Critical Care Medicine
Textbook Exam Questions
Course Introduction
Critical Care Medicine is an advanced course designed to equip students with the essential knowledge and practical skills required to manage critically ill patients. The curriculum covers a broad range of topics including pathophysiology, advanced life support, monitoring techniques, mechanical ventilation, management of shock and sepsis, sedation and analgesia, as well as ethical and organizational aspects of intensive care. Through a combination of lectures, case studies, and hands-on simulations, students learn to assess and intervene in acute life-threatening situations, apply evidence-based treatment protocols, and collaborate effectively within multidisciplinary healthcare teams. This course prepares future healthcare professionals to make rapid, informed decisions in high-pressure environments to improve patient outcomes in the intensive care setting.
Recommended Textbook
Respiratory Disease A Case Study Approach to Patient Care 3rd Edition by James R. Dexter
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20 Chapters
484 Verified Questions
484 Flashcards
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2
Chapter 1: Introduction to Patient Assessment
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49 Verified Questions
49 Flashcards
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Sample Questions
Q1) Which of the following conditions often causes the patient to breathe rapidly and shallowly?
A)Atelectasis
B)Pulmonary fibrosis
C)Pneumonia
D)All the above
Answer: D
Q2) Your patient has right heart failure due to chronic lung disease.Which of the following findings is NOT consistent with signs of right heart failure?
A)Hepatomegaly
B)JVD
C)Pedal edema
D)A heave at the left midaxillary region
Answer: D
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Page 3
Chapter 2: Introduction to Respiratory Failure
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Sample Questions
Q1) You are monitoring a patient during mechanical ventilation and the peak pressure is reaching 55 cm H<sub>2</sub>0.What problem does this potentially cause?
A)Barotrauma
B)Renal failure
C)Hypertension
D)Auto-PEEP
Answer: A
Q2) The patient with inadequate oxygenation of the brain will usually display what symptom(s)?
A)Confusion
B)Excitement
C)Diminished cognitive function
D)A and C only
Answer: D
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Chapter 3: Asthma
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23 Flashcards
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Sample Questions
Q1) Which of the following conditions is least likely to mimic the symptoms of an asthma attack?
A)Congestive heart failure
B)Bronchitis
C)Acute respiratory distress syndrome
D)Acute upper airway obstruction
Answer: C
Q2) What complication is common when mechanical ventilation is used to treat the patient with severe asthma?
A)Pneumonia
B)Auto-PEEP
C)Circulatory failure
D)Pulmonary embolism
Answer: B
Q3) Which of the following is NOT associated with provoking an asthma attack?
A)Aspirin use
B)Exercise
C)Viral respiratory infection
D)Use of Atropine to increase heart rate
Answer: D
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Chapter 4: Chronic Obstructive Pulmonary Disease
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30 Flashcards
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Sample Questions
Q1) You are caring for a COPD patient who is experiencing an acute exacerbation due to bilateral pneumonia which is not expected to resolve quickly.It has been determined that the patient needs ventilatory assistance.Which of the following approaches to positive pressure ventilation is NOT likely to be the best option?
A)Intubation with IMV
B)Intubation with pressure support
C)Noninvasive positive pressure ventilation
D)Intubation with CPAP
Q2) Which of the following symptoms is least common among COPD patients?
A)Cough
B)Exertional dyspnea
C)Sputum production
D)Chest pain
Q3) What abnormality on the ECG suggests right axis deviation due to cor pulmonale?
A)Positive QRS in lead II
B)Negative QRS in lead I
C)Tall QRS waves in the limb leads
D)Small QRS waves in the chest leads
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Chapter 5: Cystic Fibrosis
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Sample Questions
Q1) What therapy has been shown to reduce sputum viscosity in the number of exacerbations in patients with cystic fibrosis?
