ACCS Hemodynamic Monitoring and Shock Management 2

Question 1

In hypovolemic shock, which hemodynamic pattern is expected?

Accepted Answer

Low CVP, low PAWP, low CO with elevated SVR

Answer

High CVP, high PAWP, high CO

Answer

Normal CVP, high CO, low SVR

Answer

High SVR, high CO, low CVP

Question 2

Passive leg raising (PLR) is used in the ICU primarily to assess which parameter?

Accepted Answer

Fluid responsiveness

Answer

Pulmonary compliance

Answer

Cardiac contractility

Answer

Systemic vascular resistance

Question 3

Which dynamic parameter is MOST reliable for predicting fluid responsiveness in mechanically ventilated patients without arrhythmias?

Accepted Answer

Pulse pressure variation (PPV)

Answer

Central venous pressure (CVP)

Answer

Pulmonary artery wedge pressure (PAWP)

Answer

Mean arterial pressure (MAP)

Question 4

Massive pulmonary embolism causing obstructive shock primarily impairs hemodynamics by:

Accepted Answer

Blocking pulmonary blood flow and increasing right ventricular afterload

Answer

Decreasing systemic vascular resistance

Answer

Directly depressing left ventricular contractility

Answer

Causing severe mitral regurgitation

Question 5

Per the Surviving Sepsis Campaign guidelines, which vasopressor is recommended as the FIRST-LINE agent in septic shock?

Accepted Answer

Norepinephrine

Answer

Epinephrine

Answer

Vasopressin

Answer

Dopamine

Question 6

A central venous oxygen saturation (ScvO2) below 70% in a shock patient most likely indicates:

Accepted Answer

Increased oxygen extraction due to insufficient delivery

Answer

Adequate oxygen delivery to tissues

Answer

Systemic hyperoxia

Answer

Decreased cellular oxygen consumption

Question 7

Which echocardiographic finding is MOST specific for cardiac tamponade?

Accepted Answer

Diastolic collapse of the right ventricle

Answer

Left ventricular hypertrophy

Answer

Severe mitral regurgitation

Answer

Right ventricular hypertrophy