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100
According to the Berlin Criteria (New), a patient is classified with severe ARDS when his PaO2/FiO2 Ratio is:
What is less than 100
100
Chest radiograph changes associated with congestive heart failure include (select all that apply): 1. Bilateral radiolucency 2. Increased pulmonary vasculature 3. Cardiomegaly
What is 2. Increased pulmonary vasculature 3. Cardiomegaly
100
A patient in the ICU has developed leukocytosis, fever and an infiltrate on his chest radiograph three days after being intubated and placed on mechanical ventilation. This patient has most likely developed: a. A viral infection b. Ventilator associated pneumonia c. Rhabdomyolysis d. Malignant hyperthermia
What is b. Ventilator associated pneumonia
100
The adult critical care specialist is caring for a patient with a traumatic brain injury (TBI) on mechanical ventilation in the ICU. The physician has requested minimal stimulation and prolonged deep sedation. Which of the following medications would be most appropriate for this patient? a. Remifentanil b. Haloperidol c. Propofol d. Phenobarbital
What is c. Propofol
100
What is the arterial oxygen content for a patient with a PaO2 of 50 torr, SaO2 of 85% and Hb level of 10 g?
What is 11.6 vol%
200
You are called to evaluate your patient in the ICU because the nurse noticed that there is continuous bubbling in the suction control bottle. What do you tell the nurse?
What is this is normal
200
Upon inspection of your patient you notice that the trachea has deviated to the right side. This patient has had increasing SOB and dyspnea, and breath sounds are markedly decreased on the right side with some scattered inspiratory crackles. Which of the following is most likely going on with your patient? a. Right sided pneumothorax b. Right sided pleural effusion c. Severe atelectasis on the right side d. Left lower lobe pneumonia
What is c. Severe atelectasis on the right side
200
A patient who suffered multiple traumas in a bicycle-automobile accident is being prepared for transport to a major medical center that is approximately 160 miles away. Which type of transport should the adult critical care specialist recommend?
What is fixed wing aircraft
200
A 30 year-old postoperative orthopedic patient is receiving morphine for pain management. The medical emergency team is called to the bedside because the patient has a decreased level of consciousness and miosis. Respirations are shallow at 6/min and SpO2 is 88% on room air. A stat ABG reveals acute respiratory acidosis. The adult critical care specialist should first recommend: a. Doxapram b. Aminophylline c. Naloxone HCl d. Intubation and mechanical ventilation
What is c. Naloxone HCl
200
You are monitoring your patient on a ventilator. The patient has been hemodynamically stable ever since he returned to the ICU from having surgery to fix his fractured femur. You just ran an ABG on your patient and noticed that the PaCO2 was 45 torr. When you compare it to the PetCO2, you see that the PetCO2 is much less than your ABG (20 torr). What could this be due to? a. The monitor isn’t plugged in b. You got a venous sample instead of an arterial sample c. There is a sudden excess in alveolar deadspace d. There is a sudden decrease in alveolar deadspace
What is c. There is a sudden excess in alveolar deadspace
300
A patient has been intubated in the ED and has an end-tidal CO2 reading of 4%. What does this indicate?
What is the tube is in the correct position
300
8. A 76 year-old male presents to the ED with SOB. Upon entering the room, the adult critical care specialist determines that the patient is alert and anxious on oxygen at 5 L/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 mm Hg SpO2 90% Which tests should the specialist recommend to confirm a suspicion of congestive heart failure?
What is BNP
300
Which of the following hypnotic drugs used to maintain sedation has a major disadvantage of hypotension? a. Etomidate b. Propofol c. Fentanyl d. Remifentanil
What is b. Propofol
300
A 47 year-old female patient with 3rd degree burns over 80% of her body requires intubation in the ED. Succinylcholine is given for rapid induction intubation. The major complication of this medication is: a. Upper airway edema b. An uncooperative patient c. Hypovolemia d. Hyperkalemia
What is d. Hyperkalemia
300
The majority of VAP is caused by what?
What is gram - bacteria
400
Post-operatively, Mr. Hart has a 2-3 mm ST segment elevation on his 12 lead electrocardiograph. This is indicative of: a. Ventricular hypertrophy b. Hyperkalemia c. Digitalis toxicity d. Myocardial injury
What is D Myocardial injury
400
A 55 year-old male is admitted with a two week history of SOB and dyspnea. The CXR reveals a large left pleural effusion and atelectasis of the left lower lobe. Which of the following diagnostic findings should the adult critical care specialist recommend to determine whether the pleural fluid is an exudate or transudate? a. Lateral decubitus radiograph b. Amylase c. Protein d. BNP
What is c. Protein
400
Treatment for a STEMI may include all of the following anti-ischemic medications EXCEPT: a. Oxygen b. Plavix c. Nitroglycerin d. Amiodarone
What is d. Amiodarone
400
While administering aerosolized acetylcysteine to a patient with COPD, the adult critical care specialist notes that the patient’s breath wheezing becomes more pronounced during the treatment. Prior to the next treatment, the specialist should: a. Have the patient take several deep breaths b. Administer a beta-agonist drug c. Decrease the dose of acetylcysteine d. Decrease the nebulizer flow
What is b. Administer a beta-agonist drug
400
Which of the following would you find in a patient that has VAP (select all that apply)? I. Hypothermia II. Increased WBCs III. Purulent endotracheal aspirate IV. New or persistent lung opacity on CXR
What is II. Increased WBCs III. Purulent endotracheal aspirate IV. New or persistent lung opacity on CXR
500
A patient who was struck in the head with a blunt object is recovering in the ICU. He doesn’t respond to any stimuli. You know that his Glasgow Coma Scale score is
What is 3
500
The adult critical care specialist is asked to obtain a tracheal aspirate from a patient who has a small amount of thick, tenacious sputum. The patient is orally intubated and receiving mechanical ventilation. Two previous samples sent to the lab were found to be contaminated. Which of the following is the most appropriate strategy to ensure that the sample is not contaminated? a. BAL b. Thoracentesis c. Single use suction catheter and Lukens’s trap d. Closed suction system
What is a. BAL
500
When is rapid sequence induction using Succinylcholine contraindicated: a. Burn Patients b. Hypertension c. Acute asthma d. AMI
What is a. Burn Patients
500
While reviewing lab results for a patient in the ICU, the adult critical care specialist discovers that the patient’s BUN is increased (BUN 108 mg/dL). The most likely cause is:
What is Renal Failure
500
Which of the following methods can help prevent VAP (select all that apply)? I. Don’t wean the patient off the ventilator II. Continually sedate your patient III. Keep the head of bed at 30-45 degrees IV. Do regular oral care
What is III. Keep the head of bed at 30-45 degrees IV. Do regular oral care