.What is the first laboratory value that becomes abnormal in acute kidney
injury?
Serum creatinine (rise of ≥0.3 mg/dL within 48 hours)
, 19.What is the ideal initial tidal volume setting for a patient with acute
respiratory distress syndrome (ARDS) on volume control ventilation?
6 mL/kg predicted body weight
20.What is the normal range for pulmonary artery occlusion pressure (PAOP) in
a healthy adult?
4-12 mmHg
21.What is the most common etiology of out-of-hospital cardiac arrest in
adults?
Acute coronary syndrome (myocardial infarction)
22.What is the first step in the management of a patient with suspected tension
pneumothorax?
Immediate needle decompression (second intercostal space,
midclavicular line)
23.What is the most reliable sign of a properly placed supraglottic airway (e.g.,
King LT or LMA)?
Bilateral breath sounds, absent gastric insufflation, and a normal
end-tidal CO₂ waveform
24.What is the primary mechanism of action of ketamine for rapid sequence
intubation?
NMDA receptor antagonism (dissociative anesthesia)
25.What is the reversal agent for a patient with suspected opioid overdose who
is apneic but has a pulse?
Naloxone (0.4-2 mg IV/IM/IN)
26.What is the most common preventable cause of secondary brain injury after
traumatic brain injury?
Hypotension and hypoxemia
27.What is the optimal head of bed position for a patient with increased
intracranial pressure?
Elevated to 30-45 degrees with the head in midline position
28.What is the initial dose of alteplase (tPA) for acute ischemic stroke when
administered within 4.5 hours of symptom onset?
0.9 mg/kg (max 90 mg) with 10% as bolus, remainder infused over 60
minutes
(Actual 2025/2026) – 200
Questions and Verified Answers
1. What is the most reliable method of confirming and monitoring correct
placement of an endotracheal tube?
Continuous waveform capnography
2. In a patient with severe traumatic brain injury, what is the target PaCO₂
range during the first 24 hours to prevent secondary injury?
35-45 mmHg (normocapnia); avoid hyperventilation unless signs of
herniation
3. What is the first-line vasopressor for septic shock after adequate fluid
resuscitation?
Norepinephrine
4. A patient on pressure control ventilation has a tidal volume of 350 mL with
a set pressure of 20 cmH₂O. Lung compliance suddenly decreases to 15
mL/cmH₂O. What change in tidal volume would be expected?
Tidal volume will decrease significantly because pressure-controlled
breaths are not volume-guaranteed
5. What is the most common arrhythmia immediately following a blunt cardiac
injury?
Sinus tachycardia
6. In a patient with undifferentiated shock and a narrow QRS, what is the initial
vasoactive agent of choice?
Norepinephrine
7. What is the normal range for central venous pressure (CVP)?
2-6 mmHg (or 4-8 cmH₂O)
,8. What is the diagnostic finding of cardiac tamponade on echocardiography?
Diastolic collapse of the right ventricle and/or right atrium with a
circumferential pericardial effusion
9. What is the most common cause of non-traumatic hemorrhagic shock in a
young adult?
Ruptured ectopic pregnancy (in females) or ruptured esophageal
varices (in both sexes)
10.What is the preferred method of intraosseous access in a critically ill adult
during cardiac arrest?
Proximal tibia or humeral head using a semiautomatic drill device
11.What is the initial fluid of choice for resuscitation in a patient with diabetic
ketoacidosis?
0.9% normal saline
12.What is the target mean arterial pressure (MAP) for a patient with septic
shock after initial fluid resuscitation?
≥65 mmHg
13.What is the most sensitive and specific test for acute mesenteric ischemia?
CT angiography of the abdomen
14.In a patient with status epilepticus refractory to benzodiazepines, what is the
next first-line anticonvulsant?
Fosphenytoin (or levetiracetam if fosphenytoin unavailable)
15.What is the primary determinant of coronary artery perfusion pressure?
Aortic diastolic pressure minus left ventricular end-diastolic pressure
16.What is the preferred method of advanced airway management in a patient
with suspected cervical spine injury?
Video laryngoscopy with manual in-line stabilization
17.What is the most common acid-base disturbance seen in a patient with
salicylate overdose?
Mixed high-anion-gap metabolic acidosis and respiratory alkalosis
18.What is the first laboratory value that becomes abnormal in acute kidney
injury?
Serum creatinine (rise of ≥0.3 mg/dL within 48 hours)
, 19.What is the ideal initial tidal volume setting for a patient with acute
respiratory distress syndrome (ARDS) on volume control ventilation?
6 mL/kg predicted body weight
20.What is the normal range for pulmonary artery occlusion pressure (PAOP) in
a healthy adult?
4-12 mmHg
21.What is the most common etiology of out-of-hospital cardiac arrest in
adults?
Acute coronary syndrome (myocardial infarction)
22.What is the first step in the management of a patient with suspected tension
pneumothorax?
Immediate needle decompression (second intercostal space,
midclavicular line)
23.What is the most reliable sign of a properly placed supraglottic airway (e.g.,
King LT or LMA)?
Bilateral breath sounds, absent gastric insufflation, and a normal
end-tidal CO₂ waveform
24.What is the primary mechanism of action of ketamine for rapid sequence
intubation?
NMDA receptor antagonism (dissociative anesthesia)
25.What is the reversal agent for a patient with suspected opioid overdose who
is apneic but has a pulse?
Naloxone (0.4-2 mg IV/IM/IN)
26.What is the most common preventable cause of secondary brain injury after
traumatic brain injury?
Hypotension and hypoxemia
27.What is the optimal head of bed position for a patient with increased
intracranial pressure?
Elevated to 30-45 degrees with the head in midline position
28.What is the initial dose of alteplase (tPA) for acute ischemic stroke when
administered within 4.5 hours of symptom onset?
0.9 mg/kg (max 90 mg) with 10% as bolus, remainder infused over 60
minutes
