ACCS Review Practice Exam questions with
correct answers
Average urine output per hour is approximately? Answer✔✔ 40 mL
According to the Berlin Criteria, a patient is classified with severe ARDS when his
Pao2/Fio2 ratio is? Answer✔✔ Less than 100
A patient is admitted to the ED with a possible CVA. Which diagnostic test is most
appropriate for identification of an acute cerebral infarction? Answer✔✔ CT Scan:
checks chest, abdomen and brain (2-3 dimensions)
Cerebral angiography Answer✔✔ measures abnormal cerebral circulation
PET scan Answer✔✔ checks for cancer, brain disorders and heart diseases
A patient has been intubated in the ED and has a end tidal CO2 reading of 4%. The
specialist should suspect that the:
A. patient has a pulmonary embolus
B. ET tube is in the correct position
C. ET tube is in the esophagus
D. ET tube is in the right main stem bronchus Answer✔✔ B. ET tube is in the
correct position
*etco2 will be > if in the esophagus
,Post-operatively, Mr. Hart has a 2-3 mm ST segment elevation on his 12 lead
electrocardiograph. This is indicative of Answer✔✔ Myocardial injury
Which of the following would most accurately provide necessary information
regarding fluid management in the care of a critically ill patient with pulmonary
edema?
A. Bedside PFT
B. Intake and Output measurements
C. Daily weights
D. Pulmonary artery catheter Answer✔✔ D. Pulmonary artery catheter
A patient who was struck in the head with a blunt object is recovering in the ICU.
He is angry, combative, and irritable. He opens his eyes, grunts, and withdraws
when the sole of his foot is stimulated with a sharp object. What is his score on the
Glasgow Coma scale? Answer✔✔ 8
Chest radiograph changes associated with congestive heart failure include:
1. Bilateral radiolucency
2. Increased pulmonary Vasculature
3. Cardiomegaly
A. 1 & 2 only
B. 2&3 only
C. 1& 3 only
D. All of the above Answer✔✔ B. 2 & 3
,1 is normal
2 and 3 indicates CHF
A 57 year old male is admitted to the ICU with chest pain radiating down his left
arm. Which of the following lab tests would best confirm the diagnosis of
myocardial infarction?
A. PvO2
B. Phosphate
C. Troponin
D. Lactate Answer✔✔ C. Troponin
A 67 year old male with chest pain and shortness of breath is placed on a cardiac
monitor in the intensive care unit. The following rhythm is observed on the
monitor - what is the correct interpretation of a 3rd degree AV block? Answer✔✔
No PR interval
Describe a 2nd degree AV block Answer✔✔ P wave longer and skips a beat
Describe a Multifocal PVC Answer✔✔ it's unidentifiable = treat with O2 and
amiodarone
Which of the following tests should the adult critical care specialist recommend in
order to confirm the diagnosis of pulmonary artery hypertension?
A. pulmonary functions tests
B. high resolution CT scan
, C. Right heart catheterization
D. Six minute walk test Answer✔✔ C. Right heart catheterization
A 76 y.o. male presents to the ED with shortness of breath. Upon entering the
room the adult critical care specialist determines that the patient is alert and
anxious on oxygen at 5L/min by nasal cannula. He is seated in the tripod position
and using accessory muscles to breathe. He has audible crackles bilaterally, jugular
venous distension, and +2 peripheral edema. The following patient data is
obtained:
HR 110/min
RR 31/min
BP 154/92 mmHg
Spo2 90%
Which of the following tests should the specialist recommend to confirm a
suspicion of congestive heart failure?