A)Use of mucomyst
B)Aerosolized saline
C)Use of bronchoscopy to clear retained mucus
D)Use of DNase
Q2) Which of the following symptoms is suggestive of a new respiratory infection in the patient with cystic fibrosis?
A)New onset of cough
B)Sudden decrease in FEV1
C)Lack of expected weight gain
D)All the above
Q3) Which of the following pulmonary function results is NOT typical for cystic fibrosis?
A)Reduced FEV1
B)Reduced FVC
C)Reduced RV
D)Reduced expiratory flows
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Chapter 6: Hemodynamic Monitoring and Shock
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20 Flashcards
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Sample Questions
Q1) Your patient has a history of heart disease and is now complaining of chest pain.What finding on the ECG would suggest coronary hypoperfusion?
A)Elevated ST segment
B)Depressed ST segment
C)Inverted T waves
D)All the above
Q2) What therapy is often needed for patients with cardiogenic shock?
A)Vasopressors
B)Bronchodilators
C)Positive inotropics
D)Fluids
Q3) Your patient has hypovolemic shock from severe diarrhea.Which of the following is least likely to be needed for care?
A)Close CVP monitoring
B)Mechanical ventilation with PEEP
C)Fluid therapy
D)Oxygen therapy
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8
Chapter 7: Pulmonary Thromboembolic Disease
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Sample Questions
Q1) Which of the following statements is true about the use of "D-dimer" in evaluating the patient for PTE?
A)A value of >200 ng/mL is suggestive of PTE
B)Negative results are good evidence that PTE is not present
C)High values are proof of PTE
D)None of the above
Q2) What is the most common symptom associated with pulmonary thromboembolism?
A)Transient acute dyspnea
B)Pleuritic chest pain
C)Hemoptysis
D)Cough
Q3) Which of the following findings in a patient with PTE would cause you to most likely consider using thrombolytic therapy?
A)PaO<sub>2</sub> 65 mmHg
B)PaCO<sub>2</sub> 44 mmHG
C)Blood pressure 80/45 mmHg
D)Pulse rate = 110/min
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Chapter 8: Heart Failure
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23 Flashcards
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Sample Questions
Q1) What is the mortality rate for patients with severe cases of congestive heart failure?
A)40-50%
B)50-70%
C)80-90%
D)None of the above
Q2) When looking at the chest radiograph,what term is associated with an abnormal increase in blood flow to the apices?
A)Ascites
B)Cephalization
C)Caudalization
D)Homans' sign
Q3) Which of the following is NOT one of the primary ways in which edema forms from leakage of fluid out of the capillaries?
A)Increased capillary permeability
B)Increased capillary hydrostatic pressure
C)Increased blood protein concentrations
D)Lymphatic obstruction
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10
Chapter 9: Smoke Inhalation Injury and Burns
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) Most burn patients become colonized with which of these bacteria within a week of admission?
A)Serratia marscescens
B)Bacillus cereus
C)Staphylococcus aureus
D)Eikenella corrodens
Q2) About how many people die each year in the United States due to fire injuries?
A)1,000
B)4,000
C)10,000
D)15,000
Q3) Your patient is more than 7 days post-burn.He develops tachypnea,increasing minute ventilation with marked decrease in the PaO<sub>2</sub>/FIO<sub>2</sub> ratio and an increase in the P(a-ET)CO<sub>2</sub>.What is the most likely cause?
A)Acute bronchitis
B)Pulmonary embolism
C)ARDS
D)Tracheitis
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Chapter 10: Near Drowning
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Sample Questions
Q1) According to the Orlowski Score,what pH value on the arterial blood gas suggests a poor prognostic sign in near drowning victims?
A)pH below 7.25
B)pH below 7.15
C)pH below 7.10
D)None of the above
Q2) Which of the following age groups is not considered at high risk for drowning?
A)Toddlers between ages 1 and 4 years
B)Adolescents
C)Young adults between ages 15 and 24 years
D)Adult males between ages 45 and 55 years
Q3) About how many people drown in the United States each year?
