ACCS Prep (NBRC Prac ce Exam 1)| Updated RATED A+ |
NEW 2026
A 50 year old male present to the Ed with syncope and shock. He is admi ed to the intensive
care and pulmonary artery catheter is inserted. pa ent data is as follows:
BP 70/40 MAP 50 CVP 20 RV 45/0 PAP 45/15 Mean PAP 25 PCWP 7
QT 2.5 SVR 18 (1440 dynes) PVR 8.4 (670 dynes)
ABG (RA) pH:7.32,CO2 32,PaO2 59 SpO2, 89%.
Mixed VBG: pH 7.28 CO2 38 PaO2 28 SpO2 49%
Ca-vO2 difference is 8.0 vol%.
The adult cri cal care specialist should recommend that the pa ent be treated quickly for:
A. acute pulmonary embolism
B. le= heart failure
C. right heart failure
D. hypervolemia
A. acute pulmonary embolism (>PAP, >CVP)
Normal:
BP 120/80.....MAP 90......CVP 10.....RV 25/0.....PAP 25/8.....Mean PAP 14.....PCWP 8-10.......Qt 4-
8.....
SVR <20 or 1600dynes (Le= heart system)
PVR <2.5 or 200 dynes (Right heart - pulmonary sytem)
-----
Le= heart failure (>PCWP, <MAP, <QT)
Right heart failure (>CVP, <PAP)
Hypervolemia (all values are increased >)
cerebral angiography
exams head, brain, and neck blood vessels to iden fy abnormali es: aneurysms, strokes,
blockages
Positron Emission Tomography (PET)
, Narrow neck vessels
checks (cancer, brain disorders, heart disease)
A pa ent has been intubated in the ED and has an end- dal CO2 reading of 4%. The specialist
should suspect that the:
A. pa ent has a pulmonary embolus
B. ET tube is in the correct posi on
C. ET tube is in the esophagus
D. ET tube is in the right main stem bronchus
B. ET tube is in the correct posi on
NOTE: ETCO2 will be > if in the esophagus
Post-opera vely, Mr. Hart has a 2-3 mm ST segment eleva on on his 12 lead electrocardiograph.
This is indica ve of
Myocardial Injury
Acute Cerebral Infarc on:
ischemic stroke by sudden brain blood vessel blockage (clot)
Acute Cerebral Infarc on (Dx Test)
Imaging: CTA, PET, MRA, CT scan (chest, abs, brain)
----
Blood tests, platelet, electrolyte, Prothrombin me, par al thromboplas n me (measures
cloFng me)
Cerebrovascular Accident (CVA)
general for stroke includes ischemic(clot) & hemorrhagic (rupture) stroke
CVA Diagnos c Test
Imaging: CT. MRI, Ultrasound, angiography
-----
Blood tests: CBC,electrolytes, cloFng test, thyroid hormone test
----
Electrocardiogram (EKG)
Which of the following would most accurately provide necessary informa on regarding fluid
management in the care of a cri cally ill pa ent with pulmonary edema?
A. Bedside PFT
B. Intake and Output measurements
NEW 2026
A 50 year old male present to the Ed with syncope and shock. He is admi ed to the intensive
care and pulmonary artery catheter is inserted. pa ent data is as follows:
BP 70/40 MAP 50 CVP 20 RV 45/0 PAP 45/15 Mean PAP 25 PCWP 7
QT 2.5 SVR 18 (1440 dynes) PVR 8.4 (670 dynes)
ABG (RA) pH:7.32,CO2 32,PaO2 59 SpO2, 89%.
Mixed VBG: pH 7.28 CO2 38 PaO2 28 SpO2 49%
Ca-vO2 difference is 8.0 vol%.
The adult cri cal care specialist should recommend that the pa ent be treated quickly for:
A. acute pulmonary embolism
B. le= heart failure
C. right heart failure
D. hypervolemia
A. acute pulmonary embolism (>PAP, >CVP)
Normal:
BP 120/80.....MAP 90......CVP 10.....RV 25/0.....PAP 25/8.....Mean PAP 14.....PCWP 8-10.......Qt 4-
8.....
SVR <20 or 1600dynes (Le= heart system)
PVR <2.5 or 200 dynes (Right heart - pulmonary sytem)
-----
Le= heart failure (>PCWP, <MAP, <QT)
Right heart failure (>CVP, <PAP)
Hypervolemia (all values are increased >)
cerebral angiography
exams head, brain, and neck blood vessels to iden fy abnormali es: aneurysms, strokes,
blockages
Positron Emission Tomography (PET)
, Narrow neck vessels
checks (cancer, brain disorders, heart disease)
A pa ent has been intubated in the ED and has an end- dal CO2 reading of 4%. The specialist
should suspect that the:
A. pa ent has a pulmonary embolus
B. ET tube is in the correct posi on
C. ET tube is in the esophagus
D. ET tube is in the right main stem bronchus
B. ET tube is in the correct posi on
NOTE: ETCO2 will be > if in the esophagus
Post-opera vely, Mr. Hart has a 2-3 mm ST segment eleva on on his 12 lead electrocardiograph.
This is indica ve of
Myocardial Injury
Acute Cerebral Infarc on:
ischemic stroke by sudden brain blood vessel blockage (clot)
Acute Cerebral Infarc on (Dx Test)
Imaging: CTA, PET, MRA, CT scan (chest, abs, brain)
----
Blood tests, platelet, electrolyte, Prothrombin me, par al thromboplas n me (measures
cloFng me)
Cerebrovascular Accident (CVA)
general for stroke includes ischemic(clot) & hemorrhagic (rupture) stroke
CVA Diagnos c Test
Imaging: CT. MRI, Ultrasound, angiography
-----
Blood tests: CBC,electrolytes, cloFng test, thyroid hormone test
----
Electrocardiogram (EKG)
Which of the following would most accurately provide necessary informa on regarding fluid
management in the care of a cri cally ill pa ent with pulmonary edema?
A. Bedside PFT
B. Intake and Output measurements