A. troponin
B. brain natriuretic peptide
C. magnesium level
D. MB fraction of creatinine phosphokinase Answer✔✔ B. Brain natriuretic
peptide
The adult critical care specialist assigned to the cardiovascular intensive care unit
hears an alarm sound in Room 4. Upon entering the room, the specialist notes that
the pulmonary artery pressure tracing is dampened. The specialist should:
Answer✔✔ flush the catheter
correct answers
Average urine output per hour is approximately? Answer✔✔ 40 mL
According to the Berlin Criteria, a patient is classified with severe ARDS when his
Pao2/Fio2 ratio is? Answer✔✔ Less than 100
A patient is admitted to the ED with a possible CVA. Which diagnostic test is most
appropriate for identification of an acute cerebral infarction? Answer✔✔ CT Scan:
checks chest, abdomen and brain (2-3 dimensions)
Cerebral angiography Answer✔✔ measures abnormal cerebral circulation
PET scan Answer✔✔ checks for cancer, brain disorders and heart diseases
A patient has been intubated in the ED and has a end tidal CO2 reading of 4%. The
specialist should suspect that the:
A. patient has a pulmonary embolus
B. ET tube is in the correct position
C. ET tube is in the esophagus
D. ET tube is in the right main stem bronchus Answer✔✔ B. ET tube is in the
correct position
*etco2 will be > if in the esophagus
,Post-operatively, Mr. Hart has a 2-3 mm ST segment elevation on his 12 lead
electrocardiograph. This is indicative of Answer✔✔ Myocardial injury
Which of the following would most accurately provide necessary information
regarding fluid management in the care of a critically ill patient with pulmonary
edema?
A. Bedside PFT
B. Intake and Output measurements
C. Daily weights
D. Pulmonary artery catheter Answer✔✔ D. Pulmonary artery catheter
A patient who was struck in the head with a blunt object is recovering in the ICU.
He is angry, combative, and irritable. He opens his eyes, grunts, and withdraws
when the sole of his foot is stimulated with a sharp object. What is his score on the
Glasgow Coma scale? Answer✔✔ 8
Chest radiograph changes associated with congestive heart failure include:
1. Bilateral radiolucency
2. Increased pulmonary Vasculature
3. Cardiomegaly
A. 1 & 2 only
B. 2&3 only
C. 1& 3 only
D. All of the above Answer✔✔ B. 2 & 3
,1 is normal
2 and 3 indicates CHF
A 57 year old male is admitted to the ICU with chest pain radiating down his left
arm. Which of the following lab tests would best confirm the diagnosis of
myocardial infarction?
A. PvO2
B. Phosphate
C. Troponin
D. Lactate Answer✔✔ C. Troponin
A 67 year old male with chest pain and shortness of breath is placed on a cardiac
monitor in the intensive care unit. The following rhythm is observed on the
monitor - what is the correct interpretation of a 3rd degree AV block? Answer✔✔
No PR interval
Describe a 2nd degree AV block Answer✔✔ P wave longer and skips a beat
Describe a Multifocal PVC Answer✔✔ it's unidentifiable = treat with O2 and
amiodarone
Which of the following tests should the adult critical care specialist recommend in
order to confirm the diagnosis of pulmonary artery hypertension?
A. pulmonary functions tests
B. high resolution CT scan
, C. Right heart catheterization
D. Six minute walk test Answer✔✔ C. Right heart catheterization
A 76 y.o. male presents to the ED with shortness of breath. Upon entering the
room the adult critical care specialist determines that the patient is alert and
anxious on oxygen at 5L/min by nasal cannula. He is seated in the tripod position
and using accessory muscles to breathe. He has audible crackles bilaterally, jugular
venous distension, and +2 peripheral edema. The following patient data is
obtained:
HR 110/min
RR 31/min
BP 154/92 mmHg
Spo2 90%
Which of the following tests should the specialist recommend to confirm a
suspicion of congestive heart failure?
A. troponin
B. brain natriuretic peptide
C. magnesium level
D. MB fraction of creatinine phosphokinase Answer✔✔ B. Brain natriuretic
peptide
The adult critical care specialist assigned to the cardiovascular intensive care unit
hears an alarm sound in Room 4. Upon entering the room, the specialist notes that
the pulmonary artery pressure tracing is dampened. The specialist should:
Answer✔✔ flush the catheter
