ACCS Hemodynamic Monitoring and Shock Management

Question 1

What is the target mean arterial pressure (MAP) recommended for critically ill adults to ensure adequate organ perfusion?

Accepted Answer

65–100 mmHg

Answer

A MAP of 65–100 mmHg is the accepted target range in critically ill patients, with 65 mmHg as the minimum threshold recommended in septic shock guidelines.

Question 2

Which hemodynamic parameter best reflects left ventricular preload in a critically ill patient?

Accepted Answer

Pulmonary artery wedge pressure (PAWP)

Answer

PAWP (pulmonary capillary wedge pressure) reflects left ventricular end-diastolic pressure and is the most reliable indirect measure of left ventricular preload.

Question 3

A patient in cardiogenic shock would most likely present with which hemodynamic profile?

Accepted Answer

Decreased CO and elevated SVR

Answer

Cardiogenic shock is characterized by pump failure causing decreased cardiac output, with the body compensating through vasoconstriction to maintain blood pressure.

Question 4

Which type of shock is classically characterized by distributive physiology with markedly low systemic vascular resistance?

Accepted Answer

Septic shock

Answer

Septic shock is the prototypical distributive shock, where inflammatory mediators cause widespread vasodilation resulting in low SVR and maldistribution of blood flow.

Question 5

The Fick equation is primarily used to calculate which hemodynamic parameter?

Accepted Answer

Cardiac output

Answer

The Fick equation calculates cardiac output by dividing oxygen consumption (VO2) by the arteriovenous oxygen content difference (CaO2 – CvO2).

(ACCS) Adult Critical Care Specialty Practice Test

(ACCS) Adult Critical Care Specialty Practice Test

ACCS Hemodynamic Monitoring and Shock Management