ADULT CRITICAL CARE SPECIALTY (ACCS)
STUDY GUIDE EXAM WITH VERIFIED
QUESTIONS AND ANSWERS 2026/2027
1. Normal Urine Output: 40-80 mL/hr
2. Normal CVP: 2-6 mmHg
3. Orthostatic Hypotension: Decrease in blood pressure related to positional or postural changes from
lying to sitting or standing positions
4. Causes of Peripheral Edema: CHF, pulmonary hypertension, venous insuflciency, renal failure
5. Finger Clubbing: enlargement of the terminal phalanges of the fingers and toes commonly associated with
pulmonary disease
6. Kyphosis: excessive outward curvature of the spine, causing hunching of the back.
7. Scoliosis: abnormal lateral curvature of the spine
8. Causes of asymmetrical chest movements: Atelectasis, pneumothorax, flail chest (paradoxi-
cal), Intubated patient with one lung
9. Cheyne-Stokes breathing: a distinct pattern of breathing characterized by quickenin
respirations followed by a period of apnea lasting up to 60 seconds
10. Causes of Cheyne-Stokes breathing:: Increased ICP, Meningitis, Drug overdose
11. Kussmaul respirations: very deep, labored breathing, irregular rhythm
12. Causes of Kussmaul's breathing:: hypoxemia, metabolic acidosis, renal failure, DKA
13. Pulsus Paradoxus: beats have weaker amplitude with respiratory inspiration, stronger with expiration.
May indicate cardiac tamponade or status asthmaticus or hypovolemia.
14. Tracheal Deviation: Pulled to Abnormal Side: atelectasis, fibrosis, pneumonectomy, paral-
ysis
15. Tracheal Deviation: Pulled to Normal Side: Pleural ettusions, tension pneumothorax, neck
tumors, large mediastinal mass
16. Rhonchi indicates: obstruction of larger airways by secretions
,19. PetCO2 as exhaled CO2 %: 3-5%
20. Normal PetCO2 Range: 34-36 mm Hg
21. Calculate Alveolar Minute Ventilation: (Vt-Vd) * f = VA
22. Normal Deadspace to Tidal Volume Ratio: 20-40%, up to 60% for ventilated patients
23. Large differences between the calculated and measured values of oxygen
saturation may be due to:: Elevated carbon monoxide levels
24. Heart Contractility:: the ability of the myocardial fibers to shorten during systole. Ability for the heart to
stretch
25. Preload:: volume of blood in ventricles at end of diastole
26. Afterload:: the amount of resistance to ejection of blood from the ventricle
27. Frank-Starling Curve: A graphic illustration that shows the relationship between the d
dial stretch and cardiac output.
28. Atropine:: Chronotropic, increases heart rate
29. Beta Blockers: decrease heart rate and dilate arteries by blocking beta receptors. -olol drugs.
30. Inotropics:: Medications that ettect the contractility of the heart or the force of cardiac contractions
31. Decreasing Contractility Results In: decreasing blood pressure
32. A-a gradient of 66-300 torr indicates what?: V/Q mismatch
33. A-a gradient of >300 indicates what?: Shunting
, 34. V/Q mismatch: An imbalance in the amount of oxygen received in the alveoli and the amount of blood
flowing through the alveolar capillaries
35. shunting of blood: A term that implies that blood passing through the pulmonary circuit did not become
saturated with oxygen and, therefore, returns to the left side of the heart with lower than optimal levels of oxygen
36. ACE inhibitors: "PRIL" Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful va
Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss.
37. If the transducer is positioned too low, the pressure will read: Higher than actual
38. If the transducer is positioned too high, the pressure will read: Lower than actual
39. normal cardiac output: 4-8 L/min
40. normal cardiac index: 2.5-4 L/min/m2
41. Other terms for CVP: right atrial pressure, right side preload, right ventricular end-diastolic pressure
42. Other terms for PCWP: Left atrial pressure, left side preload, left ventricular end diastolic pressure
43. Prostacyclin: -Potent vasodilators that target the pulmonary vasculature by redistributing pulmonary blood
flow.