A)1,200
B)3,400
C)6,000
D)8,500
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Chapter 11: Acute Respiratory Distress Syndrome
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) All the following statements are true regarding the use of static compliance measurements in monitoring the ARDS patient except:
A)Is indicative of lung stiffness only
B)Is obtained with the following formula: Cst = Vt / (Pstat-PEEP)
C)Is obtained using a short inspiratory hold after a volume-limited breath
D)Plateau pressures of <30 cwp are usually indicative of acceptable static compliance in the adult
Q2) All of the following are side effects of PEEP except:
A)Decreased lung compliance from overdistended alveoli
B)Barotrauma
C)Increased cardiac output
D)Increased PVR
Q3) Your ARDS patient is being mechanically ventilated with PEEP.The PEEP is increased from 10 cwp to 15 cwp.Subsequently,the mixed venous PO<sub>2</sub> drops from 40 mmHg to 32 mm Hg.What does this indicate?
A)PaO<sub>2</sub> dropped
B)Cardiac output dropped
C)PEEP should be increased more
D)The FIO<sub>2 </sub>should be increased
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Page 13
Chapter 12: Chest Trauma
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28 Flashcards
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Sample Questions
Q1) The primary survey of a chest trauma patient should be rapid,evaluating all of the following except:
A)Vital signs,e.g.,airway,breathing,heart rate,and blood pressure
B)Life-threatening hemorrhage
C)Level of consciousness
D)Chest x-ray
Q2) Unilateral trauma to the lung or bronchi might necessitate which of these?
A)Double-sided chest tubes
B)Placing the patient in the lateral position with the involved side down
C)Independent lung ventilation with a double-lumen endotracheal tube
D)None of the above
Q3) Which of the following statements is true regarding flail chest?
A)It is a common accompaniment of chest injury
B)It is,more times than not,a cosmetic rather than a serious medical or surgical problem
C)Paradoxical breathing can result from chest wall instability
D)Surgery is required in all cases once the patient becomes stable
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14
Chapter 13: Postoperative Atelectasis
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Sample Questions
Q1) Which two physical examination findings are commonly seen in patients with postoperative atelectasis?
A)Fever and cough
B)Tachypnea and cough
C)Tachypnea and late-inspiratory crackles
D)Bronchial breath sounds and bradypnea
Q2) What is the primary objective when intrapulmonary percussive ventilation (IPV)is applied to the postoperative patient with atelectasis?
A)Hyperinflate the lung
B)Enhance secretion removal
C)Improve surfactant production
D)Improve CO<sub>2</sub> removal
Q3) What abnormalities would be seen in bedside spirometry tests for the patient with severe atelectasis?
A)Reduced vital capacity
B)Reduced inspiratory capacity
C)Reduced FEV1/FVC
D)A and B only
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15
Chapter 14: Interstitial Lung Disease
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20 Flashcards
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Sample Questions
Q1) ILD typically involves what areas of the lung?
A)Right middle lobe
B)Lingula
C)Superior basal segments
D)All lobes
Q2) Clubbing of the digits
A)Is a frequent finding in ILD
B)Is rare,but always belies serious underlying pathology
C)Is seen particularly with asbestosis
D)None of the above
Q3) The drug amiodarone,a particularly potent drug associated with ILD,is used to treat what group of disorders?
A)Bronchogenic carcinoma
B)Rheumatoid lung disease
C)Gastrointestinal disorders
D)Cardiac dysrrhythmias
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16
Chapter 15: Neuromuscular Diseases
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28 Flashcards
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Sample Questions
Q1) Which statement(s)is/are true regarding Guillain-Barré syndrome?
A)It often follows on the heels of an upper respiratory viral infection
B)It is typically,but not exclusively,an ascending paralysis
C)High protein levels in the CSF can be diagnostic
D)All the above
Q2) Which of the following modalities is NOT useful in patients with neuromuscular disease?
