Practice Test Geeks(ACCS) Adult Critical Care Specialty Practice Test
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Patient Management and Care 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 Patient Management and Care flashcards as text

  1. A patient with acute liver failure develops cerebral edema. Which intervention is the priority to reduce intracranial pressure?

    Answer: Elevate head of bed to 30° and give hypertonic saline or mannitol

    Head-of-bed elevation with osmotic therapy (mannitol or hypertonic saline) is the first-line approach to lower ICP in acute liver failure.

  2. A patient with pulmonary embolism is hemodynamically unstable. Systolic BP is 80 mmHg despite fluids. What is the most appropriate intervention?

    Answer: Perform systemic thrombolysis with alteplase

    Massive PE with hemodynamic instability is an indication for systemic thrombolysis with alteplase unless contraindicated.

  3. Which parameter best guides fluid resuscitation in a mechanically ventilated patient with septic shock?

    Answer: Pulse pressure variation (PPV)

    Pulse pressure variation >13% in a fully ventilated patient reliably predicts fluid responsiveness, unlike static measures like CVP.

  4. A patient in the ICU develops Clostridioides difficile colitis not responding to oral vancomycin. What is the next best treatment?

    Answer: Oral fidaxomicin

    Fidaxomicin is preferred over vancomycin for non-severe CDI and has shown superiority in recurrence reduction; it is the appropriate escalation.

  5. A trauma patient receives massive transfusion. Which electrolyte abnormality is most commonly associated with rapid packed RBC transfusion?

    Answer: Hypocalcemia

    Citrate in banked blood chelates ionized calcium, causing hypocalcemia during massive transfusion, which impairs cardiac contractility.

  6. Which approach is recommended when weaning vasopressors in a patient recovering from septic shock?

    Answer: Wean adjunctive vasopressors before reducing norepinephrine

    Adjunctive vasopressors (vasopressin, phenylephrine) should be weaned first while maintaining norepinephrine, reducing the risk of hemodynamic instability.

  7. A patient with severe TBI has an ICP of 28 mmHg and CPP of 55 mmHg despite head elevation and sedation. What is the next step?

    Answer: Administer hyperosmolar therapy (mannitol or hypertonic saline)

    Hyperosmolar therapy is the next step for ICP >20 mmHg unresponsive to first-tier measures before considering surgical decompression.