Deck 15: Critical Care Guidelines and Bundles

Question 1

During CPR, the cardiac monitor shows ventricular tachycardia. From the radial pulse, the heart rate is about 70/min. The therapist should:

A) defibrillate at 200 joules biphasic.
B) perform CPR.
C) initiate oral intubation.
D) evaluate and treat ventricular tachycardia.

Answer 1

D

Question 2

The typical dose for epinephrine during CPR for asystole or PEA is:

A) 1 mg every 3 to 5 minutes.
B) 1 mg every 10 minute.
C) 5 mg every 3 to 5 minutes.
D) 5 mg every 10 minute.

Answer 2

A

Question 3

The best method to confirm the depth placement of an endotracheal tube is:

A) auscultation.
B) capnography.
C) CT scan.
D) chest radiograph.

Answer 3

D

Question 4

A patient complaints of dizziness and weakness and has a heart rate of 45/min and blood pressure of 88/46 mm Hg. The ECG shows sinus bradycardia. This patient should initially be treated with:

A) transcutaneous pacing.
B) atropine.
C) dopamine.
D) epinephrine.

Question 5

A patient complaints of dyspnea at rest has a heart rate of 160/min. The initial treatment for this type of tachycardia should be:

A) norepinephrine.
B) atropine.
C) cardioversion.
D) CPR.

Question 6

Based on the AHA guidelines for adult cardiovascular life support, cricoid pressure during endotracheal intubation:

A) is recommended.
B) is not recommended.
C) enhances visualization of vocal cords.
D) significantly reduces incidence of aspiration.

Question 7

According to the AHA guidelines for adult cardiovascular life support, the F_IO₂ used during CPR should be:

A) 100% or highest available.
B) no higher than 60%.
C) 40% to 60%.
D) based on the patient's arterial blood gases.

Question 8

When capnography is not available following intubation, all of the following nonwaveform CO₂ devices may be used except a(n):

A) color-change CO₂ detecting device.
B) esophageal detector.
C) ultrasound.
D) pulse oximeter.

Question 9

Which of the following is most accurate with regard to the use of epinephrine and vasopressin during cardiac arrest?

A) 1 mg of epinephrine by IV is recommended.
B) Administer epinephrine as soon as feasible after onset of cardiac arrest due to an initial nonshockable rhythm.
C) High single-dose epinephrine is recommended.
D) Vasopressin offers no advantage over epinephrine.

Question 10

To perform a traditional nasal intubation on an adult patient:

A) a Magill forceps is required.
B) a flexible stylet is required.
C) the patient must first be orally intubated.
D) the ET tube must be size 5 or smaller.

Question 11

In comparing the PADIS and ABCDEF bundles:

A) PADIS and ABCDEF are essentially identical.
B) PADIS does not include SAT and SBT.
C) ABCDEF includes all categories in PADIS.
D) PADIS includes family engagement/empowerment.

Question 12

A visual analogue scale is used in which assessment method?

A) Behavioral Pain Scale (BPS)
B) Confusion Assessment Method (CAM)
C) Richards-Campbell Sleep Questionnaire (RCSQ)
D) Richmond Agitation and Sedation Scale (RASS)

Question 13

For mechanically ventilated patients, which mode of ventilation is recommended by PADIS during sleep?

A) Assist/control mode
B) Pressure support ventilation
C) Airway pressure release ventilation
D) Continuous positive airway pressure

Question 14

According to the ABCDEF bundle, pain assessment may be evaluated by all of the following except the:

A) Numerical Rating Scale (NRS).
B) Behavioral Pain Scale (BPS).
C) Critical-Care Pain Observation Tool (CPOT).
D) Likert Pain Scale (LPS).

Question 15

Hypoxia, respiratory and circulatory adverse outcomes, falling, disconnection of access lines and ET tube are some complications associated with:

A) inadequate sedation.
B) early mobility and exercise.
C) excessive pain.
D) spontaneous breathing trial.

Question 16

The physician orders a spontaneous awakening trial (SAT) for a patient in the ICU. Which condition should SAT proceed?

A) Continuous sedative infusion is used for seizures.
B) Sedative dose for agitation remains unchanged.
C) Patient requires neuromuscular blocker.
D) Patient has elevated intracranial pressure.

Question 17

Prior to a spontaneous breathing trial, the patient's ability to sustain spontaneous breathing may be evaluated by:

A) serial arterial blood gases.
B) serial pulse oximetry.
C) vital capacity or maximal inspiratory pressure.
D) pulmonary function test.

Question 18

If a ventilator is used to implement the spontaneous breathing trial, the pressure support ventilation:

A) must be set as time cycled.
B) must be set as pressure cycled.
C) setting should be from 8 to 12 cm H₂O.
D) setting should be from 5 to 8 cm H₂O.

Question 19

A patient with severe agitation is being sedated using the Richmond Agitation and Sedation Scale (RASS) for titration of sedatives. What should be the recommended titration end-point?

A) −5 to −3
B) −4 to −3
C) −2 to 0
D) +1 to +3

Question 20

Gastric residual volume is a clinical procedure to determine a patient's tolerance to:

A) enteral nutritional therapy.
B) parenteral nutritional therapy.
C) macronutrients such as protein, carbohydrate, and lipid.
D) micronutrients such as minerals and electrolytes.