ACCS Neurological and Renal Care Flashcards
6 cards from real ACCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 ACCS Neurological and Renal Care flashcards as text
Which clinical sign is most specific for herniation syndrome in a comatose ICU patient?
Answer: Unilateral fixed and dilated pupil
A unilateral fixed and dilated pupil indicates compression of CN III from uncal herniation, a neurosurgical emergency.
What is the primary goal of osmotic therapy with mannitol in elevated ICP management?
Answer: Reduce cerebral edema by creating an osmotic gradient
Mannitol draws water out of brain tissue into the vasculature via osmosis, reducing cerebral edema and ICP.
A patient with oliguric AKI has a fractional excretion of sodium (FeNa) of 0.8%. What does this suggest?
Answer: Pre-renal azotemia
FeNa <1% indicates the kidneys are avidly retaining sodium, consistent with pre-renal azotemia and intact tubular function.
Which neuromuscular blocking agent is preferred for rapid sequence intubation in a patient with suspected elevated potassium?
Answer: Rocuronium
Rocuronium is preferred when hyperkalemia is suspected because succinylcholine can dangerously elevate potassium levels.
What is the target serum sodium range when treating hyponatremia-related cerebral edema with hypertonic saline in the ICU?
Answer: 125–130 mEq/L
In symptomatic hyponatremia with cerebral edema, sodium is corrected toward 125–130 mEq/L to relieve edema while avoiding osmotic demyelination.
Which dialysis prescription parameter most directly determines small solute clearance in CRRT?
Answer: Effluent dose (mL/kg/hr)
Effluent dose, expressed as mL/kg/hr, is the primary determinant of small solute clearance in CRRT.