Practice Test Geeks(ACCS) Adult Critical Care Specialty Practice Test
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Clinical Knowledge and Skills Flashcards

7 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 7 Clinical Knowledge and Skills flashcards as text

  1. A patient with ARDS is on mechanical ventilation with FiO2 0.8 and PEEP 14 cmH2O. PaO2 is 58 mmHg. What is the most appropriate next intervention?

    Answer: Initiate prone positioning

    Prone positioning improves V/Q matching and oxygenation in moderate-to-severe ARDS (PaO2/FiO2 <150) when conventional ventilation fails.

  2. Which hemodynamic pattern is most consistent with cardiogenic shock?

    Answer: Low CO, high SVR, high PCWP

    Cardiogenic shock is characterized by reduced cardiac output, elevated systemic vascular resistance (compensatory), and elevated pulmonary capillary wedge pressure reflecting fluid backup.

  3. A patient develops sudden severe hypertension, diaphoresis, and bradycardia after a spinal cord injury at T4. What is the priority intervention?

    Answer: Sit the patient upright and identify the noxious stimulus

    Autonomic dysreflexia requires immediate upright positioning and removal of the precipitating stimulus (e.g., bladder distension) to relieve the hypertensive crisis.

  4. Which acid-base disturbance is expected in a patient with prolonged nasogastric suction?

    Answer: Metabolic alkalosis with hypochloremia

    Loss of hydrochloric acid via NG suction causes metabolic alkalosis accompanied by hypochloremia and often hypokalemia.

  5. A patient receiving total parenteral nutrition develops hyperglycemia, elevated serum osmolality, and altered mental status without ketosis. What complication is most likely?

    Answer: Hyperosmolar hyperglycemic state

    Hyperosmolar hyperglycemic state presents with extreme hyperglycemia, elevated osmolality, and altered mentation without significant ketoacidosis.

  6. Which finding on a 12-lead ECG is most specific for hyperkalemia at life-threatening levels?

    Answer: Sine wave pattern

    A sine wave pattern on ECG represents severe, life-threatening hyperkalemia where P waves disappear and QRS complexes merge with T waves.

  7. In managing elevated intracranial pressure, which intervention is CONTRAINDICATED?

    Answer: Hypotonic IV fluid administration

    Hypotonic fluids lower serum osmolality and worsen cerebral edema, making them contraindicated in elevated ICP management.