A)Bronchial hygiene
B)Assisted cough
C)Incentive spirometry
D)IPPB
Q3) What neurotransmitter is operable at the respiratory neuromuscular junctions?
A)Acetylcholine
B)Norepinephrine
C)Dopamine
D)Epinephrine
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17
Chapter 16: Bacterial Pneumonia
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Sample Questions
Q1) All of these are pulmonary factors that can predispose to pneumonia except:
A)Asthma
B)Smoking
C)Pulmonary hypertension
D)Bronchial obstruction by tumor
Q2) Criteria for a poor sputum sample include all of the following except
A)Many squamous epithelial cells surround the flora on the microscope slide
B)Sample was obtained from mouth in such a way as to suggest patient was merely clearing throat or spitting
C)No or very few WBCs are present in the sample
D)The sample was aspirated aseptically and taken to the lab promptly
Q3) Lobar pneumonia is evidenced by all of the following except:
A)Unilateral chest expansion on involved side
B)Increased tactile fremitus on involved side
C)Bronchial breath sounds
D)Increased resonance to percussion
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18
Chapter 17: Pneumonia in the Immunocompromised Patient
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Sample Questions
Q1) Which is/are true regarding antibodies?
A)They come in 5 classes: G,A,M,D,E
B)They are also called immunoglobulins
C)They originate from plasma cells
D)All the above
Q2) Which of these is a polymorphonuclear leukocyte?
A)Neutrophil
B)Lymphocyte
C)Monocyte
D)None of the above
Q3) All of the following are true regarding antigens except:
A)They have molecular configurations that are foreign to the host
B)Immune "memory" enables the body to mount an amplified response on subsequent antigen invasions
C)Antigens are nonspecific as to their molecular configuration
D)Vaccinations are antigens resembling the organism the body needs to defend itself against
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Page 19
Chapter 18: Sleep Disordered Breathing
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Sample Questions
Q1) Which of the following problems is NOT associated with obstructive sleep apnea?
A)Poor memory
B)Impotence
C)Morning headaches
D)Joint pain
Q2) Why do patients with obstructive sleep apnea complain of excessive daytime sleepiness?
A)CO<sub>2</sub> build up during sleep makes the brain abnormal
B)Sleep is normal,but patient perception is not
C)Sleep is very fragmented
D)Nobody knows
Q3) How would you describe the normal changes in breathing and breathing patterns during the deeper stages of NREM sleep?
A)Increased and regular
B)Decreased and regular
C)Increased and irregular
D)Decreased and irregular
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20
Chapter 19: Tuberculosis
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Sample Questions
Q1) About how many new cases of tuberculosis are diagnosed around the world each year?
A)3 million
B)5 million
C)9 million
D)15 million
Q2) What arterial blood gas findings are typical for the patient with dormant TB lung infection?
A)Moderate hypoxemia
B)Mild hypercapnia
C)Metabolic acidosis
D)None of the above
Q3) Which of the following are know to increase the risk of reactivating dormant TB?
A)Malnutrition
B)Alcohol abuse
C)Diabetes
D)All the above
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Chapter 20: Lung Cancer
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Sample Questions
Q1) Magnetic resonance imaging (MRI)has this advantage over CT for evaluating pulmonary nodules or mediastinal metastases
A)Better for seeing chest wall invasion
B)Uses less ionizing radiation
C)Is less expensive than CT
D)Is more available to the patient
Q2) What has long been the gold standard among staging tests of mediastinal lymph nodes and offers possibility of biopsy?
A)Flexible fiberoptic bronchoscopy
B)Direct laryngoscopy
C)Mediastinoscopy
D)Pleurocentesis
Q3) Which of the following is/are true regarding primary lung cancer?
A)Is also known as bronchogenic carcinoma
B)Is often metastasized from other sites
C)Lags behind breast cancer in women and prostate cancer in men as the most common fatal malignancy
D)All the above
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22