-Given via Aerogen
44. normal pulmonary artery pressure (PAP): 25/8 mmHg
Mean 13-14 mmHg
45. Systemic Vascular Resistance (SVR): the pressure in the peripheral blood vessels that the heart
must overcome to pump blood into the system
46. Eosinophils: WBCs associated with asthma, increased with allergic reactions
47. Clinical manifestations of hypocalcemia:: -Cardiac arrhythmias
-hypotension
-bradycardia
-cardiac arrest
48. Clinical manifestations of phosphate depletion:: -lethargy
-disorientation
-respiratory failure
-muscle weakness
49. What is a d-dimer?: Fibrin degradation product that is elevated in the presence of a thrombus.
Elevation can indicated possible DVT or PE but may also be elevated in patients s/p surgery and most hospitalized
STUDY GUIDE EXAM WITH VERIFIED
QUESTIONS AND ANSWERS 2026/2027
1. Normal Urine Output: 40-80 mL/hr
2. Normal CVP: 2-6 mmHg
3. Orthostatic Hypotension: Decrease in blood pressure related to positional or postural changes from
lying to sitting or standing positions
4. Causes of Peripheral Edema: CHF, pulmonary hypertension, venous insuflciency, renal failure
5. Finger Clubbing: enlargement of the terminal phalanges of the fingers and toes commonly associated with
pulmonary disease
6. Kyphosis: excessive outward curvature of the spine, causing hunching of the back.
7. Scoliosis: abnormal lateral curvature of the spine
8. Causes of asymmetrical chest movements: Atelectasis, pneumothorax, flail chest (paradoxi-
cal), Intubated patient with one lung
9. Cheyne-Stokes breathing: a distinct pattern of breathing characterized by quickenin
respirations followed by a period of apnea lasting up to 60 seconds
10. Causes of Cheyne-Stokes breathing:: Increased ICP, Meningitis, Drug overdose
11. Kussmaul respirations: very deep, labored breathing, irregular rhythm
12. Causes of Kussmaul's breathing:: hypoxemia, metabolic acidosis, renal failure, DKA
13. Pulsus Paradoxus: beats have weaker amplitude with respiratory inspiration, stronger with expiration.
May indicate cardiac tamponade or status asthmaticus or hypovolemia.
14. Tracheal Deviation: Pulled to Abnormal Side: atelectasis, fibrosis, pneumonectomy, paral-
ysis
15. Tracheal Deviation: Pulled to Normal Side: Pleural ettusions, tension pneumothorax, neck
tumors, large mediastinal mass
16. Rhonchi indicates: obstruction of larger airways by secretions
,19. PetCO2 as exhaled CO2 %: 3-5%
20. Normal PetCO2 Range: 34-36 mm Hg
21. Calculate Alveolar Minute Ventilation: (Vt-Vd) * f = VA
22. Normal Deadspace to Tidal Volume Ratio: 20-40%, up to 60% for ventilated patients
23. Large differences between the calculated and measured values of oxygen
saturation may be due to:: Elevated carbon monoxide levels
24. Heart Contractility:: the ability of the myocardial fibers to shorten during systole. Ability for the heart to
stretch
25. Preload:: volume of blood in ventricles at end of diastole
26. Afterload:: the amount of resistance to ejection of blood from the ventricle
27. Frank-Starling Curve: A graphic illustration that shows the relationship between the d
dial stretch and cardiac output.
28. Atropine:: Chronotropic, increases heart rate
29. Beta Blockers: decrease heart rate and dilate arteries by blocking beta receptors. -olol drugs.
30. Inotropics:: Medications that ettect the contractility of the heart or the force of cardiac contractions
31. Decreasing Contractility Results In: decreasing blood pressure
32. A-a gradient of 66-300 torr indicates what?: V/Q mismatch
33. A-a gradient of >300 indicates what?: Shunting
, 34. V/Q mismatch: An imbalance in the amount of oxygen received in the alveoli and the amount of blood
flowing through the alveolar capillaries
35. shunting of blood: A term that implies that blood passing through the pulmonary circuit did not become
saturated with oxygen and, therefore, returns to the left side of the heart with lower than optimal levels of oxygen
36. ACE inhibitors: "PRIL" Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE in lungs from converting angiotensin I to angiotensin II (powerful va
Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss.
37. If the transducer is positioned too low, the pressure will read: Higher than actual
38. If the transducer is positioned too high, the pressure will read: Lower than actual
39. normal cardiac output: 4-8 L/min
40. normal cardiac index: 2.5-4 L/min/m2
41. Other terms for CVP: right atrial pressure, right side preload, right ventricular end-diastolic pressure
42. Other terms for PCWP: Left atrial pressure, left side preload, left ventricular end diastolic pressure
43. Prostacyclin: -Potent vasodilators that target the pulmonary vasculature by redistributing pulmonary blood
flow.
-Given via Aerogen
44. normal pulmonary artery pressure (PAP): 25/8 mmHg
Mean 13-14 mmHg
45. Systemic Vascular Resistance (SVR): the pressure in the peripheral blood vessels that the heart
must overcome to pump blood into the system
46. Eosinophils: WBCs associated with asthma, increased with allergic reactions
47. Clinical manifestations of hypocalcemia:: -Cardiac arrhythmias
-hypotension
-bradycardia
-cardiac arrest
48. Clinical manifestations of phosphate depletion:: -lethargy
-disorientation
-respiratory failure
-muscle weakness
49. What is a d-dimer?: Fibrin degradation product that is elevated in the presence of a thrombus.
Elevation can indicated possible DVT or PE but may also be elevated in patients s/p surgery and most hospitalized
