ACUTE & CRITICAL CARE MEDICINE
ARCHER REVIEW 2025 EDITION
NCLEX
Acute & Critical Care Medicine – Archer
Review 2025 Edition | High-Yield NCLEX and
Advanced Practice Study Guide with NGN
Clinical Case Questions, Prioritization, and
Life-Saving Intervention
,CRITICAL CARE NCLEX
What is the phlebostatic axis?
CORRECT ANSWER ✔✔
fourth intercostal space, midaxillary line. This is where we level to zero lines to ensure accurate
numbers. This can be accomplished with the pt lying supine or HOB at 45. Lines should be
zeroed every 4 hrs.
What is CVP and what does it measure?
CORRECT ANSWER ✔✔
Central Venous Pressure (or right atrial pressure): estimates central venous blood/fluid volume
and right heart function. Normal is 2-6 mmhg
How can CVP be affected?
CORRECT ANSWER ✔✔
decreased cardiac output, forced exhalation, HF, hypovolemia, PEEP, pleural effusion, PE, fluid
status
What is PAP and what does it measure?
CORRECT ANSWER ✔✔
Pulmonary Pressure: used to measure left ventricular filling pressures. This is displayed like a BP
normal sys: 15-25mmhg normal diastolic: 8-15 mmhg
How can PAP be affected?
CORRECT ANSWER ✔✔
What is SVR and what does it measure?
CORRECT ANSWER ✔✔
,Systemic vascular resistance: measures the resistance in the circulatory system that is used to
create blood pressure.
how can SVR be affected?
CORRECT ANSWER ✔✔
vasoconstriction/vasodilation
What is Cardiac Index and how can it be affected?
CORRECT ANSWER ✔✔
Cardiac output divided by body surface area. This gives us a more patient specific number. This
can be affected by preload, after load, contractility, and the patient's body surface area.
What is Cardiac Output and how can it be affected?
CORRECT ANSWER ✔✔
amount of blood pumped by each ventricle during a given period. This can be affected by after
load, pre load, contractility.
What invasive lines can be used to measure hemodynamics?
CORRECT ANSWER ✔✔
arterial line or pulmonary artery catheter (swan Ganz)
What is the nursing care for a patient with an invasive line?
CORRECT ANSWER ✔✔
Assist with line insertion, monitor respiratory and cardiac status, maintain line patency and
integrity, obtain hemodynamic readings from catheter, prevent infection.
What hemodynamic changes may occur with dysrhythmias?
CORRECT ANSWER ✔✔
, low SV, CO, BP
What is included in the assessment of the patient with dysrhythmias/signs of altered cardiac
output?
CORRECT ANSWER ✔✔
changes in LOC, chest pain, hypotension, weak pulses, fatigue, SOB, crackles, dizzy,
restlessness
What is asystole?
CORRECT ANSWER ✔✔
flat line, no QRS present, no pulse, HR=0, no BP, lethal if not corrected in 3-5 minutes.
What is the treatment for asystole?
CORRECT ANSWER ✔✔
DO NOT SHOCK!!!!! CPR, check asystole in two leads, epinephrine, pacemaker, consider the
causes.
What is sinus tachycardia?
CORRECT ANSWER ✔✔
100-150bpm. rhythm is normal but too fast. workload of the heart is increased while the
perfusion is decreased. this is a normal response to the body's increased demand for O2
What is the treatment for sinus tachycardia?
CORRECT ANSWER ✔✔
treat the cause: pain, hypovolemia, fever, exercise, anxiety, medications that stimulate
sympathetic response, stimulants, illicit drugs
What is sinus bradycardia?
ARCHER REVIEW 2025 EDITION
NCLEX
Acute & Critical Care Medicine – Archer
Review 2025 Edition | High-Yield NCLEX and
Advanced Practice Study Guide with NGN
Clinical Case Questions, Prioritization, and
Life-Saving Intervention
,CRITICAL CARE NCLEX
What is the phlebostatic axis?
CORRECT ANSWER ✔✔
fourth intercostal space, midaxillary line. This is where we level to zero lines to ensure accurate
numbers. This can be accomplished with the pt lying supine or HOB at 45. Lines should be
zeroed every 4 hrs.
What is CVP and what does it measure?
CORRECT ANSWER ✔✔
Central Venous Pressure (or right atrial pressure): estimates central venous blood/fluid volume
and right heart function. Normal is 2-6 mmhg
How can CVP be affected?
CORRECT ANSWER ✔✔
decreased cardiac output, forced exhalation, HF, hypovolemia, PEEP, pleural effusion, PE, fluid
status
What is PAP and what does it measure?
CORRECT ANSWER ✔✔
Pulmonary Pressure: used to measure left ventricular filling pressures. This is displayed like a BP
normal sys: 15-25mmhg normal diastolic: 8-15 mmhg
How can PAP be affected?
CORRECT ANSWER ✔✔
What is SVR and what does it measure?
CORRECT ANSWER ✔✔
,Systemic vascular resistance: measures the resistance in the circulatory system that is used to
create blood pressure.
how can SVR be affected?
CORRECT ANSWER ✔✔
vasoconstriction/vasodilation
What is Cardiac Index and how can it be affected?
CORRECT ANSWER ✔✔
Cardiac output divided by body surface area. This gives us a more patient specific number. This
can be affected by preload, after load, contractility, and the patient's body surface area.
What is Cardiac Output and how can it be affected?
CORRECT ANSWER ✔✔
amount of blood pumped by each ventricle during a given period. This can be affected by after
load, pre load, contractility.
What invasive lines can be used to measure hemodynamics?
CORRECT ANSWER ✔✔
arterial line or pulmonary artery catheter (swan Ganz)
What is the nursing care for a patient with an invasive line?
CORRECT ANSWER ✔✔
Assist with line insertion, monitor respiratory and cardiac status, maintain line patency and
integrity, obtain hemodynamic readings from catheter, prevent infection.
What hemodynamic changes may occur with dysrhythmias?
CORRECT ANSWER ✔✔
, low SV, CO, BP
What is included in the assessment of the patient with dysrhythmias/signs of altered cardiac
output?
CORRECT ANSWER ✔✔
changes in LOC, chest pain, hypotension, weak pulses, fatigue, SOB, crackles, dizzy,
restlessness
What is asystole?
CORRECT ANSWER ✔✔
flat line, no QRS present, no pulse, HR=0, no BP, lethal if not corrected in 3-5 minutes.
What is the treatment for asystole?
CORRECT ANSWER ✔✔
DO NOT SHOCK!!!!! CPR, check asystole in two leads, epinephrine, pacemaker, consider the
causes.
What is sinus tachycardia?
CORRECT ANSWER ✔✔
100-150bpm. rhythm is normal but too fast. workload of the heart is increased while the
perfusion is decreased. this is a normal response to the body's increased demand for O2
What is the treatment for sinus tachycardia?
CORRECT ANSWER ✔✔
treat the cause: pain, hypovolemia, fever, exercise, anxiety, medications that stimulate
sympathetic response, stimulants, illicit drugs
What is sinus bradycardia?
