Clinical Simulation Exam Strategies 20 Questions with Verified Answers
Information Gathering - CORRECT ANSWER
1. Visual
2. Bedside
3. Basic
... [Show More] Labs
4. Special Test
Visuals - CORRECT ANSWER General appearance, color, inspection
Height and Weight
History
Pulse (pick last)
Sensorium
Posture
anything gathered on a monitor
If CHF pick pedal edema
Bedside - CORRECT ANSWER Interview of patient
Palpitation
Percussion
Tracheal devation
auscultation
B/P
Temp
Vent Settings
Bowel Movement only with NG or newborn
Reflex only with neurological patients (same w/pupil)
Vt, MIP, VC only with neuromuscular problems
peak flow only with asthma
Coombs - pregnant
Moro - babies
Capillary - MI, chest pain
Basic Labs - CORRECT ANSWER CBC - never for baby after birth
ABG
12 Lead EKG
Electrolytes
CXR
(if lab found abnormal keep choosing until normal)
Special Test - CORRECT ANSWER CT scan for PE if not seen then choose V/Q Scan
(if long plane ride or vericous vein choose V/Q)
Pulmonary angiography for PE as well
Echocardiogram if pre/post ductal > 15 (dx shunt in babies)
Sweat Chloride test CF
Tenslion Test - MG (facial droop ect...)
APGAR - newborn
Special test continue - CORRECT ANSWER ELISA - HIV
Blood Sugar for obesity
Cardiac Enzymes - chest pain
Polysomnography - sleep study (OSA)
Cultures - if infection is expected
Lateral Neck - epiglotittis
BUN/Creatine - kidney
PFT
Bronchoscopy
Thoracentesis - Pleural effusions
3 Procedures to keep doing - CORRECT ANSWER If upper airway is obstructed - abdominal thrust
Merconium Aspiration - suction until clear
PEEP - keep raising unless something bad happens
Intubate/Mechanically intubate - CORRECT ANSWER apnea, acute vent failure, impending resp failure, oxygenation as last resort (ARDS)
Compliance < 25ml/cmH20 A-a >300, Os/Qt > 20%
burns around face
Initial vent settings - CORRECT ANSWER Vt 6-8ml/kg, 4-8 w/ards and asthma
RR 10-20
FIO2 - on room air or unknown 40 - 60%
Choose what was picked prior to intubation
100% with cardiac or other emergencies IE CO poisoning, pulmonary edema, crushed chest
PEEP 2-6, match level of CPAP
Mode-Any mode is fine
PC - CORRECT ANSWER Choose plateau pressure taken from VC or acheive target Vt with a pressure < or equal to 35cmH2O
IBW esitmation male - CORRECT ANSWER 50kg + (2 x inches over 5ft) +2
IBW estimation female - CORRECT ANSWER 50kg + (2 x inches over 5ft) - 2
Decrease PaCO2 - CORRECT ANSWER remove mechanical Vd (unless is SIMV)
increase Vt or PIP
Increase Rate
Increase PaCo2 - CORRECT ANSWER evaluate cause and fix (hypoxemia/pain/anxiety)
decrease RR unless PT is breathing above vent (switch to SIMV)
decrease Vt or PIP
Fixing Low Oxygenation issues - CORRECT ANSWER 1. increase FIO2 by 5-10%
2. increase PEEP 2-5cmH20 until negative effects occur
Fixing High Oxygenation issues - CORRECT ANSWER 1. If PaO2 is elevated decrease until 60% is reached
2. Lower PEEP
Eliminate Vent Choices - CORRECT ANSWER 1. FIO2
2. PEEP
3. RR
4. Vt
Infant Settings - CORRECT ANSWER SIMV/IMV
Rate 20 - 30
Insp Pressure 20 - 30 (4-6ml/kg)
Room air no prior O2 40-60%
PEEP same as CPAP or 2-4cmH20
Flow 5-6LPM
I time .5 - .6
Babies PaO2 - CORRECT ANSWER 60 - 80mmHg
APGAR - CORRECT ANSWER 0-3 resuscitate
4-6 stimulate, warm, give O2
7 - 10 routine care [Show Less]